Objective: Axial spinal pain generators are difficult to identify using current diagnostic modalities. Merging CT with SPECT (CT-SPECT) scans allows for accurate identification of areas with increased osteoblastic activity, which may reflect pain generators. In this study, the authors aimed to evaluate the degree of pain improvement in patients who underwent surgery, addressing primary pain generators identified by CT-SPECT.
Methods: The authors retrospectively reviewed all patients with chronic axial spine pain who underwent diagnostic CT-SPECT at their institution and analyzed pain improvement in those who underwent surgical treatment in order to determine whether CT-SPECT correctly identified the primary pain generator.
Results: A total of 315 patients underwent diagnostic CT-SPECT between January 2014 and August 2018. Forty-eight patients underwent either cervical or lumbar fusion; there were 26 women (16 cervical, 10 lumbar) and 22 men (9 cervical, 13 lumbar). The overall axial spinal pain, as assessed through self-reporting of visual analog scale scores at 6 months postoperatively, improved from 9.04 ± 1.4 to 4.34 ± 2.3 (p = 0.026), with cervical fusion patients improving from 8.8 ± 1.8 to 3.92 ± 2.2 (p = 0.019) and lumbar fusion patients improving from 9.35 ± 0.7 to 4.87 ± 2.3 (p = 0.008).
Conclusions: CT-SPECT may offer a diagnostic advantage over current imaging modalities in identifying the primary pain generator in patients with axial spinal pain.
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http://dx.doi.org/10.3171/2019.9.FOCUS19608 | DOI Listing |
BMC Med
January 2025
Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Keele, UK.
Background: Pain is a major challenge for patients with rheumatoid arthritis (RA), with many people suffering chronic pain. Current RA management guidelines focus on assessing and reducing disease activity using disease-modifying anti-rheumatic drugs (DMARDs). Consequently, pain care is often suboptimal, with growing evidence that analgesics are widely prescribed to patients with RA, despite potential toxicities and limited evidence for efficacy.
View Article and Find Full Text PDFBMC Anesthesiol
January 2025
Department of Anesthesiology and Reanimation, Faculty of Medicine, Van Yüzüncü Yıl University, Van, Turkey.
Background: Patient safety is important in daily anesthesia practices, and providing deep anesthesia is difficult. Current debates on the optimal anesthetic agents highlight the need for safer alternatives. This study was justified by the need for safer and more effective anesthetic protocols for outpatient hysteroscopic procedures, particularly those conducted outside the operating room.
View Article and Find Full Text PDFInt Dent J
January 2025
Department of Dental Pathology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.
Introduction And Aims: Blood loss is a common side-effect in orthognathic surgery. Deliberated hypotensive anaesthesia can reduce blood loss. The purpose was to evaluate the effect of add-on dexmedetomidine compared with the usual hypotensive drug bolus on blood loss and patient outcomes in orthognathic surgery.
View Article and Find Full Text PDFJ Cardiothorac Vasc Anesth
January 2025
Department of Anesthesiology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, China. Electronic address:
Various regional analgesia techniques are used to reduce postoperative pain in pediatric patients undergoing cardiothoracic surgeries. This study aimed to determine the relative efficacy of regional analgesic interventions. PubMed, EMBASE, Web of Science, and Cochrane databases were searched to identify all randomized controlled studies evaluating the effects of regional block after cardiothoracic surgery.
View Article and Find Full Text PDFBMJ Open
January 2025
Department of Orthopaedics, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
Introduction: The infrapatellar fat pad and synovium are the sites of immune cell infiltration and the origin of proinflammation. Studies have shown that Hoffa's synovitis may be a sign of early-stage osteoarthritis (OA). However, there have been no effective interventions specifically for Hoffa's synovitis.
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