The primary diagnosis and the coexisting anxiety disorders have no impact on the additional surgical procedure after spinal cord stimulators implantation: An analysis of 11,029 patients

Publication date: Available online 14 October 2017 Source:Journal of Clinical Neuroscience Author(s): Koji Tamai, Zorica Buser, Christopher Wang, Permsak Paholpak, Hiroaki Nakamura, Jeffrey C. Wang, Patrick C. Hsieh Studies have demonstrated superior outcomes and cost effectiveness of the spinal cord stimulation (SCS) for the treatment of chronic pain syndromes such as failed back surgery syndrome (FBSS) or complex regional pain syndrome (CRPS). However, little is known about the impact of primary diagnosis or mental disorders on the revision rate. This is the Retrospective cohort study to analyze the reintervention rates based on the primary diagnosis or comorbid mental disorder. Data of the annual trends of SCS use, revision and removal rate of SCS and additional surgical rate after removal was collected and analyzed for patients undergoing SCS between 2007 and 2015, within a private insurance billing database. Trial cases were excluded from this study. The results showed 11,029 patients received SCS implantation with percutaneous electrodes (PE, n = 7418) or surgical electrode (SE, n = 3611). There was a trend of increasing use of SCS from 2007 to 2013, followed by a decrease in last two years. There was no significant difference in the neither removal nor revision rate regardless between the patients with FBSS or CRPS at each time point. Although the removal rates within 2 years were significantly higher in the patients with anxiety disorders compared to the pa...
Source: Journal of Clinical Neuroscience - Category: Neuroscience Source Type: research

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We present a surgical technique that diminishes tension of the repair with MCPJ flexion. Twenty-two EDC tendon stabilization procedures were performed between 2006 and 2017 using a tendon flap method. The selection criteria for this group of patients included completely dislocating extensor tendons with persistent complaints of pain and decrease in finger extension despite at least a 6-week conservative treatment attempt. All subjects underwent surgical treatment for tendon centralization using a distally based tendinous flap from the EDC sutured to the adjacent finger volar plate. A mathematical model was developed to ana...
Source: Techniques in Hand and Upper Extremity Surgery - Category: Surgery Tags: Technique Source Type: research
Radiocapitellar arthrosis represents a serious sequela of pediatric elbow injuries. Although persistent pain and disability are not uncommon in such cases, treatment remains controversial. The present study aimed to review the clinical outcomes after a new surgical treatment with partial radial head resection and corium interposition arthroplasty. To date, 3 adolescent cases underwent the surgical procedure and postoperative care. Thorough clinical and radiographic follow-up was performed. The mean age at the time of surgery was 14.4 years (range, 13 to 16 y) and mean duration of follow-up was 19 months (range, 12 t...
Source: Techniques in Hand and Upper Extremity Surgery - Category: Surgery Tags: Technique Source Type: research
We present a case report of an adult woman with AKL-positive ALCL, diagnosed by endobronchial ultrasound-guided transbronchial needle aspirate (EBUS-TBNA).A 59-year-old women with no history of breast implants, was admitted for a four-month low back pain. Initially, the patient was treated for a spondyloarthropathy, but due to persistence of the symptoms, a lumbosacral MRI was performed, showing changes in morphology and signal intensity in the vertebral body of L3, along with edema and a paravertebral collection that affected the left psoas muscle, suggesting granulomatous spondylodiscitis. Chest CT-scan showed mild left ...
Source: Respiratory Medicine Case Reports - Category: Respiratory Medicine Source Type: research
Chronic pain in adolescents is a serious issue that can lead to decreased social interactions, school absences, and impaired academic performance. In addition to physiologic, psychologic, and social factors, parental anxiety is believed to contribute to the development and maintenance of chronic pain. Retrospectively, we examined the charts of 144 patients, ages 8 –18, with various chronic pain conditions and placed them into one of six diagnostic groups: complex regional pain syndrome, abdominal pain, back pain, hypermobility, headache, and fibromyalgia.
Source: The Journal of Pain - Category: Materials Science Authors: Source Type: research
The pain seemed to come from nowhere. Although fifth-grader Amelia Watt had sprained her ankle playing soccer a few weeks earlier, the injury had seemed inconsequential. Yet now, she couldn’t put any weight on her foot without crying. Soon, the burning pain crept up her leg and her foot began to turn purple. Even taking a shower had become excruciating. At age 11, this vibrant, active girl was relegated to crutches, afraid to walk. Eventually, Amelia’s local physicians diagnosed her with complex regional pain syndrome (CRPS), a chronic pain condition believed to be caused by malfunction of the nervous system. C...
Source: Thrive, Children's Hospital Boston - Category: Pediatrics Authors: Tags: Diseases & Conditions Our Patients’ Stories chronic pain Chronic Pain Clinic complex regional pain syndrome Dr. Edin Randall Pediatric Pain Rehabilitation Center (PPRC) Source Type: news
Conclusions: Currently available immersive virtual reality technology with myolectric and motion tracking control may represent a possible therapy option for treatment-resistant phantom limb pain. Keywords: virtual reality, phantom limb pain, rehabilitation, amputation, therapy, pain Innov Clin Neurosci. 2017;14(7–8):3–7 Phantom limb pain (PLP), the sensation of pain in an absent limb, is a frequent complication after amputation, with reported prevalence rates ranging from 40 to 85 percent.1,2 While the exact mechanism of PLP remains to be elucidated, peripheral and central neural factors are thought to contrib...
Source: Innovations in Clinical Neuroscience - Category: Neuroscience Authors: Tags: Case Report Current Issue amputation pain phantom limb pain rehabilitation therapy virtual reality Source Type: research
“Buprenorphine is a kappa receptor antagonist. For these reasons, buprenorphine might be unique in its ability to treat chronic pain and possibly OIH.” The opioid crisis has been fueled by the use of opioids to treat chronic pain.  Practice patterns have changed, but doctors are still criticized for their roles in the overuse of opioids.  I’ve sat through community ‘heroin forums’ (sometimes on stage) as sheriffs, politicians, and ‘recovered addicts’ firmly pointed fingers at health professionals.  I, meanwhile, kept my finger under the table, but had the t...
Source: Suboxone Talk Zone - Category: Addiction Authors: Tags: Acute Pain Buprenorphine Chronic pain Suboxone treatment buprenorphine treats chronic pain chronic pain treatment opioid induced hyperalgesia opioid pain relief pain vs. addiction Source Type: blogs
“I have chosen a surreal art approach to represent my invisible disability, due to the surreal nature of mental illness,” tattoo artist Lindsay Carter expressed in a statement. Carter’s image ― featured on the right, above ― shows a bird whose head is a cage with a giant eyeball protruding from the dreamlike vision.  “As long as I’ve been consciously aware, I’ve been diagnosed with generalized anxiety disorder and major depressive disorder,” she continued. “Severe episodes can happen for no apparent reason and at that point I cannot help nor snap out of the...
Source: Healthy Living - The Huffington Post - Category: Consumer Health News Source Type: news
Publication date: Available online 15 July 2016 Source:Joint Bone Spine Author(s): Pascale Vergne-Salle Chronic postsurgical pain (CPSP) affects 10 to 30% of surgical patients overall and 16 to 20% of patients after knee surgery. Patients report persistent pain in the absence of infection, mechanical disorders, or complex regional pain syndrome type I. In many cases, the mechanism is neuropathic pain related to an intraoperative nerve injury or impaired pain modulation with central sensitization. The clinical risk factors and pathophysiology of CPSP are being actively investigated. Risk factors include preoperative pain; ...
Source: Joint Bone Spine - Category: Orthopaedics Source Type: research
CONCLUSION: The multidisciplinary pain management program in this French pediatric functional rehabilitation center shows results comparable to the programs described in other countries. Chronic pain should be evaluated with standardized and validated tools, such as the measurement of the pain-related disability with the Functional Disability Index. PMID: 27345555 [PubMed - as supplied by publisher]
Source: Archives de Pediatrie - Category: Pediatrics Authors: Tags: Arch Pediatr Source Type: research
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