scholarly journals PLATELET-RICH PLASMA INJECTION THERAPY FOR REFRACTORY COCCYDYNIA: A CASE SERIES

2018 ◽  
pp. 183-188
Author(s):  
Fergie-Ross Montero-Cruz
Keyword(s):  
Pain Relief ◽  
Conservative Management ◽  
Rating Scale ◽  
Platelet Rich Plasma ◽  
Case Series ◽  
Small Sample ◽  
Rapid Weight Loss ◽  
Post Injection ◽  
Retrospective Case ◽  
Retrospective Case Series

Background: Coccydynia is pain in the coccyx region. The most common cause of coccydynia is trauma, either from a direct axial force such as during a fall onto the coccyx or from cumulative trauma as a result of poor sitting mechanics. Risk factors include obesity, female gender and rapid weight loss. The anatomy of the region is not well vascularized, and consists of the coccyx bones, and supporting ligaments and tendons. For a majority of patients, conservative management may be successful but for the remainder of patients, pain relief may only be transient and pain can become debilitating. What has yet to be fully explored is the possible beneficial effect of local injection of platelet-rich plasma (PRP) for the treatment of refractory coccydynia. PRP injections have been successful in treating a variety of chronic tendon, ligament and bone injuries by inducing an inflammatory response to promote or re-initiate healing. In addition, local injections of PRP to the coccyx would be a less invasive option than surgery for patients who have exhausted all other treatment options and continue to struggle with the debilitating effects of coccydynia. Objectives: To demonstrate the important role of PRP therapy in treating coccydynia refractory to traditional conservative management. Study Design: Retrospective case series. Methods: Three patients with coccygeal pain for greater than 6 months who presented to an outpatient pain management office in New York from 2014 until 2016, and failed conventional treatments. When the pain was deemed refractory for the patient, offering for PRP was done. This was presented with the option to repeat once again at the 6-8 week mark if needed. All patients underwent PRP with fluoroscopic injection, and the use of the same PRP commercially available system; Magellan-Arteriocyte. The patients were evaluated with a numerical rating scale, and percentage of pain relief at 6-8 week post-injection, 6 months post-injection, 12 months post-injection, and 24 months post-injection was recorded. Percentage of pain relief was then calculated. Results: Overall the patient series demonstrated significant improvement in numeric pain scale, as well as percentage of pain reduction. At the 6-8 week follow-up for all the post-PRP injections, there was an average of 75% improvement in overall pain. At 6 months, 1 patient had no change, while 2 patients maintained the same reduction in pain at the 12- and 24-month follow-ups. Limitations: This retrospective case series is only a small sample size of pat i e n t s w i t h r e f r a c t o r y c o c c y d y n i a . Conclusions: Here we discuss the first case series of PRP for coccydynia. The results of the 3 patients in this case series are encouraging.

scholarly journals Pain Outcomes after Platelet-Rich Plasma Application in Chronic Tibialis Anterior Pain: A Retrospective Case Series Analysis

2020 ◽  
pp. 9-13
Author(s):  
Calvin Rong Chen
Keyword(s):  
Regenerative Medicine ◽  
Adverse Effects ◽  
Pain Score ◽  
Tibialis Anterior ◽  
Rating Scale ◽  
Platelet Rich Plasma ◽  
Case Series ◽  
Small Sample ◽  
Pain Clinic ◽  
Control Group

Background: Platelet-rich plasma (PRP) has become a main component of regenerative medicine. It is used in various musculoskeletal tendinous and skeletal injuries, however, literature regarding PRP’s use in chronic anterior ankle pain is limited. Objectives: To determine the effectiveness of PRP in treating tibialis anterior (TA) tendon pain in patients who have failed traditional conventional therapeutic treatments. Study Design: Retrospective chart review. Setting: Outpatient interventional pain clinic at an academic center. Methods: Adults (n = 10), aged 18 and older, with greater than 6 months of TA tendon pain who failed conservative therapies. Patients who had undergone previous regenerative injections were excluded. PRP injection was administered with ultrasound guidance. Change in pain score was assessed using the Numeric Rating Scale (NRS-11: 0 = no pain, 10 = excruciating pain), and patient’s self-reported reduction in pain (percentage), pre- and postprocedure. There was a reduction in opioid dosage postprocedure. Adverse effects were recorded. Results: Average pain score at baseline was 8 ± 1.5 on the NRS-11 scale. The average percent change in pain between baseline and 8 weeks posttreatment was a 36% ± 23.2% reduction in pain. This was a significant reduction in pain score at 8 weeks post-PRP treatment when compared with baseline, P = 0.008. Average reduction in opioid dose between baseline and 8 weeks posttreatment was 17% ± 21.2%, P = 0.063. No patients experienced adverse effects. Limitations: Small sample size, and no doubleblind randomization with control group. Conclusions: PRP use in chronic TA pain 8 weeks post-PRP treatment significantly improved chronic TA pain. There is also a tendency toward lower opioid pain medication dosages after 8 weeks post-PRP treatment, although this was not statistically significant. Key words: Platelet-rich plasma, regenerative medicine, pain, ultrasound

scholarly journals Transoral vertebroplasty for the C1 lateral mass

2020 ◽  
Vol 12 (9) ◽  
pp. 879-885
Author(s):  
Frédéric Clarençon ◽  
Eimad Shotar ◽  
Evelyne Cormier ◽  
Kevin Premat ◽  
Mehdi Drir ◽  
...  
Keyword(s):  
Pain Relief ◽  
Rating Scale ◽  
Osteolytic Lesion ◽  
Case Series ◽  
Major Complication ◽  
Cement Leakage ◽  
Clinical Consequence ◽  
Lateral Mass ◽  
Retrospective Case ◽  
Osteolytic Lesions

BackgroundOsteolytic lesions of the atlas (C1) are challenging to treat by vertebroplasty due to the vicinity of the vertebral artery and the spinal cord.ObjectiveTo present our experience with transoral vertebroplasty (TOV) for osteolytic lesions of the lateral mass of the atlas.MethodsRetrospective case series involving 15 consecutive patients (nine male, six female, mean age 63 years) who underwent TOV for the treatment of an osteolytic lesion of the lateral mass of the atlas. Among the osteolytic lesions, 10/15 (67%) were bone metastases from various cancers; 4/15 (27%) were lesions related to multiple myeloma; and one lesion (7%) was an aggressive hemangioma. All the TOVs were performed under general anesthesia and in most cases (10/15; 67%) in a hybrid angiosuite combining a C-arm flat panel and a CT scan. The remaining five patients were treated under biplane fluoroscopic guidance.ResultsVertebroplasty of the lateral mass of C1 through a transoral route was feasible in all cases. Significant pain relief was obtained in most cases (1 month average decrease in Numeric Rating Scale: 4.9±4.1). No major complication was recorded. In 7/15 cases (47%), cement leakage surrounding the C1 lateral mass was seen; none of these leakages had a significant clinical consequence. No additional spine surgery was required in any of the patients.ConclusionTOV of osteolytic lesions of the lateral mass of the atlas is feasible and seems safe and effective, providing pain relief and bone stabilization.

scholarly journals A Retrospective Case Series of a Novel Spinal Cord Stimulator Trial Technique with Less Displacement and Migration of the Trial Leads

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
N. Shaparin ◽  
K. Gritsenko ◽  
P. Agrawal ◽  
S. Kim ◽  
S. Wahezi ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Case Series ◽  
Small Sample ◽  
Spinal Cord Stimulator ◽  
Retrospective Case ◽  
Thoracic Spinal Cord ◽  
Retrospective Case Series ◽  
Lead Placement ◽  
Spine Pathology ◽  
And Migration

Background. Spinal cord stimulation is an established treatment option for certain chronic pain conditions which have been previously unresponsive to conservative therapies or potentially for a subset of patients who have not improved following spine surgery. Prior to permanent lead implantation, stimulator lead trials are performed to ensure adequate patient benefit. During these trials, one of the most common complications and reasons for failure is the displacement and migration of the trial leads, resulting in lost therapeutic coverage. Other complications include infection and dislodged bulky dressings. There is a paucity of literature describing an adequate procedural method to prevent these common complications. Objective. This study utilizes a series of 19 patients to evaluate a new technique for securing percutaneous spinal cord simulator trial leads, which may minimize dislodgement and migration complications and improve the rate of trial success. Study Design. Retrospective case series. Setting. New Jersey Medical School, Department of Anesthesiology, Pain Management Division. Methods. A retrospective chart review was conducted on 19 consecutive patients undergoing placement of the percutaneous thoracic spinal cord stimulator trial leads for pain associated with lumbar spine pathology over a two-year period (2010–2012). Results. Of the 19 patients in our cohort, there was one trial lead displacement, no lead migrations, and no site infections. Thirteen patients went on to permanent lead implantation. This improved trial lead placement technique had a high success rate with a low number of complications. Limitations. Small sample size, retrospective case series, and no control group for comparison. Conclusion. This case series was able to demonstrate that our described novel spinal cord stimulator trial lead placement and dressing technique can decrease the incidence of lead displacement and migration, thus improving trial success.

“ROLE OF AUTOLOGOUS PLATELET RICH PLASMA THERAPY IN TREATMENT OF PLANTAR FASCIITIS, A PROSPECTIVE STUDY.”

2021 ◽  
pp. 51-52
Author(s):  
Kashif Iqbal ◽  
Vivek Kumar ◽  
Himanshu Patel ◽  
Anurag Tiwari
Keyword(s):  
Plantar Fasciitis ◽  
Platelet Rich Plasma ◽  
Corticosteroid Injection ◽  
Case Series ◽  
Small Sample ◽  
Treatment Modalities ◽  
Post Injection ◽  
Plasma Therapy ◽  
Autologous Platelet Rich Plasma ◽  
Autologous Platelet

Plantar fasciitis is fairly common in orthopaedics out-patient department. Although, majority of the patients do well with conservative treatment, some patients continue to have painful feet despite a course of conservative management. These patients of plantar fasciitis are provided with other treatment modalities such as local corticosteroid but the chronic condition requires multiple dosages and are associated with adverse reaction. Autologous platelet rich plasma therapy is another modality for treatment of such cases and are not associated with adverse effects when compared with corticosteroid injection therapy. This prospective case series analyses the improvement of pain using visual analogue scale of plantar fasciitis patients treated with autologous platelet rich plasma over the course of 3 months. 30 patients were enrolled in the study. The mean VAS score at pre injection was 7.13 which signicantly reduced to 3.3 at 6 weeks post injection and 2.36 at 6 weeks post injection. There was signicant improvement in pain. This study is limited with small sample size and short follow up.

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