Comparison of three CT-guided epidural steroid injection approaches in 104 patients with cervical radicular pain: transforaminal anterolateral, posterolateral, and transfacet indirect
AbstractIntroductionThe treatment of persistent cervical radicular pain (CRP) by CT-guided epidural steroid injections (CTESI) by a transforaminal anterolateral (TFA) approach is associated with rare but serious complications. Two recently described transforaminal posterolateral (TFP) and transfacet indirect (TFT) approaches may be safer options, but have not been extensively evaluated. We compared the efficacy of three CTESI approaches (TFA, TFP, and TFT) in the treatment of persistent CRP (>6 weeks).MethodsPatients were prospectively assessed for pain using the visual analog scale (VAS) and for functional disability by the Neck Disability Index (NDI) before treatment, then 6 weeks and 6 months after CTESI.ResultsA total of 104 patients were included (n = 30 TFA,n = 36 TFP, andn = 38 TFT approaches). Each group was found to have a statistically significant improvement at 6 weeks (median VAS values: 7 (2–9) at D0 and 2 (3–6) at 6 weeksp
Knee OA is a common cause of pain and disability, with many patients relying on chronic pain medications and/or joint injections. These options unfortunately result in short-term relief, or have associated increased morbidity, and knee replacement surgery may ultimately be performed. Researchers have postulated that synovial neovascularity develops as a result of inflammation and subsequently leads to knee pain. While previous overseas reports of success with GAE have been published, we present our final results from a prospective US multicenter clinical trial.
ConclusionOur results showed that anxiety is highly related to TMD and we concluded that 62.8% of female dental students has anxiety of different levels.
DiscussionThis will be the first community-based trial to assess the benefits of exercise and education in the management of CLBP among adults in rural Nigeria. The study may provide a relatively inexpensive, assessable, and effective alternative intervention for reducing CLBP disability in a low-resource rural Nigerian community.
ConclusionsThe measurement properties of the Danish SPADI are similar to those of the English version. SPADI should be reported as two separate subscales. For the pain subscale, DIF with respect to age was disclosed, but the impact was small. The eight-item disability subscale did not fit the Rasch model. A six-item version of the disability subscale exhibited adequate fit in the Danish version. The same items were also found to fit the Rasch model in the English version.
Conclusion: A thorough preoperative understanding of the fragment patterns and preparation of tools for adequate reduction and fixation are necessary for satisfactory clinical and radiological outcomes. However, further comparative trials of conservative management versus surgery for CPF fixation, and any differences in outcomes according to the CPF fixation options, are required.
This study examined the effects of combining traditional physical therapy exercises with sensorimotor training on joint position sense, pain, muscle endurance, balance and disability in patients with chronic, non-specific neck pain.
ConclusionsPatients reported improvements in back and leg pain following minimally invasive lumbar decompression regardless of predominant presenting symptom; however, patients with predominant leg pain may experience greater improvement than those with predominant back pain.
The age-related degeneration of joint cartilage is a strongly inflammatory condition, in which the accumulation of senescent cells plays an important role. Senescent cells produce potent inflammatory signaling that harms the local environment in a range of ways. Systemic inflammation is also thought to be a meaningful contribution to osteoarthritis, however. The immune system becomes dysfunctional throughout the body with age, becoming more active and inflammatory even as it becomes ever less capable of defending against pathogens and errant cells. Minimizing joint issues with aging will no doubt require dealing with both ...
Injuries to the tarsometatarsal joint complex are known as Lisfranc injuries. Although relatively rare when considered with all other injuries about the foot and ankle, they are frequently seen in the orthopedic clinic. These injuries are often missed and can lead to long-standing pain and disability. Therefore, a high index of suspicion must be maintained by the evaluating orthopedic surgeon. Studies have shown that anatomic reduction is critical to obtain a good result. Transarticular screw fixation has the ability to obtain and maintain an anatomic reduction. This technique has historically been the most common method o...
Musculoskeletal pain disorders (MDs), such as osteoarthritis, low back pain and neck pain, are common health problems and a major cause of disease burden worldwide.10,13 MDs are the second most frequent cause of disability, accounting for 21.3% of the total years lived with disability, second only to mental health conditions.47,67 Psychological factors are strongly associated with MDs,6,13,24,48 and are thought to play a role in the development of chronic MDs (defined as pain lasting longer than three months).