Pain medicine case reports最新文献

{"title":"Severe Osteoarthritis and Avascular Necrosis of the Hips in a 37-Year-Old Man: Case Report.","authors":"Min Ju Kim, Kevin Batti, Moorice Caparo","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Hip osteoarthritis has been considered a condition commonly encountered in the elderly, however, it is predicted to be increasing in prevalence in the population below age 50. Avascular necrosis (AVN) is usually caused by a compromise in blood flow, usually occurring in patients with risk factors.</p><p><strong>Case report: </strong>A 37-year-old man presented with left-sided hip pain. Magnetic resonance imaging revealed severe left hip osteoarthritis, as well as bilateral hip AVN, although the patient had no known risk factors.</p><p><strong>Conclusions: </strong>Historically, differential diagnoses for hip pain in younger patients have not typically included osteoarthritis. However, hip osteoarthritis can occur in younger patients, and coexisting AVN can occur without known risk factors. It is crucial to consider these as differential diagnoses in young patients with hip pain. Future studies are needed to evaluate the prevalence of early hip osteoarthritis with coexisting AVN in patients younger than 50 years.</p>","PeriodicalId":520525,"journal":{"name":"Pain medicine case reports","volume":"10 7","pages":"603-605"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187428","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":"Case Series: MILD® Procedure as a Minimally Invasive Option for Lumbar Synovial Cyst Decompression.","authors":"Shemar Crawford, Caroline Jones, Simran Prakash, Ali Mostoufi","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Lumbar synovial cysts are benign, fluid-filled lesions arising from the facet joints, often associated with degenerative changes and segmental instability. These cysts can cause neurogenic claudication and radiculopathy, significantly limiting mobility and quality of life. While traditional treatments include conservative management, injections, aspiration, and open surgery, each has notable limitations. The Minimally Invasive Lumbar Decompression (MILD®) procedure, originally designed for lumbar stenosis, may offer a less invasive alternative for synovial cyst resection, especially in patients who are poor candidates for extensive surgery.</p><p><strong>Case report: </strong>Three patients with symptomatic lumbar synovial cysts refractory to conservative therapy underwent the MILD® procedure. The first, a 68-year-old man with an L4-5 cyst, experienced minimal relief from injections but showed marked improvement in walking and standing tolerance after MILD®, with magnetic resonance imaging (MRI) at one year demonstrating significant cyst reduction and canal restoration. The second, a 73-year-old man with bilateral radiculopathy and an L4-5 cyst, reported substantial functional gains, walking up to one hour at 12 weeks post-procedure. The third, an 80-year-old woman with multifactorial stenosis and a right L4-5 cyst, underwent 2-level MILD® decompression, resulting in improved ambulation and standing capacity at follow-up.</p><p><strong>Conclusions: </strong>The MILD® procedure is a minimally invasive procedure that was associated with clinical improvement in 3 reported cases of patients with lumbar synovial cysts causing neurogenic claudication or radiculopathy after conservative measures failed. This technique may offer the potential for rapid functional recovery and reduced morbidity, which could be particularly advantageous for older adults or those with comorbidities. While larger studies are needed to better establish its safety and efficacy for this indication, these cases suggest that MILD® may be a potential treatment option for symptomatic lumbar synovial cysts.</p>","PeriodicalId":520525,"journal":{"name":"Pain medicine case reports","volume":"10 7","pages":"597-602"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187473","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":"Peripheral Neuromodulation for Central Pain: A Case of Thalamic Pain Syndrome Managed With Percutaneous Nerve Stimulation.","authors":"Rohan Gogoi, Maximos Bogdady, Min Ju Kim, Marco Lawandy, Kevin Sperber","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Thalamic pain syndrome is a debilitating neuropathic condition that may develop after a thalamic stroke. Patients experience diffuse whole-body pain, contralateral to their stroke, that is often refractory to standard therapies.</p><p><strong>Case report: </strong>A 53-year-old woman with a history of right basal ganglia and thalamic hemorrhagic stroke presented with 10 years of severe, left-sided pain unresponsive to antispasmodics, anticonvulsants, and nonsteroidal anti-inflammatory drugs. A diagnostic sciatic nerve block provided temporary relief, prompting placement of a percutaneous peripheral nerve stimulator (PNS) of the sciatic nerve using the SPRINT system. The patient reported approximately 50% pain reduction throughout the patient's left calf, foot, and ankle during treatment, which persisted after lead explantation.</p><p><strong>Conclusions: </strong>This case suggests that percutaneous may offer sustained pain relief for thalamic pain syndrome refractory to conventional management. Further research is needed to clarify its mechanism and long-term efficacy in central neuropathic pain.</p>","PeriodicalId":520525,"journal":{"name":"Pain medicine case reports","volume":"10 7","pages":"613-616"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187414","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 Epidural Hematoma Managed Conservatively After a Spinal Cord Stimulation Trial: A Case Report.","authors":"Lucky Patel, Shekher Mohan, Justin Dumont, James Reynolds","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Spinal cord stimulation (SCS) is used to treat chronic pain but carries a rare risk of spinal epidural hematoma (SEH), which can cause serious neurologic injury. Urgent surgical decompression is often considered when neurologic deficits develop.</p><p><strong>Case report: </strong>A 73-year-old man developed severe back pain during an SCS trial and was found to have a thoracolumbar SEH after trial lead removal. He remained neurologically stable during hospitalization and was managed with close observation. His pain improved, and follow-up imaging showed a reduction in the hematoma without surgery.</p><p><strong>Conclusions: </strong>This case illustrates conservative management of SEH in a neurologically stable patient with close monitoring. Further evidence is needed to define which patients may be managed without surgical decompression.</p>","PeriodicalId":520525,"journal":{"name":"Pain medicine case reports","volume":"10 7","pages":"649-652"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187495","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":"Peripheral Nerve Stimulation for Chest Wall and Persistent Shoulder Pain After Reverse Total Shoulder Arthroplasty: A Case Report.","authors":"Derek Bui, Kimberly Youngren","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Persistent pain after reverse total shoulder arthroplasty (RTSA) warrants evaluation for surgical and infectious causes. Peripheral nerve stimulation (PNS) may be considered when these causes have been assessed, but evidence for its use in chest wall and shoulder pain after RTSA is limited.</p><p><strong>Case report: </strong>A 70-year-old man had persistent right anterior shoulder pain and new chest wall pain after revision RTSA. Diagnostic testing did not establish a surgical or infectious cause. A right pectoral nerve (PECS I) block provided temporary relief. A temporary PNS lead was placed near the lateral pectoral nerve under ultrasound guidance. After lead removal at 60 days, he reported 90% pain reduction and improved daily activities at 3 and 4 months.</p><p><strong>Conclusions: </strong>This case describes sustained patient-reported relief following temporary lateral pectoral nerve PNS. Further study is needed to determine its effectiveness for pain after RTSA.</p>","PeriodicalId":520525,"journal":{"name":"Pain medicine case reports","volume":"10 7","pages":"639-643"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187482","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 Wolf in Disguise: Tuberculous Spondylitis Masquerading as Modic Changes With Reactivation After Epidural Steroid Injection - A Case Report.","authors":"Gamze Gul Gulec, Savas Sencan, Serdar Kokar, Osman Hakan Gunduz","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Epidural steroid injections (ESIs) are commonly used for chronic low back pain but can rarely lead to serious infectious complications. Reactivation of latent tuberculous spondylodiscitis after ESI is uncommon. Our case highlights diagnostic challenges of underlying spinal infection prior to interventional pain procedures.</p><p><strong>Case report: </strong>A 43-year-old woman presented with low back and radicular pain. There were no constitutional symptoms, and baseline laboratory findings were unremarkable. Lumbar magnetic resonance imaging (MRI) showed Modic-type degenerative changes and nerve root compression. A transforaminal ESI was performed for presumed lumbar radiculopathy, but the pain persisted. Three weeks later, contrast-enhanced MRI revealed findings consistent with spondylodiscitis. Computed tomography-guided biopsy confirmed tuberculous spondylodiscitis, and antituberculosis therapy was initiated, leading to clinical improvement before any complications developed.</p><p><strong>Conclusions: </strong>Spinal tuberculosis may masquerade as degenerative Modic changes and may become clinically apparent following ESI. Persistent or worsening pain after spinal intervention should prompt reconsideration of the diagnosis.</p>","PeriodicalId":520525,"journal":{"name":"Pain medicine case reports","volume":"10 7","pages":"623-627"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187501","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":"Safe Implementation of Spinal Cord Stimulation in a Patient With a Ventriculoperitoneal Shunt: A Case Report and Review of Procedural Considerations.","authors":"Karim Jandali Rifai, Andrew Aboujaoude, Patricia Y Wang, Christopher Winfree, Melissa Chao","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Spinal cord stimulation (SCS) is a treatment approved for the management of chronic pain refractory to conservative medical treatment. Ventriculoperitoneal (VP) shunts can pose unique challenges during spinal procedures. This case highlights the careful considerations when evaluating patients with VP shunts for SCS and contributes to the growing body of evidence supporting the safe use of neuromodulation therapies in this medically complex population.</p><p><strong>Case report: </strong>A 58-year-old woman with communicating hydrocephalus status post VP shunt placement presented with refractory lower back pain despite conservative medical therapy. Subsequently, the patient had permanent SCS placement under general anesthesia without any complications. At follow-up, the patient reported excellent pain control with no evidence of shunt malfunction or neurological compromise.</p><p><strong>Conclusions: </strong>SCS may be safely performed in patients with VP shunts following multidisciplinary evaluation and careful procedural planning. This case adds to the limited literature supporting neuromodulation as a treatment for chronic pain in medically complex patients.</p>","PeriodicalId":520525,"journal":{"name":"Pain medicine case reports","volume":"10 7","pages":"629-632"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187471","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":"In Errata.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":520525,"journal":{"name":"Pain medicine case reports","volume":"10 7","pages":"655"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187479","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 Novel Case Report of Closed-Loop Spinal Cord Stimulation for Neuropathic Pain in Cervical Spinal Cord Injury.","authors":"Ruben Dovlatyan, David Jevotovsky, Jarna R Shah, Erika A Petersen","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Neuropathic pain after spinal cord injury (SCI) is common and often refractory. Closed-loop spinal cord stimulation (CL-SCS) is a novel intervention that adjusts stimulation based on evoked compound action potentials in real time, but its use for pain in complete SCI is not well described.</p><p><strong>Case report: </strong>A 45-year-old man with complete C6-C7 SCI developed severe, diffuse neuropathic pain below the injury level refractory to multiple medications, an intrathecal fentanyl pump trial, and ketamine infusions. With extensive epidural scarring, a staged buried CL-SCS trial with a combined open/percutaneous approach implanted bilateral C2-C5 leads. Trial stimulation produced complete analgesia. After internalization, pain improved to 4/10 on the Numeric Rating Scale at 3 months, with sustained 50-60% subjective improvement through 12 months. A wound complication at 11 months prompted surgical washout. Persistent concern for device colonization ultimately led to explantation at 18 months.</p><p><strong>Conclusions: </strong>CL-SCS may provide meaningful, sustained analgesia and functional benefit in select patients with complete cervical SCI. Systematic studies are needed to quantify benefit, durability, and risk.</p>","PeriodicalId":520525,"journal":{"name":"Pain medicine case reports","volume":"10 7","pages":"607-611"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187486","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":"Paraparesis After Ultrasound-Guided Lumbar Erector Spinae Plane Block: A Case Report and Review.","authors":"Sabiyya Ozgun, Sena Unver, Ridvan Isik, Kemal Nas","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Erector spinae plane block (ESPB) is an interfascial block used to manage perioperative acute and chronic pain. Local anesthetics administered during the procedure may occasionally cause temporary motor block.</p><p><strong>Case report: </strong>A 39-year-old woman presented with low back and right leg pain due to lumbar disc herniation. Her neurological examination was normal. Under ultrasound guidance, ESPB was performed at the right L4 level using 20 mL of a solution containing bupivacaine, saline, and dexamethasone. Fifteen minutes later, she had decreased motor strength in the right lower extremity and mild weakness on the left. Muscle strength and sensation returned to normal within 18 hours.</p><p><strong>Conclusions: </strong>Evidence concerning ESPB complications and the optimal volume and concentration of local anesthetic remains limited. Further research is needed to evaluate its safety.</p>","PeriodicalId":520525,"journal":{"name":"Pain medicine case reports","volume":"10 7","pages":"633-637"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187463","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}