Posts Tagged ‘quality of life’
Free Article: Long-term Outcomes of DBS for Neuropathic Pain
Background: Deep brain stimulation (DBS) to treat neuropathic pain refractory to pharmacotherapy has reported variable outcomes and has gained United Kingdom but not USA regulatory approval.
Objective: To prospectively assess long-term efficacy of DBS for chronic neuropathic pain in a single-center case series.
Methods: Patient reported outcome measures were collated before and after surgery, using a visual analog score, short-form 36-question quality-of-life survey, McGill pain questionnaire, and EuroQol-5D questionnaires (EQ-5D and health state).
Ahead of Print: Multi-column SCS in Pudendal Neuralgia
Background and Importance: There is large variation in the success of decompressive surgery for pudendal neuralgia (PN), the most chronic, disabling form of perineal pain. We attempt to determine whether spinal cord stimulation (SCS) using new generation multi-column leads could form part of the treatment algorithm for refractory PN.
Clinical Presentation: A man with PN that was unresponsive to conventional treatment demonstrated a neuropathic component, and had a negative response to nerve infiltrations (so he was not indicated for decompressive surgery) and a positive response to perianal TENS, and was implanted with a 16-contacts surgical lead at the level of conus medullaris, allowing multi-column stimulation. Using transverse combinations, it was possible to obtain 100% paresthesia over the perineal area without unwanted dorsal root stimulation. Perineal and radicular pain was successfully relieved for up to 12 months (80% and 60% reduction in the visual analogue scores, respectively), with an improvement in all quality of life domains and a reduction in drug consumption.
Ahead of Print: Quality of Life Unruptured Aneurysm
Background: Awareness of having an unruptured intracranial aneurysm can affect quality of life and provoke feelings of anxiety and depression, even in treated patients, because of fear of recurrence of aneurysms.
Objective: We assessed quality of life and feelings of anxiety and depression in patients with an unruptured aneurysm with or without aneurysm occlusion.
Methods: We sent postal questionnaires (MOS Short Form-36, EuroQol EQ-5D, Hospital Anxiety and Depression scale) to 229 patients with an unruptured aneurysm and no prior history of subarachnoid haemorrhage identified from our database. Group mean scores and corresponding 95% confidence intervals (95%CI) were compared between the “no intervention” group and the “intervention” group and with reference population using Students t-test and Chi-square test.
Ahead of Print: Cervical Laminectomy Versus Laminoplasty
Background: Cervical laminoplasty is often used for the decompression of multilevel cervical spondylotic myelopathy without creating spinal instability and kyphosis.
Objective: To assess the axial pain, quality of life, sagittal alignment and extent of decompression after standard cervical laminectomy or laminoplasty. We further evaluate if the sagittal alignment changes over time after both procedures, and if axial pain depends on sagittal alignment.
Methods: We reviewed 268 patients with cervical radiculopathy or myelopathy who had standard cervical laminectomy or laminoplasty between January 1999 and January 2009. The clinical outcome was analyzed by Visual analogue scale (VAS) for neck pain. The quality of life was analyzed by EQ5D questionnaire. The degree of deformity and extent of decompression were assessed using the Ishihara index and Pavlov’s ratio, respectively.
