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Spinal Pain (spinal + pain)

Distribution by Scientific Domains

Medical Sciences	100%

Kinds of Spinal Pain

cervical spinal pain

Selected Abstracts

The Incidence of Spontaneous Epidural Abscess in Olmsted County from 1990 Through 2000: A Rare Cause of Spinal Pain

PAIN MEDICINE, Issue 4 2007
Anne E. Ptaszynski MD
ABSTRACT Objective., The primary objective of this study is to determine the population-based incidence of spontaneous epidural abscess. The secondary objective is to characterize the clinical course of patients with this rare infectious disease. Design., The records-linkage system of the Rochester Epidemiology Project was used to identify incident cases of spontaneous epidural abscess in residents of Olmsted County, Minnesota, USA, from 1990 through 2000. Setting., Tertiary referral medical center. Patients., All patients were residents of Olmsted County and had spontaneous epidural abscesses that were radiographically or surgically confirmed. Results., Eight patients, including six women, were identified and the mean age was 56 years (range, 40,80). The incidence of epidural abscess was 0.88 cases per 100,000 person-years (95% confidence interval, 0.27,1.48). The median time from symptom onset to diagnosis was 18 days (interquartile range, 4,30 days). Six patients presented with spinal pain and one presented with focal neurological deficits. Risk factors were identified in all patients, including concomitant infections, diabetes mellitus, immunosuppression, and intravenous substance abuse. Staphylococcus aureus was cultured in six patients and streptococcal species were cultured in two patients. Three patients were treated surgically and five received medical treatment. One patient treated surgically and one patient treated medically had residual neurological deficits. One patient, who was immunosuppressed and received medical treatment died of pneumonia. Conclusions., This is the first published report of the population-based incidence of spontaneous epidural abscess. These findings could serve as a reference point for further epidemiological research related to this uncommon infection. [source]

Prevalence of cervical spinal pain in craniomandibular pain patients

EUROPEAN JOURNAL OF ORAL SCIENCES, Issue 2 2001
Corine M. Visscher
It has often been suggested that patients with a craniomandibular disorder (CMD) more often suffer from a cervical spine disorder (CSD) than persons without a CMD. However, in most studies no controlled, blind design was used, and conclusions were based on differing signs and symptoms. In this study, the recognition of CMD and CSD was based upon the presence of pain. The aim of this study was to determine the prevalence of cervical spinal pain in persons with or without craniomandibular pain, using a controlled, single-blind design. From 250 persons, a standardised oral history was taken, and a physical examination of the masticatory system and the neck was performed. Three classification models were used: one based on symptoms only; a second on signs only; and a third one based on a combination of symptoms and signs. The CMD patients were also subdivided in three subgroups: patients with mainly myogenous pain; mainly arthrogenous pain; and both myogenous and arthrogenous pain. Craniomandibular pain patients more often showed cervical spinal pain than persons without craniomandibular pain, independent of the classification model used. No difference in the prevalence of cervical spinal pain was found between the three subgroups of craniomandibular pain patients. [source]

Clinical tests in distinguishing between persons with or without craniomandibular or cervical spinal pain complaints

EUROPEAN JOURNAL OF ORAL SCIENCES, Issue 6 2000
Corine M. Visscher
The recognition of a craniomandibular or cervical spinal pain is usually based upon the pain complaint of the patient, reported during an oral history, and the pain responses provoked in a clinical examination. Often used clinical tests are palpation, and function tests like dynamic/static tests or active movements. The relative importance of these tests for the recognition of the musculoskeletal pain is important. Therefore, it was the aim of the present study to determine which test, or combination of tests, best discriminates between persons with or without craniomandibular and/or cervical spinal pain complaints. Two hundred and fifty persons participated. From each person, a standardized oral history was taken. Then, in a randomized order and using a blind design, physical examinations of the craniomandibular system and of the neck were performed. Forward stepwise logistic regression analyses showed that the dynamic/static tests discriminated better between persons with and without pain complaints than the other tests did. In conclusion, in studies to the coexistence of craniomandibular and cervical spinal pain, it may be a good choice to base the recognition of these disorders on the pain complaints reported in the oral history which are verified by the pain response of the dynamic/static tests. [source]

Neck pain and disability: A cross-sectional survey of the demographic and clinical characteristics of neck pain seen in a rheumatology clinic

INTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 2 2005
A.O. Frank
Summary This hospital-based cross-sectional cohort study examines the clinical and demographic features of neck pain, disability (using the Northwick Park neck pain questionnaire) and relationships to handicap in employment. Of 173 consecutive referrals to a rheumatology clinic with neck pain, 70% had neck/arm pain without neurological involvement, 13% other conditions, 11% nerve involvement and 5% other spinal pain. 141 patients (mean age 50 years) had mechanical or degenerative neck pain, of which 13% was probably work-related and 13% was trauma-related. 44 had taken sickness absence for an average of 30 weeks. Comorbidities were frequent (lumbar pain 51%). Those in work were significantly less disabled than those not working (p = 0.001) and those off sick (p < 0.01). Those reporting sleep disturbance, tearfulness and crying were significantly more disabled (p = 0.0001) than those who did not. Neck pain in secondary care is complicated by physical and emotional comorbidities. Comprehensive management requires a biopsychosocial model of care. [source]

Steroid-Responsive Meningitis-Arteritis in Dogs with Noninfectious, Nonerosive, Idiopathic, Immune-Mediated Polyarthritis

JOURNAL OF VETERINARY INTERNAL MEDICINE, Issue 3 2002
Aubrey A. Webb
Signs related to spinal pain are commonly reported in dogs with noninfectious, nonerosive, idiopathic immune-mediated polyarthritis (IMPA). This study examined the prevalence and etiology of spinal pain in these dogs through a retrospective review of 62 case records of dogs with IMPA. All dogs with IMPA and signs suggestive of spinal pain were described with regard to age, gender, breed, physical stature, location of vertebral pain, rectal temperature, and clinical laboratory findings. The prevalence of spinal pain in these dogs was 29% (18 of 62). Fourteen of the 18 dogs with spinal pain and IMPA were male. Cerebrospinal fluid (CSF) from 11 dogs with signs of spinal pain was analyzed. Five of these (46%) had concurrent steroid-responsive meningitis-arteritis (SRMA). We concluded that SRMA does occur concurrently in some dogs having IMPA. Meningeal involvement may explain the origin of spinal pain observed in some of these dogs. [source]

The Incidence of Spontaneous Epidural Abscess in Olmsted County from 1990 Through 2000: A Rare Cause of Spinal Pain

Temporary Neurologic Deficit After Cervical Transforaminal Injection of Local Anesthetic

PAIN MEDICINE, Issue 2 2004
Michael Karasek MD
ABSTRACT Objective To describe the effects of spinal cord block after injection of local anesthetic into a cervical radicular artery. Design Case report. Setting Neurology practice specializing in spinal pain. Interventions A patient underwent a C6,7 transforaminal injection. Contrast medium indicated correct and safe placement of the needle. Results After the injection of local anesthetic, the patient developed quadriplegia. The injection was terminated. The neurologic impairment resolved after 20 minutes observation. Conclusion Despite correct placement of the needle for a cervical transforaminal injection, injectate may nevertheless enter a cervical radicular artery. Whereas local anesthetic, so injected, appears to have only a temporary effect on spinal cord function, particulate steroids may act as an embolus and cause permanent impairment. [source]

The Prevalence of Facet Joint-Related Chronic Neck Pain in Postsurgical and Nonpostsurgical Patients: A Comparative Evaluation

PAIN PRACTICE, Issue 1 2008
Laxmaiah Manchikanti MD
,,Abstract Background: Facet (zygapophysial) joints may be clinically important sources of chronic cervical spinal pain. Previous studies have demonstrated the value and validity of controlled, comparative local anesthetic blocks in the diagnosis of facet joint pain, and reported an overall prevalence of 36% to 67% facet joint involvement in cervical spinal pain. The reports of lumbar facet joint-involvement in postsurgery syndrome have been shown to be highly variable with prevalence ranging from 8% to 32%. To date, however, the prevalence of postsurgical facet joint-related pain in the cervical spine has not been evaluated. In light of this, the present retrospective study was conducted to assess and compare the prevalence of chronic postsurgical facet joint cervical spinal pain to nonsurgical, chronic cervical facet joint pain. Methods: Patients presenting with chronic neck pain were studied. The procedures were performed by a single physician in an interventional pain management ambulatory surgery center. The prevalence of cervical facet joint pain in postsurgical patients was assessed and compared to nonsurgical patients. Results: A total of 251 patients (45 postsurgery vs. 206 nonsurgical patients) with chronic persistent neck pain were evaluated using controlled, comparative local anesthetic blocks in accordance with IASP criteria. The prevalence of the cervical facet joint pain and false-positive rate of single blocks in postsurgical patients were 36% and 50% compared with 39% and 43% in nonsurgical patients. Conclusions: Cervical facet joints are clinically important pain generators in a significant proportion of patients with chronic persistent neck pain after surgical intervention(s). The prevalence of cervical facet joint pain was similar in both postsurgical and nonsurgical patients.,, [source]

Technical Aspects of Radiofrequency

PAIN PRACTICE, Issue 3 2002
M. Sluijter MD
If the resulting current flows through a percutaneously introduced electrode, heat will be produced around the electrode because the body tissue acts as a resistor. RF can, therefore, be used to ablate nervous tissue in the treatment of chronic pain. This method has gained acceptance for percutaneous cordotomy and for the treatment of trigeminal neuralgia. For spinal pain, the method had little success initially, but since the introduction of small diameter instrumentation, the results have markedly improved. he mechanism of action of RF has not been challenged until recently even though there was awareness that some observations were not consistent with the heat concept. The formation of heat is not the only occurrence during RF treatment, however. The tissue surrounding the electrode is also exposed to the RF electric field. This exposure has a biological effect as has been demonstrated both in cells in a cell culture and in the exposure to RF of dorsal root ganglia, resulting in transsynaptal induction of early gene expression in the dorsal horn. The mode of action of RF is, therefore, uncertain at the moment. The method of pulsed RF is based on the concept that the production of heat has been a by-product of RF treatment and that the clinical effect is due to exposure to the electric field. In pulsed RF, the generator output is interrupted to allow for the elimination of heat in the silent period. The early results have been encouraging, but the results of controlled, prospective studies are not yet available. Since there are now 2 almost diametrically opposed views on the mode of action of RF, it is difficult to give recommendations for treatment. The decision is easy for indications for which heat RF has traditionally been contraindicated such as the treatment of peripheral nerves and trigger points. When the application of heat carries a potential risk, for instance if the dorsal root ganglion is the target structure, the use of pulsed RF is also recommended. As for the medial branch the situation is controversial. Since there are controlled studies available showing the effect of heat lesions, it is recommended that the technique should not be changed until further studies have been completed. Finally, the equipment for RF treatment is described and safety issues are discussed. [source]

ORIGINAL ARTICLE: Risk of intravascular injection in transforaminal epidural injections

ANAESTHESIA, Issue 9 2010
F. S. Nahm
Summary Transforaminal epidural injection is an effective method for treating spinal pain but can cause devastating complications that result from accidental vascular uptake of the injectate or a direct vascular injury. We prospectively evaluated the patient factors that might be associated with intravascular uptake during transforaminal epidural injections. A total of 2145 injections were performed on 1088 patients under contrast-enhanced real-time fluoroscopic guidance. The collected data included the patient's age, sex, body mass index, diagnosis, injection level, side of injection, history of spinal surgery at the targeted level, and the number of injections at the targeted site. The overall incidence of intravascular injection was 10.5% (224/2145). The highest incidence was at the cervical level (28/136; 20.6%), followed by the sacral level (111/673; 16.5%), the thoracic level (23/280; 8.2%) and the lumbar level (64/1056; 6.1%). The difference was significant for the cervical and sacral level compared with the lumbar and thoracic levels (p < 0.001). Intravascular injection was not associated with the other patient characteristics studied. [source]