Pain Characteristics of the Posterior Longitudinal Ligament in Percutaneous Endoscopic Lumbar Discectomy and its Significance: A Retrospective Study. | LitMetric
Introduction: In percutaneous endoscopic lumbar discectomy (PELD), pain occurs when the posterior longitudinal ligament (PLL) is exposed, removed, and decompressed. However, pain characteristics of the PLL stimulated in PELD have not been reported.
Methods: A total of 932 patients underwent PELD under local anesthesia. Pain distribution and intensity were recorded on a posterior body diagram during the operation. Pain intensity was assessed by the visual analog scale scores for the back (VAS-B). The PLL specimens were collected and observed using hematoxylin-eosin (HE) staining and immunohistochemistry.
Results: Patients with lumbar disc herniation (LDH) at L4/5 and L5/S1 had pain foci in different regions. The mean VAS-B scores between the ventral and dorsal sides of the PLL were 6.14 ± 0.97 and 4.80 ± 1.15, respectively (P < 0.05). The distribution of nociceptive nerve fibers in the dorsal side was uniform and scattered, while those in the ventral side were mainly distributed near the outer surface of the annulus fibrosus. The positive expression of substance P (SP) and calcitonin gene-related peptide (CGRP) was higher in the ventral side of the PLL than in the dorsal side (P < 0.0001).
Conclusions: Differences in pain distribution and intensity were observed when the PLL was incited at different spinal levels during PELD surgery.
Objective: Acute Subdural Hematoma (A-SDH) in patients with a Glasgow Coma Scale (GCS) score of 3 presents significant challenges in clinical decision-making owing to high mortality rates and the likelihood of severe disability. Here, we analyzed data to assess the number of surgical treatments and overall treatment outcomes for patients with A-SDH admitted in a comatose state and discussed the value of such aggressive surgical interventions based on these findings.
Methods: A retrospective analysis was conducted using data from five regional trauma centers in Korea registered with the Korean Neurotrauma Data Bank System.
There has been a predominant focus on psychosocial risk factors associated with poor pain outcomes among individuals with chronic pain. However, it is also important to identify resilience factors that may mitigate the negative impact of or confer successful adaptation to pain. We argue for a dual-focus approach that evaluates the contributions of both risk and resilience factors.
Background: Delirium is common in hospitalized patients and correlated with increased morbidity and mortality. Despite this, delirium is underdiagnosed, and many institutions do not have sufficient resources to consistently apply effective screening and prevention.
Objective: To develop a machine learning algorithm to identify patients at highest risk of delirium in the hospital each day in an automated fashion based on data available in the electronic medical record, reducing the barrier to large-scale delirium screening.
Background: Dual-task activities, which involve performing two separate tasks simultaneously, often result in reduced motor function and daily activity performance among individuals with knee osteoarthritis (OA).
Objective: This study aimed to investigate the impact of single- and dual-task conditions on muscle strength and performance in individuals with knee OA and examine how cognitive load influences physical task performance in this population.
Methods: Sixty patients with knee OA were included.
Introduction: For patients with acute intermittent porphyria (AIP), a true attack could be difficult to distinguish from chronic abdominal pain. This study focused on treatment responses from two patients with confirmed elevated biochemical data (delta-aminolevulinic acid (ALA), porphobilinogen (PBG)) and clinical evidence for acute attacks before starting givosiran.
Methods: Data from patients who participated in the phase III givosiran trial in Taiwan between May 2018 and May 2021 were reviewed.
