The Impact of Tobacco Smoking on Spinal Cord Stimulation Effectiveness in Complex Regional Pain Syndrome Patients

ObjectivesWe aim to investigate the correlation of smoking and spinal cord stimulation (SCS) effectiveness for pain relief in complex regional pain syndrome (CRPS) patients while controlling for possible confounding factors including opioid intake.Materials and MethodsFollowing Institutional Review Board approval, a retrospective cohort study was performed by collecting data for all CRPS patients treated with SCS at Cleveland Clinic between 1998 and 2013. We divided patients into three groups based on their smoking status at the time of SCS device implant: Current smokers, former smokers, or nonsmokers. We used a linear mixed modeling to assess the association between smoking status and pain score at baseline and at 3, 6, and 12  months. We then used pairwiset‐tests for post hoc comparisons of pain scores.ResultsOf the 420 CRPS patients treated with SCS implants, the reduction in pain score was highest among nonsmokers. Nonsmokers demonstrated a consistent and steady decrease in pain scores over time, whereas the current and former smoker cohorts showed an initial reduction in pain at three  months compared to baseline which was not sustained to the 12‐months benchmark. Nonetheless, former smokers continued to report slightly lower pain scores than current smokers, although not statistically significant. The baseline opioid consumption was least among nonsmokers (30 [0, 62] oral mg morphine sulfate equivalent). We also found a statistically significan...
Source: Neuromodulation: Technology at the Neural Interface - Category: Biotechnology Authors: Tags: Clinical Research Source Type: research

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CONCLUSION: This study showed that calcitonin could be helpful analgesic agent in different painful situations. Calcitonin can be considered an eligible treatment for acute pains related to vertebral fractures and a feasible alternative for the treatment of the acute and chronic neuropathic pains where other medications might fail. PMID: 31810524 [PubMed - as supplied by publisher]
Source: Revista Brasileira de Anestesiologia - Category: Anesthesiology Tags: Rev Bras Anestesiol Source Type: research
Authors: Gofiţă CE, Ciurea ME, Dinescu ŞC, Vreju AF, Stoica LE, Ciurea RN, Boldeanu MV, Rogoveanu OC, Trăistaru MR, Bumbea AM, Ciurea PL, Muşetescu AE Abstract Metatypical basal cell carcinoma (MTBCC) is a rare form of tumor, which associates the clinical and histopathological (HP) characteristics of both basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), with a 5% chance for the development of metastases. The reference diagnosis remains the HP confirmation from the lesional tissue. The current report illustrates the case of a 74-year-old patient, diagnosed with MTBCC consequently to the biopsy from...
Source: Romanian Journal of Morphology and Embryology - Category: General Medicine Tags: Rom J Morphol Embryol Source Type: research
ConclusionThis study showed that calcitonin could be helpful analgesic agent in different painful situations. Calcitonin can be considered an eligible treatment for acute pains related to vertebral fractures and a feasible alternative for the treatment of the acute and chronic neuropathic pains where other medications might fail.ResumoJustificativa e objetivosA calcitonina é um hormônio polipeptídico que regula o metabolismo do cálcio no organismo. Por muitos anos a calcitonina tem sido usada para manter e melhorar a densidade mineral óssea e reduzir a incidência de fraturas. Muitos ...
Source: Brazilian Journal of Anesthesiology - Category: Anesthesiology Source Type: research
ConclusionsEarly detection and treatment of CRPS after lumbar discectomy was successful. Although differentiating CRPS from post-operative syndrome in the lumbar spine is difficult, we recommend that CRPS is considered to be the cause of unusual postoperative pain in the lumbar spine and the main concentration for diagnosis.
Source: Interdisciplinary Neurosurgery - Category: Neurosurgery Source Type: research
by Drew Rosielle (@drosielle)A Series of Observations on Opioids By a Palliative Doc Who Prescribes A Lot of Opioids But Also Has Questions.This is the 5th post in a series about opioids, with a focus on how my thinking about opioids has changed over the years. See also:Part 1 – Introduction, General Disclaimers, Hand-Wringing, and a Hand-Crafted Graph.Part 2 – We Were Wrong 20 years Ago, Our Current Response to the Opioid Crisis is Wrong, But We Should Still Be Helping Most of our Long-Term Patients Reduce Their Opioid DosesPart 3 – Opioids Have Ceiling Effects, High-Doses are Rarely Therapeutic, and Ano...
Source: Pallimed: A Hospice and Palliative Medicine Blog - Category: Palliative Care Tags: opioid pain rosielle The profession Source Type: blogs
Publication date: Available online 25 September 2019Source: Joint Bone SpineAuthor(s): Amélie Bernard, Cécile Morice, Christian Marcelli, Frédérique Sarazin, Achille Aouba, Alexandra Audemard-Verger
Source: Joint Bone Spine - Category: Orthopaedics Source Type: research
Publication date: Available online 19 September 2019Source: Arthroscopy TechniquesAuthor(s): Adnan Kasapovic, Yorck Rommelspacher, Martin Gathen, Davide Cucchi, Rahel Bornemann, Robert Pflugmacher, Sebastian G. WalterAbstractSpinal cord stimulation (SCS) is an evidence-based, reversible but invasive procedure for the treatment of chronic pain syndromes: for example, in patients with failed-back-surgery syndrome or complex regional pain syndrome. A more recent, similar technique uses high-frequency stimulation for SCS and follows a different mechanism of action that does not result in paresthesia. This Technical Note and vi...
Source: Arthroscopy Techniques - Category: Surgery Source Type: research
Conclusions The authors conclude that sympathetic blocks may be therapeutic in patients with complex regional pain syndrome regardless of preprocedure limb temperatures. The effects of sympathetic blocks do not predict the success of spinal cord stimulation.
Source: Anesthesiology - Category: Anesthesiology Source Type: research
Complex regional pain syndrome (CRPS) type I and CRPS type II diminish quality of life and can lead to significant disability.15 Both conditions have varied and complex clinical features, with chronic debilitating pain being the primary symptom, usually involving the lower or upper extremities.16,24 The conditions are differentiated by the absence (CRPS-I) or presence (CRPS-II) of demonstrable nerve damage as an underlying etiology.
Source: The Journal of Pain - Category: Materials Science Authors: Source Type: research
Complex regional pain syndrome (CRPS) is a severely disabling disease characterized by pain, temperature changes, motor dysfunction, and edema that most often occurs as an atypical response to a minor surgery or fracture. Inflammation involving activation and recruitment of innate immune cells, including both peripheral and central myeloid cells (ie, macrophages and microglia, respectively), is a key feature of CRPS. However, the exact role and time course of these cellular processes relative to the known acute and chronic phases of the disease are not fully understood. Positron emission tomography (PET) of translocator pr...
Source: Pain - Category: Anesthesiology Tags: Research Paper Source Type: research
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