scholarly journals Wireless Neuromodulation for Chronic Back Pain: Delivery of High-Frequency Dorsal Root Ganglion Stimulation by a Minimally Invasive Technique

2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Bart Billet ◽  
Roel Wynendaele ◽  
Niek E. Vanquathem
Keyword(s):  
Quality Of Life ◽  
Back Pain ◽  
Dorsal Root Ganglion ◽  
Minimally Invasive ◽  
High Frequency ◽  
Dorsal Root ◽  
Chronic Back Pain ◽  
Leg Pain ◽  
Invasive Technique

Objective. To evaluate the analgesic effect of a dorsal root ganglion (DRG) stimulation technology utilizing high-frequency pulse rates to treat intractable chronic back and leg pain. Methods. This case study presents the outcomes, with a novel, wireless, minimally invasive miniature neurostimulator system in a case of chronic back pain. The subject was implanted bilaterally with a Freedom 4A quadripolar electrode array at the L2 dorsal root ganglion. Stimulation was applied using 10 kHz pulse rate and 30 μs pulse width. A VAS pain-rating scale, Oswestry Disability Index (ODI), EQ-5D-5L Quality of Life Questionnaire 5 dimensions, and Patients’ Global Impression of Change (PGIC) scale were evaluated at 12 weeks and 6 months post implantation. Results. VAS pain scores for back pain reduced from 91 to 31 mms and 80 to 35 mms for leg pain. Additionally, while stimulation remained paresthesia-free, there were a marked decrease in pain medications and an increase in quality of life. Also, an increase in functionality from crippled to moderate was reported. There were no adverse reactions related to the procedure or device. Conclusion. The minimally invasive, wireless approach to deliver high-frequency, paresthesia-free DRG stimulation for treatment of chronic back and leg pain associated with FBSS was effective and encouraging.

scholarly journals One-year evaluation of epiduroscopy in chronic back pain with and without radiculopathy: a retrospective study

2019 ◽  
Vol 56 (1) ◽  
Author(s):  
Mert Akbas ◽  
Huseyin Babun ◽  
Haitham Hamdy Salem ◽  
Tamer Hussien Emara ◽  
Shereen Elmosly ◽  
...  
Keyword(s):  
Back Pain ◽  
Minimally Invasive ◽  
Chronic Back Pain ◽  
Failed Back Surgery Syndrome ◽  
Invasive Technique ◽  
Disc Prolapse ◽  
Quality Of Sleep ◽  
Vas Score ◽  
Failed Back Surgery

Abstract Background Back pain is a frequent complaint among the individuals in the society. It significantly affects the daily activities and the social and psychological life aspects leading to an economic health burden. Epiduroscopy is a relatively new minimally invasive technique that is used as a diagnostic and therapeutic tool in cases of chronic back pain. Aim of the study To evaluate the extent of long-term benefit of epiduroscopy in patients with refractory chronic back pain with/without radiculopathy. Materials and methods Retrospective data of 148 patients with failed back surgery syndrome (FBSS) and/or symptomatic lumbosacral disc prolapse who underwent epiduroscopy were collected. A 50% reduction in the visual analog scale (VAS) score was set as the primary outcome. Pre- and post-procedure analgesic use, quality of sleep, and changes in the activities of daily livings (ADLs) after 1-year follow-up were reviewed. Incidence and types of complications were recorded. Results The mean age of the studied sample was 56.6 years with a higher percentage of females (61.5%). Patients having radicular pain represented 45.1%. Disc prolapse was prevalent (61.5%) compared to patients with FBSS (38.5%). A reduction of 50% or more in VAS score was reached in 52.7% (p < 0.01). This reduction was more evident in younger patients (p = 0.004). There was an improvement in ADLs (p < 0.01), quality of sleep (p < 0.05), and analgesic intake (p < 0.05). Conclusion Epiduroscopy is a relatively recent, safe, and minimally invasive tool that showed effectiveness in the difficult to treat patients with back pain with/without radiculopathy especially in FBSS.

Changes in Perceptions of Narcotic Analgesic Treatment and Quality of Life in Chronic Back Pain Patients

2017 ◽  
Vol 24 (2) ◽  
pp. 65
Author(s):  
Min-Wook Kim ◽  
Choong-Young Kim ◽  
Ji-Won Lee ◽  
Cheol-Hwan Kim ◽  
Ju-Sim Oh ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Back Pain ◽  
Chronic Back Pain ◽  
Narcotic Analgesic ◽  
Analgesic Treatment ◽  
Pain Patients

Minimally Invasive Separation Surgery for Metastases in the Vertebral Column: A Technical Report

2019 ◽  
Vol 18 (6) ◽  
pp. 606-613
Author(s):  
Rafael A Vega ◽  
Jeffrey I Traylor ◽  
Ahmed Habib ◽  
Laurence D Rhines ◽  
Claudio E Tatsui ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Spinal Cord ◽  
Minimally Invasive ◽  
Definitive Treatment ◽  
Invasive Technique ◽  
Thoracic Vertebrae ◽  
Minimally Invasive Techniques ◽  
Invasive Approach ◽  
Invasive Techniques

Abstract BACKGROUND Epidural spinal cord compression (ESCC) is a common and severe cause of morbidity in cancer patients. Minimally invasive surgical techniques may be utilized to preserve neurological function and permit the use of radiation to maximize local control. Minimally invasive techniques are associated with lower morbidity. OBJECTIVE To describe a novel, minimally invasive operative technique for the management of metastatic ESCC. METHODS A minimally invasive approach was used to cannulate the pedicles of the thoracic vertebrae, which were then held in place by Kirschner wires (K-wires). Following open decompression of the spinal cord, cannulated screws were placed percutaneously with stereotactic guidance through the pedicles followed by cement induction. Stereotactic radiosurgery is performed in the postoperative period for residual metastatic disease in the vertebral body. RESULTS The minimally invasive technique used in this case reduced tissue damage and optimized subsequent recovery without compromising the quality of decompression or the extent of metastatic tumor resection. Development of more minimally invasive techniques for the management of metastatic ESCC has the potential to facilitate healing and preserve quality of life in patients with systemic malignancy. CONCLUSION ESCC from vertebral metastases poses a challenge to treat in the context of minimizing potential risks to preserve quality of life. Percutaneous pedicle screw fixation with cement augmentation provides a minimally invasive alternative for definitive treatment of these patients.

scholarly journals Quality of life in patients with chronic back pain

2020 ◽  
Vol 13 (1) ◽  
pp. 29-37
Author(s):  
Jana Haluzíková ◽  
Gabriela Wieclawová
Keyword(s):  
Quality Of Life ◽  
Back Pain ◽  
Chronic Back Pain

scholarly journals Clinical implications of lumbar developmental spinal stenosis on back pain, radicular leg pain, and disability

2021 ◽  
Vol 103-B (1) ◽  
pp. 131-140
Author(s):  
Marcus Kin Long Lai ◽  
Prudence Wing Hang Cheung ◽  
Dino Samartzis ◽  
Jaro Karppinen ◽  
Kenneth Man Chee Cheung ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Back Pain ◽  
Spinal Stenosis ◽  
Large Scale ◽  
Leg Pain ◽  
Decompression Surgery ◽  
Study Cohort ◽  
The Past ◽  
Canal Diameter

Aims To study the associations of lumbar developmental spinal stenosis (DSS) with low back pain (LBP), radicular leg pain, and disability. Methods This was a cross-sectional study of 2,206 subjects along with L1-S1 axial and sagittal MRI. Clinical and radiological information regarding their demographics, workload, smoking habits, anteroposterior (AP) vertebral canal diameter, spondylolisthesis, and MRI changes were evaluated. Mann-Whitney U tests and chi-squared tests were conducted to search for differences between subjects with and without DSS. Associations of LBP and radicular pain reported within one month (30 days) and one year (365 days) of the MRI, with clinical and radiological information, were also investigated by utilizing univariate and multivariate logistic regressions. Results Subjects with DSS had higher prevalence of radicular leg pain, more pain-related disability, and lower quality of life (all p < 0.05). Subjects with DSS had 1.5 (95% confidence interval (CI) 1.0 to 2.1; p = 0.027) and 1.8 (95% CI 1.3 to 2.6; p = 0.001) times higher odds of having radicular leg pain in the past month and the past year, respectively. However, DSS was not associated with LBP. Although, subjects with a spondylolisthesis had 1.7 (95% CI 1.1 to 2.5; p = 0.011) and 2.0 (95% CI 1.2 to 3.2; p = 0.008) times greater odds to experience LBP in the past month and the past year, respectively. Conclusion This large-scale study identified DSS as a risk factor of acute and chronic radicular leg pain. DSS was seen in 6.9% of the study cohort and these patients had narrower spinal canals. Subjects with DSS had earlier onset of symptoms, more severe radicular leg pain, which lasted for longer and were more likely to have worse disability and poorer quality of life. In these patients there is an increased likelihood of nerve root compression due to a pre-existing narrowed canal, which is important when planning surgery as patients are likely to require multi-level decompression surgery. Cite this article: Bone Joint J 2021;103-B(1):131–140.

scholarly journals Electrochemotherapy and Simultaneous Photodynamic Bone Stabilization of Upper Limbs in Metastatic Renal Cancer Disease: Case Report and Literature Review

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Ugo Albertini ◽  
Andrea Conti ◽  
Nicola Ratto ◽  
Pietro Pellegrino ◽  
Michele Boffano ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Minimally Invasive ◽  
Bone Disease ◽  
Metastatic Bone Disease ◽  
Invasive Technique ◽  
Bone Lesions ◽  
Disease Case ◽  
Lytic Bone Lesions

Introduction. Metastatic bone disease represents a systemic pathology that heavily affects the quality of life of oncologic patients causing pain and functional disability. Methodology. We present the case of a patient with a history of renal cell cancer presenting pathologic fractures of both humeri and proximal right radius. Results. After a careful multidisciplinary approach, an adjuvant anticancer therapy and a photodynamic bone stabilization procedure were performed with a minimally invasive technique aiming to minimize pain and local disease progression, while restoring functional autonomy and improving the patient’s quality of life. Electrochemotherapy was delivered on the lytic bone lesions with extraskeletal involvement of the proximal left humerus and the proximal right radius, and then polymeric bone stabilization was performed on both humeri. At two months of follow-up, the patient presented satisfactory functional scores (MSTS score: 12/30 bilaterally; DASH scores: 46.7/100 for the right side and 48.3/100 for the left one), and pain was well controlled with opioid analgesics. Radiographs showed good results in terms of ossification of lytic bone lesions and durability of polymeric stabilization. At four months of follow-up, the patient reported a stable clinical scenario. Six months after surgery, due to extremely poor prognosis after the progression of primary disease, the patient was referred to palliative care and died shortly thereafter. Conclusion. Over the last decade, the management of metastatic bone disease has changed. Low-toxicity and minimally invasive procedures such as electrochemotherapy and polymeric bone stabilization might be performed concomitantly in selected patients, as an alternative to radiation therapy and to more demanding surgical procedures such as plating and adjuvant cementing.

A clinical case of reoperation with Chiari malformation

2020 ◽  
pp. 28-31
Author(s):  
Ilmira Gilemkhanova ◽  
Shamil M. Safin ◽  
Khristina Derevyanko ◽  
Nargiza Askatovna Garifullina
Keyword(s):  
Quality Of Life ◽  
Minimally Invasive ◽  
Treatment Strategy ◽  
High Frequency ◽  
Chiari Malformation ◽  
Clinical Case ◽  
Pediatric Neurosurgery ◽  
Surgical Interventions ◽  
Minimally Invasive Surgical

Since the active introduction of neuroimaging methods, the prevalence of registered children with craniovertebral anomalies, including the Chiari malformation (CM), has a statistically significant tendency to increase. Minimally invasive surgical interventions are the most acceptable in pediatric neurosurgery, however, currently experience has been accumulated enough that does not confirm the universality of this method, due to the high frequency of reoperations at an older age, as well as a decrease of children’s quality of life in the interoperative periods. Considering the imperfection of treatment strategy mentioned above, the aim of this article was to analyze modern surgical interventions in pediatric and adult neurosurgeons with confirmation of our own results as an example of a clinical case of Chiari malformation in our clinic.

Biopsychosocial Rehabilitation Programme for Patients with Chronic Back Pain. Pilot Study

2017 ◽  
Vol 19 (2) ◽  
pp. 165-174 ◽  
Author(s):  
Anna Cabak ◽  
Agnieszka Rudnicka ◽  
Leszek Kulej ◽  
Wiesław Tomaszewski
Keyword(s):  
Quality Of Life ◽  
Back Pain ◽  
Pain Threshold ◽  
Ad Hoc ◽  
Chronic Back Pain ◽  
Functional Limitations ◽  
Rehabilitation Treatment ◽  
Disability Questionnaire ◽  
Experimental Group

Background. In the search for effective and comprehensive therapies of back pain, an increasing emphasis in being placed on the biopsychosocial model and multidimensional support programmes for patients as well the use of modern technologies in this area of medicine. This study aimed to assess a programme of customised ad hoc physiotherapeutic consultations for patients with back pain who had been on the waiting list for rehabilitation treatment for a long time. Material and method. The study group comprised 68 patients of the Rehabilitation Centre Non-Public Health Care Institution who had been waiting for rehabilitation treatment for at least three months. The patients, diagnosed with chronic back pain and aged 40-80 years, were randomly assigned into two groups. The experimental group took part in a programme of three consultations, provided on average once a month. The patients from both groups were assessed after the three-month programme, immediately before the commencement of the prescribed rehabilitation treatment. We evaluated the pain threshold at trigger points of selected muscles using the algometric method (kg/cm 2 ), subjective assessment of pain (VAS), functional limitations (Rolland Morris Disability Questionnaire) and quality of life (36-Item Short Form Health Survey, SF-36). The statistical analysis of the results used non-parametric methods: significance of differences between the groups was evaluated with the Mann–Whitney U test and correlations between the variables were assessed separately for each group using Spearman’s rank order correlation. The significance threshold was accepted at α=0.05. Results. The algometric evaluation of all the muscles revealed significantly lower sensitivity to pain, demonstrated by a higher pain threshold (p<0.0001), in the experimental group. Moreover, this group also included a much smaller percentage of patients with a high level of functional limitations according to the Rolland Morris Disability Questionnaire. The quality of life evaluation revealed that the control group scored poorer in the mental domain (p=0.02). Conclusions. The ad hoc intervention programme for patients referred for rehabilitation due to chronic back pain showed demonstrable beneficial effects with regard to their psychophysical health. Similar programmes should be more readily offered to patients at health care centres and implemented into clinical practice.

Sign in / Sign up

Export Citation Format

Share Document