iFuse Implant System for Treating Chronic Sacroiliac Joint Pain: A NICE Medical Technology Guidance

AbstractTreatment and management of sacroiliac joint pain is often non-surgical, involving packages of care that can include analgesics, physiotherapy, corticosteroid injections and radiofrequency ablation. Surgical intervention is considered when patients no longer respond to conservative management. The iFuse Implant System is placed across the sacroiliac joint using minimally invasive surgery, stabilising the joint and correcting any misalignment or weakness that can cause chronic pain. The iFuse system was evaluated in 2018 by the UK National Institute for Health and Care Excellence (NICE) as part of the Medical Technologies Evaluation Programme (MTEP). Clinical evidence for iFuse suggests improved pain, Oswestry disability index (ODI) and quality of life compared to non-surgical management. The company (SI-Bone®) submitted two cost models indicating that iFuse was cost saving compared with open surgery and non-surgical management. Clinicians advised that non-surgical management was the most appropriate comparator and Cedar (a health technology research centre) made changes to the model to test the impact of higher acquisition and procedure costs. Cedar found iFuse to be cost incurring by approximately £560 per patient at 7 years. During the consultation period, the company reduced the cost of some iFuse consumables, and Cedar extended the time horizon to test the assumption that iFuse would become cost saving over time. These changes indicated that iFuse b...
Source: Applied Health Economics and Health Policy - Category: Health Management Source Type: research

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ConclusionsWe did not detect a difference in patient outcomes using the dorsal longitudinal mini-arthrotomy; however, it may prevent incongruent joint reconstruction since all cases occurred in Group 1. In the absence of intraoperative CT scan, longitudinal mini-arthrotomy may be used to enhance visualization and achieve joint surface reconstruction.
Source: European Journal of Trauma and Emergency Surgery - Category: Emergency Medicine Source Type: research
Conclusion: The relatively high prevalence of symptoms of the cervical spine dysfunction, chronic pain, stress, and neck disability among young people may indicate that numerous spinal disorders identified in dentists result not only from their profession, in which spine is significantly overloaded, but also individual predispositions including biopsychosocial profile and the changing lifestyle habits of young people.
Source: Frontiers in Neurology - Category: Neurology Source Type: research
Chronic tension type headache (CTTH) is one of the common cause of hospital visits among adolescents and adults. Chronic tension type headache produces pain, sleep disturbances, and disability among patients leading to a poor quality of life. Knowledge pattern of headache and various associated factors will aid appropriate management.
Source: Pain Management Nursing - Category: Nursing Authors: Tags: Original Article Source Type: research
Chronic pain is known to alter the brain's network dynamics. These dynamics are often demonstrated by identifying alterations in the brain network topology. A common approach used for this purpose is graph theory. To date, little is known on how these potentially altered networks in chronic pain relate to the symptoms reported by these patients. Here, we applied a graph theoretical approach to identify network changes in patients suffering from chronic neck pain, a group that is often neglected in chronic pain research. Participants with chronic traumatic and nontraumatic neck pain were compared to healthy pain-free contro...
Source: Pain - Category: Anesthesiology Tags: Research Paper Source Type: research
Objective The aim of the study was to evaluate the efficacy of dextrose prolotherapy in the treatment of chronic resistant plantar fasciitis through comparison with a control group. Design In this double-blind, randomized, controlled study, the patients were divided into two groups. The prolotherapy group (n = 30) was administered 5 ml of 30% dextrose, 4 ml of saline, and 1 ml of 2% lidocaine mixture (15% dextrose solution) and the control group was given 9 ml of saline and 1 ml of 2% lidocaine mixture twice at a 3-wk interval. During the 15-wk follow-up period, pain intensity was measured using the visual analog scal...
Source: American Journal of Physical Medicine and Rehabilitation - Category: Rehabilitation Tags: Original Research Articles Source Type: research
__ Time for a new edition of SharpBrains’ e‑newsletter, featuring this time 14 timely news and resources for mental health and brain health innovation. First of all, let’s remain safe, healthy, and centered during the current health crisis by following these tips provided by the Greater Good Science Center at UC Berkeley: 1. Stay calm and focused 2. Pay attention to those doing the right thing 3. Show gratitude 4. Remember our common bonds 1) “Of course, all of these guidelines don’t supplant the importance of practicing good hygiene. We need to continue to frequently wash our hands and avoid...
Source: SharpBrains - Category: Neuroscience Authors: Tags: Cognitive Neuroscience Education & Lifelong Learning Health & Wellness Technology adhd brain brain health Brain Teasers brain-functions chronic pain coronavirus outbreak cross-train the brain dementia innovation LivaNova Medt Source Type: blogs
Osteoarthritis (OA) is characterized by inflammation and extracellular matrix (ECM) degradation and is one of the most common chronic degenerative joint diseases that causes pain and disability in adults. Urol...
Source: Journal of Inflammation - Category: Allergy & Immunology Authors: Tags: Research Source Type: research
CONCLUSIONS: Pharmaceuticals' abilities to treat medical conditions directly relates to their ability to act upon the endogenous biological systems related to the conditions. Thus, these recent findings are likely a reflection of the central role that the endogenous opioid system has in these mental illnesses. Further studies are necessary to study the involvement of endogenous opioid systems, and specifically KOR, in mediating buprenorphine's beneficial effects and the ability to treat these medical conditions while minimizing risks for misuse and diversion. PMID: 32204739 [PubMed - as supplied by publisher]
Source: Psychological Medicine - Category: Psychiatry Authors: Tags: Psychol Med Source Type: research
IntroductionIntermittent dosing (ID), in which periods of stimulation ‐on are alternated with periods of stimulation‐off, is generally employed using 30 sec ON and 90 sec OFF intervals with burst spinal cord stimulation (SCS). The goal of this study was to evaluate the feasibility of using extended stimulation‐off periods in patients with chronic intractable pain.Materials and MethodsThis prospective, multicenter, feasibility trial evaluated the clinical efficacy of the following ID stimulation ‐off times: 90, 120, 150, and 360 sec with burst waveform parameters. After a successful trial (≥5...
Source: Neuromodulation: Technology at the Neural Interface - Category: Biotechnology Authors: Tags: Clinical Research Source Type: research
This study found that between-group differences in pain intensity were statistically significant (P
Source: Acupuncture in Medicine : journal of the British Medical Acupuncture Society - Category: Complementary Medicine Authors: Tags: Acupunct Med Source Type: research
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