Cervical epidural blood patch--A literature review.

Objective: Epidural blood patches (EBP) are rarely performed at the cervical levels, primarily due to fear of neurological complications such as spinal cord compression. We reviewed the literature to provide an evidence-based review of performance of cervical EBPs, with a specific focus on indication, technique, safety, and efficacy.

Design: A comprehensive electronic literature search was done to include studies that reported on performance of cervical EBPs in patients with CSF leak at the cervical level.

Diagnostic errors in the intensive care unit: a systematic review of autopsy studies.

Context: Misdiagnoses may be an underappreciated cause of preventable morbidity and mortality in the intensive care unit (ICU). Their prevalence, nature, and impact remain largely unknown.

Objectives: To determine whether potentially fatal ICU misdiagnoses would be more common than in the general inpatient population (~5%), and would involve more infections or vascular events.

Noncardiac chest pain during war.

Objectives: Noncardiac chest pain (NCCP) has emerged as one of the biggest challenges facing military healthcare providers. The objectives of this study are to determine disease burden and diagnostic breakdown of NCCP, and to identify factors associated with return-to-duty (RTD).

Methods: Data were prospectively collected from the Deployed Warrior Medical Management Center in Germany on 1935 service and nonservice members medically evacuated out of Operations Iraqi and Enduring Freedom for a primary diagnosis of NCCP between 2004 and 2007.

Neck pain during combat operations: an epidemiological study analyzing clinical and prognostic factors.

Unlabelled: STUDY DESIGN. Prospective observational study among soldiers medically evacuated out of theaters of combat operations for neck pain, with retrospective analysis of variables associated with return-to-duty.

Objectives: To provide an epidemiological overview of the burden of neck pain in deployed soldiers involved in combat operations and to identify factors associated with return-to-duty.

Systematic review of the incidence of discitis after cervical discography.

Background Context: Cervical discography is not uniformly used in part because of the fear of discitis. Studies report widely varying rates of this life-threatening infection.

Purpose: The aim of this study was to estimate the incidence of discitis after cervical discography, delineate the consequences of discitis, and identify factors that may influence this complication.

Back pain during war: an analysis of factors affecting outcome.

Background: Back pain is the leading cause of disability in the world, but it is even more common in soldiers deployed for combat operations. Aside from battle injuries and psychiatric conditions, spine pain and other musculoskeletal conditions are associated with the lowest return-to-unit rate among service members medically evacuated out of Operations Iraqi and Enduring Freedom.

Methods: Demographic, military-specific, and outcome data were prospectively collected over a 2-week period at the Deployed Warrior Medical Management Center in Germany on 1410 consecutive soldiers medically evacuated out of theaters of combat operations for a primary diagnosis pertaining to back pain between 2004 and 2007.

Intravenous infusion tests have limited utility for selecting long-term drug therapy in patients with chronic pain: a systematic review.

Since the first description in the early 1990s, the scope of intravenous infusions tests has expanded to encompass multiple drug classes and indications. Purported advantages of these tests include elucidating mechanisms of pain, providing temporary relief of symptoms, and usefulness as prognostic tools in guiding drug therapy. In an attempt to discern the value of these tests, the authors conducted a systematic review to explore the rationale and evidence behind the following intravenous infusion tests: lidocaine, ketamine, opioid, and phentolamine.