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Pain Secondary (pain + secondary)

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Medical Sciences	100%

Selected Abstracts

Correlation between radiculalgia and counts of T lymphocyte subsets in the peripheral blood of patients with lumbar disc herniation

ORTHOPAEDIC SURGERY, Issue 4 2009
Peng Tian MD
Objective:, To determine the correlation between the degree of radiculalgia and counts of T lymphocyte subsets in the peripheral blood of patients with lumbar disc herniation. Methods:, Forty-nine patients with lumbar disc herniation (group A) were divided into three subgroups according to Visual Analogue Scale (VAS) pain scores (group A1: n= 12, VAS 0,4.0; A2: n= 24, VAS 4.1,7.0; A3: n= 13, VAS 7.1,10.0. Twenty health blood donors who volunteered to be involved in the study comprised the control group (group B). Peripheral blood counts of various T lymphocyte subsets were measured in each group. Results:, (i) The counts of CD4+ T and CD4+/CD8+ lymphocytes were higher in group A than in group B, and the difference between the two groups was statistically significant (P < 0.05). There were also statistically significant differences between group A and group B in the counts of CD3+ and CD8+ T lymphocytes (P < 0.05); (ii) There was no correlation between the VAS scores and the counts of CD3+ T lymphocytes (r= 0.194, P > 0.05). A strong significant correlation was observed between the VAS scores and counts of CD4+ T lymphocytes (r= 0.542, P < 0.05), CD4+/CD8+ (r= 0.468, P < 0.05), which increased with increasing VAS scores in the three subgroups of group A (P < 0.05). However there was a significant negative linear correlation between CD8+ T lymphocyte counts and pain scores (r=,0.462, P < 0.05). Conclusion:, Our results suggest that changes in T lymphocyte subsets in peripheral blood take place after prolapse of lumbar intervertebral discs. The current results may provide support for involvement of immunologic mechanisms in low back pain secondary to herniation of the lumbar disc. T lymphocytes may play an important role in the development of symptoms in patients with lumbar intervertebral disc herniation. [source]

Trans-facet Joint Approach to Pulsed Radiofrequency Ablation of the L5 Dorsal Root Ganglion in a Patient with Degenerative Spondylosis and Scoliosis

PAIN PRACTICE, Issue 3 2008
David Abejón MD, FIPP
,,Abstract: Mechanical low back pain secondary to degenerative facet joint changes is a common reason for referral to pain clinics. When these changes cause encroachment into the intervertebral foramen, radicular pain may result. While pulsed radiofrequency of the dorsal root ganglion can be used in this setting, the anatomic deformity may make the transforaminal approach difficult. We report a case where a trans-facet approach was used successfully and describe the technique.,, [source]

Median Arcuate Ligament Syndrome,A Novel Treatment Using an Intrathecal Morphine Pump to Relieve Intractable Visceral Pain

PAIN PRACTICE, Issue 2 2008
Oren T. Guttman MD
,,Abstract Purpose: Median arcuate ligament syndrome, which presents with intractable visceral pain, is difficult to both diagnose and treat. This case report describes the first use of an intrathecal morphine pump as an effective therapeutic intervention. Clinical features: We describe a 39-year-old female who presented with a four-year history of misdiagnosed debilitating abdominal pain. After multiple failed attempts at medical management and surgeries, a trial of intrathecal narcotics provided significant relief. Six months after insertion of an intrathecal morphine pump, the patient was pain-free and had resumed all activities of daily living. Conclusion: The use of an intrathecal narcotic pump should be considered for treatment of patients with intractable visceral pain secondary to median arcuate ligament syndrome.,, [source]

Using gabapentin to treat failed back surgery syndrome caused by epidural fibrosis: A report of 2 cases. (University of Pennsylvania Health System, School of Medicine, Pennsylvania, PA).

PAIN PRACTICE, Issue 4 2001
Arch Phys Med Rehabil.
Failed back surgery syndrome (FBSS) is a long-lasting often disabling, and relatively frequent (5% to 10%) complication of lumdosacral spine surgery. Epidural fibrosis is among the most common causes of FBSS, and it is often recalcitrant to treatment. Repeated surgery for fibrosis has only a 30% to 35% success rate, whereas 15% to 20% of patients report worsening of their symptoms. Long-term outcome studies focusing on pharmacologic management of chronic back pain secondary to epidural fibrosis are lacking in the literature. This report presented 2 cases of severe epidural fibrosis managed successfully with gabapentin monotherapy. In both cases, functional status improved markedly and pain was significantly diminished. Gabapentin has an established, favorable safety profile and has been shown to be effective in various animal models and human studies of chronic neuropathic pain. Conclude clinicians should consider gabapentin as a pharmacological treatment alternative in the management of FBSS caused by epidural fibrosis. [source]