Abstract:
BACKGROUND:Extensive decompression with laminectomy, where appropriate, is often still described as the method of choice when operating on degenerative lumbar spinal stenosis. Nonetheless, tissue-sparing procedures are becoming more common. Endoscopic techniques have become the standard in many areas because of the surgical advantages they offer and the benefits for rehabilitation. One key issue when operating on the spine was the development of instruments to provide sufficient bone resection under continuous visual control. This was achieved by using endoscopes for operations carried out in cases of spinal canal stenosis. OBJECTIVE:This study of patients with degenerative lumbar central spinal stenosis compares the results of spinal decompression using the full-endoscopic interlaminar technique (FI) with a conventional microsurgical laminotomy technique (MI). STUDY DESIGN:Prospective, randomized, controlled study. SETTINGS:135 patients with microsurgical or full-endoscopic decompression were followed up for 2 years. Alongside general and specific parameters, the following measuring instruments were also used for the investigation: Visual Analog Scale (VAS), German version of the North American Spine Society Instrument (NASS), Oswestry Low-Back-Pain-Disability Questionnaire (ODI). RESULTS:Postoperatively 72 % of the patients no longer had leg pain or the pain was almost completely reduced and 21.2 % experienced occasional pain. The clinical results were the same in both groups. The rate of complications and revisions was significantly reduced in the FI Group. The full-endoscopic techniques brought advantages in the following areas: operation, complications, traumatization, rehabilitation. LIMITATIONS:Lack of placebo control group. CONCLUSIONS:The recorded results demonstrate that the full-endoscopic interlaminar bilateral decompression adopting a unilateral approach provides an adequate and safe supplement and alternative to the conventional microsurgical bilateral laminotomy technique when the indication criteria are fulfilled. At the same time, it offers the advantages of a minimally invasive intervention.
journal_name
Pain Physicianjournal_title
Pain physicianauthors
Komp M,Hahn P,Oezdemir S,Giannakopoulos A,Heikenfeld R,Kasch R,Merk H,Godolias G,Ruetten Ssubject
Has Abstractpub_date
2015-01-01 00:00:00pages
61-70issue
1eissn
1533-3159issn
2150-1149journal_volume
18pub_type
杂志文章,随机对照试验相关文献
Pain Physician文献大全abstract:BACKGROUND:Peripheral neuromodulation is often used as chronic neuropathic pain treatment. Percutaneous electrical nerve stimulation (PENS) is generally utilized with several probes at the same time and repeated treatments. OBJECTIVES:Evaluate the short- and long-term efficacy of a single probe and single shot PENS ap...
journal_title:Pain physician
pub_type: 杂志文章,多中心研究
doi:
更新日期:2016-01-01 00:00:00
abstract:BACKGROUND:Post-dural puncture headache (PDPH) is the most common complication of procedures in which the dura mater is penetrated. OBJECTIVES:To evaluate the effectiveness of caudal saline injections as a therapeutic approach for handling post-dural puncture headache. STUDY DESIGN:Prospective observational study bet...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2011-05-01 00:00:00
abstract:BACKGROUND:Glucocorticoids adversely affect bone mineral density (BMD) and increase the risk of fracture. Yet, the cause-and-effect relationship between epidural steroid injection (ESI) and BMD has not been thoroughly investigated, and available results are inconsistent. This is probably a consequence of differences in...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2018-07-01 00:00:00
abstract:BACKGROUND:Low back pain (LBP) is a heterogeneous disorder including patients with dominant nociceptive (e.g., myofascial low back pain), neuropathic (e.g., lumbar radiculopathy), and central sensitization pain. In order to select an effective and preferably also efficient treatment in daily clinical practice, LBP pati...
journal_title:Pain physician
pub_type: 杂志文章,评审
doi:
更新日期:2015-05-01 00:00:00
abstract:BACKGROUND:Palliative radiation therapy (RT) is an established tool in the management of symptoms caused by malignancies. RT is effective at palliating both locally advanced and metastatic cancer, including related symptoms of pain, bleeding, or obstruction. Most data on palliative RT is in regard to its use in the tre...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2007-03-01 00:00:00
abstract:BACKGROUND:Vertebral compression fractures are common among the elderly, which is conditioned by osteoporosis. They cause back pain and limit the patient's activities. The Kiva® VCF Treatment System is a new device to treat vertebral compression fractures. Compared to other methods, the utilization of the Kiva System r...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2013-09-01 00:00:00
abstract:BACKGROUND:Elderly patients in general exhibit a higher incidence of chronic and neuropathic pain conditions. This group poses a particular clinical challenge due to age-related pharmacokinetic and pharmacodynamic issues, comorbid conditions, and polypharmacy, as well as frailty and cognitive decline. Poor control of p...
journal_title:Pain physician
pub_type: 杂志文章,评审
doi:
更新日期:2015-09-01 00:00:00
abstract:BACKGROUND:Regenerative medicine is a medical subspecialty that seeks to recruit and enhance the body's own inherent healing armamentarium in the treatment of patient pathology. This therapy's intention is to assist in the repair, and to potentially replace or restore damaged tissue through the use of autologous or all...
journal_title:Pain physician
pub_type: 杂志文章,实务指引
doi:
更新日期:2019-01-01 00:00:00
abstract::Cervical interlaminar epidural steroid injections (ESIs) are commonly performed as one part of a multi-modal analgesic regimen in the management of upper extremity radicular pain. Spinal epidural hematoma (SEH) is a rare complication with a reported incidence ranging from 1.38 in 10,000 to 1 in 190,000 epidurals. Curr...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2014-05-01 00:00:00
abstract:BACKGROUND:The increase in the utilization of various techniques in managing chronic pain, including interventional techniques, is a major concern for policy-makers and the public at large. Consequently, multiple regulations have been instituted to reduce health care expenditures in general and expenditures related to ...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2016-05-01 00:00:00
abstract::Proper coding and documentation for evaluation and management services continuously and progressively are becoming not only complicated, but also confusing. Although medical evaluation of patients has been a fact of life since the beginnings of medical history, medicine has been substantially influenced by federal reg...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2000-07-01 00:00:00
abstract:BACKGROUND:Cervicogenic headache descriptors include its unilateral nature, "signs and symptoms linking it to the neck," and trauma of the neck. Since the pain often occurs over the C2 or C3 nerve root, we used a modification of the deep cervical block technique for treatment of this refractory type headache. OBJECTIV...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2008-11-01 00:00:00
abstract::The lifetime prevalence of spinal pain has been reported as 65% to 80% in the neck and low back. In the US each year, 500,000 - 1,000,000 spine surgeries and 2 to 5 million interventional procedures are estimated to be performed. The burden created by chronic pain is enormous on the patient and society. Thus, the soma...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2003-10-01 00:00:00
abstract:BACKGROUND:Over the last decade various guidelines for quality assurance in pain medicine have been published for cancer pain, acute postoperative pain and other pain conditions. However, quality assurance for interventional pain management procedures has yet to be addressed. An interventional pain program should at le...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2006-04-01 00:00:00
abstract:BACKGROUND:Gonadal hormones are critical factors in modulating the experience of pain, as suggested by the several sex differences observed: women have a greater risk of many clinical pain conditions, and postoperative and procedural pain may be more severe in them than in men. A growing body of literature demonstrates...
journal_title:Pain physician
pub_type: 杂志文章,评审
doi:
更新日期:2012-07-01 00:00:00
abstract::Complex regional pain syndrome (CRPS) is a chronic, debilitating, neuropathic pain condition which is often misdiagnosed, difficult to manage, and lacks proven methods for remission. Most available methods provide some relief to a small percentage of patients. Recent FDA approval and superiority of the Nevro Senza 10-...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2017-01-01 00:00:00
abstract:BACKGROUND:This case report identifies a patient with complex regional pain syndrome Type 2 (causalgia) with sympathetically maintained pain in a distal extremity associated with an anterior sacroiliac fusion with local bone graft. CASE DESCRIPTION:A sacroiliac fusion was undertaken due to chronic back pain that was t...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2005-07-01 00:00:00
abstract::Digital subtraction angiography (DSA) has been touted as a radiologic adjunct to interventional neuraxial procedures where it is imperative to identify vascular compromise during the injection. Transforaminal epidural steroid injections (TFESI) are commonly performed interventions for treating acute and chronic radicu...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2012-11-01 00:00:00
abstract::Clinical outcome data was analyzed for 67 patients with contained disc herniation who underwent percutaneous disc decompression procedure using Coblation(R) technology, also referred to as Nucleoplasty after failing to respond to conservative management. Patients presented with clinical symptoms of discogenic low back...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2002-07-01 00:00:00
abstract:BACKGROUND:The activation of mitogen-activated protein kinases (MAPKs) have been observed in synaptic plasticity processes of learning and memory in neuropathic pain. Cerebrospinal fluid-contacting nucleus (CSF-CN) has been identified with the onset and persistence of neuropathic pain. However, whether extracellular si...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2015-11-01 00:00:00
abstract:BACKGROUND:Corticosteroids have been used for the past 70 years in the treatment of various musculoskeletal conditions. This includes its use for joint pain such as rheumatoid arthritis and osteoarthritis. OBJECTIVES:A narrative review of the literature from its initial discovery to the present day to summarize the re...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2021-01-01 00:00:00
abstract:BACKGROUND:Recently, transforaminal balloon adhesiolysis was introduced to manage patients with chronic radicular pain occurring with or without low back pain. However, the factors associated with successful responses to transforaminal balloon adhesiolysis are not known. OBJECTIVE:To evaluate the factors associated wi...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2017-09-01 00:00:00
abstract::In this brief study we provide evidence that earlier and more recent findings pertaining to the anatomy and physiology of the sacroiliac joint suggest that dysfunction in this joint could, similar to a herniated lumbar disc, produce pain along the sciatic nerve. These observations might explain some of the cases of sc...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2003-07-01 00:00:00
abstract:BACKGROUND:Degenerative spondylolisthesis is one of the major causes for low back pain. Morphological abnormalities of the zygapophysial joints are a predisposing factor in the development of degenerative spondylolisthesis. Therefore, radiofrequency neurotomy seems to be a rational therapy. OBJECTIVES:To determine if ...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2012-01-01 00:00:00
abstract::The effectiveness of splanchnic nerve neurolysis (SNN) for cancer-related abdominal pain has been investigated using numeric pain intensity rating as an outcome variable. The outcome variable in this study used the grid method for obtaining a targeted pain drawing score on 60 patients with pain from pancreatic or gast...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2016-07-01 00:00:00
abstract:BACKGROUND:Throughout the COVID-19 pandemic, clinicians have had to think quickly, adapt to changing recommendations sometimes on a daily basis, and have often had to rely on trial-and-error-based treatment protocols under various conditions. As we move on past the apex of the COVID-19 curve, new treatment protocols fo...
journal_title:Pain physician
pub_type: 杂志文章,评审
doi:
更新日期:2020-08-01 00:00:00
abstract:BACKGROUND:A superior hypogastric plexus block is difficult to perform and hampered by bony structures of the iliac crest and transverse process of L5. OBJECTIVE:We report on a fluoroscopically guided posterolateral transdiscal technique for superior hypogastric plexus neurolysis using a single needle. STUDY DESIGN:A...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2018-07-01 00:00:00
abstract:BACKGROUND:Lumbar selective nerve root blocks have been performed to establish the origin of lumbar radiculopathy in clinically difficult cases. The diagnostic ability of selective nerve root blocks remains controversial because of concern over potential spread of an injectate onto adjacent structures. OBJECTIVE:To in...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2007-05-01 00:00:00
abstract:BACKGROUND:Among the multiple modalities of treatments available in managing chronic spinal pain, including surgery and multiple interventional techniques, epidural injections by various routes, such as interlaminar epidural injections, caudal epidural injections, transforaminal epidural injections, and percutaneous ad...
journal_title:Pain physician
pub_type: 临床试验,杂志文章
doi:
更新日期:2012-03-01 00:00:00
abstract::Zygapophysial or facet joints have been implicated as cause of low back, mid back, upper back and neck pain with referred pain. Cervical, thoracic and lumbar facet joints are innervated by the medial branches of the dorsal rami. Zygapophysial (facet) joints have been implicated as the source of chronic pain in 15% to ...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2002-10-01 00:00:00