A Randomized Controlled Trial of Fluoroscopically-Guided Sacroiliac Joint Injections: A Comparison of the Posteroanterior and Classical Oblique Techniques.

Objective: The sacroiliac joint can be a primary source of pain or part of multifactorial syndromes. As there is no single historical, physical examination-based, or radiological feature that definitively establishes a diagnosis of sacroiliac joint pain, diagnostic blocks are regarded as the gold standard. The primary aim of this randomized trial was to compare the posteroanterior approach with the classic oblique approach for sacroiliac joint injection based on an assessment of procedure times and patient-reported pain outcomes in subjects scheduled for fluoroscopically-guided sacroiliac joint injections.

Retrospective Review of Magnetic Resonance Imaging of the Lumbosacral Spine: Are We Overinvestigating?

Objective: Lower back pain (LBP) is a worldwide health problem, and magnetic resonance imaging (MRI) is a common modality used to aid in its diagnosis. Although specific guidelines for assessing the necessity of MRI usage exist, the use of MRI as the initial imaging method for LBP seems to be more common than necessary in general practice.

Methods: We conducted a retrospective chart review of 313 patients who had undergone MRI of the lumbosacral spine during 2014-2015.

Risks and Benefits of Ceasing or Continuing Anticoagulant Medication for Image-Guided Procedures for Spine Pain: A Systematic Review.

Objective: To determine the risks of continuing or ceasing anticoagulant or antiplatelet medications prior to image-guided procedures for spine pain.

Design: Systematic review of the literature with comprehensive analysis of the published data.

Interventions: Following a search of the literature for studies pertaining to spine pain interventions in patients on anticoagulant medication, seven reviewers appraised the studies identified and assessed the quality of evidence presented.

Radiofrequency Ablation of the Sphenopalatine Ganglion Using Cone Beam Computed Tomography for Intractable Cluster Headache.

Unlabelled: Percutaneous radiofrequency ablation (RFA) of the sphenopalatine ganglion (SPG) has been shown to be an effective modality of treatment for patients with intractable chronic cluster headaches (CHs). While the use of fluoroscopy for RFA of the SPG is common, to our knowledge there are no documented cases of procedures using cone beam computed tomography (CBCT) for image guidance. We present a case report of a patient suffering from chronic intractable CH with complete long-lasting relief after RFA of the SPG using CBCT.

Paraplegia After Thoracic Epidural Steroid Injection.

Epidural steroid injections are a common procedure performed by pain physicians. The American Society of Regional Anesthesia along with several other groups recently provided guidelines for performing epidural injections in the setting of anticoagulants. We present a case of a patient who developed an epidural hematoma and subsequent paraplegia despite strict adherence to these guidelines.

A rare case of aortic dissection presenting as pure transient global amnesia.

Transient global amnesia (TGA) is a well-described neurological phenomenon. Clinically, it manifests with the sudden onset of a paroxysmal, transient loss of anterograde memory and disorientation but with intact consciousness. Typically, symptoms last for only a few hours.

Persistent hiccups with continuous intrathecal morphine infusion.

Objective: To report a case of hiccups secondary to intrathecal (IT) morphine infusion.

Methods: Case report and discussion.

Results: The hiccups in our patient resolved on substitution of IT morphine infusion with hydromorphone.