1
|
Deer TR, Grider JS, Pope JE, Lamer TJ, Wahezi SE, Hagedorn JM, Falowski S, Tolba R, Shah JM, Strand N, Escobar A, Malinowski M, Bux A, Jassal N, Hah J, Weisbein J, Tomycz ND, Jameson J, Petersen EA, Sayed D. Best Practices for Minimally Invasive Lumbar Spinal Stenosis Treatment 2.0 (MIST): Consensus Guidance from the American Society of Pain and Neuroscience (ASPN). J Pain Res 2022; 15:1325-1354. [PMID: 35546905 PMCID: PMC9084394 DOI: 10.2147/jpr.s355285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 04/06/2022] [Indexed: 11/23/2022] Open
Abstract
Introduction Methods Results Discussion Conclusion
Collapse
Affiliation(s)
- Timothy R Deer
- Centers for Pain Relief, Charleston, WV, USA
- Correspondence: Timothy R Deer, The Spine and Nerve Centers of the Virginias, 400 Court Street, Suite 100, Charleston, WV, 25301, USA, Tel +1 304 347-6141, Email
| | - Jay S Grider
- UK HealthCare Pain Services, Department of Anesthesiology, University of Kentucky College of Medicine, Lexington, KY, USA
| | | | - Tim J Lamer
- Division of Pain Medicine, Department of Anesthesiology, Mayo Clinic, Rochester, MN, USA
| | - Sayed E Wahezi
- Montefiore Medical Center, SUNY-Buffalo, Buffalo, NY, USA
| | - Jonathan M Hagedorn
- Department of Anesthesiology and Perioperative Medicine, Division of Pain Medicine, Mayo Clinic, Rochester, MN, USA
| | - Steven Falowski
- Director Functional Neurosurgery, Neurosurgical Associates of Lancaster, Lancaster, PA, USA
| | - Reda Tolba
- Pain Management Department, Anesthesiology Institute, Cleveland Clinic, Abu Dhabi, UAE
| | - Jay M Shah
- SamWell Institute for Pain Management, Colonia, NJ, USA
| | - Natalie Strand
- Department of Anesthesiology, Division of Pain Medicine, Mayo Clinic, Phoenix, AZ, USA
| | - Alex Escobar
- Department of Anesthesiology and Pain Medicine, University of Toledo Medical Center, Toledo, OH, USA
| | | | - Anjum Bux
- Bux Pain Management, Lexington, KY, USA
| | | | - Jennifer Hah
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University, Palo Alto, CA, USA
| | | | - Nestor D Tomycz
- Department of Neurological Surgery, Allegheny General Hospital, Allegheny Health Network, Pittsburgh, PA, USA
| | | | - Erika A Petersen
- Department of Neurosurgery, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Dawood Sayed
- Pain Medicine, Multidisciplinary Pain Fellowship, The University of Kansas Health System, Kansas City, KS, USA
| |
Collapse
|
2
|
Deer TR, Russo MA, Grider JS, Pope J, Rigoard P, Hagedorn JM, Naidu R, Patterson DG, Wilson D, Lubenow TR, Buvanendran A, Sheth SJ, Abdallah R, Knezevic NN, Schu S, Nijhuis H, Mehta P, Vallejo R, Shah JM, Harned ME, Jassal N, Gonzalez JM, Pittelkow TP, Patel S, Bojanic S, Chapman K, Strand N, Green AL, Pahapill P, Dario A, Piedimonte F, Levy RM. The Neurostimulation Appropriateness Consensus Committee (NACC): Recommendations for Surgical Technique for Spinal Cord Stimulation. Neuromodulation 2022; 25:1-34. [PMID: 35041578 DOI: 10.1016/j.neurom.2021.10.015] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 09/21/2021] [Accepted: 10/06/2021] [Indexed: 12/19/2022]
Abstract
INTRODUCTION The field of neurostimulation for the treatment of chronic pain is a rapidly developing area of medicine. Although neurostimulation therapies have advanced significantly as a result of technologic improvements, surgical planning, device placement, and postoperative care are of equal importance to optimize outcomes. This Neurostimulation Appropriateness Consensus Committee (NACC) project intends to provide evidence-based guidance for these often-overlooked areas of neurostimulation practice. MATERIALS AND METHODS Authors were chosen based on their clinical expertise, familiarity with the peer-reviewed literature, research productivity, and contributions to the neuromodulation literature. Section leaders supervised literature searches of MEDLINE, BioMed Central, Current Contents Connect, Embase, International Pharmaceutical Abstracts, Web of Science, Google Scholar, and PubMed from the last NACC publication in 2017 to the present. Identified studies were graded using the United States Preventive Services Task Force criteria for evidence and certainty of net benefit. Recommendations are based on evidence strength and consensus when evidence was scant. RESULTS This NACC project provides guidance on preoperative assessment, intraoperative techniques, and postoperative management in the form of consensus points with supportive evidence. These results are based on grade of evidence, strength of consensus, and expert opinion. CONCLUSIONS The NACC has given guidance for a surgical plan that encompasses the patient journey from the planning stage through the surgical experience and postoperative care. The overall recommendations are designed to improve efficacy and the safety of patients undergoing these neuromodulation procedures and are intended to apply throughout the international community.
Collapse
Affiliation(s)
- Timothy R Deer
- The Spine and Nerve Centers of the Virginias, Charleston, WV, USA.
| | - Marc A Russo
- Hunter Pain Specialists, Newcastle, New South Wales, Australia
| | - Jay S Grider
- UKHealthCare Pain Services, Department of Anesthesiology, University of Kentucky College of Medicine, Lexington, KY, USA
| | - Jason Pope
- Evolve Restorative Center, Santa Rosa, CA, USA
| | - Philippe Rigoard
- Department of Spine Surgery and Neuromodulation, PRISMATICS Lab, Poitiers University Hospital, Poitiers, France
| | - Jonathan M Hagedorn
- Department of Anesthesiology and Perioperative Medicine, Division of Pain Medicine, Mayo Clinic, Rochester, MN, USA
| | - Ramana Naidu
- California Orthopedics & Spine, Larkspur, CA, USA
| | | | - Derron Wilson
- Goodman Campbell Brain and Spine, Department of Neurological Surgery, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Timothy R Lubenow
- Department of Anesthesiology, Rush University Medical Center, Chicago, IL, USA
| | | | - Samir J Sheth
- Department of Anesthesiology and Pain Medicine, University of California, Davis, Davis, CA, USA
| | - Rany Abdallah
- Center for Interventional Pain and Spine, Milford, DE, USA
| | - N Nick Knezevic
- Department of Anesthesiology and Surgery at University of Illinois, Department of Anesthesiology, Advocate Illinois Masonic Medical Center, Chicago, IL, USA
| | - Stefan Schu
- Leitender Arzt Neuromodulation, Neurochirurgie, Sana Kliniken Duisburg GmbH, Duisburg, Germany
| | - Harold Nijhuis
- Department of Anesthesiology, St. Antonius Hospital, Nieuwegein, The Netherlands
| | | | | | - Jay M Shah
- SamWell Institute for Pain Management, Colonia, NJ, USA
| | - Michael E Harned
- UKHealthCare Pain Services, Department of Anesthesiology, University of Kentucky College of Medicine, Lexington, KY, USA
| | | | - Jose Manuel Gonzalez
- Hospital Clínico Universitario Virgen de la Victoria, Servicio Andaluz de Salud, Málaga, Spain
| | - Thomas P Pittelkow
- Division of Pain Medicine, Department of Anesthesiology and Perioperative Medicine, Mayo Clinic College of Medicine and Science, Rochester, MN, USA
| | | | - Stana Bojanic
- Department of Neurosurgery, Oxford University Hospitals NHS Foundation Trust, Oxford, England, UK
| | - Kenneth Chapman
- Department of Anesthesiology, Perioperative Care, and Pain Medicine, The Pain and Spine Institute of New York, New York, NY, USA
| | - Natalie Strand
- Department of Anesthesiology, Division of Pain Medicine, Mayo Clinic, Phoenix, AZ, USA
| | - Alexander L Green
- Nuffield Department of Surgical Sciences, Oxford University, Oxford, England, UK
| | - Peter Pahapill
- Functional Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Alessandro Dario
- Department of Neurosurgery, ASST Settelaghi, Insubria University, Varese, Italy
| | | | - Robert M Levy
- International Neuromodulation Society, Neurosurgical Services, Clinical Research, Anesthesia Pain Care Consultants, Tamarac, FL, USA
| |
Collapse
|
3
|
Deer TR, Grider JS, Lamer TJ, Pope JE, Falowski S, Hunter CW, Provenzano DA, Slavin KV, Russo M, Carayannopoulos A, Shah JM, Harned ME, Hagedorn JM, Bolash RB, Arle JE, Kapural L, Amirdelfan K, Jain S, Liem L, Carlson JD, Malinowski MN, Bendel M, Yang A, Aiyer R, Valimahomed A, Antony A, Craig J, Fishman MA, Al-Kaisy AA, Christelis N, Rosenquist RW, Levy RM, Mekhail N. Corrigendum to: A Systematic Literature Review of Spine Neurostimulation Therapies for the Treatment of Pain. Pain Med 2021; 22:236. [PMID: 32875323 DOI: 10.1093/pm/pnaa209] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
|
4
|
Shafiq M, Huang J, Shah JM, Wang X, Rahman SU, Ali I, Chen L, Wang L. Characterization and virulence factors distribution of bla CTX-M and mcr-1carrying Escherichia coli isolates from bovine mastitis. J Appl Microbiol 2021; 131:634-646. [PMID: 33411963 DOI: 10.1111/jam.14994] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 12/22/2020] [Accepted: 12/30/2020] [Indexed: 11/26/2022]
Abstract
AIM To investigate the occurrence of ESBL and colistin-resistant E. coli and its genotypic characterization and identification of virulence determinants in cases of bovine mastitis in three provinces of China. MATERIALS AND METHODS Five hundred and thirty-five milk samples presenting mastitis symptoms were screened for the presence of ESBL, colistin-resistant and different virulence genes. Susceptibility testing was identified by the micro-dilution method. Escherichia coli isolates were used to detect ESBL genes (blaCTX-M , blaSHV and blaTEM ) and colistin-resistant genes mcr-(1-9). Multiplex PCR approach was used for the detection of major blaCTX-M groups, different phylogroups and virulence genes. The clonal relationship was then evaluated with MLST, MLSA and PFGE. RESULTS Multi-drug resistance (MDR) was found in more than 85% of ESBL and colistin-resistant E. coli isolates. Genotypic characterization showed a dominance of the blaCTX-M-1 group, and the most prevalent alleles observed were blaCTX-M-28 (38·37%), blaCTX-M-14 (17·44%), blaCTX-M-66 (13·95%) and blaCTX-M-55 (10·46%). The targeted virulence genes were detected in 97·89% of isolates. Sequence types ST58 and ST410 were the most predominant (2/20 = 20%). The majority of the E. coli isolates carrying ESBL and mcr-1 were clonally unrelated. CONCLUSION High level of association was observed between ESBL-producing and COL-resistance in E. coli of bovine mastitis. SIGNIFICANCE AND IMPACT OF THE STUDY To the best of our knowledge, this is the first report which shows the genetic diversity of ESBL and mcr-1, and various virulent features of E. coli strains isolated from bovine clinical mastitis in three different provinces of China. The major carriers of the blaCTX-M-1 and blaCTX-M-9 were blaCTX-M-28 and blaCTX-M-14 alleles respectively. The association of ESBL-producing E. coli with mcr-1 is of particular concern.
Collapse
Affiliation(s)
- M Shafiq
- MOE Joint International Research Laboratory of Animal Health and Food Safety, College of Veterinary Medicine, Nanjing Agricultural University, Nanjing, China
| | - J Huang
- MOE Joint International Research Laboratory of Animal Health and Food Safety, College of Veterinary Medicine, Nanjing Agricultural University, Nanjing, China
| | - J M Shah
- MOE Joint International Research Laboratory of Animal Health and Food Safety, College of Veterinary Medicine, Nanjing Agricultural University, Nanjing, China
| | - X Wang
- MOE Joint International Research Laboratory of Animal Health and Food Safety, College of Veterinary Medicine, Nanjing Agricultural University, Nanjing, China
| | - S U Rahman
- College of Veterinary Sciences and Animal Husbandry, Abdul Wali Khan University, Mardan, KP, Pakistan
| | - I Ali
- College of Animal Sciences, Nanjing Agricultural University, Nanjing, China
| | - L Chen
- MOE Joint International Research Laboratory of Animal Health and Food Safety, College of Veterinary Medicine, Nanjing Agricultural University, Nanjing, China
| | - L Wang
- MOE Joint International Research Laboratory of Animal Health and Food Safety, College of Veterinary Medicine, Nanjing Agricultural University, Nanjing, China
| |
Collapse
|
5
|
Deer TR, Esposito MF, McRoberts WP, Grider JS, Sayed D, Verrills P, Lamer TJ, Hunter CW, Slavin KV, Shah JM, Hagedorn JM, Simopoulos T, Gonzalez DA, Amirdelfan K, Jain S, Yang A, Aiyer R, Antony A, Azeem N, Levy RM, Mekhail N. A Systematic Literature Review of Peripheral Nerve Stimulation Therapies for the Treatment of Pain. Pain Medicine 2020; 21:1590-1603. [DOI: 10.1093/pm/pnaa030] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
AbstractObjectiveTo conduct a systematic literature review of peripheral nerve stimulation (PNS) for pain.DesignGrade the evidence for PNS.MethodsAn international interdisciplinary work group conducted a literature search for PNS. Abstracts were reviewed to select studies for grading. Inclusion/exclusion criteria included prospective randomized controlled trials (RCTs) with meaningful clinical outcomes that were not part of a larger or previously reported group. Excluded studies were retrospective, had less than two months of follow-up, or existed only as abstracts. Full studies were graded by two independent reviewers using the modified Interventional Pain Management Techniques–Quality Appraisal of Reliability and Risk of Bias Assessment, the Cochrane Collaborations Risk of Bias assessment, and the US Preventative Services Task Force level-of-evidence criteria.ResultsPeripheral nerve stimulation was studied in 14 RCTs for a variety of painful conditions (headache, shoulder, pelvic, back, extremity, and trunk pain). Moderate to strong evidence supported the use of PNS to treat pain.ConclusionPeripheral nerve stimulation has moderate/strong evidence. Additional prospective trials could further refine appropriate populations and pain diagnoses.
Collapse
Affiliation(s)
- Timothy R Deer
- The Spine and Nerve Center of the Virginias, Charleston, West Virginia
| | | | | | - Jay S Grider
- UKHealthCare Pain Services, Department of Anesthesiology, University of Kentucky College of Medicine, Lexington, Kentucky
| | - Dawood Sayed
- University of Kansas Medical Center, Kansas City, Kansas, USA
| | | | - Tim J Lamer
- Division of Pain Medicine, Department of Anesthesiology, Mayo Clinic, Rochester, Minnesota
| | - Corey W Hunter
- Ainsworth Institute of Pain Management, New York, New York
| | - Konstantin V Slavin
- Department of Neurosurgery, University of Illinois at Chicago, Chicago, Illinois
| | - Jay M Shah
- SamWell Institute for Pain Management, Colonia, New Jersey
| | | | - Tom Simopoulos
- Department of Anesthesiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | | | | | - Sameer Jain
- Pain Treatment Centers of America, Little Rock, Arkansas
| | - Ajax Yang
- Mt. Sinai Hospital, New York, New York
| | - Rohit Aiyer
- Interventional Pain Management and Pain Psychiatry Faculty, Henry Ford Health System, Detroit, Michigan
| | - Ajay Antony
- University of Florida College of Medicine, Jacksonville, Florida
| | - Nomen Azeem
- Florida Spine & Pain Specialists, Bradenton, Florida
| | - Robert M Levy
- Director of Neurosurgical Services, Director of Clinical Research, Anesthesia Pain Care Consultants, Tamarac, Florida
| | - Nagy Mekhail
- Evidence-Based Pain Management Research and Education, Cleveland Clinic, Cleveland, Ohio, USA
| |
Collapse
|
6
|
Deer TR, Grider JS, Lamer TJ, Pope JE, Falowski S, Hunter CW, Provenzano DA, Slavin KV, Russo M, Carayannopoulos A, Shah JM, Harned ME, Hagedorn JM, Bolash RB, Arle JE, Kapural L, Amirdelfan K, Jain S, Liem L, Carlson JD, Malinowski MN, Bendel M, Yang A, Aiyer R, Valimahomed A, Antony A, Craig J, Fishman MA, Al-Kaisy AA, Christelis N, Rosenquist RW, Levy RM, Mekhail N. A Systematic Literature Review of Spine Neurostimulation Therapies for the Treatment of Pain. Pain Medicine 2020; 21:1421-1432. [DOI: 10.1093/pm/pnz353] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Abstract
Objective
To conduct a systematic literature review of spinal cord stimulation (SCS) for pain.
Design
Grade the evidence for SCS.
Methods
An international, interdisciplinary work group conducted literature searches, reviewed abstracts, and selected studies for grading. Inclusion/exclusion criteria included randomized controlled trials (RCTs) of patients with intractable pain of greater than one year’s duration. Full studies were graded by two independent reviewers. Excluded studies were retrospective, had small numbers of subjects, or existed only as abstracts. Studies were graded using the modified Interventional Pain Management Techniques–Quality Appraisal of Reliability and Risk of Bias Assessment, the Cochrane Collaborations Risk of Bias assessment, and the US Preventative Services Task Force level-of-evidence criteria.
Results
SCS has Level 1 evidence (strong) for axial back/lumbar radiculopathy or neuralgia (five high-quality RCTs) and complex regional pain syndrome (one high-quality RCT).
Conclusions
High-level evidence supports SCS for treating chronic pain and complex regional pain syndrome. For patients with failed back surgery syndrome, SCS was more effective than reoperation or medical management. New stimulation waveforms and frequencies may provide a greater likelihood of pain relief compared with conventional SCS for patients with axial back pain, with or without radicular pain.
Collapse
Affiliation(s)
- Timothy R Deer
- The Spine and Nerve Center of the Virginias, Charleston, West Virginia
| | - Jay S Grider
- UK HealthCare Pain Services, Department of Anesthesiology, University of Kentucky College of Medicine, Lexington, Kentucky
| | - Tim J Lamer
- Division of Pain Medicine, Department of Anesthesiology, Mayo Clinic, Rochester, Minnesota
| | - Jason E Pope
- Evolve Restorative Center, Santa Rosa, California
| | - Steven Falowski
- Department of Neurosurgery, Neurosurgical Associates of Lancaster, Lancaster, Pennsylvania
| | - Corey W Hunter
- Ainsworth Institute of Pain Management, New York, New York
| | | | - Konstantin V Slavin
- Department of Neurosurgery, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Marc Russo
- Hunter Pain Specialists, Broadmeadow, NSW, Australia
| | - Alexios Carayannopoulos
- Department of Physical Medicine and Rehabilitation, Rhode Island Hospital, Providence, Rhode Island
- Department of Neurosurgery, Brown Medical School, Providence, Rhode Island
| | - Jay M Shah
- New York Presbyterian Hospital, Memorial Sloan Kettering Cancer Center, Hospital for Special Surgery, New York, New York
| | - Michael E Harned
- UK HealthCare Pain Services, Department of Anesthesiology, University of Kentucky College of Medicine, Lexington, Kentucky
| | - Jonathan M Hagedorn
- Division of Pain Medicine, Department of Anesthesiology, Mayo Clinic, Rochester, Minnesota
| | - Robert B Bolash
- Anesthesiology, Pain Management and Evidence Based Pain Research, Cleveland Clinic, Cleveland, Ohio
| | - Jeff E Arle
- Department of Neurosurgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Leo Kapural
- Carolina Pain Institute at Brookstown, Wake Forest Baptist Health, Winston-Salem, North Carolina
| | | | - Sameer Jain
- Pain Treatment Centers of America, Little Rock, Arkansas
| | - Liong Liem
- St. Antonius Hospital, Nieuwegein, the Netherlands
| | | | | | - Markus Bendel
- Division of Pain Medicine, Department of Anesthesiology, Mayo Clinic, Rochester, Minnesota
| | - Ajax Yang
- Mt. Sinai Hospital, New York, New York
| | - Rohit Aiyer
- Interventional Pain Management and Pain Psychiatry Faculty, Henry Ford Health System, Detroit, Michigan
| | - Ali Valimahomed
- Advanced Orthopedics and Sports Medicine Institute, Freehold, New Jersey
| | - Ajay Antony
- University of Florida College of Medicine, Jacksonville, Florida
| | - Justin Craig
- UK HealthCare Pain Services, Department of Anesthesiology, University of Kentucky College of Medicine, Lexington, Kentucky
| | - Michael A Fishman
- Center for Interventional Pain and Spine, Bryn Mawr, Pennsylvania, USA
| | - Adnan A Al-Kaisy
- Pain Management and Neuromodulation Centre at Guy’s and St. Thomas’ NHS Trust, London, UK
| | - Nick Christelis
- Pain Specialists Australia, Richmond, Monash University, Victoria, Australia
| | - Richard W Rosenquist
- Anesthesiology, Pain Management and Evidence Based Pain Research, Cleveland Clinic, Cleveland, Ohio
| | - Robert M Levy
- Neurosurgical Services, Clinical Research, Anesthesia Pain Care Consultants, Tamarac, Florida, USA
| | - Nagy Mekhail
- Anesthesiology, Pain Management and Evidence Based Pain Research, Cleveland Clinic, Cleveland, Ohio
| |
Collapse
|
7
|
Rakesh N, Magram YC, Shah JM, Gulati A. Localized Corticosteroid Injections for Malignant Joint Pain in the Oncologic Population: A Case Series. A A Pract 2019; 13:27-30. [PMID: 30762588 DOI: 10.1213/xaa.0000000000000977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Pain is a common issue that is present in cancer survivors as well as those with active malignant processes. Despite opioid analgesics and adjuvant therapies such as systemic corticosteroids, many patients have persistent localized pain. We describe a case series of 3 cancer patients who have concurrent hip- and greater trochanteric-related pain. We performed a single-insertion-site, ultrasound-guided injection to target both the intra-articular hip and greater trochanteric bursa for each patient. All patients reported an improvement in pain symptoms and function with no major complications. Targeted corticosteroid injections provide a potential for relief of malignant joint pain.
Collapse
Affiliation(s)
- Neal Rakesh
- From the Department of Rehabilitation and Regenerative Medicine, NewYork-Presbyterian Hospital - University Hospital of Columbia and Cornell, New York, New York
| | - Yan Cui Magram
- Weill Cornell Tri-Institutional Pain Medicine Program, Department of Anesthesiology, Weill Cornell Medicine, New York, New York
| | - Jay M Shah
- Weill Cornell Tri-Institutional Pain Medicine Program, Department of Anesthesiology, Weill Cornell Medicine, New York, New York
| | - Amitabh Gulati
- Department of Anesthesiology and Critical Care, Memorial Sloan Kettering Cancer Center, New York, New York
| |
Collapse
|
8
|
Wahezi SE, Molina JJ, Alexeev E, Georgy JS, Haramati N, Erosa SA, Shah JM, Downie S. Cervical Medial Branch Block Volume Dependent Dispersion Patterns as a Predictor for Ablation Success: A Cadaveric Study. PM R 2018; 11:631-639. [PMID: 30367999 DOI: 10.1016/j.pmrj.2018.10.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 10/03/2018] [Indexed: 01/04/2023]
Abstract
BACKGROUND Neck pain is one of the most common causes of chronic pain and the fourth leading cause of disability worldwide; it is estimated that between 36% and 67% of this pain is due to facet arthropathy. For patients who have pain refractory to conservative treatments literature supports management with diagnostic cervical medial branch blocks (MBBs) to identify the associated facet innervation as the source of pain followed by therapeutic radiofrequency ablation (RFA) of the identified nerves. Cervical RFA has good published outcomes; however, the procedure is dependent upon the specificity of the diagnostic block to achieve maximal success. Currently, this prerequisite test has false positive rates between 27% and 63% and recent studies have shown that this may, in part, be a consequence of currently accepted injection volumes of 0.50 mL or more, which may decrease the sensitivity of MBBs. OBJECTIVE To evaluate the possible differences in volume dispersion between 0.25 and 0.50 mL of injectate during cervical MBBs. STUDY DESIGN Cadaveric study. SETTING An academic medical center in the United States. PATIENTS Not applicable. METHODS This was a cadaveric study in which six subjects were chosen with intact cervical spines. Cervical MBB were performed bilaterally at the midcervical spine, using a posterior approach under fluoroscopic guidance. 0.25 or 0.50 mL of a 9:1 solution of Omnipaque 180 mg iodine/mL and 1% medical grade methylene blue were administered on the left and right sides, respectively. Postinjection computed tomography (CT) imaging and gross dissection were performed to assess injectate spread. MAIN OUTCOME MEASURES Outcome measures after using commonly injected volumes for cervical MBB, included visualized and measured spread (by CT and gross dissection) of cervical medial branch blocks, coating adjacent structures not targeted by RFA. RESULTS Postinjection CT imaging and cadaveric dissection demonstrated that, although both volumes adequately coated the medial branches, the 0.50 mL cohort reliably spread dorsally to superficial muscles (splenius) and nerves distant from the targeted nerves (dorsal motor branches to splenius), whereas the 0.25 mL injectate cohort was contained in the deep and intermediate muscular cervical layers directly juxtaposed to the targeted cMBBs. CONCLUSION Results suggest that 0.50 mL injections of local anesthetic during cervical MBBs contacts many nonintended targets, thus decreasing the specificity of a targeted diagnostic cervical MBB. Furthermore, we demonstrated that 0.25 mL of injectate reliably bathed the cervical medial branches without extensive extravasation. This indicates that there would potentially be fewer local anesthetic effects on distant tissues, increasing the specificity of cervical MBBs and likely improving RFA planning.
Collapse
Affiliation(s)
- Sayed E Wahezi
- Department of Physical Medicine and Rehabilitation, Department of Anesthesiology, Multidisciplinary Pain Program, 1250 Waters Place, Tower Two, 8th Floor, Bronx, New York 10461
| | - Jocelin J Molina
- Department of Anesthesiology, Montefiore Medical Center, 111 East 210th Street, Bronx, NY 10467
| | - Edward Alexeev
- Department of Physical Medicine and Rehabilitation, Montefiore Medical Center, 150 E 210 Street, Bronx, NY 10467
| | - John S Georgy
- Department of Physical Medicine and Rehabilitation, Montefiore Medical Center, 150 E 210 Street, Bronx, NY 10467
| | - Nogah Haramati
- Department of Radiology, Montefiore Medical Center, 1825 Eastchester Rd, Bronx, NY 10461
| | - Stephen A Erosa
- Department of Physical Medicine and Rehabilitation, Montefiore Medical Center, 150 E 210 Street, Bronx, NY 10467
| | - Jay M Shah
- Department of Physical Medicine and Rehabilitation, Montefiore Medical Center, 150 E 210 Street, Bronx, NY 10467
| | - Sherry Downie
- Department of Structural Biology and Anatomy, Department of Physical Medicine and Rehabilitation, 1300 Morris Park Avenue, Bronx, NY 10461
| |
Collapse
|
9
|
Wahezi SE, Alexeev E, Georgy JS, Haramati N, Erosa SA, Shah JM, Downie S. Lumbar Medial Branch Block Volume-Dependent Dispersion Patterns as a Predictor for Ablation Success: A Cadaveric Study. PM R 2017; 10:616-622. [PMID: 29174073 DOI: 10.1016/j.pmrj.2017.11.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Revised: 10/25/2017] [Accepted: 11/02/2017] [Indexed: 11/18/2022]
Abstract
BACKGROUND Lumbar facet arthropathy is a common cause of low back pain. Literature supports treatment with radiofrequency ablation (RFA) of associated nerves that innervate lumbar facets when alternative conservative therapies have failed. Diagnostic local anesthetic blocks precede therapeutic ablation, but have a false-positive rate of 27%-63%, and some authors have questioned their utility in predicting therapeutic response to RFA. The authors of the current study believe that injectate volume may be a contributing factor to false positivity. OBJECTIVE To evaluate the difference in volume dispersion between 0.25 mL and 0.5 mL of injectate when performing lumbar medial branch blocks. We hypothesized that injection volumes greater than 0.25 mL during lumbar medial branch blocks would affect the distal branches of the adjacent medial branches, thus decreasing the specificity of the procedure. Thus, we attempted to demonstrate that injection volumes greater than 0.25 mL during lumbar medial branch blocks would affect the distal branches of the adjacent medial branches, which might increase false positivity of the blocks. STUDY DESIGN Cadaveric investigation. SETTING Tertiary care center. PARTICIPANTS Not applicable. OUTCOME MEASUREMENTS To demonstrate that the spread of lumbar medial branch blocks using commonly injected volume coats adjacent structures that are not affected by radiofrequency ablation. METHODS Six cadavers were chosen with nondissected lumbar spines. Fluoroscopically guided medial branch injections were performed bilaterally using the posterior oblique approach. A volume of 0.25 mL or 0.50 mL of a 9:1 solution of Omnipaque 240 and 1% medical grade methylene blue were delivered to the left and right sides, respectively. Postinjection computed tomographic imaging was performed, followed by dissection. RESULTS Both volumes adequately coated the medial branches, but in the 0.5-mL injectate cohort there was consistent spread dorsally to the superficial muscles and distal segments of the dorsal branches distant to the target nerves, whereas in the 0.25-mL injectate cohort the spread was contained in the deep and intermediate muscular lumbar layers, close to the intended target. CONCLUSION We suggest that a 0.5-mL injectate volume in clinical practice may produce an adjacent-level nerve block in addition to the intended injection level, thus decreasing the specificity of a targeted lumbar medial branch block. A 0.25-mL quantity of injectate reliably contacted the lumbar medial branches without extensive extravasation. Presumably, this means that 0.25 mL total volume for a lumbar medial branch block may provide greater specificity for RFA planning. LEVEL OF EVIDENCE NA.
Collapse
Affiliation(s)
- Sayed E Wahezi
- Department of Physical Medicine and Rehabilitation, Montefiore Medical Center, 1250 Waters Place, Tower Two, 8th Floor, Bronx, NY 10461
- Department of Physical Medicine and Rehabilitation, Montefiore Medical Center, Bronx, NY
- Department of Radiology, Montefiore Medical Center, Bronx, NY
- Department of Structural Biology and Anatomy, Department of Physical Medicine and Rehabilitation, Albert Einstein College of Medicine, Bronx, NY
| | - Edward Alexeev
- Department of Physical Medicine and Rehabilitation, Montefiore Medical Center, 1250 Waters Place, Tower Two, 8th Floor, Bronx, NY 10461
- Department of Physical Medicine and Rehabilitation, Montefiore Medical Center, Bronx, NY
- Department of Radiology, Montefiore Medical Center, Bronx, NY
- Department of Structural Biology and Anatomy, Department of Physical Medicine and Rehabilitation, Albert Einstein College of Medicine, Bronx, NY
| | - John S Georgy
- Department of Physical Medicine and Rehabilitation, Montefiore Medical Center, 1250 Waters Place, Tower Two, 8th Floor, Bronx, NY 10461
- Department of Physical Medicine and Rehabilitation, Montefiore Medical Center, Bronx, NY
- Department of Radiology, Montefiore Medical Center, Bronx, NY
- Department of Structural Biology and Anatomy, Department of Physical Medicine and Rehabilitation, Albert Einstein College of Medicine, Bronx, NY
| | - Nogah Haramati
- Department of Physical Medicine and Rehabilitation, Montefiore Medical Center, 1250 Waters Place, Tower Two, 8th Floor, Bronx, NY 10461
- Department of Physical Medicine and Rehabilitation, Montefiore Medical Center, Bronx, NY
- Department of Radiology, Montefiore Medical Center, Bronx, NY
- Department of Structural Biology and Anatomy, Department of Physical Medicine and Rehabilitation, Albert Einstein College of Medicine, Bronx, NY
| | - Stephen A Erosa
- Department of Physical Medicine and Rehabilitation, Montefiore Medical Center, 1250 Waters Place, Tower Two, 8th Floor, Bronx, NY 10461
- Department of Physical Medicine and Rehabilitation, Montefiore Medical Center, Bronx, NY
- Department of Radiology, Montefiore Medical Center, Bronx, NY
- Department of Structural Biology and Anatomy, Department of Physical Medicine and Rehabilitation, Albert Einstein College of Medicine, Bronx, NY
| | - Jay M Shah
- Department of Physical Medicine and Rehabilitation, Montefiore Medical Center, 1250 Waters Place, Tower Two, 8th Floor, Bronx, NY 10461
- Department of Physical Medicine and Rehabilitation, Montefiore Medical Center, Bronx, NY
- Department of Radiology, Montefiore Medical Center, Bronx, NY
- Department of Structural Biology and Anatomy, Department of Physical Medicine and Rehabilitation, Albert Einstein College of Medicine, Bronx, NY
| | - Sherry Downie
- Department of Physical Medicine and Rehabilitation, Montefiore Medical Center, 1250 Waters Place, Tower Two, 8th Floor, Bronx, NY 10461
- Department of Physical Medicine and Rehabilitation, Montefiore Medical Center, Bronx, NY
- Department of Radiology, Montefiore Medical Center, Bronx, NY
- Department of Structural Biology and Anatomy, Department of Physical Medicine and Rehabilitation, Albert Einstein College of Medicine, Bronx, NY
| |
Collapse
|
10
|
Taschner CA, Sankowski R, Shah JM, Urbach H, Hartmann R, Prinz M. Freiburg Neuropathology Case Conference : A Pituitary Mass Lesion. Clin Neuroradiol 2016; 26:493-497. [PMID: 27830265 DOI: 10.1007/s00062-016-0549-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- C A Taschner
- Department of Neuroradiology, University Medical Centre Freiburg, Freiburg, Germany.
| | - R Sankowski
- Department of Neuropathology, University Medical Centre Freiburg, Freiburg, Germany
| | - J M Shah
- Department of Neurosurgery, University Medical Centre Freiburg, Freiburg, Germany
| | - H Urbach
- Department of Neuroradiology, University Medical Centre Freiburg, Freiburg, Germany
| | - R Hartmann
- Department of Neuroradiology, University Medical Centre Freiburg, Freiburg, Germany
| | - M Prinz
- Department of Neuropathology, University Medical Centre Freiburg, Freiburg, Germany
| |
Collapse
|
11
|
Wahezi SE, Shah JM. Hypodermis Tension Loop: A New Preventative Measure for Lead Migration in the Morbidly Obese. Pain Physician 2015; 18:E1123-E1126. [PMID: 26606026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Electrode migration/displacement is reported to be the most common complication of spinal cord stimulator (SCS) implantation, with the literature reporting incidences from 13.2% to 22.6%. There have been numerous publications describing techniques preventing lead migration, with most involving tying leads to skin and fascia for trial and permanent leads, respectively. However, few have addressed how to prevent migration in the case of hypermobile tissue seen in the morbidly obese. We describe the creation of subcutaneous tension loops to prevent lead migration.
Collapse
Affiliation(s)
| | - Jay M Shah
- Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, USA
| |
Collapse
|
12
|
Evans EGV, Shah JM, Joshipura RC. One-week treatment of tinea corporis and tinea cruris with terbinafine (Lamisil) 1% cream: a placebo-controlled study. J DERMATOL TREAT 2009. [DOI: 10.3109/09546639209088719] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
13
|
Dani SI, Thanvi S, Shah JM, Prajapti J, Jain S, Joshi H. Hyperhomocysteinemia masquerading as pulmonary embolism. J Assoc Physicians India 2003; 51:914-5. [PMID: 14710983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Abstract
We describe a 30-year-old male who presented with acute onset of breathlessness, tachycardia, and palpitations associated with distension of jugular vein and clear lungs on physical examination. The chest X-ray was normal and ECG was showing S1Q3T3 and right ventricular strain pattern. His 2-D echocardiography was showing dilated right atrium, right ventricular dilatation and moderate pulmonary arterial hypertension. He was found to have thrombosis involving left side of deep venous system with normal superficial venous system (Doppler proved). All routine blood investigations for etiology of recurrent DVT were normal except serum homocyteine level, which was significantly raised. Megaloblastic anemia on peripheral smear and hyperhomocysteinemia prompted us to search for its cause, which was subsequently found to be vitamin B12 deficiency. Such an association of megaloblastic anemia due to vitamin B12 deficiency leading to hyperhomocysteinemia and subsequent thrombosis in left venous system presenting as acute pulmonary embolism has not been described earlier in the medical literature.
Collapse
Affiliation(s)
- S I Dani
- UN Mehta Institute of Cardiology and Research Centre, Civil Hospital Campus, Ahmedabad 380016 (Gujarat)
| | | | | | | | | | | |
Collapse
|
14
|
Mangalvedhekar SS, Gogtay NJ, Phadke AV, Gore S, Shah JM, Shah SM, Kshirsagar NA. Adverse drug reactions postal survey-bronchial asthma and angioedema with nimesulide. J Assoc Physicians India 2000; 48:548. [PMID: 11273160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/16/2023]
|
15
|
Abstract
A partially obstructing lesion of the splenic flexure was discovered during a barium enema examination, and subsequent colonoscopy and biopsy demonstrated a squamous cell carcinoma. This is the first reported instance of squamous cell carcinoma of the colon in which the splenic flexure has been involved. The case is discussed, and the recent literature on this entity is reviewed.
Collapse
|
16
|
|
17
|
Gould L, Shah JM, Patel M, Curtis GT. Pseudodigitation in ectopic ossification. J Med Soc N J 1982; 79:131-3. [PMID: 6801264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
|
18
|
Dastur FD, Shah J, Awatramani V, Shah JM, Pardiwalla BS, Nair KG, Mehta MN, Desai KB. Thyroid function in tetanus. J Assoc Physicians India 1981; 29:519-25. [PMID: 7328074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
|
19
|
Manikeri SR, Kshirsagar NA, Karandikar SM, Dastur FD, Awatramani V, Shah J, Shah JM. Platelet function and blood coagulation in tetanus. J Postgrad Med 1981; 27:109-15. [PMID: 7277245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
|
20
|
Siraslewalla R, Pardiwalla BS, Shah JM, Dastur FD. Typhoid fever presenting as cerebellar ataxia. J Assoc Physicians India 1981; 29:227-8. [PMID: 7275923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
|