scholarly journals Caudal epidural blockades for chronic pain in the lower back in working age

2022 ◽  
pp. 143-151
Author(s):  
I. I. Litvinov ◽  
I. V. Lokhovinin ◽  
V. V. Savgachev
Keyword(s):  
Back Pain ◽  
Local Therapy ◽  
City Hospital ◽  
Efficacy And Safety ◽  
Middle Aged ◽  
Aged Patients ◽  
Septic Complications ◽  
Lower Back ◽  
Epidural Catheterization ◽  
Caudal Epidural

Introduction. Chronic back pain syndrome, which significantly restricts a person’s daily activity, can cause the formation of depressive states and is a significantly more difficult task for treatment compared to acute pain.Aim. To evaluate the efficacy and safety of caudal epidural catheterization (CEC) and local therapy with anesthetics and glucocorticoids for chronic nonspecific discogenic and chronic radicular low back pain (LBP) in young and middle-aged patients.Materials and methods. 42 patients aged from 29 to 59 years, who in the neurosurgical department of the Vologda City Hospital No. 1 in 2017–2019 underwent an operation to install a caudal epidural catheter and prolonged injection therapy of local anesthetics and glucocorticosteroids for chronic nonspecific discogenic and chronic radicular LBP.Results. There were no purulent-septic complications, hematomas of the spinal canal. In the group of patients with radicular syndrome the average values of LBP according to VAS were as follows: before CEC – 78.5 mm; 5 days after CEC – 24.1 mm; 6 months after CEC – 19.6 mm; after 12 months – 17.9 mm. In the group of patients with nonspecific discogenic LBP the average pain estimates for VAS were as follows: before CEC – 78.1 mm; 5 days after CEC – 21.7 mm; 6 months after CEC – 20.9 mm; after 12 months – 23.4 mm.Сonclusion. Our experience indicates a high long-term efficacy and safety of treatment with caudal epidural catheterization and local prolonged therapy with anesthetics and glucocorticoids for chronic radicular and chronic nonspecific discogenic pain in the lower back in young and middle-aged patients selected on the basis of a special system of criteria.

scholarly journals Caudal Epidural for Pain Management of Prostate Cancer

2020 ◽  
Vol 3 (2) ◽  
pp. 64-67
Author(s):  
Rajesh Kumar Muniandy ◽  
Nagarajan Nagalingam
Keyword(s):  
Quality Of Life ◽  
Prostate Cancer ◽  
Back Pain ◽  
Bone Pain ◽  
Lower Back ◽  
Stage 4 ◽  
Metastatic Bone Pain ◽  
Advanced Stages ◽  
Caudal Epidural

Prostate cancer is the second commonest cancer found in men. Pain can occur in both early and advanced stages of prostate cancer, with an incidence of 30-50%. The pain can be caused directly by the cancer or related to the cancer treatment. Currently, pain in prostate cancer is managed with surgery, medication, radiotherapy or chemotherapy. It can also be managed by intra-thecal morphine, psoas sheet catheter and superior hypogastric block. However, all these procedures involve risks. We present a case of Stage 4 Prostate Cancer who presented with severe lower back pain. We performed a caudal epidural, which was very successful to reduce the patient's pain and improve his quality of life. We recommend a caudal epidural should be considered as an option to manage metastatic bone pain in prostate cancer patients.

scholarly journals Non-secreting adrenal myelolipoma in a middle-aged male patient manifesting with sudden onset of severe lower back pain

2020 ◽  
Vol 92 (3) ◽  
Author(s):  
Carlo Introini ◽  
Fabio Campodonico ◽  
Marco Ennas ◽  
Antonia Di Domenico ◽  
Luca Foppiani
Keyword(s):  
Back Pain ◽  
Male Patient ◽  
Lower Back Pain ◽  
Imaging Techniques ◽  
Surgical Excision ◽  
Sudden Onset ◽  
Middle Aged ◽  
Adrenal Myelolipoma ◽  
Lower Back ◽  
Middle Aged Male

Adrenal myelolipoma (AML) is a rare benign tumor, usually non-functioning and asymptomatic until it reaches large size. AML is mostly detected incidentally by imaging and is composed of adipose tissue and hematopoietic elements. Only symptomatic tumor needs surgical excision. We report the case of a large non-functioning adrenal tumor discovered by means of combined imaging techniques in a middle-aged male patient who complained the sudden onset of severe lower back pain; successful laparoscopic removal was performed, and AML was diagnosed at histopathology.

scholarly journals Infectious Sacroiliitis Caused by Staphylococcus aureus following acupuncture: A case report

2014 ◽  
Vol 32 (1) ◽  
pp. 77-80 ◽  
Author(s):  
Yu-Chen Tseng ◽  
Ya-Sung Yang ◽  
Yu-Cheng Wu ◽  
Sheng-Kang Chiu ◽  
Te-Yu Lin ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Back Pain ◽  
Lower Back Pain ◽  
Antimicrobial Treatment ◽  
Hip Pain ◽  
Septic Complications ◽  
Lower Back ◽  
The Right ◽  
Tract Infections

Determination of the origin of infectious sacroiliitis (ISI), a rare form of septic arthritis, is often time consuming and clinically difficult owing to its various presentations, which include joint, skin and urinary tract infections. This report describes the diagnosis, determination of infectious origin and treatment of a case of ISI attributed to the use of acupuncture for the treatment of lower back pain. We report on a 61-year-old man who developed right hip pain and fever 3 days after undergoing acupuncture over the right buttock region for the treatment of lower back pain. Blood culture showed infection with methicillin-susceptible Staphylococcus aureus and MRI disclosed the presence of an inflamed area over the right iliac bone and the right portion of the sacrum. The patient was cured after a 4-week course of antimicrobial treatment. Clinicians should take a history of acupuncture use when evaluating patients presenting with fever of unknown origin and/or bacteraemia and consider the possibility of ISI when evaluating patients with hip pain and infectious signs after acupuncture or other possible causes of infection. This indicates the importance of performing clinically clean procedures to prevent septic complications when treating patients with acupuncture.

scholarly journals Lumbosacral Angle Variations in Middle Aged Patients with Chronic Low Back Pain - A Retrospective Study

2021 ◽  
Vol 8 (04) ◽  
pp. 208-212
Author(s):  
Ushnish Mukherjee ◽  
Sourav Kundu ◽  
Rachit Gulati ◽  
Prabir Mandal
Keyword(s):  
Body Mass Index ◽  
Low Back Pain ◽  
Back Pain ◽  
Retrospective Study ◽  
Chronic Low Back Pain ◽  
Significant Positive Correlation ◽  
P Value ◽  
Low Back ◽  
Middle Aged ◽  
Aged Patients

BACKGROUND Chronic low back pain (CLBP) is one of the common debilitating condition in middle-age population. Often the pain is "non-specific" or related to mechanical origin; so, often it is termed as chronic mechanical low back pain. Among the various predisposing factors, abnormal lumber lordosis is more often seen. Radiographic assessment of lumbar lordosis can be done by measuring lumbosacral angle (LSA). Therefore, study of variations in LSA among these patients can give important clues in both pathogenesis and management. The aim of the study is to determine different factors leading to the variations of lumbosacral angle amongst the middle-aged patients presenting with chronic mechanical low back pain. METHODS This retrospective study was conducted by analysing records of 105 CLBP patients of both sex (male = 32, female = 73) in the age group of 45 - 65 years. LSA was directly measured digitally by Ferguson technique from the selected patients’ lateral lumbosacral radiographs. Data was collected in Microsoft Excel 2016 and analysis was done with International Business Machines Statistical Package for the Social Sciences (IBM SPSS) Statistics version 23. RESULTS The difference in median of LSA of male [Median (IQR) = 37.00 (10.00)] and female [Median (IQR) = 45.00 (8.50)] patients was statistically significant (p-value 0.000). Significant positive correlation was also found between LSA and BMI for both sexes, but more in case of female (Spearman’s rho 0.806 p = 0.000) than male (Spearman’s rho 0.680 p-value 0.000). CONCLUSIONS Variation of LSA was found to have significant relations with sex and body mass index (BMI), but not with the age. Statistically significant positive correlation between LSA and BMI alongside higher BMI of the females in the study group suggested that they are more prone to develop CLBP. To formulate proper rehabilitation protocol for middle aged CLBP patients, LSA variations and related factors can be kept in mind. KEYWORDS Chronic Low Back Pain (CLBP), Lumbosacral Angle (LSA), Lordosis, Rehabilitation, Body Mass Index, Lordosis, Spine, Radiography, Rehabilitation

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