Transcranial direct current stimulation of the primary motor cortex on postoperative pain and spontaneous oscillatory electroencephalographic activity following lumbar spine surgery: A pilot study.
Transcranial direct current stimulation of the primary motor cortex on postoperative pain and spontaneous oscillatory electroencephalographic activity following lumbar spine surgery: A pilot study. Restor Neurol Neurosci. 2018 Jul 18;: Authors: Jiang N, Li G, Wei J, Wei B, Zhu FF, Hu Y Abstract BACKGROUND: Transcranial direct current stimulation (tDCS) on primary motor cortex (M1) provides a new way to relieve postoperative pain. Previous studies only found postoperative analgesia dosage significantly reduced in tDCS group while the patient-controlled analgesia (PCA) was applied. However, there lacks the study about the effect of M1-tDCS on pain intensity and brain activity while the analgesia dosage is the same for both groups. OBJECTIVE: To investigate whether M1-tDCS can (1) reduce pain intensity and (2) change spontaneous electroencephalography (EEG) oscillations in prefrontal cortex, in patients with postoperative pain, after taking the constant dosage of analgesics. METHODS: A prospective, single-blind, randomized, sham-controlled study was conducted. 32 patients with postoperative pain after lumbar spine surgery were recruited. All patients received same dosage of dezocine before intervention. In the morning of the first day after surgery and before dezocine injection, a single 20-minute session of anodal M1-tDCS was applied to 'tDCS' group while sham stimulation to 'sham' group. Numeric rating scale (NRS) and resting-state EEG with eyes-cl...
This study is registered with ClinicalTrials.gov, number NCT02176382.FindingsBetween Oct 15, 2014, and June 10, 2016, 269 women were assessed for eligibility. 76 participants were randomly assigned to 20 μg teriparatide (n=39) or 40 μg teriparatide (n=37), of whom 69 completed at least one post-baseline visit. At 15 months, mean spine aBMD had increased to a significantly greater extent in the 40 μg group (17·5% [SD 6·0] increase) than the 20 μg group (9·5% [3·2]; difference 8·1%, 95% CI 5·5 to 10·6, p
Pushups are a beneficial exercise that people can do every day. Pushups can increase muscle mass and cardiovascular health. Risks include back pain. Learn more here.
CONCLUSION: Patients with IBS in Germany are likely not receiving sufficient diag- nostic evaluation in conformity with the relevant guidelines. The high prevalence of comorbid mental disorders and other pain syndromes implies that the complaints of patients with IBS need to be more comprehensively evaluated and treated. PMID: 31431234 [PubMed - in process]
Generic and spine-specific surveys are used before surgery for lumbar degenerative spondylolisthesis (LDS) to measure pain. While both types of surveys can discern various aspects of pain, such as pain intensity and pain-associated disability, their ability to capture how pain impacts other outcomes, such as fulfillment of expectations, is not known.
We describe a novel, pre-emptive, opioid-sparing pain medication protocol that is started 2 days prior to surgery, in accordance with first-order pharmacokinetics, and continued postoperatively until discharge with the goal of decreasing postoperative pain, improving mobilization, and decreasing the patient's length of hospital stay.
Patients are instructed to restrict activity for several months after lumbar surgery to safely recuperate. However, after recuperation many patients continue sedentary lifestyles because of fear of spine injury, persistent pain, deconditioning, and habit. Lack of activity has serious long-term adverse consequences for spine health and other physical and mental diagnoses (ie, Sedentary Death Syndrome). Because surgeons comprehensively understand the spine condition and extent of surgery, they and their surgical team are uniquely positioned to address apprehensions and advise/encourage prudent activity.
Surgery is increasingly recommended for the treatment of degenerative cervical myelopathy (DCM) as it effectively halts neurological progression and improves functional impairment, disability and quality of life. Although neck pain is a common complaint in patients with DCM, high-quality, prospective studies that summarize the incidence and severity of preoperative pain and evaluate the impact of surgery on pain outcomes are scarce.
Weinstein and Ponsetti demonstrated that despite increased pain, adults with previously unoperated adolescent idiopathic scoliosis (AIS) typically lead normal functioning lives. The Oswestry Disability Index (ODI) is a validated questionnaire for assessing back disability with 0-20 indicating minimal disability. A score of>30 has been used in past FDA trials as an inclusion criterion for surgical studies. We predict that increasing ODI scores will correlate with age, curve size, curve location and progression to surgery.
The sacroiliac joint (SIJ) is an underappreciated pain generator in 15-30% of patients with low back pain. The SIJ functions as a primary structure which transfers loads of the upper body to the lower extremities. Sacroiliac joint dysfunction (SIJD) is characterized by SIJ laxity with symptoms manifesting primarily as low back and lower extremity pain. Additionally, there is growing evidence that gait patterns may also be affected by SIJD. Although there is still much controversy, minimally invasive sacroiliac fusion (SIF) is gaining interest as a procedure for SIJD patients with unremitting pain.
Pseudarthrosis is a common indication for revision spine operations. Clinical presentations of pseudarthrosis are heterogeneous. While the majority of patients present with pain, many can be symptomatic. Etiologies of pseudarthrosis also vary from structural to biologic, including infection.