Aims. Cervical radiculopathy is a significant cause of pain and morbidity. For patients with severe and poorly controlled symptoms who may not be candidates for surgical management, treatment with transforaminal
Neurogenic claudication is most frequently observed
in patients with degenerative lumbar spinal stenosis. We describe
a patient with lumbar
We have assessed whether an
Aims. The aim of this study was to determine the efficacy of repeat
Aims. Our aim was to perform a systematic review of the literature
to assess the incidence of post-operative
Metastatic
In order to identify the risk factors and the incidence of post-operative spinal
1.
We selected 20 matched pairs of patients who had had total hip arthroplasty by the same surgeon using the same cemented technique. Matching was by age, sex, height, weight and diagnosis. One of each pair had received hypotensive
Aims. This non-blinded randomised controlled trial compared the effect
of patient-controlled
In a randomised controlled pragmatic trial we
investigated whether local infiltration analgesia would result in earlier
readiness for discharge from hospital after total knee replacement
(TKR) than patient-controlled
We report a prospective double-blind trial of the efficacy of a single
We describe two patients who developed gluteal compartment syndrome after total knee arthroplasty (TKA) carried out under
This retrospective study compared post-operative
epidural analgesia (E), continuous peripheral nerve blocks (CPNB) and
morphine infusion (M) in 68 children undergoing limb reconstruction
with circular frames. The data collected included episodes of severe
pain, post-operative duration of analgesia, requirement for top-up
analgesia, number of osteotomies, side effects and complications.
There was a significant difference between the number of episodes
of severe pain in patients receiving a morphine infusion and those
receiving
Aims. The aim of this study was to explore the prognostic factors for postoperative neurological recovery and survival in patients with complete paralysis due to neoplastic
Aims. To evaluate the incidence of primary venous thromboembolism (VTE),
epidural haematoma, surgical site infection (SSI), and 90-day mortality
after elective spinal surgery, and the effect of two protocols for
prophylaxis. Patients and Methods. A total of 2181 adults underwent 2366 elective spinal procedures
between January 2007 and January 2012. All patients wore anti-embolic
stockings, mobilised early and were kept adequately hydrated. In
addition, 29% (689) of these were given low molecular weight heparin
(LMWH) while in hospital. SSI surveillance was undertaken using the
Centers for Disease Control and Prevention criteria. Results. In patients who only received mechanical prophylaxis, the incidence
of VTE was 0.59% and that of SSI 2.1%. In patients who were additionally
given LMWH, the incidence of VTE was 0% and that of SSI 0.7%. The
unadjusted p-value was 0.04 for VTE and 0.01 for SSI. There were
no cases of
In a prospective multicentre study we investigated
variations in pain management used by knee arthroplasty surgeons
in order to compare the differences in pain levels among patients
undergoing total knee replacements (TKR), and to compare the effectiveness
of pain management protocols. The protocols, peri-operative levels
of pain and patient satisfaction were investigated in 424 patients
who underwent TKR in 14 hospitals. The protocols were highly variable
and peri-operative pain levels varied substantially, particularly
during the first two post-operative days. Differences in levels
of pain were greatest during the night after TKR, when visual analogue
scores ranged from 16.9 to 94.3 points. Of the methods of managing pain, the combined use of peri-articular
infiltration and nerve blocks provided better pain relief than other
methods during the first two post-operative days. Patients managed
with peri-articular injection plus nerve block, and
We report a case of Lemierre’s syndrome complicated by an
Despite new technologies for total knee arthroplasty (TKA), approximately 20% of patients are dissatisfied. A major reason for dissatisfaction and revision surgery after TKA is persistent pain. The radiological grade of osteoarthritis (OA) preoperatively has been investigated as a predictor of the outcome after TKA, with conflicting results. The aim of this study was to determine if there is a difference in the intensity of pain 12 months after TKA in relation to the preoperative radiological grade of OA alone, and the combination of the intensity of preoperative pain and radiological grade of OA. The preoperative data of 300 patients who underwent primary TKA were collected, including clinical information (age, sex, preoperative pain), psychological variables (depression, anxiety, pain catastrophizing, anticipated pain), and quantitative sensory testing (temporal summation, pressure pain thresholds, conditioned pain modulation). The preoperative radiological severity of OA was graded according to the Kellgren-Lawrence (KL) classification. Persistent pain in the knee was recorded 12 months postoperatively. Generalized linear models explored differences in postoperative pain according to the KL grade, and combined preoperative pain and KL grade. Relative risk models explored which preoperative variables were associated with the high preoperative pain/low KL grade group.Aims
Methods