Cauda equina syndrome after vertebroplasty
69-years-old female with lumbar fracture after falling (Figure 1) complaining of low-back pain was submitted to vertebroplasty. She was addressed to our service 10 days later with intense femoral neuropathy, paraparesis, and urinary disturbances. CT-scan confirmed intracanal cement extravasation (Figure 2A). Emergency laminectomy with complete removal of intradural compressive cement (Figure 2B), and posterior arthrodesis were made. There was immediate leg pain improvement. During 3-year follow-up period, gradual complete recovery of motor deficits and sphincter control was observed.
Conclusion: Lumbar disc herniations rarely present as PEMLDF resulting in symptoms varying from radiculopathy to cauda equina syndrome. These should be included among the differential diagnostic considerations for dorsolateral epidural lesions. PMID: 31966923 [PubMed]
Condition: Chronic Low-back Pain Interventions: Drug: PP353; Drug: PP353-B Sponsors: Persica Pharmaceuticals Ltd; Micron Research Ltd Not yet recruiting
Conditions: Lower Back Pain; Postpartum Period Intervention: Procedure: Laser acupuncture treatment Sponsor: Chang Gung Memorial Hospital Completed
Patients with radicular low back pain (radicular LBP, sciatica) frequently describe their pain as “shooting” or “radiating.” The dictionary meaning of these words implies rapid movement, and indeed, many sufferers report feeling pain moving rapidly from the lower back or buttock into the leg. But, others do not. Moreover, the sensation of movement is paradoxical; it is neither predicted nor accounted for by current ideas about the pathophysiology of radicular LBP. We have used a structured questionnaire to evaluate the sensory qualities associated with “shooting” and “radiating&rdq...
(Technische Universit ä t Dresden) A team of psychologists from Technische Universit ä t Dresden, in cooperation with experts from health sciences and the Federal Institute for Occupational Safety and Health, has carried out a meta-analysis to identify psychosocial work factors that pose a risk for the development of chronic low back pain (CLBP). Their study clearly indicates that not only physical but also psychological and social factors exert considerable influence on the development of the disease.
Low back pain, neck pain and other musculoskeletal disorders are among the ten leading causes of years lived with disability worldwide in 2016.12 Despite the wide range of treatments and health care resources devoted to low back pain, back-related disability and population burden have increased 10,11,14 and this development has recently called for international action.2 Since the US opioid crisis, the value of analgesics in general and of opioids in particular in the treatment of chronic pain is under discussion.
ConclusionsInappropriate imaging continues to be a driver of wasteful health care spending. Both physician experience and specialty training were highly associated with inappropriate imaging.
AbstractPurpose of ReviewThe aims of this article are to review the driving forces for increased utilization of imaging within the US and to review the strategies currently being implemented to curtail the use of inappropriate advanced diagnostic imaging (ADI) in the setting of acute uncomplicated low back pain.Recent FindingsStrategies aimed at reducing inappropriate ADI in the setting of uncomplicated low back pain, including guideline dissemination, clinical decision support (CDS), audit and feedback, prior authorization, and prior notification.SummaryIncreasing utilization of inappropriate ADI is a multifactorial probl...
The aim of this study was to reanalyze and reinterpret data obtained in PACE, the first large randomized controlled trial evaluating the efficacy of paracetamol in acute low back pain, to assess the inferential reproducibility of the original conclusions.
Conditions: Acupuncture; Low Back Pain Interventions: Device: Acupuncture; Other: Standard of care Sponsor: laurie wallace Not yet recruiting