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BACKGROUND CONTEXT The publication of several recent studies showing minimal benefit for radiofrequency (RF) lumbar zygapophysial (l-z) joint denervation have led many investigators to reevaluate selection criteria. One controversial explanation for these findings is that the most commonly used cutoff value for selecting patients for l-z (facet) joint RF(More)
Spinal cord stimulation is the most common mode of neuromodulation used in managing chronic low back pain. It is minimally invasive and reversible as opposed to nerve ablation. The basic scientific background of the initial spinal cord stimulation trials was based on the gate control theory of Melzack and Wall. It has been demonstrated in multiple studies(More)
OBJECTIVE To determine the clinical factors associated with the success and failure of radiofrequency denervation of the lumbar facet joints. METHODS Clinical data were garnered from 3 academic medical centers on 192 patients with low back pain who underwent radiofrequency denervation after a positive response to diagnostic blocks. Success was defined as(More)
BACKGROUND AND OBJECTIVES The concept of opioid-induced hyperalgesia has recently gained prominence as a contributing factor for opioid tolerance and long-term treatment failure. But whereas the preclinical data for this phenomenon are strong, the mixed clinical data derive primarily from experimental pain models conducted in volunteers and heroin addicts,(More)
STUDY DESIGN A multicenter, retrospective analysis of cervical epidurograms. OBJECTIVES To determine the effectiveness of the loss of resistance (LOR) technique in identifying the cervical epidural space. To delineate the pattern of epidural contrast spread during cervical epidural steroid injections. BACKGROUND Previous studies have shown that if(More)
OBJECTIVE The purpose of this study was to determine the factors associated with false-positive medial branch blocks (MBB), the nerve blocks used to diagnose facet arthropathy, in soldiers and retirees. METHODS The study subjects were 78 patients with chronic low back pain who underwent diagnostic MBB to determine whether or not the facet joints were pain(More)
STUDY DESIGN A bi-institutional, retrospective clinical data analysis. OBJECTIVES To determine risk factors for failure and complications of intradiscal electrothermal therapy, a treatment for discogenic back pain. SUMMARY OF THE BACKGROUND DATA Intradiscal electrothermal therapy is a relatively new treatment for discogenic back pain. Though previous(More)
Neurostimulation methods for control of chronic neuropathic pain have recently gained in popularity. The reasons for this are multifactorial. As opposed to nerve ablation, these methods are minimally invasive and reversible. The improvements in hardware design simplified implantation techniques and prolonged equipment longevity. Stimulation trials have(More)
BACKGROUND AND OBJECTIVES Medial branch blocks are an important tool for the diagnosis of facet joint arthropathy. The most commonly used technique involves multiple needle placements, one for each nerve blocked. This multiple needle technique may require a large amount of local anesthetic for anesthetizing the skin, thereby increasing the rate of(More)
BACKGROUND AND OBJECTIVES Since its advent more than 50 years ago, the use of discography has been mired in controversy. The purpose of this review is to provide a clinical overview of lumbar discography and discogenic back pain, with special emphasis on determining the accuracy of discography and whether or not the procedure improves outcomes for surgery.(More)