scholarly journals Steroids Spinal Injections

2018 ◽  
Vol 35 (04) ◽  
pp. 290-298 ◽  
Author(s):  
Chiara Zini ◽  
Joshua Hirsch ◽  
Ronil Chandra ◽  
Matteo Bellini ◽  
Stefano Marcia
Keyword(s):  
Patient Outcomes ◽  
Patient Selection ◽  
Image Guidance ◽  
Imaging Finding ◽  
Spinal Pain ◽  
Cost Utility ◽  
Common Condition ◽  
Short Term ◽  
Significant Disability ◽  
Spinal Injections

AbstractSpinal pain is a common condition leading to significant disability and high cost. Spinal injections have been demonstrated to be effective short-term treatments with cost–utility superior to numerous other treatments, including surgical procedures. Appropriate patient selection—based on clinical and imaging finding—and the use of image guidance associated with technical precautions improve the safety and effectiveness of spinal injection and overall patient outcomes.

Short Term Radiographic and Patient Outcomes of a Biplanar Plating System for Triplanar Hallux Valgus Correction

2020 ◽  
Author(s):  
Kshitij Manchanda ◽  
Alice Chang ◽  
Blake Wallace ◽  
Junho Ahn ◽  
Yin Xi ◽  
...  
Keyword(s):  
Hallux Valgus ◽  
Patient Outcomes ◽  
Short Term

scholarly journals The benefit of radiologically-guided steroid injections for trapeziometacarpal osteoarthritis

2010 ◽  
Vol 92 (8) ◽  
pp. 680-684 ◽  
Author(s):  
MG Swindells ◽  
AJ Logan ◽  
DJ Armstrong ◽  
P Chan ◽  
FD Burke ◽  
...  
Keyword(s):  
Observational Study ◽  
Local Anaesthetic ◽  
Common Condition ◽  
Trapeziometacarpal Joint ◽  
Steroid Injections ◽  
Analgesic Effects ◽  
Trapeziometacarpal Osteoarthritis ◽  
Significant Disability

INTRODUCTION Osteoarthritis of the trapeziometacarpal joint (TMJ) is a common condition causing significant disability. Conservative treatments include intra-articular steroid injections. PATIENTS AND METHODS This clinical, observational study prospectively reviewed the longevity of benefit of steroid injections into the TMJ. Eighty-three patients were recruited with a median age of 62 years and injected with steroid and local anaesthetic under radioscopic guidance. They were followed up until the analgesic effects ceased with a questionnaire including visual analogue scores. RESULTS Two-thirds of patients were improved at 2 months, with nearly half having a 3-month improvement. One in six patients had a 6-month benefit, with some patients still improved 2 years after injection. Previously injected patients had a reduced duration of benefit compared to their previous injection. Severity of osteoarthritis did not affect the injection efficacy. CONCLUSIONS Based on this study, we recommend steroid injections in all degrees of TMJ osteoarthritis.

scholarly journals Health economic measures in schizophrenia research

2007 ◽  
Vol 191 (S50) ◽  
pp. s42-s45 ◽  
Author(s):  
Paul McCrone
Keyword(s):  
Health Economic ◽  
Economic Evaluation ◽  
Cost Utility ◽  
Outcome Data ◽  
Cost Utility Analysis ◽  
Economic Evaluations ◽  
Utility Analysis ◽  
Short Term ◽  
Effectiveness Analysis

BackgroundIt is essential in economic evaluations of schizophrenia interventions that all relevant costs are identified and measured appropriately Also of importance is the way in which cost data are combined with information on outcomesAimsTo examine the use of health economicsin evaluations of interventions for schizophreniaMethodsAreview of the key methods used to estimate costs and to link costs and outcomes was conductedResultsCosts fall on a number of different agencies and can be short term or long term. Cost-effectiveness analysis and cost-utility analysis are the most appropriate methods for combing cost and outcome dataConclusionsSchizophrenia poses a number of challenges for economic evaluation

The learning curve following adoption of a novel short-stem prosthesis in total hip arthroplasty: implications on short-term patient outcomes

2018 ◽  
Vol 29 (4) ◽  
pp. 819-825 ◽  
Author(s):  
Jorge A. Padilla ◽  
Afshin A. Anoushiravani ◽  
James E. Feng ◽  
Ran Schwarzkopf ◽  
James Slover ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Learning Curve ◽  
Patient Outcomes ◽  
Hip Arthroplasty ◽  
Short Stem ◽  
Short Term ◽  
Total Hip

scholarly journals Interventional Techniques: Evidence-based Practice Guidelines in the Management of Chronic Spinal Pain

2007 ◽  
Vol 1;10 (1;1) ◽  
pp. 7-111
Author(s):  
ASIPP ASIPP
Keyword(s):  
Facet Joint ◽  
Spinal Pain ◽  
Evidence Based ◽  
Short Term ◽  
Steroid Injections ◽  
Interventional Techniques ◽  
Epidural Steroid Injections ◽  
Epidural Steroid ◽  
Chronic Spinal Pain

Background: The evidence-based practice guidelines for the management of chronic spinal pain with interventional techniques were developed to provide recommendations to clinicians in the United States. Objective: To develop evidence-based clinical practice guidelines for interventional techniques in the diagnosis and treatment of chronic spinal pain, utilizing all types of evidence and to apply an evidence-based approach, with broad representation by specialists from academic and clinical practices. Design: Study design consisted of formulation of essentials of guidelines and a series of potential evidence linkages representing conclusions and statements about relationships between clinical interventions and outcomes. Methods: The elements of the guideline preparation process included literature searches, literature synthesis, systematic review, consensus evaluation, open forum presentation, and blinded peer review. Methodologic quality evaluation criteria utilized included the Agency for Healthcare Research and Quality (AHRQ) criteria, Quality Assessment of Diagnostic Accuracy Studies (QUADAS) criteria, and Cochrane review criteria. The designation of levels of evidence was from Level I (conclusive), Level II (strong), Level III (moderate), Level IV (limited), to Level V (indeterminate). Results: Among the diagnostic interventions, the accuracy of facet joint nerve blocks is strong in the diagnosis of lumbar and cervical facet joint pain, whereas, it is moderate in the diagnosis of thoracic facet joint pain. The evidence is strong for lumbar discography, whereas, the evidence is limited for cervical and thoracic discography. The evidence for transforaminal epidural injections or selective nerve root blocks in the preoperative evaluation of patients with negative or inconclusive imaging studies is moderate. The evidence for diagnostic sacroiliac joint injections is limited. The evidence for therapeutic lumbar intraarticular facet injections is moderate for short-term and long-term improvement, whereas, it is limited for cervical facet joint injections. The evidence for lumbar and cervical medial branch blocks is moderate. The evidence for medial branch neurotomy is moderate. The evidence for caudal epidural steroid injections is strong for short-term relief and moderate for long-term relief in managing chronic low back and radicular pain, and limited in managing pain of postlumbar laminectomy syndrome. The evidence for interlaminar epidural steroid injections is strong for short-term relief and limited for long-term relief in managing lumbar radiculopathy, whereas, for cervical radiculopathy the evidence is moderate. The evidence for transforaminal epidural steroid injections is strong for short-term and moderate for long-term improvement in managing lumbar nerve root pain, whereas, it is moderate for cervical nerve root pain and limited in managing pain secondary to lumbar post laminectomy syndrome and spinal stenosis. The evidence for percutaneous epidural adhesiolysis is strong. For spinal endoscopic adhesiolysis, the evidence is strong for short-term relief and moderate for long-term relief. For sacroiliac intraarticular injections, the evidence is limited. The evidence for radiofrequency neurotomy for sacroiliac joint pain is limited. The evidence for intradiscal electrothermal therapy is moderate in managing chronic discogenic low back pain, whereas for annuloplasty the evidence is limited. Among the various techniques utilized for percutaneous disc decompression, the evidence is moderate for short-term and limited for long-term relief for automated percutaneous lumbar discectomy, and percutaneous laser discectomy, whereas it is limited for nucleoplasty and for DeKompressor technology. For vertebral augmentation procedures, the evidence is moderate for both vertebroplasty and kyphoplasty. The evidence for spinal cord stimulation in failed back surgery syndrome and complex regional pain syndrome is strong for shortterm relief and moderate for long-term relief. The evidence for implantable intrathecal infusion systems is strong for short-term relief and moderate for long-term relief. Conclusion: These guidelines include the evaluation of evidence for diagnostic and therapeutic procedures in managing chronic spinal pain and recommendations for managing spinal pain. However, these guidelines do not constitute inflexible treatment recommendations. These guidelines also do not represent a “standard of care.” Key words: Interventional techniques, chronic spinal pain, diagnostic blocks, therapeutic interventions, facet joint interventions, epidural injections, epidural adhesiolysis, discography, radiofrequency, disc decompression, vertebroplasty, kyphoplasty, spinal cord stimulation, intrathecal implantable systems

scholarly journals Impact of Having a Planned Additional Operation at Time of Liver Transplant on Graft and Patient Outcomes

2020 ◽  
Vol 9 (2) ◽  
pp. 608
Author(s):  
Shirin Salimi ◽  
Keval Pandya ◽  
Vinay Sastry ◽  
Claire West ◽  
Susan Virtue ◽  
...  
Keyword(s):  
Patient Outcomes ◽  
Operating Time ◽  
Length Of Hospital Stay ◽  
Liver Graft ◽  
Short Term ◽  
Additional Operation ◽  
Additional Surgery ◽  
Surgical Complexity ◽  
Abdominal Operations ◽  
Baseline Characteristics

Advances in liver transplantation (LT) have allowed for expanded indications and increased surgical complexity. In select cases, additional surgery may be performed at time of LT rather than prior to LT due to the significant risks associated with advanced liver disease. We retrospectively studied the characteristics and outcomes of patients who underwent an additional planned abdominal or cardiac operation at time of LT between 2011–2019. An additional operation (LT+) was defined as a planned operation performed under the same anesthetic as the LT but not directly related to the LT. In total, 547 patients were included in the study, of which 20 underwent LT+ (4%). Additional operations included 10 gastrointestinal, 5 splenic, 3 cardiac, and 2 other abdominal operations. Baseline characteristics between LT and LT+ groups were similar. The median total operating time was significantly longer in LT+ compared to LT only (451 vs. 355 min, p = 0.002). Graft and patient survival, intraoperative blood loss, transfusion of blood products, length of hospital stay, and post-operative complications were not significantly different between groups. In carefully selected patients undergoing LT, certain additional operations performed at the same time appear to be safe with equivalent short-term outcomes and liver graft survival as those undergoing LT alone

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