Pain physician最新文献

{"title":"Effectiveness of Radiofrequency Ablation of the Genicular Nerves of the Knee for the Management of Intractable Pain from Knee Osteoarthritis.","authors":"Sang Hoon Lee, Hyun Hee Choi, Sang Gyu Kwak, Min Cheol Chang","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>The knee joint is one of the most common diseases in elderly individuals. This is a progressive and debilitating condition. The purpose of knee osteoarthritis treatment is to manage pain, increase mobility, and improve the quality of life.</p><p><strong>Objectives: </strong>This study evaluated the therapeutic effect of radiofrequency thermocoagulation (RFTC) on the genicular nerves in patients with intractable pain due to knee osteoarthritis, as well as its effects on pain severity and magnetic resonance imaging (MRI) findings.</p><p><strong>Study design: </strong>A prospective outcome study.</p><p><strong>Setting: </strong>The outpatient clinic of a single academic medical center.</p><p><strong>Methods: </strong>We conducted a prospective study. Fifty consecutive patients with intractable knee pain due to osteoarthritis were enrolled and underwent ultrasound (US)-guided RFTC of the genicular nerves (medial superior genicular nerve, medial inferior genicular nerve, and lateral superior genicular nerve). Pain severity was measured using the Numeric Rating Scale (NRS), and knee osteoarthritis-associated symptoms were evaluated using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) at pretreatment and one, 3, and 6 months after RFTC treatment. We also analyzed the relationship between therapeutic outcomes and pain severity based on pre-treatment and knee MRI findings.</p><p><strong>Results: </strong>No dropouts were observed. The most significant reduction in knee symptoms associated with knee osteoarthritis was observed after one month of treatment; however, at 3 and 6 months, there was a rebound effect, leading to a decrease in therapeutic efficacy. Nonetheless, there was still a noticeable decrease in symptoms due to knee osteoarthritis compared to those prior to RFTC treatment. The effect of RFTC treatment was better when pre-treatment pain was relatively less severe, knee effusion was not severe, there were no meniscal tears in the middle or posterior zones, no bone marrow edema in the middle and posterior zones of the femur and tibia, and no severe cartilage defects in the posterior femur and middle and posterior tibia.</p><p><strong>Limitations: </strong>We conducted our study without a control or a placebo group.</p><p><strong>Conclusion: </strong>RFTC of the genicular nerve is a good therapeutic option for controlling intractable pain following knee osteoarthritis. In addition, we found that a lower level of pain prior to treatment, along with the absence or lesser degree of knee joint effusion, as well as an absence or less severe middle or posterior knee pathologies associated with knee osteoarthritis, can predict a more favorable therapeutic outcome.</p>","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141161783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Targeted Nerve Root Stimulation Alleviates Intractable Chronic Limb Pain Associated with Complex Regional Pain Syndrome - A Prospective Multi-Center Feasibility Study.","authors":"Ricardo Vallejo, Michael A Fishman, Binit Shah, Philip Kim, Ramsin Benyamin, Francesco Vetri, Dana M Tilley, David L Cedeno","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>There are limited therapeutic options to treat complex regional pain syndrome (CRPS). Spinal cord stimulation and dorsal root ganglion stimulation are proven therapies for treating chronic low limb pain in CRPS patients. There is limited evidence that stimulation of dorsal nerve roots can also provide relief of lower limb pain in these patients.</p><p><strong>Objectives: </strong>To demonstrate that electrical stimulation of dorsal nerve roots via epidural lead placement provides relief of chronic lower limb pain in patients suffering from CRPS.</p><p><strong>Study design: </strong>Prospective, open label, single arm, multi-center study.</p><p><strong>Setting: </strong>The study was performed at the Center for Interventional Pain and Spine (Exton, PA), Millennium Pain Center (Bloomington, IL), and the Carolinas Pain Center (Huntersville, NC). It was approved by the Western Institutional Review Board-Copernicus Group Institutional Review Board and is registered at clinicaltrials.gov (NCT03954080).</p><p><strong>Methods: </strong>Sixteen patients with intractable chronic severe lower limb pain associated with CRPS were enrolled in the study. A standard trial period to evaluate a patients' response to stimulation of the dorsal nerve roots was conducted over 3 to 10-days. Patients that obtained 50% or greater pain relief during the trial period underwent permanent implantation of a neurostimulation system. The primary outcome was the evaluated pain level after 3 months of device activation, based on NRS pain score relative to baseline. Patients were followed up for 6 months after activation of the permanently implanted system.</p><p><strong>Results: </strong>At the primary endpoint, patients reported a significant (P = 0.0006) reduction in pain of 3.3 points, improvement in quality of life, improved neuropathic pain characteristics, improved satisfaction, and an overall perception of improvement with the therapy. Improvements were sustained throughout the duration of the study up to the final 6-month visit.</p><p><strong>Limitations: </strong>Due to the COVID-19 pandemic occurring during patient enrollment, only 16 patients were enrolled and trialed, with 12 being permanently implanted. Nine were able to complete the end of study evaluation at 6 months.</p><p><strong>Conclusions: </strong>The results of this short feasibility study confirm the functionality, effectiveness, and safety of intraspinal stimulation of dorsal nerve roots in patients with intractable chronic lower limb pain due to CRPS using commercially approved systems and conventional parameters.</p>","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141161827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Medical Ozone for Treatment of Chronic Musculoskeletal Pain with Abnormal Mitochondrial Redox State: Prospective Randomized Clinical Trial.","authors":"Ayman Eldemrdash, Taha Tairy, Lilly Sabry, Ahmed Aelmulla, Maher Kamel, Engi Yousry","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Chronic primary musculoskeletal pain is multifaceted and 20% of the adult population lives with severe chronic pain and experience symptoms such as intense pain, depression, weakness, sleep problems, decreased quality of life and decreased emotional well-being.</p><p><strong>Objectives: </strong>This paper studies the efficacy of trigger point injections with ozone compared to standard steroid injection or combination therapy for the treatment of chronic musculoskeletal pain in patients with abnormal mitochondrial redox state.</p><p><strong>Study design: </strong>This is a prospective randomized clinical study conducted with 51 patients experiencing chronic musculoskeletal pain.</p><p><strong>Setting: </strong>Medical Research Institute Hospital, Alexandria University.</p><p><strong>Methods: </strong>By computer-generated random numbers the 51 patients were divided into 3 groups. Group A (17 patients) received ozone injection, group B (17 patients) received betamethasone injection and group C (17 patients) received combined ozone and betamethasone injections. The groups were compared based on the intensity of pain and correction of mitochondrial redox state of the patients.</p><p><strong>Results: </strong>Three days after intervention, the visual analog scale (VAS) scores reported by patients were lower in group A compared to group B (with a mean difference 1.27, 95% confidence interval (CI) of 0.15-2.39 (P < 0.02). One and 3 weeks after intervention, VAS scores of patients were lower in groups A and C compared to group B. At one week the mean difference between A and B was 1.2, with a 95% CI of 0.15-2.25 (P < 0.02) and the mean difference between C and B was 1.73 with a 95% CI of 0.69-2.78 (P < 0.001). At 3 weeks the mean difference between A and B was 1.5 with a 95% CI of 0.2-2.87 (P < 0.01) and the mean difference between C and B was 2.27 with a 95% CI of 0.93-3.60 (P < 0.0001). The reduced/oxidized glutathione ratio after intervention was higher in groups A and C compared to group B (P > 0.008). The mitochondrial copy number was higher in group A compared to group B (P < 0.002).</p><p><strong>Limitation: </strong>This study didn't allow for the comparison of the experimental groups with a placebo or control group for musculoskeletal pain conditions in orderto establish the role of an abnormal mitochondrial redox state on the pathogenesis of patients from an ethical view.</p><p><strong>Conclusions: </strong>Ozone therapy or combined ozone and betamethasone treatment are  effective techniques for management of pain since it produced a significant reduction of muscle pain and increase of the pain free interval experienced by patients. Ozone therapy causes pain improvement which increases with time and it improves muscle oxygenation and mitochondrial function.</p><p><strong>Trial registration: </strong>This study was approved by the Ethics Committee of Medical Research Institute (IORH: IOR 00088812) and was registe","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141161872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Comparison of Minimally Invasive Surgical Techniques and Standard Open Discectomy for Lumbar Disc Herniation: A Network Meta-analysis.","authors":"Lu Qin, Xiaoqian Jiang, Shishun Zhao, Wenlai Guo, Di You","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Lumbar disc herniation is a common spinal disease that causes low back pain; surgery is required when conservative treatment is ineffective. There is a growing demand for minimally invasive surgery in younger patient populations due to their fear of significant damage and a long recovery period following standard open discectomy. The development history of minimally invasive surgery is relatively short, and no gold standard has been established.</p><p><strong>Objectives: </strong>We aimed to find, via a network meta-analysis, the best treatment for low back pain in younger patient populations.</p><p><strong>Study design: </strong>Network meta-analysis.</p><p><strong>Methods: </strong>The PubMed, Embase, Cochrane Library, and Web of Science databases were searched. Data quality was evaluated using RevMan 5.3 (The Nordic Cochrane Centre for The Cochrane Collaboration), while STATA 14.0 (StataCorp LLC) was used for the network meta-analysis and to merge data on the Visual Analog Scale (VAS) score, Oswestry Disability Index (ODI) score, complication, blood loss, reoperation rate, and function score.</p><p><strong>Results: </strong>We included 50 randomized controlled trials, involving 7 interventions; heterogeneity and inconsistency were acceptable. Comparatively, microendoscopic discectomy and percutaneous endoscopic lumbar discectomy were the best surgical procedures from the aspects of VAS score and ODI score, while standard open discectomy was the worst one from the aspect of ODI score. Regarding complications, tubular discectomy was preferred with the fewest complications. Additionally, microendoscopic discectomy outperformed other surgical procedures in reducing blood loss and reoperation rate.</p><p><strong>Limitations: </strong>First, follow-up data were not reported in all included studies, and the follow-up time varied from several months to 8 years, which affected the results accuracy of our study to some extent. Second, there were some nonsurgical factors that also affected the self-reported outcomes, such as rehabilitation and pain management, which also brought a certain bias in our study results.</p><p><strong>Conclusions: </strong>Compared to standard open discectomy, minimally invasive surgical procedures not only achieve satisfactory efficacy, but also microendoscopic discectomy and percutaneous endoscopic lumbar discectomy can obtain a more satisfactory short-term VAS score and ODI score. Microendoscopic discectomy has significant advantages in blood loss and reoperation rate, and tubular discectomy has fewer postoperative complications.</p>","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140175924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Systematic Review and Meta-analysis of the Analgesic Effects of Lidocaine Administered Intravenously or Intraperitoneally Post-Abdominal Surgery.","authors":"Yanmei Bi, Min Diao, Yunkai Tao, Hao Li, Xuemei Lin","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Reducing postoperative pain is still a tremendous challenge for perioperative clinicians. Lidocaine is a local anesthetic that belongs to the amide class and has anti-inflammatory, anti-hyperalgesic, and analgesic effects. Extensive research has been conducted to determine the optimal route for its administration.</p><p><strong>Objective: </strong>To compare the efficacy of perioperative intravenous lidocaine with that of intraperitoneal lidocaine on postoperative analgesia in patients undergoing abdominal surgery.</p><p><strong>Study design: </strong>EMBASE, PubMed, and The Cochrane Library were searched for randomized controlled trials published through December 2022 that compared patients receiving perioperative intravenous lidocaine with those receiving intraperitoneal lidocaine. The primary outcome measures included the pain score, as evaluated by the Visual Analog Scale, and opioid analgesia requirements. The secondary outcome measures were hospitalization length, gastrointestinal function recovery, etc. The data were acquired and recorded in electronic spreadsheets that had been designed for this purpose.</p><p><strong>Methods: </strong>This systematic review's design was based on the Cochrane Handbook for Systematic Reviews of Interventions and was reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) method was used to examine the certainty of the evidence. Furthermore, we examined the dependability of the calculated (favorable) treatment effects through considerations of information size and modified significance thresholds (trial sequential analysis).</p><p><strong>Results: </strong>Seven trials including 478 patients were included. Our meta-analysis demonstrates that compared with intravenous lidocaine, patients who received intraperitoneal lidocaine had lower pain scores at 4 hours (mean difference [MD] 1.40; 95% CI, 0.22 to 2.59); 12 hours (MD 0.18; 95% CI, 0.06 to 0.30); and 24 hours (MD -0.12; 95% CI -0.40 to 0.17) postsurgery. However, no obvious difference in opioid consumption (P > 0.05) was found. In addition, the intraperitoneal lidocaine group had a longer postsurgery hospital stay than the intravenous lidocaine group (95%CI, -0.17 to -0.00; I2 = 0%). Intravenous lidocaine was more beneficial for achieving gastrointestinal return than intraperitoneal lidocaine (95% CI, -0.26 to -0.10; I2 = 2%).</p><p><strong>Limitations: </strong>The sample size of enrolled RCTs was small, which could potentially result in an overestimation or underestimation of the treatment effect in the collected data. There was high heterogeneity among the studies.</p><p><strong>Conclusion: </strong>This meta-analysis suggests that post-abdominal surgery intraperitoneal lidocaine administration has a better analgesic effect than intravenous lidocaine, with a lower pain score. Howe","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140175925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on \"Hemodynamic Influences of Remimazolam Versus Propofol During the Induction Period of General Anesthesia\".","authors":"I-Wen Chen, Wei-Ting Wang, Kuo-Chuan Hung","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140175930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasound-Guided Radiofrequency Ablation for Chronic Osteoarthritis Knee Pain in the Elderly: A Randomized Controlled Trial.","authors":"Yingcun Ma, Yu Si Chen, Botao Liu, Lei Sima","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Osteoarthritis of the knee (KOA) is the main cause of disability in elderly people. Patients with KOA may often not achieve adequate pain control even after receiving all treatment modalities.</p><p><strong>Objectives: </strong>The objective of this study was to examine the efficacy of ultrasound-guided radiofrequency ablation (RFA) as a treatment for moderate and severe KOA.</p><p><strong>Study design: </strong>A prospective randomized controlled study.</p><p><strong>Setting: </strong>The study was performed in the National Pain Management and Research Center of China-Japan Friendship Hospital.</p><p><strong>Methods: </strong>Eligible participants were over 50 years old and had suffered from chronic knee joint pain for more than 6 months, scoring at least 4 on a numeric rating scale (NRS) and grade III-IV according to the Kellgren-Lawrence classification system. The target nerve selection principle was as follows: the superomedial genicular nerve (SMGN) branch and inferior medial genicular nerve (IMGN) branch of the saphenous nerve for medial knee pain, the superolateral genicular nerve (SLGN) branch of the femoral nerve for lateral pain, and the SMGN, IMGN, and SLGN branches for total knee pain. The main outcomes were the NRS pain score (including the most severe pain), the average pain, and the proportion of patients who had reached pain reduction of more than 2 points. The secondary outcome was the Western Ontario McMaster University Osteoarthritis Index (WOMAC) score. RFA at 70ºC was performed for 120 seconds per patient in the RFA group, and knee nerve blocks were performed in the control group.</p><p><strong>Results: </strong>A total of 120 patients who met the inclusion criteria were selected in this study. The treatment groups showed significant differences in their mean NRS scores and worst pain during the first, third, and sixth months after treatment. There were significant differences in the mean WOMAC pain, physical function, and total scores between the treatment groups and over time. Between the treatment groups and over time, the mean WOMAC stiffness scores were not different. At each time point after treatment, the proportion of patients who needed analgesic drugs was significantly lower in the RFA group than in the control group. Univariate analysis showed that gender, age, pain course, and body mass index were not significantly correlated with the positive rate (NRS >= 2 score reduction). After we adjusted for multiple factors, the perceived beneficial effect of therapy was less when gonarthritis was more severe (P < 0.01).</p><p><strong>Limitation: </strong>This study's limitation is that it was performed in only one unit of the National Pain Management and Research Center.</p><p><strong>Conclusions: </strong>Ultrasound-guided RFA applied to knee nerves can significantly reduce KOA pain, improve knee joint function, improve patient satisfaction, and provide a feasible, safe, and effective minim","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140175872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Radiofrequency Ablation and Craniotomy Microvascular Decompression for Treatment of Hemifacial Spasm.","authors":"Huidan Lin, Shun Zhang, Xiang Gao, Lei Wu, Gang Cao, Lina Xuan, Yuyue Xun, Yongqing Liu, Changshun Huang, Bing Huang","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Hemifacial spasm (HFS) is distinguished by sudden and involuntary spasms of the facial muscles, predominantly on one side of the face. Microvascular decompression (MVD) is an efficacious surgical technique for treating HFS; however, MVD may occasionally lead to noteworthy postoperative complications. Previously, we reported the successful utilization of an innovative awake computed tomography-guided percutaneous puncture of the stylomastoid foramen for administering radiofrequency ablation (RFA) therapy in the treatment of HFS.</p><p><strong>Study design: </strong>Prospective clinical research study.</p><p><strong>Setting: </strong>Department of Anesthesiology and Pain Medical Center, Ningbo, China.</p><p><strong>Objectives: </strong>The aim of this study was to compare and contrast the clinical outcomes and adverse reactions associated with attempts to use RFA and MVD to manage primary HFS.</p><p><strong>Methods: </strong>Three hundred patients received either RFA or MVD treatment (Group R and Group M). We tracked and recorded each patient's cure rate, remission rate, intraoperative and postoperative complications, short-term and long-term therapeutic outcomes, hospitalization duration, hospitalization expenses, and operation time.</p><p><strong>Results: </strong>One hundred and fifty-eight patients were placed in the R group, and 142 patients were sorted into the M group. In the R group, 87.34% of patients showed improvement, 9.49% experienced relief, and 3.16% experienced treatment failure. Similarly, in the M group, 85.92% of patients showed improvement, 10.56% experienced relief, and 3.52% experienced treatment failure. The difference in therapeutic efficacy between the 2 groups was not significant. However, the M group had significantly lower recurrence rates at 3 months, 6 months, and one year post-operation than the R group did. Notably, the M group also experienced a higher rate of postoperative complications. Among the complications reported in the M group were 25 cases of dizziness or headache (17.6%) following the operation, 22 cases of hearing damage, including one case of complete hearing loss on the side involved, and 28 cases of peripheral nerve injury with abnormal skin sensation. Postoperative facial paralysis occurred in 15 patients, including 10 cases of moderate to severe facial paralysis that were relieved to grade II after one year. In comparison, the R group had 40 cases of grade II and 53 cases of grade III, and no cases of more severe facial paralysis were found. There were also 13 cases of peripheral nerve injury, such as local skin numbness and tenderness. Importantly, there were no cases of facial hematoma, intracranial hemorrhage, infection, or any other complications in either group, and no fatalities occurred during the study period.</p><p><strong>Limitations: </strong>The limitations of this study are the exclusion of transient postoperative complications, the lack of in-person foll","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140175931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of the Clinical Efficacy and Bone Cement Distribution Difference Between Kummell's Disease and Osteoporotic Vertebral Compression Fracture After Percutaneous Kyphoplasty.","authors":"Yuzhi Ning, Ziyu Li, Jiahu Huang, Shuang Xu, Qing Wang, Jiyuan Yan, Song Wang","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Kummell's disease (KD) and osteoporotic vertebral compression fracture (OVCF) are commonly found in patients with osteoporosis. Several studies have been conducted on bone cement distribution in OVCF or KD; a comparison between the 2 diseases is rarely reported.</p><p><strong>Objectives: </strong>To compare the clinical efficacy and bone cement distribution difference between KD and OVCFs after percutaneous kyphoplasty (PKP).</p><p><strong>Study design: </strong>This was a retrospective, nonrandomized controlled study.</p><p><strong>Setting: </strong>Department of Orthopedics from an affiliated hospital.</p><p><strong>Methods: </strong>From January 2018 to December 2020, 61 patients who underwent PKP surgery for single KD or OVCF and met the inclusion criteria were retrospectively reviewed. All patients were assigned to 2 groups: the KD group and the OVCF group. Clinical and radiologic characteristics, including the bone cement volume, leakage, bone cement dispersion scale, anterior vertebral height (AVH), median vertebral height (MVH), posterior vertebral height (PVH), Cobb angle and Visual Analog Scale (VAS) were analyzed and compared using Mimics three-dimensional (3D) reconstruction images and 3D reconstruction computed tomography, preoperatively, postoperatively, and 2 years after the operation, respectively. The correlations between the bone cement dispersion scale and the VH improvement rate (VHIR), VH change rate (VHCR), VAS improvement rate (VASIR), and follow-up VAS improvement rate (f-VASIR) were also evaluated.</p><p><strong>Results: </strong>The mean follow-up time was 24.0 months. Postoperative VH, Cobb angle, vertebra volume, and VAS score were significantly improved in the 2 groups (P < 0.05). There was no statistical difference in postoperative parameters between the 2 groups. While a strong positive correlation between VHIR and bone cement dispersion scale was observed in the OVCF group (P < 0.01), no significant correlation between VHIR and bone cement dispersion scale was found in the KD group. There was no correlation between VASIR and bone cement dispersion scale in both groups. Compared with postoperation, VH was lower in both groups in later follow-up, and the difference between the 2 groups was statistically significant (P < 0.05). VH, VAS, f-VASIR, and VHCR had a worse manifestation in the KD group than in the OVCF group. However, no significant correlation was found between VHCR, f-VASIR, and bone cement dispersion scale in the 2 groups.</p><p><strong>Limitations: </strong>This study was limited by the non-randomized design, small sample size, and lack of a comprehensive follow-up period.</p><p><strong>Conclusions: </strong>Although there was no significant difference in the bone cement distribution and early clinical efficacy between KD and OVCF patients under the same surgical plan and surgeon, OVCF patients exhibited better long-term radiologic and clinical outcomes.</p>","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140175932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In Response to Comment on \"Associations Between Headache (Migraine and Tension-Type Headache) and Psychological Symptoms (Depression and Anxiety) in Pediatrics\".","authors":"Min Cheol Chang","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140175937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}