Publications by authors named "Ricardo Buenaventura"

Article Synopsis
  • Complex Regional Pain Syndrome (CRPS) is a rare and difficult-to-treat neuropathic disorder affecting less than 200,000 people in the U.S. each year, with current treatments mainly providing inadequate pain relief.
  • This systematic review aimed to evaluate the effectiveness of low-dose naltrexone in treating various chronic pain syndromes through an extensive search of medical literature, resulting in the analysis of 30 relevant studies.
  • Findings suggest that low-dose naltrexone may offer symptom relief for chronic pain, dystonia, and sleep issues, but further focused studies are necessary to confirm its efficacy specifically for CRPS.
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Article Synopsis
  • * The aim of the updated guidelines is to provide evidence-based guidance for various therapeutic epidural procedures across the lumbar, cervical, and thoracic regions of the spine.
  • * A comprehensive literature review, including 47 systematic reviews and 43 randomized controlled trials, has been conducted to inform recommendations regarding the efficacy and safety of epidural interventions, especially for conditions like disc herniation.
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Background: The coronavirus disease 2019 (COVID-19) pandemic has drastically altered daily living and medical care for Ohio residents and the practice of medicine for the interventional pain management physician. As a state, Ohio tends to be demographically representative of the broader US population.

Objective: Reviewing the efforts deployed by Ohio to flatten the COVID-19 infection curve and reduce the spread of the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an important component of determining optimal procedures for mitigating the effects of the COVID-19 pandemic.

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Background: The COVID-19 pandemic has worsened the pain and suffering of chronic pain patients due to stoppage of "elective" interventional pain management and office visits across the United States. The reopening of America and restarting of interventional techniques and elective surgical procedures has started. Unfortunately, with resurgence in some states, restrictions are once again being imposed.

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Article Synopsis
  • Chronic axial spinal pain, primarily caused by facet joints, leads to significant disability and increased healthcare costs, emphasizing the need for effective diagnostic and therapeutic interventions.
  • The study focuses on evidence-based methods for diagnosing and treating facet joint issues, utilizing literature reviews and established standards to guide recommendations.
  • Key findings highlight that physical examinations are essential for diagnosis, while fluoroscopic or CT guidance is strongly recommended for interventions, with varying levels of evidence backing different diagnostic techniques.*
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Background: The use of bone marrow concentrate (BMC) for treatment of musculoskeletal disorders has become increasingly popular over the last several years, as technology has improved along with the need for better solutions for these pathologies. The use of cellular tissue raises a number of issues regarding the US Food and Drug Administration's (FDA) regulation in classifying these treatments as a drug versus just autologous tissue transplantation. In the case of BMC in musculoskeletal and spine care, this determination will likely hinge on whether BMC is homologous to the musculoskeletal system and spine.

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Article Synopsis
  • Opioid use and abuse have dramatically increased since the 1990s, leading to a significant spike in overdose deaths, particularly from heroin and synthetic opioids like fentanyl.
  • Despite evidence against their efficacy for chronic pain, a majority of physicians and patients still believe opioids effectively relieve pain and improve quality of life.
  • New guidelines aim to help physicians prescribe opioids responsibly for chronic non-cancer pain, reduce the risk of drug abuse, and ensure patients who truly need them still have access.
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Article Synopsis
  • Epidural injections have been used since 1901 to treat low back pain and sciatica, but the effectiveness of these injections for managing chronic spinal pain remains debated despite various treatment options available.
  • The study aims to systematically review randomized controlled trials evaluating the efficacy of epidural injections in addressing chronic spinal pain, focusing on pain relief and functional improvement.
  • A total of 52 trials were included in the review, showing that epidural injections provide moderate evidence for long-term pain relief in conditions like lumbar and cervical disc herniation, but no considerable differences in results were found between various injection methods.
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Background:   Lumbosacral selective nerve root blocks and/ or transforaminal epidural injections are used for diagnosis and treatment of different disorders causing low back and lower extremity pain. A clear consensus on the use of selective nerve root injections as a diagnostic tool does not currently exist. Additionally, the validity of this procedure as a diagnostic tool is not clear.

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Article Synopsis
  • The objective of the text is to create evidence-based clinical guidelines for diagnosing and treating chronic spinal pain using various interventional techniques.
  • The methodology involves a systematic review of existing literature to evaluate the effectiveness of these procedures.
  • Key findings highlight varying levels of evidence for different techniques, such as good evidence for lumbar facet joint nerve blocks and caudal epidural injections, but limited evidence for others like transforaminal epidural injections and certain intradiscal procedures.
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Background: Among the multiple interventions used in managing chronic spinal pain, lumbar epidural injections have been used extensively to treat lumbar radicular pain. Among caudal, interlaminar, and transforaminal, transforaminal epidural injections have gained rapid and widespread acceptance for the treatment of lumbar and lower extremity pain. The potential advantages of transforaminal over interlaminar and caudal, include targeted delivery of a steroid to the site of pathology, presumably onto an inflamed nerve root.

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Article Synopsis
  • Comprehensive guidelines for interventional techniques aimed at managing chronic spinal pain are developed based on evidence to assist clinicians in their practice.
  • The study involved a systematic review of existing literature and categorized the strength of evidence using U.S. Preventive Services Task Force criteria.
  • Key findings include high-level evidence supporting diagnostic and therapeutic procedures like facet joint nerve blocks and epidural steroid injections for effective pain management.
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Background: Epidural injection of corticosteroids is one of the most commonly used interventions in managing chronic spinal pain. The transforaminal route to the lumbar epidural space for steroid injection has gained rapid and widespread acceptance for the treatment of lumbar and leg pain. However, there are few well-designed randomized, controlled studies to determine the effectiveness of epidural injections.

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Background: Caudal epidural injection of local anesthetics with or without steroids is one of the most commonly used interventions in managing chronic low back and lower extremity pain. However, there has been a lack of well-designed randomized, controlled studies to determine the effectiveness of caudal epidural injections in various conditions - disc herniation and radiculitis, post-lumbar laminectomy syndrome, spinal stenosis, and chronic low back pain of disc origin without disc herniation or radiculitis.

Study Design: A systematic review of caudal epidural injections with or without steroids in managing chronic pain secondary to lumbar disc herniation or radiculitis, post lumbar laminectomy syndrome, spinal stenosis, and discogenic pain without disc herniation or radiculitis.

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Medications which bind to opioid receptors are increasingly being prescribed for the treatment of multiple and diverse chronic painful conditions. Their use for acute pain or terminal pain is well accepted. Their role in the long-term treatment of chronic noncancer pain is, however, controversial for many reasons.

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Article Synopsis
  • The intervertebral disc may cause chronic spine pain, and discography is currently the best method to assess disc-related pain despite uncertainty in diagnosis.
  • A systematic review was conducted to evaluate the diagnostic accuracy of discography in relation to chronic spinal pain, utilizing specific criteria and rating instruments for accuracy.
  • The review found strong evidence supporting discography's effectiveness for identifying lumbar discogenic pain, moderate evidence for cervical discogenic pain, and limited evidence for thoracic discogenic pain.
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Article Synopsis
  • The guidelines aim to provide evidence-based recommendations for managing chronic spinal pain using interventional techniques, designed for clinicians in the U.S.
  • The guideline development involved thorough literature reviews, consensus evaluations, and a structured method for assessing the quality of evidence, ranging from conclusive to indeterminate.
  • Findings show strong accuracy for certain diagnostic interventions, such as facet joint nerve blocks and lumbar discography, while evidence for others, like cervical discography and diagnostic sacroiliac joint injections, is more limited or moderate.
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Pain physicians in Ohio come from many medical backgrounds and use different medical boards to claim board certification in the field of pain medicine. Our goal was to explore the number, demographics, and qualifications of pain physicians in Ohio. The names of Ohio physicians designating themselves as pain physicians were collected from the State Medical Board of Ohio and the American Medical Association.

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