Pain Management Case Reports最新文献

{"title":"Exposed Hardware: A True Contraindication for a Spinal Cord Stimulator? A Case Report and Review of the Literature","authors":"","doi":"10.36076/pmcr.2021.5.231","DOIUrl":"https://doi.org/10.36076/pmcr.2021.5.231","url":null,"abstract":"BACKGROUND: Infection is one of the most common complications of spinal cord stimulator (SCS) implantation and causes severe morbidity for the patients and is costly for the health system and insurance. Every effort to minimize the risk of infection Post-SCS implantation has to be made.\u0000\u0000CASE REPORT: A 55-year-old man suffered right arm brachial plexus avulsion and subdural hematoma requiring a craniotomy and subsequently a cranioplasty with a metal mesh in 1998. Over the years he developed significant neuropathic pain which was controlled with a combination medication regimen until recently. In our clinic, a trial of cervical SCS showed significant improvement of pain. The consulting neurosurgeon, while evaluating his skull, noticed a very small skin defect, exposing a metal plate with no signs of infection. Based on that, he refused to implant the SCS. The patient is now seeking alternative treatment methods.\u0000\u0000CONCLUSION: Well-designed animal/human studies investigating the effects of exposed hardware for seeding infection to remote implants in the body are required to scientifically extrapolate if exposed hardware is a true contraindication for implanting an SCS or other devices in the body. \u0000\u0000KEY WORDS: Spinal cord stimulator, brachial plexus injury, complex regional pain syndrome, exposed hardware, surgical infection","PeriodicalId":110696,"journal":{"name":"Pain Management Case Reports","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124159441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High Frequency Spinal Cord Stimulation in a Patient with Bilateral Cochlear Implants","authors":"","doi":"10.36076/pmcr.2021.5.189","DOIUrl":"https://doi.org/10.36076/pmcr.2021.5.189","url":null,"abstract":"BACKGROUND: High-frequency spinal cord stimulation (HF-SCS) has become very popular in the management of chronic pain worldwide. As it relies on generating high-frequency electrical impulses, there is a risk of interference with other devices such as cochlear implants that utilize similar principles. A literature search did not reveal any case reports of HF-SCS implantation in a patient with cochlear implants.\u0000\u0000CASE REPORT: A 75-year-old White woman with a history of bilateral cochlear implants (Cochlear Americas Nucleus® with cp910 processor) for severe sensorineural hearing loss presented to our chronic pain clinic with lumbosacral radiculopathy. The patient underwent a HF-SCS trial with entry point at the L1-L2 space and the leads positioned at the top and bottom of T8. The patient did not experience any auditory interference with her Cochlear implant at triple the average SCS stimulation strength. During the follow-up visit the next week, the patient reported nearly 80% symptomatic pain relief and significant functional improvement. There was no change in her hearing and no evidence of interference. The patient ultimately underwent percutaneous SCS paddle electrode placement and at 3 months, continues to have excellent pain relief without any auditory interactions.\u0000\u0000CONCLUSION: We successfully implanted a HF-SCS at the thoracic level in a patient with bilateral cochlear implants without any auditory interference. \u0000\u0000KEY WORDS: Cochlear implant, lumbar radiculopathy, spinal cord stimulation","PeriodicalId":110696,"journal":{"name":"Pain Management Case Reports","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114115170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Retrospective, Single-Center Study Investigating the Effects of a Novel Miniature Wireless Spinal Cord Stimulation System for the Treatment of Chronic Back and Leg Pain","authors":"N. V. Ba","doi":"10.36076/PMCR.2020/4/185","DOIUrl":"https://doi.org/10.36076/PMCR.2020/4/185","url":null,"abstract":"BACKGROUND: Tietze syndrome is believed to be a result of recurrent microtrauma and characterized by painful localized inflammation and swelling of the chest wall. Chronic inflammatory changes may infiltrate surrounding tissues, leading to nerve root irritation and subsequent neuralgia. Resultant chronic neuropathy has been historically treated with conservative therapies and local nerve blocks, but the role of implantable neurostimulators have not been well described.\u0000\u0000CASE REPORT: A 73-year-old woman presented with chronic pain in the left paracentral chest area with episodes of burning and tingling, which radiated to the left shoulder, left arm, and left upper side of the jaw and face. Following the implantation of a permanent neurostimulator, the patient reported a near complete resolution of her pain symptoms.\u0000\u0000CONCLUSION: The role of implantable neurostimulators in the treatment of chronic neuropathy in the setting of Tietze syndrome is promising and their use may become a mainstay option in the future.\u0000\u0000KEY WORDS: Tietze Syndrome, neuromodulation, spinal cord nerve stimulation, pain management, neuralgia, implantable spinal cord stimulator","PeriodicalId":110696,"journal":{"name":"Pain Management Case Reports","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115313651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medial Branch Radiofrequency Ablation as an Alternative of\u0000Vertebroplasty for Pain Treatment after Vertebral Compression\u0000Fractures","authors":"Laureano Delange Segura","doi":"10.36076/pmcr.2019/3/179","DOIUrl":"https://doi.org/10.36076/pmcr.2019/3/179","url":null,"abstract":"Vertebral fractures are very frequent among the population affected by osteoporosis, being pain one of the most distressing associated symptoms. The classic treatment of vertebral fractures is, in principle, conservative. However, in the case of persistent pain, vertebral augmentation techniques and radiofrequency ablation (in the event that vertebral augmentation techniques can’t be applied) have proved to be useful. We present the case of a patient who developed severe pain secondary to an acute T2 and L3 fracture, in addition to a posterior T6 fracture. It was treated successfully with L3 vertebroplasty and facet joints denervation of T1-T2 and later T5-T6, this being justified by the technical impossibility of performing vertebroplasty on said levels. The patient was discharged from the hospital with managed pain relief and more than a 50% reduction in opioids doses. Three months later, she continued experiencing pain relief. Radiofrequency ablation of the medial branch of facet joints can be useful in the treatment of pain associated with vertebral fractures in patients where vertebral augmentation techniques are contraindicated or as a complementary treatment for persistent pain. Key words: Vertebral compression fracture, percutaneous vertebroplasty, radiofrequency ablation, medial branch, facet joints, osteoporosis","PeriodicalId":110696,"journal":{"name":"Pain Management Case Reports","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125600102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Conventional Thermal versus Water-Cooled Genicular Nerve\u0000Radiofrequency Lesioning: A Retrospective Chart Review","authors":"Cristina Shea","doi":"10.36076/pmcr.2019/3/167","DOIUrl":"https://doi.org/10.36076/pmcr.2019/3/167","url":null,"abstract":"Background: Genicular nerve radiofrequency\u0000lesioning (RFL) is an interventional approach to\u0000chronic knee pain. It is currently unknown whether\u0000conventional thermal RFL (CT-RFL) or watercooled\u0000RFL (WC-RFL) yields better outcomes.\u0000Objective: The objective of this research was\u0000to analyze and compare outcomes of genicular\u0000nerve conventional thermal radiofrequency lesioning\u0000(CT-RFL) vs water-cooled radiofrequency\u0000lesioning (WC-RFL) for the treatment of chronic\u0000knee pain.\u0000Study Design: We used retrospective chart\u0000review.\u0000Setting: The research took place in an outpatient\u0000pain clinic at a large academic medical center.\u0000Methods: Patients who participated in the study\u0000were those aged 18 and older who received genicular\u0000nerve RFL for chronic knee pain between\u0000January 1, 2014 and December 31, 2016. Random\u0000intercepts models were used to examine Visual\u0000Analog Scale (VAS) pain scores across the first\u0000year of follow-up, adjusting for age, gender, and\u0000prior history of knee surgery.\u0000Results: Overall, VAS scores were significantly\u0000reduced from baseline (mean = 6.66, standard\u0000deviation [SD] = 1.36) by 1.46 points during the\u0000first follow-up month (95% confidence interval [CI],\u00000.6-2.3, P = .001), 2.22 points during the second\u0000follow-up month (95% CI, 1.4-3.1, P = < .001), and\u00001.24 points during the sixth follow-up month (95%\u0000CI, 0.1-2.4, P = .035) but were not significantly\u0000reduced at other months during the one-year followup\u0000time period. There was no statistically significant\u0000difference in follow-up pain scores (mean difference\u0000= 0.73, 95% CI, -0.14-1.59, P = .116) or rates of\u0000complications (P = .10, 2-tailed Fisher exact test)\u0000between RFL types.\u0000Limitations: Study shortcomings include patient\u0000loss to follow-up, heterogeneity of CT-RFL techniques,\u0000and heterogeneity of study patients.\u0000Conclusions: Genicular RFL is a promising strategy\u0000for long-term management of treatment-resistant\u0000chronic knee pain. In this study, no significant difference\u0000in outcomes was detected between CT-RFL\u0000and WC-RFL techniques. Larger prospective studies\u0000are warranted to compare outcomes of these\u0000techniques and guide future care.\u0000Key words: Radiofrequency lesioning, knee pain,\u0000chronic pain, osteoarthritis, genicular, cooled radiofrequency\u0000lesioning, water-cooled radiofrequency\u0000lesioning, conventional radiofrequency lesioning","PeriodicalId":110696,"journal":{"name":"Pain Management Case Reports","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115398815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of Spinal Cord Injury with Interlaminar Cervical Epidural\u0000Steroid Injections, Related to the Dorsal Muscular Artery, and\u0000Retrograde Flow","authors":"M. Yland","doi":"10.36076/pmcr.2019/3/193","DOIUrl":"https://doi.org/10.36076/pmcr.2019/3/193","url":null,"abstract":"","PeriodicalId":110696,"journal":{"name":"Pain Management Case Reports","volume":"103 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124155626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spinal Seroma in a Patient with Lumbar Fusion","authors":"Ivan Urits","doi":"10.36076/pmcr.2019/3/165","DOIUrl":"https://doi.org/10.36076/pmcr.2019/3/165","url":null,"abstract":"","PeriodicalId":110696,"journal":{"name":"Pain Management Case Reports","volume":"48 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115332432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PERCUTANEOUS ENDOSCOPIC DECOMPRESSION FOR THORACIC TUBERCULOSIS FOLLOWING POSTERIOR INSTRUMENTATION: A CASE REPORT","authors":"Qing-feng Hu","doi":"10.36076/pmcr.2019/3/153","DOIUrl":"https://doi.org/10.36076/pmcr.2019/3/153","url":null,"abstract":"","PeriodicalId":110696,"journal":{"name":"Pain Management Case Reports","volume":"227 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125336815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Approach to Psychological Assessment of Chronic Pain Patient\u0000Evaluated for Implantable Devices","authors":"S. Javed","doi":"10.36076/pmcr.2019/3/159","DOIUrl":"https://doi.org/10.36076/pmcr.2019/3/159","url":null,"abstract":"Chronic pain is a multidimensional field in which\u0000a patient’s physical, environmental, and psychological\u0000state must be fully understood to further\u0000assess their problem. These variables form a\u0000complex interaction with each other and play\u0000a critical role in the treatment of chronic pain.\u0000The clinical interview is the cornerstone of the\u0000psychological evaluation. An important purpose\u0000of the interview is to identify any psychiatric\u0000conditions that might exacerbate pain or complicate\u0000treatment, such as psychosis, substance\u0000dependence, or a personality disorder.\u0000The patient was seen in the chronic pain clinic\u0000and assessed by the pain clinical psychologist.\u0000We present the case of a patient who presented\u0000to the chronic pain clinic and underwent evaluation\u0000for spinal cord stimulator trial placement. As part of\u0000this evaluation, the patient underwent psychological\u0000assessment by the pain clinical psychologist;\u0000we discuss the approach to psychological assessment\u0000using observational narrative.\u0000Psychological evaluation can help guide a physician’s\u0000treatment plan to better meet the patient’s\u0000needs. Psychological assessment prior to interventional\u0000management should be used as a tool\u0000to give the patient the best chance for success.\u0000Key words: Psychological assessment, psychological\u0000evaluation, spinal cord stimulation,\u0000intrathecal pump","PeriodicalId":110696,"journal":{"name":"Pain Management Case Reports","volume":"70 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131421006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case of Intrathecal Pump Therapy for Intractable Head and Neck\u0000Cancer Pain","authors":"Enas S Kandil","doi":"10.36076/pmce.2019/3/139","DOIUrl":"https://doi.org/10.36076/pmce.2019/3/139","url":null,"abstract":"We present a case of a 34-year-old man who had\u0000refractory oral pain secondary to squamous cell\u0000carcinoma of the tongue and describe his status\u0000post multiple surgical procedures. After failing\u0000a variety of treatment modalities, an intrathecal\u0000pump (ITP) was placed in the lower cervical\u0000spine region. He was assessed at several points,\u0000initially every 2 weeks, then every 6 months and\u0000reported significant and continued pain relief with\u0000the ITP past the first 6-month follow-up and no\u0000neurological or respiratory side effects were noted.\u0000In addition to substantial pain relief, this invasive\u0000modality allowed the patient to be a candidate\u0000for further chemotherapeutic medications, which\u0000induced temporary remission and extended the\u0000patient’s life expectancy by over 4 months.\u0000Key words: Intrathecal pump, intractable pain,\u0000head and neck cancer","PeriodicalId":110696,"journal":{"name":"Pain Management Case Reports","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127451500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}