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[PMID]: 29331290
[Au] Autor:Zdilla MJ; Miller KD; Swearingen JV; Lambert HW
[Ad] Address:Associate Professor of Biology & Physician Assistant Sciences, Department of Natural Sciences and Mathematics, West Liberty University, West Liberty, WV; Associate Professor of Biology & Physician Assistant Sciences, Department of Graduate Health Sciences, West Liberty University, West Liber
[Ti] Title:The Use of Ultrasonography to Identify the Intersection of the Dorsomedial Cutaneous Nerve of the Hallux and the Extensor Hallucis Longus Tendon: A Cadaveric Study.
[So] Source:J Foot Ankle Surg;57(2):296-300, 2018 Mar - Apr.
[Is] ISSN:1542-2224
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Terminal branches of the superficial fibular nerve are at risk of iatrogenic damage during foot surgery, including hallux valgus rigidus correction, bunionectomy, cheilectomy, and extensor hallucis longus tendon transfer. One terminal branch, the dorsomedial cutaneous nerve of the hallux, is particularly at risk of injury at its intersection with the extensor hallucis longus tendon. Iatrogenic injuries of the dorsomedial cutaneous nerve of the hallux can result in sensory loss, neuroma formation, and/or debilitating causalgia. Therefore, preoperative identification of the nerve is of great clinical importance. The present study used ultrasonography to identify the intersection between the dorsomedial cutaneous nerve of the hallux and the extensor hallucis longus tendon in cadavers. On ultrasound identification of the intersection, dissection was performed to assess the accuracy of the ultrasound screening. The method successfully pinpointed the nerve in 21 of 28 feet (75%). The sensitivity, positive likelihood ratio, and positive and negative predictive values of ultrasound identification of the junction of the dorsomedial cutaneous nerve and the extensor hallucis longus tendon were 75%, 75%, 100%, and 0%, respectively. We have described an ultrasound protocol that allows for the preoperative identification of the dorsomedial cutaneous nerve of the hallux as it crosses the extensor hallucis longus tendon. The technique could potentially be used to prevent the debilitating iatrogenic injuries known to occur in association with many common foot surgeries.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180226
[Lr] Last revision date:180226
[St] Status:In-Process

  2 / 756 MEDLINE  
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[PMID]: 28467566
[Au] Autor:Özdemir I; Akbas M; Yegin A; Dagistan G; Erkan DÖ
[Ti] Title:Spinal kord stimülasyonu uygulanan 62 hastanin retrospektif degerlendirilmesi. [Spinal cord stimulation in 62 patients: Retrospective evaluation].
[So] Source:Agri;29(1):25-32, 2017 Jan.
[Is] ISSN:1300-0012
[Cp] Country of publication:Turkey
[La] Language:tur
[Ab] Abstract:OBJECTIVES: Spinal cord stimulation (SCS) is used for various indications such as Failed Back Surgey Syndrome, peripheral causalgia, neuropathic pain, complex regional pain syndrome, reflex sympathetic dystrophy, peripheral vascular disease, ischemic heart disease and cancer pain. METHODS: This is a retrospective study. 62 patients applied SCS were included in retrospective study from february 2011-january 2015 in Akdeniz University medicine faculty algology department. We asked about patients' VAS values before and after procedure, analgesic medicine usings, sleep disorders, pleasure after procedure, daily activity improvement and time of going back to work. RESULTS: We found that decrease on the patients' pain severity and improvement on quality of sleep and daily activities. CONCLUSION: As a result; our study and the other studies show that SCS is reliable and effective procedure on chronic pain management.
[Mh] MeSH terms primary: Failed Back Surgery Syndrome/therapy
Pain, Intractable/therapy
Reflex Sympathetic Dystrophy/therapy
Spinal Cord Stimulation
[Mh] MeSH terms secundary: Adult
Aged
Failed Back Surgery Syndrome/physiopathology
Female
Humans
Male
Middle Aged
Pain Measurement
Pain, Intractable/physiopathology
Reflex Sympathetic Dystrophy/physiopathology
Retrospective Studies
Treatment Outcome
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180220
[Lr] Last revision date:180220
[Js] Journal subset:IM
[Da] Date of entry for processing:170504
[St] Status:MEDLINE
[do] DOI:10.5505/agri.2016.08870

  3 / 756 MEDLINE  
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[PMID]: 29404715
[Au] Autor:Zhao J; Wang Y; Wang D
[Ad] Address:Department of Emergency Medicine, Thomas Jefferson University, Philadelphia, USA.
[Ti] Title:The Effect of Ketamine Infusion in the Treatment of Complex Regional Pain Syndrome: a Systemic Review and Meta-analysis.
[So] Source:Curr Pain Headache Rep;22(2):12, 2018 Feb 05.
[Is] ISSN:1534-3081
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:PURPOSE OF REVIEW: Complex regional pain syndrome (CRPS) is a painful debilitating neurological condition that accounts for approximately 1.2% of adult chronic pain population. Ketamine, an NMDA receptor antagonist, is an anesthetic agent that has been used by some pain specialists for CRPS. There is a growing body of clinical evidence to support the use of ketamine in the treatment of neuropathic pain, especially CRPS. This meta-analysis study was aimed to examine the efficacy of ketamine in the treatment of CRPS. RECENT FINDINGS: A search of Embase, Pubmed, Web of Knowledge, Cochrane, Clinical Trial.gov , and FDA.gov between Jan 1, 1950, and August 1, 2017, was conducted to evaluate ketamine infusion therapy in the treatment of CRPS. We selected randomized clinical trials or cohort studies for meta-analyses. I index estimates were calculated to test for variability and heterogeneity across the included studies. The primary outcome is pain relief. The effect of ketamine treatment for complex regional pain syndrome was assessed by 0-10 scale numerical rating pain score. The secondary outcome is the pain relief event rate, which is defined as the percentage of participants who achieved 30% or higher pain relief in each of the qualified studies. Our meta-analysis results showed that the Ketamine treatment led to a decreased mean of pain score in comparison to the self-controlled baseline (p < 0.000001). However, there is a statistical significance of between-study heterogeneity. The immediate pain relief event rate was 69% (95% confidence interval (CI) 53%, 84%). The pain relief event rate at the 1-3 months follow-ups was 58% (95% CI 41%, 75%). The current available studies regarding ketamine infusion for CRPS were reviewed, and meta-analyses were conducted to evaluate the efficacy of ketamine infusion in the treatment of CRPS. Our findings suggested that ketamine infusion can provide clinically effective pain relief in short term for less than 3 months. However, because of the high heterogeneity of the included studies and publication bias, additional random controlled trials and standardized multicenter studies are needed to confirm this conclusion. Furthermore, studies are needed to prove long-term efficacy of ketamine infusion in the treatment of CRPS.
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1802
[Cu] Class update date: 180209
[Lr] Last revision date:180209
[St] Status:In-Process
[do] DOI:10.1007/s11916-018-0664-x

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[PMID]: 27779368
[Au] Autor:Mekhail NA; Estemalik E; Azer G; Davis K; Tepper SJ
[Ad] Address:Pain Management Department, Cleveland Clinic, Cleveland, Ohio, U.S.A.
[Ti] Title:Safety and Efficacy of Occipital Nerves Stimulation for the Treatment of Chronic Migraines: Randomized, Double-blind, Controlled Single-center Experience.
[So] Source:Pain Pract;17(5):669-677, 2017 Jun.
[Is] ISSN:1533-2500
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: A recent multicenter study presented 52-week safety and efficacy results from an open-label extension of a randomized, sham-controlled trial for patients with chronic migraine (CM) undergoing peripheral nerve stimulation of the occipital nerves. We present the data from a single center of 20 patients enrolled at the Cleveland Clinic's Pain Management Department. METHODS: In this single center, 20 patients were implanted with a neurostimulation system, randomized to an active or control group for 12 weeks, and received open-label treatment for an additional 40 weeks. Outcomes collected included number of headache days, pain intensity, Migraine Disability Assessment (MIDAS), Zung Pain and Distress (PAD), direct patient reports of headache pain relief, quality of life, satisfaction, and adverse events (AEs). RESULTS: Headache days per month were reduced by 8.51 (±9.81) days (P < 0.0001). The proportion of patients who achieved a 30% and 50% reduction in headache days and/or pain intensity was 60% and 35%, respectively. MIDAS and Zung PAD were reduced for all patients. Fifteen (75%) of the 20 patients at the site reported at least one AE. A total of 20 AEs were reported from the site. CONCLUSION: Our results support the 12-month efficacy of 20 CM patients receiving peripheral nerve stimulation of the occipital nerves in this single-center trial.
[Mh] MeSH terms primary: Electric Stimulation Therapy/methods
Migraine Disorders/therapy
Pain Management/methods
[Mh] MeSH terms secundary: Adult
Double-Blind Method
Female
Humans
Male
Middle Aged
Peripheral Nerves/physiology
Quality of Life
Treatment Outcome
[Pt] Publication type:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Em] Entry month:1801
[Cu] Class update date: 180123
[Lr] Last revision date:180123
[Js] Journal subset:IM
[Da] Date of entry for processing:161026
[St] Status:MEDLINE
[do] DOI:10.1111/papr.12504

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[PMID]: 28960653
[Au] Autor:Harrison C; Epton S; Bojanic S; Green AL; FitzGerald JJ
[Ad] Address:John Radcliffe Hospital, University of Oxford Medical Sciences Office, Oxford, UK.
[Ti] Title:The Efficacy and Safety of Dorsal Root Ganglion Stimulation as a Treatment for Neuropathic Pain: A Literature Review.
[So] Source:Neuromodulation;, 2017 Sep 28.
[Is] ISSN:1525-1403
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:OBJECTIVE: Dorsal root ganglion stimulation (DRGS) received its first regulatory approval (CE marking in Europe) in late 2011, and so its use is now almost six years old. Several thousand patients have already been treated, and a landmark trial in lower limb complex regional pain syndrome (CRPS) and causalgia has recently been published. METHODS: In this review we have summarized the literature to date on the use of DRGS in the treatment of neuropathic pain. RESULTS: The results so far are encouraging, with reports of successful use in treating a wide range of indications including postsurgical pain, CRPS, and phantom pain. Treatment of failed back surgery syndrome (FBSS) appears less successful. The therapy is still young, and long term results are not yet available. There is now good randomized clinical trial (RCT) evidence that DRGS provides superior pain relief to spinal cord stimulation for CRPS and causalgia of the lower limb, and produces stimulation that is more posturally stable, with more precise paraesthesia coverage. However evidence of this quality for other indications and pain locations is lacking. CONCLUSION: There is now Class A RCT evidence that DRGS provides superior pain relief to SCS for CRPS and causalgia of the lower limb. In the coming years we hope that randomized controlled trials will be performed on an indication-by-indication basis, which, together with the publication of longer term follow-up data, will provide a more complete understanding of the role of DRGS in the treatment of neuropathic pain syndromes.
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1709
[Cu] Class update date: 170929
[Lr] Last revision date:170929
[St] Status:Publisher
[do] DOI:10.1111/ner.12685

  6 / 756 MEDLINE  
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[PMID]: 28875558
[Au] Autor:Dupré DA; Tomycz N; Whiting D; Oh M
[Ad] Address:Department of Neurosurgery, Allegheny General Hospital, Pittsburgh, Pennsylvania, U.S.A.
[Ti] Title:Spinal Cord Stimulator Explantation: Motives for Removal of Surgically Placed Paddle Systems.
[So] Source:Pain Pract;, 2017 Sep 05.
[Is] ISSN:1533-2500
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Despite requiring successful trials prior to implantation, spinal cord stimulation (SCS) systems for pain are often later removed. Removing surgically implanted hardware subjects patients to the risks and discomfort of a second surgery, threatens the cost-effectiveness of SCS, and limits the perceived durability of SCS technology for pain problems. OBJECTIVE: To investigate patterns of reasons given among patients who underwent SCS explant surgery (SCSES). METHODS: Retrospective review of SCSES cases over 17 years at Allegheny General Hospital, Pittsburgh, PA. RESULTS: 165 patients underwent SCSES between 1997 and 2014. The top 3 reasons for explantation were inadequate pain control (IPC; 73%), hardware discomfort (22%), and need for magnetic resonance imaging (MRI) (10%). Other less frequent reasons were infection (9%), painful dysesthesias (9%), electrical arcing (4%), resolution of inciting symptoms (4%), weakness (2%), pseudomeningocele (1%) and muscle spasms (1%). CONCLUSION: Inadequate pain control is the most common reason for SCSES. Advances in technology are needed to improve the quality and duration of pain control, as well as to design improvements to make the hardware more comfortable. A significant number of implants are removed due to need for MRI, a fact obviating the need for MRI-compatible systems. Patients considering SCS paddle lead placement should be counseled on the most common reasons for later explantation.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1709
[Cu] Class update date: 171120
[Lr] Last revision date:171120
[St] Status:Publisher
[do] DOI:10.1111/papr.12639

  7 / 756 MEDLINE  
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[PMID]: 28850441
[Au] Autor:Satteson ES; Harbour PW; Koman LA; Smith BP; Li Z
[Ad] Address:Department of Plastic & Reconstructive Surgery, Wake Forest School of Medicine, Medial Center Boulevard, Winston-Salem, NC 27157, United States. Electronic address: estolle@wakehealth.edu.
[Ti] Title:The risk of pain syndrome affecting a previously non-painful limb following trauma or surgery in patients with a history of complex regional pain syndrome.
[So] Source:Scand J Pain;14:84-88, 2017 Jan.
[Is] ISSN:1877-8879
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND AND PURPOSE: Complex regional pain syndrome (CRPS) is a challenging complication after surgery or trauma. This study sought to determine the incidence of CRPS after a second inciting event in a previously unaffected extremity in patients with a history of an ongoing CRPS diagnosis in another extremity. METHODS: A retrospective review identified patients with CRPS seen in clinic over a 20-month period. The incidence of CRPS after subsequent surgery or injury in a previous unaffected extremity was determined and compared to an average incidence reported in the literature. RESULTS: Ninety-three patients had a diagnosis of primary CRPS. Nineteen (20.4%) developed CRPS in one or more additional extremity compared to the incidence of 23.4 per 100,000 (0.0234%) in the literature (odds ratio 1069.6, p<0.0001, 95% CI 562.0-2035.7). Twenty patients had a documented secondary injury or surgery in a second extremity. Fifteen (75%) developed secondary CRPS compared to a CRPS incidence rate of 6.4% following distal radius fracture, as determined by literature review (odds ratio 11.7, p<0.001, 95% CI 5.9-23.2). CONCLUSIONS: These result suggest that patients with a history of CRPS are more likely to develop secondary CRPS compared to the rates reported in the literature among the general population. IMPLICATIONS: Patients with a history of CRPS should be counselled that they may be at risk for developing secondary CRPS if they undergo surgery or sustain trauma to another extremity.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1708
[Cu] Class update date: 170829
[Lr] Last revision date:170829
[St] Status:In-Data-Review

  8 / 756 MEDLINE  
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[PMID]: 28691184
[Au] Autor:Petersen PB; Mikkelsen KL; Lauritzen JB; Krogsgaard MR
[Ad] Address:Section for Sports Traumatology M51, Bispebjerg-Frederiksberg Hospital (Part of IOC Research Center Copenhagen), University of Copenhagen, Copenhagen, Denmark.
[Ti] Title:Risk Factors for Post-treatment Complex Regional Pain Syndrome (CRPS): An Analysis of 647 Cases of CRPS from the Danish Patient Compensation Association.
[So] Source:Pain Pract;, 2017 Jul 10.
[Is] ISSN:1533-2500
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:OBJECTIVES: Complex regional pain syndrome is a challenging condition that includes a broad spectrum of sensory, autonomic, and motor features predominantly in extremities recovering from a trauma. Few large-scale studies have addressed occurrence of and factors associated with complex regional pain syndrome (CRPS) following orthopedic treatment. The present study aimed to identify factors associated with post-treatment development of CRPS. METHODS: Using the Danish Patient Compensation Association's database, we identified 647 patients claiming post-treatment CRPS between 1992 and 2015. Age, gender, initial diagnosis, treatment, and amount of compensation were extracted. Multivariate logistic regressions were performed to identify variables associated with approval of the claim. For carpal tunnel syndrome (CTS) patients, we registered whether symptoms were bilateral or unilateral and if neurophysiology prior to treatment was pathologic. RESULTS: The following ratios were found: women:men was 4:1, primary diagnosis to the upper limb:lower limb was 2.5:1, and surgical:nonsurgical treatment was 3:1. Mean age was 47.5 ± 13.7 years, and no intergender difference was detected. Antebrachial fracture (23%) and CTS (9%) were the most common primary conditions. Surgical treatment was associated with approval of the claim (odds ratio 3.5, 95% confidence interval 2.3 to 5.3; P < 0.001). Half of CTS patients had normal neurophysiology prior to surgery; among patients with unilateral symptoms, 71.4% had normal neurophysiology. CONCLUSIONS: Female gender, surgical treatment, and treatment to the upper limb were risk factors. Elective surgery accounted for a large number of post-treatment CRPS patients. In CTS patients developing CRPS, normal neurophysiological examination findings were common, and it could be suspected that these patients were suffering from an pre-clinical stage of CRPS, not CTS.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1707
[Cu] Class update date: 170923
[Lr] Last revision date:170923
[St] Status:Publisher
[do] DOI:10.1111/papr.12610

  9 / 756 MEDLINE  
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[PMID]: 28638296
[Au] Autor:Narouze S; Souzdalnitski D
[Ad] Address:Center for Pain Medicine, Western Reserve Hospital, Cuyahoga Falls, OH.
[Ti] Title:Ultrasound-Guided Percutaneous Cervical and Upper Thoracic Sympathetic Chain Neuromodulation for Upper Extremity Complex Regional Pain Syndrome.
[So] Source:Ochsner J;17(2):199-203, 2017.
[Is] ISSN:1524-5012
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Complex regional pain syndrome (CRPS) comprises a group of conditions characterized by severe, debilitating pain that is disproportionate to any inciting event and is not distributed in a specific nerve distribution or dermatome. CASE REPORT: A 42-year-old female with a 2-year history of right upper extremity CRPS type I refractory to conventional management underwent an ultrasound-guided and fluoroscopy confirmed percutaneous peripheral nerve stimulation trial with a lead extending from the C6 to the T3 level to cover the cervical and upper thoracic sympathetic chain. The patient subsequently received a permanent ultrasound-guided lead and implantable pulse generator. At 1-month follow-up, the patient's pain intensity had declined from a weekly average of 8/10 to 1/10 on the verbal pain scale with marked improvement in function. The patient continues to be pain-free or experiences only minimal discomfort 7 years after the implant. She experienced no complications and has discontinued all her pain medications since the implant. CONCLUSION: The placement of a peripheral nerve-stimulating electrode resulted in sustained suppression of intractable pain secondary to CRPS. Ultrasonography guidance enabled the nonsurgical minimally invasive percutaneous approach. Use of ultrasonography may improve the safety of the procedure by permitting direct visualization of the related anatomic structures, thereby reducing the risk of injury to the inferior thyroid artery, vertebral artery, esophagus, intervertebral disc, and pleura.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1706
[Cu] Class update date: 170816
[Lr] Last revision date:170816
[St] Status:PubMed-not-MEDLINE

  10 / 756 MEDLINE  
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[PMID]: 28549447
[Au] Autor:Yin Y; Zhang L; Xiao H; Wen CB; Dai YE; Yang G; Zuo YX; Liu J
[Ad] Address:Department of Pain management, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, People's Republic of China.
[Ti] Title:The pre-amputation pain and the postoperative deafferentation are the risk factors of phantom limb pain: a clinical survey in a sample of Chinese population.
[So] Source:BMC Anesthesiol;17(1):69, 2017 May 26.
[Is] ISSN:1471-2253
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:BACKGROUND: To provide an overview of phantom limb pain (PLP) in China. This includes the prevalence of PLP and possible risk factors. METHODS: In a retrospective study, telephone interviews were conducted with 391 amputation patients who underwent extremity amputations at a tertiary hospital in China. RESULTS: PLP was found in 29% of the amputees. Pre-amputation pain (OR = 10.4, P = 0.002) and postoperative analgesia (OR = 4.9, P = 0.008) were identified as high-risk factors for PLP. 82.1% of PLP patients experienced pre-amputation pain. The average pain intensity of PLP was 5.1 ± 2.2, with 31.9% having severe intensity. The effects of PLP on the quality of the PLP patients were as follows: 7.8% of the patients had to limit their daily life and 29.0% of the patients had to limit their social activities. 17.3 and 25.7% of patients experienced depression and sleeping disorder respectively, while 18.9% had loss of interest and even 16.1% of PLP patients had attempted suicide. No effective treatments were found in 78.9% of these patients. CONCLUSIONS: PLP has markedly affected the lives of patients. Pre-amputation pain and postoperative epidural analgesia might be risk factors for the phantom limb pain after amputation. Prevention of pre-amputation pain and sudden post-amputation deafferentation should be recommended to the amputees.
[Mh] MeSH terms primary: Amputation
Causalgia/complications
Phantom Limb
[Mh] MeSH terms secundary: Adult
Aged
Aged, 80 and over
China
Female
Humans
Interviews as Topic
Male
Middle Aged
Pain Measurement
Postoperative Complications
Retrospective Studies
Risk Factors
Young Adult
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1711
[Cu] Class update date: 171107
[Lr] Last revision date:171107
[Js] Journal subset:IM
[Da] Date of entry for processing:170528
[St] Status:MEDLINE
[do] DOI:10.1186/s12871-017-0359-6


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