U.S. to study which treatments work best
Irregular heartbeat. Prostate cancer. Back pain. Hearing loss. The government is about to spend millions to try to uncover the best treatments for scores of ailments — and how to handle these four biggies leads a list of top 100 questions that... (Source: OrlandoSentinel: Medical Research)...
POSTED 06/30/2009 at 06:00 PM --
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Synaptically evoked glutamate transporter currents in Spinal Dorsal Horn Astrocytes
Conclusion: These results suggest that glutamate transporters of spinal astrocytes could be activated by synaptic activation, and recording glutamate transporter currents may provide a means of examining the real time physiological responses of glial cells in spinal sensory processing, sensitization, hyperalgesia and chronic pain. (Source: BioMed Central)...
POSTED 06/30/2009 at 06:00 PM --
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Inter-rater Reliability of Three Musculoskeletal Physical Examination Techniques Used to Assess Motion in Three Planes While Standing
Conclusions: The inter-rater reliability for 3 basic maneuvers of the Total Body Functional Profile is good among musculoskeletal health care providers of different disciplines. These 3 maneuvers may be used consistently as part of the musculoskeletal physical examination. (Source: PM&R)...
POSTED 06/30/2009 at 06:00 PM --
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The Rate of Detection of Intravascular Injection in Cervical Transforaminal Epidural Steroid Injections With and Without Digital Subtraction Angiography
Conclusions: The use of DSA improves the detection rate of intravascular injection during CTFESIs. (Source: PM&R)...
POSTED 06/30/2009 at 06:00 PM --
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Degenerative disc and vertebral disease – basic sciences
This article summarizes the pathophysiology of spinal degeneration from a mechanistic basic sciences viewpoint, emphasizing the interdependence of discs and vertebrae. Intervertebral disc degeneration differs from normal ageing by involving physical disruption, typically in the form of annular fissures, prolapse or endplate fracture. Frustrated attempts to heal this large avascular tissue give rise to the typical biological features of disc degeneration. Discogenic pain appears to arise from the disc periphery as a result of nerve sensitization phenomena involving displaced nucleus pulposus. A degenerated disc loses pressure in the nucleus and bulges radially, like a flat tyre. This often leads to a transient segmental instability, which can be reversed by vertebral body osteophytosis. Ann......
POSTED 06/30/2009 at 06:00 PM --
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Degenerative disc and vertebral disease – clinical
Abstract: Low back pain, disc prolapse and spinal stenosis are the three principal clinical problems in the lumbar spine. Prompt clinical triage in low back pain will allow early active management, with improved results. The specificity and sensitivity of the ‘red flags’ has been described, and in conjunction with formal review of patients allows sufficient clinical confidence. Recent National Institute for Health and Clinical Excellence guidelines have provided significant advances in back pain management. Spinal fusion for low back pain has a role in precisely defined circumstances. New research into intervertebral disc prolapse has also clarified the place of early surgery in providing more rapid improvements in pain and disability, with a significant reduction in the ‘area under ......
POSTED 06/30/2009 at 06:00 PM --
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Spinal infections
Abstract: Infection of the spine with pyogenic and non-pyogenic organisms causes significant morbidity and mortality if not recognized and treated appropriately. Careful assessment of patients with back pain who present to primary and secondary care is essential to distinguish those with insidious progression of spinal infection from benign spinal pathology. Multiple investigations, both haematological and radiological, are necessary in the investigation of the patient with a suspected infection of the spine. A combination of microbiological treatment and appropriately timed surgical intervention to address neurological compromise and mechanical failure is paramount in ensuring the best possible outcome. (Source: Surgery (Medicine Publishing))...
POSTED 06/30/2009 at 06:00 PM --
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Genetic variation in the serotonin transporter gene (5-HTTLPR, rs25531) influences the analgesic response to the short acting opioid Remifentanil in humans
Background:
There is evidence from animal studies that serotonin (5-HT) can influence the antinociceptive effects of opioids at the spinal cord level. Therefore, there could be an influence of genetic polymorphisms in the serotonin system on individual variability in response to opioid treatment of pain. The serotonin transporter (5-HTT) is a key regulator of serotonin metabolism and availability and its gene harbors several known polymorphisms that are known to affect 5-HTT expression (e.g. 5-HTTLPR, rs25531). The aim of this study was to investigate if the triallelic 5-HTTLPR influences pain sensitivity or the analgesic effect of opioids in humans. 43 healthy volunteers (12 men, 31 women, mean age 26 years) underwent heat pain stimulations before and after intravenous injection of Remife......
POSTED 06/30/2009 at 06:00 PM --
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Report Sets Priorities for Funding Effectiveness Research
HOUSTON (MedPage Today) -- Treatments for atrial fibrillation, localized prostate cancer, and low back pain should be among the government's top effectiveness research priorities, while smoking cessation, migraine, and osteoarthritis are much farther down on the list, according to a new report. (Source: MedPage Today Public Health)...
POSTED 06/30/2009 at 05:49 PM --
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Spinal Fusion Agent Raises Costs, Complication Rates (CME/CE)
PRINCETON, N.J. (MedPage Today) -- A bone growth agent increasingly used during spinal fusion operations raises medical costs and the risk of complications related to anterior cervical fusion surgery, according to a new study. (Source: MedPage Today Pain Management)...
POSTED 06/30/2009 at 03:00 PM --
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Which Treatment Works Best? Top Study Needs Listed
Irregular heartbeat. Prostate cancer. Back pain. Hearing loss. The government is about to spend millions to try to uncover the best treatments for scores of ailments -- and how to handle these four biggies leads a list of top 100 questions that doctors need answered. (Source: WDSU.com - Health)...
POSTED 06/30/2009 at 01:00 PM --
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Bone agent linked to complications in neck surgeries, higher costs in spinal fusions
CHICAGO (AP) — A bone growth agent used in thousands of spinal fusion surgeries for neck pain has been linked to complications and higher cost, according to the first nationwide study of the product.
Safety questions arose last year about the... (Source: OrlandoSentinel: Medical Research)...
POSTED 06/30/2009 at 07:03 AM --
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Sciatic nerve injury induces apoptosis of dorsal root ganglion satellite glial cells and selectively modifies neurosteroidogenesis in sensory neurons
Neurosteroids are synthesized either by glial cells, by neurons, or within the context of neuron-glia cross-talk. Various studies suggested neurosteroid involvement in the control of neurodegeneration but there is no evidence showing that the natural protection of nerve cells against apoptosis directly depends on their own capacity to produce neuroprotective neurosteroids. Here, we investigated the interactions between neurosteroidogenesis and apoptosis occurring in sensory structures of rats subjected to neuropathic pain generated by sciatic nerve chronic constriction injury (CCI). Using the terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL), we observed no apoptotic cells in the spinal cord up to 30 days after CCI although pain symptoms such as mechano-allodyni......
POSTED 06/29/2009 at 06:00 PM --
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PKCepsilon-dependent potentiation of TTX-resistant Nav1.8 current by neurokinin-1 receptor activation in rat dorsal root ganglion neurons
Conclusions:
These data suggest that activation of NK-1 receptor potentiates Nav1.8 sodium current via PKCepsilon-dependent signaling pathway, probably participating in the generation of inflammatory hyperalgesia. (Source: Molecular Pain)...
POSTED 06/29/2009 at 06:00 PM --
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Adding Gabapentin to a multimodal regimen does not reduce acute pain, opioid consumption or chronic pain after total hip arthroplasty
Gabapentin (GPN) is effective in reducing post-operative pain and opioid consumption, but its effects with regional anesthesia for total hip arthroplasty (THA) are not known. We designed this study to determine whether (1) gabapentin administration reduces pain and opioid use after THA using a multimodal analgesic regimen including spinal anesthesia; (2) pre-operative administration of gabapentin is more effective than post-operative administration. After REB approval and informed consent, 126 patients were enrolled in a double-blinded, randomized-controlled study. Patients received acetaminophen 1 g per os (p.o.), celecoxib 400 mg p.o. and dexamethasone 8 mg intravenously, 1[ndash]2 h pre-operatively. Patients were randomly assigned to one of three treatment groups (G1: Placebo/Placebo; G......
POSTED 06/29/2009 at 06:00 PM --
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ORIGINAL CONTRIBUTION: Prevalence, Complications, and Hospital Charges Associated With Use of Bone-Morphogenetic Proteins in Spinal Fusion Procedures
Conclusion Bone-morphogenetic protein was used in approximately 25% of all spinal fusions nationally in 2006, with use associated with more frequent complications for anterior cervical fusions and with greater hospital charges for all categories of fusions. (Source: JAMA)...
POSTED 06/29/2009 at 06:00 PM --
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Postural control in patients with lumbar disc herniation in the early postoperative period
Abstract Chronic spinal disc disease leads to disorders in postural movement coordination. An incorrect asymmetrical movement pattern
for the lower limbs loading impairs proprioception and deteriorates postural stability, particularly when the vision is occluded.
The standard surgical treatment improves biomechanical conditions in the lumbar spine, reduces pain, yet does it reduce the
stability deficit in the upright position? An answer to the latter question would help work out targeted therapy to improve
postural stability. We hypothesized that the standard surgical treatment would improve postural stability reflected by decreased
sway variability accounting for better use of proprioceptive inputs postoperatively. Thirty-nine patients with lumbar disc
herniation particip......
POSTED 06/29/2009 at 05:13 AM --
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Interspinous implants (X Stop®, Wallis®, Diam®) for the treatment of LSS: is there a correlation between radiological parameters and clinical outcome?
Abstract Neurogenic intermittent claudication, caused by lumbar spinal stenosis (LSS), usually occurs after the age of 50 and is one
of the most common degenerative spinal diseases in the elderly. Among patients over the age of 65 with LSS, open decompression
is the most frequently performed spinal operation. The recently introduced interspinous spacers are a new alternative under
discussion. In this retrospective study, we reviewed medical records and radiographs of patients with LSS and NIC treated
from June 2003 to June 2007. All included patients (n = 129) were treated with interspinous implants (X Stop® Wallis®, or Diam®). Evaluations of pain, using a visual analog scale (VAS), and radiographic signs, using two-plane X-rays of the lumbar spine,
were perfor......
POSTED 06/29/2009 at 05:13 AM --
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Effects of gender and cognitive-behavioral management of depressive symptoms on rehabilitation outcome among inpatient orthopedic patients with chronic low back pain: a 1 year longitudinal study
In this study,
a standard rehabilitation program for patients with CLBP and depressive symptoms was compared to a standard rehabilitation,
into which a cognitive-behavioral management training of depressive symptoms was integrated. Moreover, treatment effects of
this multidisciplinary standard rehabilitation program delivered to patients with either no or only mild depressive symptoms
were investigated. As a further aim of the present study, gender effects on rehabilitation outcomes were examined. Short-,
mid-, and long-term effects on individual global improvement as well as pain-related, psychological, and work-related measures
were evaluated among N = 199 consecutively admitted patients with CLBP, aged from 24 to 62 years. The standard rehabilitation program had no ......
POSTED 06/29/2009 at 05:13 AM --
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A systematic medline analysis of therapeutic approaches in ankylosing spondylitis
Abstract Ankylosing spondylitis (AS) is a chronic inflammatory disorder involving the sacroiliac joints (SIJs), spine and less frequently
the peripheral joints. Traditionally, it is well recognised that AS is a challenging disease to manage due to the lack of
effective therapeutic options. Current evidence would suggest this has changed and there are now a number of therapies available
that provide persistent control of inflammatory symptoms with improvement in daily function. NSAIDs remain the first step
in patient treatment. Sulphasalazine may be effective in peripheral arthritis and there are emerging data to support its use
in early inflammatory back pain. Studies have shown that pamidronate and steroid injection into SIJ have a symptom-modifying
effect in AS. Current ......
POSTED 06/29/2009 at 04:59 AM --
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