Objective: This study aims to determine the effectiveness of lumbar medial branch radiofrequency neurotomy (RFN) performed by two practitioners trained according to rigorous guidelines.
Design: Prospective, outcome study of consecutive patients with chronic back pain treated in a community setting.
Interventions: A total of 106 patients, selected on the basis of complete relief of pain following controlled, diagnostic, medial branch blocks, were treated with RFN according to the guidelines of the International Spine Intervention Society.
Outcome Measures: Successful outcome was defined as complete relief of pain for at least 6 months, with complete restoration of activities of daily living, no need for any further health care, and return to work. Patients who failed to meet any of these criteria were deemed to have failed treatment.
Results: In the two practices, 58% and 53% of patients achieved a successful outcome. Relief lasted 15 months from the first RFN and 13 months for repeat treatments. Allowing for repeat treatment, patients maintained relief for a median duration of 17-33 months, with some 70% still having relief at follow-up.
Conclusion: Lumbar RFN can be very effective when performed in a rigorous manner in appropriately selected patients. Chronic back pain, mediated by the lumbar medial branches, can be stopped and patients fully restored to normal living, if treated with RFN.
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http://dx.doi.org/10.1111/pme.12000 | DOI Listing |
Am J Perinatol
January 2025
Pediatrics, Duke University Health System, Durham, United States.
Objective: To characterize the cerebrospinal fluid (CSF) of infants with stroke and compare those findings to the CSF of infants with bacterial meningitis and neither condition in the first 14 postnatal days.
Study Design: Cohort study of 30,092 infants who received a lumbar puncture in the first 14 postnatal days discharged from >300 neonatal intensive care units from 1997-2020. CSF parameters were compared between infants with stroke and bacterial meningitis using non-parametric hypothesis testing and quantile regression.
Alzheimers Dement
December 2024
Sant Pau Memory Unit, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.
Background: To date, limited data exist concerning the utility of FDG-PET in detecting Alzheimer's Disease (AD) in Down Syndrome (DS). Yet, sensitive biomarkers for neurodegeneration are essential in this population genetically predisposed for AD. Therefore, we aimed at characterizing the effect of age, disease stage and AD pathology on brain metabolism in a large cohort of adults with DS.
View Article and Find Full Text PDFAlzheimers Dement
December 2024
School of Medicine & Public Health, University of Wisconsin-Madison, Madison, WI, USA.
Background: The timing of neurodegeneration in relation to the onset of Alzheimer's disease pathology is not fully known. This study examined the association of longitudinal atrophy derived from T1-weighted MRI with 1) cerebrospinal fluid (CSF) amyloid-tau (AT) groupings and 2) Pittsburgh compound B (PiB) PET-derived estimates of amyloid duration among cognitively unimpaired (CU) individuals.
Method: CU participants in the Wisconsin Registry for Alzheimer's Prevention and Wisconsin Alzheimer's Disease Research Center (N = 297) underwent longitudinal MRI, APOE genotyping, and lumbar puncture to determine CSF Aβ42/40 (A) and pTau181 (T) concentration at baseline using in-house cutoffs.
Alzheimers Dement
December 2024
Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Background: Semantic processing relies on temporal brain regions, including medial temporal lobe (MTL) structures, that are the first to be affected by tau pathology in Alzheimer's disease (AD). A widely used task to assess semantic memory is the category fluency. Performance on this task was demonstrated to be impaired since the prodromal stage of AD and associated to the structural integrity of the MTL.
View Article and Find Full Text PDFAlzheimers Dement
December 2024
Neuroscience Training Program, University of Wisconsin-Madison, Madison, WI, USA.
Background: The timing of neurodegeneration in relation to the onset of Alzheimer's disease pathology is not fully known. This study examined the association of longitudinal atrophy derived from T1-weighted MRI with 1) cerebrospinal fluid (CSF) amyloid-tau (AT) groupings and 2) Pittsburgh compound B (PiB) PET-derived estimates of amyloid duration among cognitively unimpaired (CU) individuals.
Method: CU participants in the Wisconsin Registry for Alzheimer's Prevention and Wisconsin Alzheimer's Disease Research Center (N = 297) underwent longitudinal MRI, APOE genotyping, and lumbar puncture to determine CSF Aß42/40 (A) and pTau181 (T) concentration at baseline using in-house cutoffs.
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