Image-Guided Percutaneous Treatment of Lumbar Stenosis and Disc Degeneration

Low back pain, radicular leg pain, and lumbar spinal stenosis are the most common of all chronic pain disorders. Discogenic pain is related to distress of annular fibers and tears, whereas spinal stenosis is related to reduction of the spinal canal dimensions and compression of the neural elements; radicular pain is mainly related to disc herniation and is initially managed conservatively. The percutaneous minimally invasive approach in discogenic and radicular pain is designed to reduce the volume of the nucleus pulposus in patients with failure of medical and physical treatment prolonged for at least 6 weeks.
Source: Neuroimaging Clinics - Category: Radiology Authors: Source Type: research

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Conclusion5R-STS performance differs according to the etiology of back and leg pain, even after adjustment for demographic covariates. In combination with machine learning algorithms, OFI can be used to infer the etiology of spinal back and leg pain with accuracy comparable to other diagnostic tests used in clinical examination.Graphic abstractThese slides can be retrieved under Electronic Supplementary Material.
Source: European Spine Journal - Category: Orthopaedics Source Type: research
Abstract Chronic low back pain due to lumbar spinal stenosis (LSS) is common, costly, mechanistically complex, and clinically challenging. However, the factors and mechanisms causing and mediating chronic pain induced by cauda equina compression remain unclear. Here, we examined the role of cyclooxygenase (COX)-2 in infiltrated macrophages, a key mediator of inflammation, in chronic neuropathic pain by LSS using an animal model. LSS was induced in adult male rats by cauda equina compression procedure using a silicone block within the epidural spaces of L5-L6 vertebrae. Locomotor deficit was observed after compress...
Source: International Immunopharmacology - Category: Allergy & Immunology Authors: Tags: Int Immunopharmacol Source Type: research
Authors: Nishishinya Aquino MB, Pereda CA, Muñoz-Ortego J Abstract Rheumatic diseases involving the spine, mainly cervical and lumbar spine, are highly prevalent, and consume considerable health resources. Acupuncture is a medical procedure endorsed by the WHO, with a wide spectrum of medical applications. The aim of this study was to review the evidence on acupuncture efficacy in these diseases. A literature search was performed in MEDLINE, CENTRAL and EMBASE (May 2017): 535 citations. We included four global reviews(45 systematic reviews) and three Systematic Reviews(70 clinical trials). Acupuncture improv...
Source: Medicina Clinica - Category: General Medicine Tags: Med Clin (Barc) Source Type: research
g Liu The accurate segmentation of the paraspinal muscle in Magnetic Resonance (MR) images is a critical step in the automated analysis of lumbar diseases such as chronic low back pain, disc herniation and lumbar spinal stenosis. However, the automatic segmentation of multifidus and erector spinae has not yet been achieved due to three unusual challenges: (1) the muscle boundary is unclear; (2) the gray histogram distribution of the target overlaps with the background; (3) the intra- and inter-patient shape is variable. We propose to tackle the problem of the automatic segmentation of paravertebral muscles using a defo...
Source: Sensors - Category: Biotechnology Authors: Tags: Article Source Type: research
The aim of this observational, cross-sectional study was to analyse lumbar magnetic resonance imaging (MRI) findings in patients with non-specific chronic low back pain (CLBP), and to evaluate any correlation with pain intensity and their capacity to predict neuropathic pain (NP) in these patients. Fifty-two patients with non-specific CLBP, between 21 and 62 years of age, 50% men, were investigated. Lumbar MRI was employed to assess disc degeneration, endplate changes, Modic changes, disc displacement, facet degeneration, foraminal stenosis and central lumbar spinal stenosis. The characteristics of pain were evaluated and...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research
Treating chronic low back pain (CLBP) with spine-focused interventions is common, potentially dangerous, and often ineffective. We posit that CLBP in older adults is a geriatric syndrome – a final common pathway for the expression of multiple contributors. We have published evidence and expert consensus-based algorithms to guide evaluation and treatment of key biopsychosocial CLBP contributors in older adults – hip osteoarthritis, myofascial pain, fibromyalgia, sacroiliac joint syndrome, lumbar spinal stenosis, leg length inequality, lateral hip/thigh pain, anxiety, depression, insomnia, and maladaptive coping....
Source: The Journal of Pain - Category: Materials Science Authors: Source Type: research
Objectives: Assessment of neuropathic pain in chronic low back syndromes is important. However, there is currently no gold standard for its diagnosis. The aim of this observational cross-sectional study was to assess the neuropathic component of pain in various chronic low back pain syndromes using a range of diagnostic tests. Materials and Methods: Included in this study were 63 patients with chronic axial low back pain (ALBP), 48 patients with chronic radicular syndromes (CRS) comprising 23 with discogenic compression (CDRS) and 25 with lumbar spinal stenosis (LSS), and 74 controls. PainDETECT questionnaire (PDQ), q...
Source: The Clinical Journal of Pain - Category: Anesthesiology Tags: Original Articles Source Type: research
Publication date: May 2018Source: Annals of Physical and Rehabilitation Medicine, Volume 61, Issue 3Author(s): Charlotte Pauwels, Alexandra Roren, Adrien Gautier, Jonathan Linières, François Rannou, Serge Poiraudeau, Christelle NguyenAbstractBackgroundLumbar-flexion-based endurance training, namely cycling, could be effective in reducing pain and improving function and health-related quality of life in older people with chronic low back pain.ObjectivesTo assess barriers and facilitators to home-based cycling in older patients with lumbar spinal stenosis (LSS).MethodsWe conducted a retrospective mixed-method s...
Source: Annals of Physical and Rehabilitation Medicine - Category: Rehabilitation Source Type: research
ConclusionsThe 30-degreed endoscopy had the advantages of obtaining a wider view. Full endoscopic decompression using 30-degreed endoscopy allowed satisfactory result clinically and reduction of surgical infection. It could be alternative method of microscopic laminectomy.
Source: Journal of Orthopaedics - Category: Orthopaedics Source Type: research
Publication date: May 2018Source: Annals of Physical and Rehabilitation Medicine, Volume 61, Issue 3Author(s): Charlotte Pauwels, Alexandra Roren, Adrien Gautier, Jonathan Linières, François Rannou, Serge Poiraudeau, Christelle NguyenAbstractBackgroundLumbar-flexion-based endurance training, namely cycling, could be effective in reducing pain and improving function and health-related quality of life in older people with chronic low back pain.ObjectivesTo assess barriers and facilitators to home-based cycling in older patients with lumbar spinal stenosis (LSS).MethodsWe conducted a retrospective mixed-method s...
Source: Annals of Physical and Rehabilitation Medicine - Category: Rehabilitation Source Type: research
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