Post–Vertebral Augmentation Back Pain: Evaluation and Management

Kamalian, Shahmir; Bordia, R.; Ortiz, A. Orlando

doi:10.3174/ajnr.a2775

Cited by 17 publications

(8 citation statements)

References 26 publications

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“…The lower lumbar spine, defined as the spine from the upper endplate of the fourth lumbar vertebra to the sacrum, is the most important part for determining lumbar lordosis. 38 , 39 In addition, it is the most common surgical site in degenerative spinal diseases. 40 The good outcome group had more lower lumbar lordosis with a cut-off point of 29°.…”

Section: Discussionmentioning

confidence: 99%

“…We investigated the predictive factors for subsequent facet joint pain after a compression fracture, and the pain is associated with recurrent pain after a compression fracture and PV. 39–42 A literature review revealed different results in pain relief after facet joint injection. In our study, 16 of 31 patients underwent vertebroplasty, and only three patients had facet joint pain at the compression sites.…”

Section: Discussionmentioning

confidence: 99%

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Optimal Cut-Off Points of Sagittal Spinopelvic Parameters as a Morphological Parameter to Predict Efficiency in Nerve Block and Pulsed Radiofrequency for Lumbar Facet Joint Pain: A Retrospective Study

Liang¹,

Wang²,

Chen³

et al. 2021

JPR

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Background After proper patient selection, anatomically correct pulsed radiofrequency of the lumbar facet joints provide long-term pain relief in a routine clinical setting. In the study, we performed an analysis of clinical and radiological predictive factors and provide the scientific basis for this promising modality. Methods The study included 198 patients with lower back pain due to lumbar facet joint disease who underwent medial branch block and pulsed radiofrequency during the period 2015–2019. According to the improvement in pain score, the patients were divided into good and poor outcome groups. Clinical and radiological data were collected and analyzed. Results The multivariable analysis revealed the predictive factors, including lumbar lordosis, lower lumbar lordosis, pelvic tilt, the number of facet joints, old compression fracture with/without vertebroplasty, and post lumbar fusion procedures. Conclusion With the results of this study, we demonstrated that the improved outcome after the surgery was related to lumbar lordosis, lower lumbar lordosis, pelvic tilt, the number of facet joints, old compression fracture with/without vertebroplasty, and the lumbar fusion procedures. Old compression fractures and lumbar fusion would change the radiological factors and cause refractory lumbar facet joint pain.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Optimal Cut-Off Points of Sagittal Spinopelvic Parameters as a Morphological Parameter to Predict Efficiency in Nerve Block and Pulsed Radiofrequency for Lumbar Facet Joint Pain: A Retrospective Study

Liang¹,

Wang²,

Chen³

et al. 2021

JPR

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“…Dual or triple array epidural leads have been used to provide stronger axial coverage [ 19 , 20 ]. This may be important in patients with more diffuse lumbar pain associated with multiple vertebral compression fractures [ 11 - 13 ]. Another option is a combination of an epidural lead with a second lead positioned in the lumbar subcutaneous tissue for peripheral nerve field stimulation (PNFS) [ 21 , 22 ].…”

Section: Discussionmentioning

confidence: 99%

“…Spinal cord stimulation or peripheral nerve field stimulation has been used to treat chronic pain after joint replacement [ 10 ]. Some degree of persistent pain after vertebral augmentation and kyphoplasties is common especially when the fractures are in the lumbar spine [ 11 , 12 ]. Back pain persisting after the first three months post vertebroplasty is seen in 19% to 23% of cases [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

“…Back pain persisting after the first three months post vertebroplasty is seen in 19% to 23% of cases [ 13 ]. Radicular pain is not usually associated with osteoporotic vertebral compression fractures, however, these elderly patients may also have chronic extremity pain from peripheral neuropathy or from other osteoporotic fractures in the hip or after joint replacement that can be helped with spinal cord stimulation targeting both the lumbar spine and lower extremities [ 11 , 13 ].…”

Section: Introductionmentioning

confidence: 99%

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Use of Spinal Cord Stimulation in Elderly Patients with Multi-Factorial Chronic Lumbar and Non-Radicular Lower Extremity Pain

Granville

Berti

Jacobson

2017

Cureus

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Spinal cord stimulation (SCS) is an effective treatment for chronic back and limb pain. The criteria for use of SCS for specific problems such as failed back surgery syndrome (FBSS), peripheral neuropathic pain and residual pain after joint replacement is well established. With an aging population, there are more patients presenting with a combination of various multi-factorial chronic pain problems rather than from a single clear cause. It is not uncommon to see patients with chronic back pain years after spine surgery with new additional pain in the area of joint replacement or due to peripheral neuropathy. In most of these patients, one area is the primary cause of their pain, while the other more secondary. Multiple chronic problems complicate the pain management of the primary cause and also can diminish the effect of SCS that only targets the primary problem. The primary and secondary causes of pain were ranked by the patient including the duration of their chronic pain for each area. This helped establish criteria for use of SCS in these complex pain patients. The patients were evaluated initially with an epidural stimulator trial and if they obtained 50% or greater pain relief to the primary pain generating area, permanent implantation of one or more arrays of spinal cord electrodes was performed but planned to cover also the secondary pain areas. Post-implant follow-up evaluation at one, three and six months included measurement of visual analog scale (VAS), use of pain medication and degree of functional activity and behavior. This report looks at the effectiveness of using multiple overlapping electrodes for SCS in patients with multi-factorial chronic pain.

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