scholarly journals The Effect of Pulsed Radiofrequency on Radicular Pain in Lumbal Herniated Nucleus Pulposus: A Systematic Review and Meta-Analysis

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Anita Marliana ◽  
Ismail Setyopranoto ◽  
Indarwati Setyaningsih ◽  
Sholahuddin Rhatomy
Keyword(s):  
Systematic Review ◽  
Nucleus Pulposus ◽  
Meta Analysis ◽  
Radicular Pain ◽  
Medical Procedure ◽  
Pulsed Radiofrequency ◽  
Pain Scores ◽  
Radiofrequency Therapy ◽  
Clinical Recommendation ◽  
Herniated Nucleus Pulposus

Context: Radiofrequency therapy is a medical procedure mainly used to reduce pain with a low complication rate (less than 1%), ease of application, and low cost. This review’s objective was to (1) evaluate the pulsed radiofrequency (PRF) effectiveness in treating radicular pain and (2) assess the PRF procedure’s safety in managing radicular pain in lumbar herniated nucleus pulposus (HNP). Methods: A systematic review and meta-analysis. A tertiary care center and an academic medical center. Six full articles with the following features were selected for this review: (1) Articles published in English; (2) studies on the PRF effect on radicular pain in lumbar HNP; and (3) randomized control trials. Results: The studies showed that the PRF group had a reduction in pain scores at each evaluation. In four of the studies, the PRF group showed a more significant reduction in pain scores than the control, and in two of the studies, the reduction in pain scores was not significant in the PRF group compared to the control. An adverse effect was reported in one patient experiencing increased radicular pain after PRF. Lack of data required for statistical analysis, and lack use of a uniform duration for the PRF procedure by all the studies. Conclusions: PRF can be used as a promising clinical recommendation for pain management with minimally invasive radicular pain techniques due to lumbar HNP.

The analgesic efficacy of liposomal bupivacaine compared with bupivacaine hydrochloride for the prevention of postoperative pain: a systematic review and meta-analysis with trial sequential analysis

2021 ◽  
pp. rapm-2020-102427
Author(s):  
Hanns-Christian Dinges ◽  
Thomas Wiesmann ◽  
Berit Otremba ◽  
Hinnerk Wulf ◽  
Leopold H Eberhart ◽  
...  
Keyword(s):  
Systematic Review ◽  
Postoperative Pain ◽  
Pain Score ◽  
Meta Analysis ◽  
End Points ◽  
Liposomal Bupivacaine ◽  
Bupivacaine Hydrochloride ◽  
Pain Scores ◽  
Score Difference ◽  
The Mean

Background/ImportanceLiposomal bupivacaine (LB) is a prolonged release formulation of conventional bupivacaine designed for prolonging local or peripheral regional single injection anesthesia. To this day, the benefit of the new substance on relevant end points is discussed controversial.ObjectiveThe objective was to determine whether there is a difference in postoperative pain scores and morphine consumption between patients treated with LB and bupivacaine hydrochloride in a systematic review and meta-analysis.Evidence reviewRandomized controlled trials (RCT) were identified in Embase, CENTRAL, MEDLINE and Web of Science up to May 2020. Risk of bias was assessed using Cochrane methodology. Primary end points were the mean pain score difference and the relative morphine equivalent (MEQ) consumption expressed as the ratio of means (ROM) 24 and 72 hours postoperatively.Findings23 RCTs including 1867 patients were eligible for meta-analysis. The mean pain score difference at 24 hours postoperatively was significantly lower in the LB group, at −0.37 (95% CI −0.56 to −0.19). The relative MEQ consumption after 24 hours was also significantly lower in the LB group, at 0.85 (0.82 to 0.89). At 72 hours, the pain score difference was not significant at −0.25 (−0.71 to 0.20) and the MEQ ratio was 0.85 (0.77 to 0.95).ConclusionThe beneficial effect on pain scores and opioid consumption was small but not clinically relevant, despite statistical significance. The effect was stable among all studies, indicating that it is independent of the application modality.

Role of Leukocytes in Radicular Pain Secondary to Herniated Nucleus Pulposus

2000 ◽  
Vol 376 ◽  
pp. 268-277 ◽  
Author(s):  
Mamoru Kawakami ◽  
Tetsuya Tamaki ◽  
Takuji Matsumoto ◽  
Koichi Kuribayashi ◽  
Toru Takenaka ◽  
...  
Keyword(s):  
Nucleus Pulposus ◽  
Radicular Pain ◽  
Herniated Nucleus Pulposus

scholarly journals Pain Perception of the First Eye versus the Second Eye during Phacoemulsification under Local Anesthesia for Patients Going through Cataract Surgery: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Chuying Shi ◽  
Jinqiu Yuan ◽  
Benny Zee
Keyword(s):  
Systematic Review ◽  
Cataract Surgery ◽  
Local Anesthesia ◽  
Fixed Effects ◽  
Pain Perception ◽  
Meta Analysis ◽  
Major Surgery ◽  
Eye Surgery ◽  
Pain Scores ◽  
The Difference

Background. Phacoemulsification under local anesthesia is regarded as the major surgery for cataract treatment. Recent research has compared the pain perception between the first eye and the second eye during phacoemulsification. However, these studies have also yielded controversial findings. Consequently, we performed a systematic review and a meta-analysis to investigate the difference in the pain perception between the first and second eyes during phacoemulsification. Method. We searched the PubMed, EMBASE, and Cochrane CENTRAL databases for the studies published up to October 5, 2018. Prospective observational studies were included. The meta-analysis was conducted by means of random-effects model and fixed-effects model according to the heterogeneity. Evaluation of the methodological quality of studies was based on Newcastle-Ottawa Scale (NOS). Results. Overall, eight studies were included in the meta-analysis. The analysis of pooled data showed that the pain scores of the first eye shortly after surgery under local anesthesia were significantly lower as compared to the second eye (WMD: 0.69; 95% CI: 0.40, 0.98; P<0.00001). The average pain scores of the first eye shortly after surgery under the topical anesthesia were also lower than those of the second eye (WMD: 1.08; 95% CI: 0.79, 1.36; P<0.00001). Conversely, anxiety scores in the first eye surgery were significantly higher than those in the second eye surgery (SMD: −0.40; 95% CI: −0.64, −0.16; P=0.001). However, the difference of the pain scores accessed on the first postoperative day between the first and second eye surgeries (WMD: −0.05; 95% CI −0.40, 0.31; P=0.79) as well as cooperation grades of patients between the first and second eye surgeries (WMD: 0.35; 95% CI −0.07, 0.76; P=0.10) was not statistically significant. Conclusion. Patients experienced more pain in the surgery of the second eye than that of the first eye, which probably related to lower anxiety before the second surgery. It suggests that we should consider preoperative intervention to reduce the perceived pain during second eye cataract surgery.

scholarly journals The Impact of a Stabilization Exercise on Neck Pain: A Systematic Review and Meta-analysis

2020 ◽  
Vol 81 (04) ◽  
pp. 342-347
Author(s):  
Binbin Wu ◽  
Hongyan Yuan ◽  
Deyu Geng ◽  
Liang Zhang ◽  
Cheng Zhang
Keyword(s):  
Systematic Review ◽  
Neck Pain ◽  
Meta Analysis ◽  
Neck Disability Index ◽  
Depression Scale ◽  
Cochrane Library ◽  
Control Group ◽  
Stabilization Exercise ◽  
Pain Scores ◽  
The Impact

Abstract Introduction The efficacy of a stabilization exercise for the relief of neck pain remains controversial. We conducted a systematic review and meta-analysis to explore the effectiveness of a stabilization exercise on neck pain. Methods We searched Embase, Web of Science, EBSCO Information Services, and the Cochrane Library databases through May 2019 for randomized controlled trials (RCTs) assessing the impact of a stabilization exercise on neck pain. This meta-analysis was performed using the random effects model. Results Six RCTs are included in the meta-analysis. Compared with the control group of patients with neck pain, a stabilization exercise can significantly reduce pain scores at 4 to 6 weeks (mean difference [MD]: −2.41; 95% confidence interval [CI], −4.46 to −0.35; p = 0.02), Neck Disability Index [NDI] at 10 to 12 weeks (MD:− 6.75; 95% CI, −11.71 to −1.79; p = 0.008), and depression scale at 4 to 6 weeks (MD: −4.65; 95% CI, −7.00 to −2.31; p = 0.02), but it has no obvious impact on pain scores at 10 to 12 weeks (MD: −1.07; 95% CI, −3.42 to 1.28; p = 0.37) or at 6 months (MD: −1.02; 95% CI, −3.43 to 1.39; p = 0.41). Conclusions A stabilization exercise can provide some benefits to control neck pain.

scholarly journals The Effectiveness of Fluoroscopically Guided Cervical Transforaminal Epidural Steroid Injection for the Treatment of Radicular Pain; a Systematic Review and Meta-analysis

Pain Medicine ◽  
2019 ◽  
Vol 21 (1) ◽  
pp. 41-54 ◽  
Author(s):  
Aaron Conger ◽  
Daniel M Cushman ◽  
Rebecca A Speckman ◽  
Taylor Burnham ◽  
Masaru Teramoto ◽  
...  
Keyword(s):  
Systematic Review ◽  
Comparison Group ◽  
Steroid Injection ◽  
Meta Analysis ◽  
Standard Of Care ◽  
Response Rates ◽  
Radicular Pain ◽  
Epidural Steroid Injection ◽  
Transforaminal Epidural Steroid Injection ◽  
Epidural Steroid

Abstract Objective Determine the effectiveness of fluoroscopically guided cervical transforaminal epidural steroid injection (CTFESI) for the treatment of radicular pain. Design Systematic review and meta-analysis. Subjects Persons aged ≥18 years with cervical radicular pain due to disc herniation or degenerative spondylosis. Comparison Sham, placebo procedure, or active standard of care treatment, excluding alternative versions of epidural steroid injection. Outcomes The primary outcome measure was patient-reported improvement in pain of at least 50% from baseline, assessed four or more weeks after the treatment intervention. Secondary outcomes included validated functional assessment tools and avoidance of spinal surgery. Methods Randomized or nonrandomized comparative studies and nonrandomized studies without internal control were included. Three reviewers independently assessed publications in the Medline, PubMed, and Cochrane databases up to July 2018. The Grades of Recommendation, Assessment, Development and Evaluation (GRADE) system was used to evaluate risk of bias and overall quality of evidence. A meta-analysis was conducted for comparative measures of effect and for within-group response rates if applicable. Results There were no studies with an internal comparison group (control group) meeting the review’s definition of comparison group. Therefore, comparative measures of effect were not calculated. In cohort studies, pooled response rates were 48% (95% confidence interval [CI] = 34–61%) at one month and 55% (95% CI = 45–64%) at three months. Conclusions Approximately 50% of patients experience ≥50% pain reduction at short- and intermediate-term follow-up after CTFESI. However, the literature is very low quality according the GRADE criteria, primarily due to a lack of studies with placebo/sham or active standard of care control comparison groups.

scholarly journals Efficacy of a New Navigable Percutaneous Disc Decompression Device (L'DISQ) in Patients with Herniated Nucleus Pulposus Related to Radicular Pain

Pain Medicine ◽  
2011 ◽  
Vol 12 (3) ◽  
pp. 370-376 ◽  
Author(s):  
Sang Heon Lee ◽  
Richard Derby ◽  
Dong geun Sul ◽  
Jung wha Hong ◽  
Gon Ho Kim ◽  
...  
Keyword(s):  
Nucleus Pulposus ◽  
Radicular Pain ◽  
Herniated Nucleus Pulposus

scholarly journals The role of single nucleotide polymorphisms of IL-1A -889C>T (rs1800587), TNF-A -238G>A (rs361525), and VDR TaqI (rs731236) on susceptibility to herniated nucleus pulposus

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 419
Author(s):  
Azharuddin Azharuddin ◽  
Muhammad Ilmawan ◽  
Jonny Karunia Fajar ◽  
Marhami Fahriani ◽  
Sukamto S. Mamada ◽  
...  
Keyword(s):  
Single Nucleotide Polymorphisms ◽  
Nucleus Pulposus ◽  
Meta Analysis ◽  
Interleukin 1 ◽  
Recessive Model ◽  
Nucleotide Polymorphisms ◽  
Necrosis Factor Alpha ◽  
Single Nucleotide ◽  
Herniated Nucleus Pulposus

Background: The objective of this study was to determine the role of single nucleotide polymorphisms (SNPs) in interleukin 1 alpha (IL-1A), tumor necrosis factor-alpha (TNF-A), and vitamin D receptor (VDR) genes on the susceptibility to herniated nucleus pulposus (HNP). Methods: Four databases (PubMed, Embase, Cochrane, and Web of Science) were searched as of April 1st, 2021. Authors, publication year, targeted genes, genotype and allele frequency in each case and control groups were collected. Newcastle-Ottawa scale was used to evaluate the publication quality. The pooled estimates of association of IL-1A -889C>T (rs1800587), TNF-A -238G>A (rs361525), and VDR TaqI (rs731236) and susceptibility to HNP were assessed using Z test and presented as odd ratio (OR) and 95% confidence intervals (95%CI). Results: We screened 3,067 unique studies for eligibility and three, two and nine studies on IL-1A -889C>T, TNF-A -238G>A, and VDR TaqI were included, respectively, in our meta-analysis. The studies consisting 369 HNP cases and 433 controls for IL-1A -889C>T, 252 cases and 259 controls for TNF-A -238G>A and 1130 cases and 2096 controls for VDR TaqI. Our pooled estimates indicated that there was no significant association of those SNPs with the susceptibility to HNP in any genotype, dominant model, recessive model, or allele comparations. Conclusion: Although individual studies suggested the important role of gene expression dysregulation associated with SNPs in IL-1A, TNF-A, and VDR, our data indicated that IL-1A -889C>T, TNF-A -238G>A, and VDR TaqI had weak association with HNP susceptibility in both genotypes and allele distributions. However, since heterogeneity was identified among studies included in this meta-analysis, further meta-analysis with a larger population and subgroup analysis on specific population are warranted to support this finding.

scholarly journals Coccydynia—The Efficacy of Available Treatment Options: A Systematic Review

2021 ◽  
pp. 219256822110653
Author(s):  
Gustav Ø. Andersen ◽  
Stefan Milosevic ◽  
Mads M. Jensen ◽  
Mikkel Ø. Andersen ◽  
Ane Simony ◽  
...  
Keyword(s):  
Systematic Review ◽  
Experimental Study ◽  
Treatment Outcome ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Treatment Options ◽  
Controlled Trials ◽  
Single Measure ◽  
Randomized Controlled ◽  
Radiofrequency Therapy

Study design Systematic Review Objective To evaluate the efficacy of available treatment options for patients with persistent coccydynia through a systematic review. Methods Original peer-reviewed publications on treatment for coccydynia were identified using Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines by performing a literature search of relevant databases, from their inception to January 17, 2020, combined with other sources. Data on extracted treatment outcome was pooled based on treatment categories to allow for meta-analysis. All outcomes relevant to the treatment efficacy of coccydynia were extracted. No single measure of outcome was consistently present among the included studies. Numeric Rating Scale, (NRS, 0–10) for pain was used as the primary outcome measure. Studies with treatment outcome on adult patients with chronic primary coccydynia were considered eligible. Results A total of 1980 patients across 64 studies were identified: five randomized controlled trials, one experimental study, one quasi-experimental study, 11 prospective observational studies, 45 retrospective studies and unpublished data from the DaneSpine registry. The greatest improvement in pain was achieved by patients who underwent radiofrequency therapy (RFT, mean Visual Analog Scale (VAS) decreased by 5.11 cm). A similar mean improvement was achieved from Extracorporeal Shockwave Therapy (ESWT, 5.06), Coccygectomy (4.86) and Injection (4.22). Although improved, the mean change was less for those who received Ganglion block (2.98), Stretching/Manipulation (2.19) and Conservative/Usual Care (1.69). Conclusion This study highlights the progressive nature of treatment for coccydynia, starting with noninvasive methods before considering coccygectomy. Non-surgical management provides pain relief for many patients. Coccygectomy is by far the most thoroughly investigated treatment option and may be beneficial for refractory cases. Future randomized controlled trials should be conducted with an aim to compare the efficacy of interventional therapies amongst each other and to coccygectomy.

scholarly journals Physical Therapies for Psychosomatic Symptoms and Quality of Life Induced by Aromatase Inhibitors in Breast Cancer Patients: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 11 ◽  
Author(s):  
Xue-Ying Zhu ◽  
Zhong Li ◽  
Cong Chen ◽  
Ru-Li Feng ◽  
Bai-Ru Cheng ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Systematic Review ◽  
Cancer Patients ◽  
Functional Assessment ◽  
Meta Analysis ◽  
Breast Cancer Patients ◽  
Psychosomatic Symptoms ◽  
Pain Scores ◽  
Sf 36

ObjectiveTo evaluate the effects of Physical Therapies (PTs) on improvement in psychosomatic symptoms and quality of life (QOL) in breast cancer patients.Data SourcesSeven databases (MEDLINE, EMBASE, Cochrane CENTRAL, China National Knowledge Infrastructure, Wangfang, VIP, and China Biology Medicine disc databases) were systematically searched from the database inception through May 18, 2021.Study SelectionRandomized controlled trials (RCTs) which compared acupuncture or exercise with a sham control or usual care for the treatment of aromatase inhibitors (AIs)-related psychosomatic symptoms and QOL.Data Extraction and SynthesisData were screened and extracted independently using predesigned forms. The quality of RCTs was assessed with the Cochrane Handbook for Systematic Reviews of Interventions. The effect size was calculated via random-effects modeling. The quality of evidence was evaluated with the Grading of Recommendations Assessment, Development and Evaluation approach.Main Outcomes and MeasuresThe score of pain was measured with BPI scale and Western Ontario and the McMaster Universities Index (WOMAC) scale. Emotional state was measured with Pittsburgh Sleep Quality Index (PSQI), Hospital Anxiety and Depression Scale (HADS-A), and Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-Fatigue). The QOL score was measured by self-reported measurements, including the Functional Assessment of Cancer Therapy-General (FACT-G) scale and 36-Item Short Form Survey (SF-36) scale.ResultsEleven RCTs (with 830 patients) were included in the systematic review, and data from 10 RCTs (with 798 patients) were used in the meta-analysis. Results showed acupuncture significantly reduced worst pain scores (P &lt; 0.00001, I2 = 83.5%) [SMD = −0.81, 95% CI (−1.51, −0.11)], but the effect of exercise therapies was not significant in overall change in worst pain scores (P =0.006, I2 = 72.3%) [SMD = −0.30, 95% CI (−0.76, 0.16)]. Both acupuncture and exercise resulted in little to no difference in overall change in HADS-A subscale (P = 0.026&lt;0.05, I2 = 79.8%) [WMD = −0.21, 95% CI (−3.44, 3.03)], PSQI subscale (P = 0.488, I2 = 0%) [WMD = 0.98, 95% CI (−0.57, 2.53)], and FACIT-Fatigue subscale (P = 0.022&lt;0.05, I2 = 81.0%) [WMD = 1.6, 95% CI (−5.75, 8.94)]. Exercise (compared with usual care) was associated with improving overall change in health-related QOL (subscales of SF-36 tool) (P = 0, I2 = 72.1%) [WMD = 7.97, 95% CI (5.68, 10.25)] and cancer-specific QOL (subscales of FACT-G tool) (P = 0.304, I2 = 16%) [WMD = 1.16, 95% CI (0.34, 1.97)].Conclusions and RelevanceThis systematic review and meta-analysis suggested that based on moderate-level evidence, acupuncture was associated with significant reductions in pain intensity, and exercise might improve QOL in breast cancer patients treated with AIs. However, in psychosomatic symptoms such as anxiety, sleep disturbance, and fatigue, acupuncture and exercise training did not result in significant improvements.

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