Neuropathic Pain Related with Spinal Disorders: A Systematic Review

Abstract

Systematic literature review. To review the evidence from high-quality studies regarding the treatment of neuropathic pain originating specifically from spinal disorders. In general, treatment guidelines for neuropathic pain cover all its various causes, including medical disease, peripheral neuropathy, and cancer. However, the natural history of neuropathic pain originating from spinal disorders may differ from that of the pain originating from other causes or lesions. An expert research librarian used terms related to neuropathic pain and spinal disorders, disc herniation, stenosis, and spinal cord injury to search in MEDLINE, Embase, and Cochrane CENTRAL for primary research from January 2000 to October 2015. Among 2,313 potential studies of interest, 25 randomized controlled trials (RCTs) and 21 systematic reviews (SRs) were included in the analysis. The selection was decided based on the agreement of two orthopedic surgeons. There was a lack of evidence about medication for radiculopathy arising from disc herniation and stenosis, but intervention procedures, including epidural block, showed positive efficacy in radiculopathy and also limited efficacy in spinal stenosis. There was some evidence based on the short-term follow-up regarding surgery being superior to conservative treatments for radiculopathy and stenosis. There was limited evidence regarding the efficacy of pharmacological and electric or magnetic stimulation therapies for neuropathic pain after spinal cord injury. This review of RCTs and SRs with high-quality evidence found some evidence regarding the efficacy of various treatment modalities for neuropathic pain related specifically to spinal disorders. However, there is a need for much more supportive evidence.

Sleep Disturbance and Its Clinical Implication in Patients with Adult Spinal Deformity: Comparison with Lumbar Spinal Stenosis

“…Interestingly, the use of sleep medications was significantly different among subcomponents of PSQI between the both groups. is might be because patients with LSS usually take medication such as benzodiazepine or gabapentinoid for radiculopathy, which is classified as a sedative drug or CNS depressants [28].…”

Dangerous Behavior and Intractable Axial Skeletal Pain in Performance Horses: A Possible Role for Ganglioneuritis (14 Cases; 2014–2019)

“…In the cervicothoracic region, vertebral endplate sclerosis and narrowing of the intervertebral disc as seen on radiographs, or protrusion of the dorsal intervertebral disc identified on CT support the diagnosis of chronic vertebral instability and IVDD (55). In humans, IVDD has been associated with the development of neuropathic pain (60). The radiographic diagnosis of impinged thoracolumbar spinous processes may be of little clinical significance in some horses (61,62), but is likely an important radiographic finding in horses that have notable pain responses to digital palpation along the dorsal midline, epaxial muscle hypertonicity or atrophy, and severe avoidance behavioral responses to spinal mobilization (e.g., flexion-extension) of the affected spinal region.…”

Acute abdominal pain: chameleon presentations of acute myelitis

“…Neurological disease presenting with abdominal pain is widely recognised, though disease processes localising to nerve roots (radiculopathies) and ganglia (gangliopathies) are more classically associated with pain. 3 Examples include spinal disc herniation, diabetic radiculopathy, Guillain Barre Syndrome, herpes zoster, and Lyme radiculitis. With the exception of Zoster, the majority of these more commonly affect the lumbar and sacral regions causing sciatica-like symptoms, but may also manifest with abdominal pain due to thoracic root involvement.…”