Pain measurement: an overview

The carpal tunnel syndrome is a compressive neuropathy with high incidence rates, and its correct diagnosis, treatment and follow-up may lead to significant benefits in healthcare, social and economic terms. In this review, based on systematic review databases and guidelines, we summarise the appropriate indications for the diagnosis, treatment and follow-up, accompanied, whenever possible, by the levels of evidence and strength of recommendations.

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“…For both conditions, both lumbosacral radiculopathy and carpal tunnel syndrome, it is fundamental to individuate the main outcome measures [52].…”

Section: Outcome Evaluation and Follow-upmentioning

confidence: 99%

Diagnosis, treatment and follow-up of the carpal tunnel syndrome: a review

et al. 2010

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“…Clinical evaluation included evaluation of pain by a visual analog scale (VAS) without leg and back pain differentiation (26), assessment of subjective functional impairment by Oswestry low back pain disability questionnaire (27), and Prolo scales (28).…”

Section: Clinical and Radiological Evaluationmentioning

confidence: 99%

Mid‐term evaluation of the effects of dynamic neutralization system on lumbar intervertebral discs using quantitative molecular MR imaging

Ciavarro

Caiani

Brayda-Bruno

et al. 2011

Magnetic Resonance Imaging

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Purpose: To evaluate the mid-term effects of implant of dynamic neutralization system (Dynesys) on disc tissue in patients with lumbar discopathy, through the quantification of glycosaminoglycans (GAG) concentration, both in treated and adjacent levels, by analysis of delayed gadolinium-enhanced MRI contrast (dGEMRIC) images. Materials and Methods:Ten patients with low back pain underwent the dGEMRIC diagnostic protocol before, 6-months and after 2 years from surgery. Each patient was also evaluated with visual analog (VAS), Oswestry, and Prolo scales both at presurgery and during follow-up. From dGEMRIC images, a DT1 parametric map was obtained for each disc, as quantitative indicator of its GAG concentration, and divided in 13 sectors, which were classified at presurgery as normal or abnormal, based on a 70-ms threshold. Evolution of DT1 was studied during the follow-up.Results: Nine of ten patients completed the follow-up. VAS, Oswestry, and Prolo grades showed an improvement. This was accompanied by a reduction of DT1 in abnormal segments while normal segments showed a pattern of initial worsening at 6 months, followed by an improvement after 2 years. Conclusion:Our study confirmed the improvement in clinical evaluation, and for the first time related this to the changes in discs GAG concentration.

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“…Pain was evaluated by means of a visual analog scale (VAS) without leg and back pain differentiation [22]. The Oswestry low back pain disability questionnaire was used to assess subjective functional impairment [23], while the Prolo semiquantitative scale was used to evaluate the functional and economic status of each patient [24].…”

Section: Clinical Evaluationmentioning

confidence: 99%

Molecular MR imaging for the evaluation of the effect of dynamic stabilization on lumbar intervertebral discs

et al. 2009

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The dynamic stabilization of lumbar spine is a non-fusion stabilization system that unloads the disc without the complete loss of motion at the treated motion segment. Clinical outcomes are promising but still not definitive, and the long-term effect on instrumented and adjacent levels is still a matter of discussion. Several experiments have been devised in order to gain a better understanding of the effect of the device on the intervertebral disc. One of the hypotheses was that while instrumented levels are partially relieved from loading, adjacent levels suffer from the increased stress. But this has not been proved yet. The aim of this study was to investigate the long-term effect of dynamic stabilization in vivo, through the quantification of glycosaminoglycans (GAG) concentration within instrumented and adjacent levels by means of the delayed Gadolinium-Enhanced Magnetic Resonance Imaging of Cartilage (dGEMRIC) protocol. Ten patients with low back pain, unresponsive to conservative treatment and scheduled for Dynesys implantation at one to three lumbar spine levels, underwent the dGEMRIC protocol to quantify GAG concentration before and 6 months after surgery. Each patient was also evaluated with visual analog scale (VAS), Oswestry, Prolo, Modic and Pfirrmann scales, both at pre-surgery and at follow-up. Six months after implantation, VAS, Prolo and Oswestry scales had improved in all patients. Pfirrmann scale could not detect any change, while dGEMRIC data already showed a general improvement in the instrumented levels: GAG was increased in 61% of the instrumented levels, while 68% of the non-instrumented levels showed a decrease in GAG, mainly in the posterior disc portion. In particular, seriously GAG-depleted discs seemed to have the greatest benefit from the Dynesys implantation, whereas less degenerated discs underwent a GAG depletion. dGEMRIC was able to visualize changes in both instrumented and non-instrumented levels. Our results suggest that the dynamic stabilization of lumbar spine is able to stop and partially reverse the disc degeneration, especially in seriously degenerated discs, while incrementing the stress on the adjacent levels, where it induces a matrix suffering and an early degeneration.

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Pain measurement: an overview

Cited by 990 publications

References 106 publications

Diagnosis, treatment and follow-up of the carpal tunnel syndrome: a review

Diagnosis, treatment and follow-up of the carpal tunnel syndrome: a review

Mid‐term evaluation of the effects of dynamic neutralization system on lumbar intervertebral discs using quantitative molecular MR imaging

Molecular MR imaging for the evaluation of the effect of dynamic stabilization on lumbar intervertebral discs

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