- Department of Neurosurgery, University of Illinois, Chicago (Ret), Center for Pain Treatment and Rehabilitation, Lake Forest Hospital, Lake Forest, Illinois (Ret)
Department of Neurosurgery, University of Illinois, Chicago (Ret), Center for Pain Treatment and Rehabilitation, Lake Forest Hospital, Lake Forest, Illinois (Ret)
DOI:10.4103/2152-7806.130671Copyright: © 2014 Pawl R This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
How to cite this article: Pawl R. Commentary on four recently published papers on chronic pain and spinal surgery. Surg Neurol Int 16-Apr-2014;5:
How to cite this URL: Pawl R. Commentary on four recently published papers on chronic pain and spinal surgery. Surg Neurol Int 16-Apr-2014;5:. Available from: http://sni.wpengine.com/surgicalint_articles/commentary-on-four-recently-published-papers-on-chronic-pain-and-spinal-surgery/
This commentary evaluates four articles dealing with chronic pain from very different perspectives. The first paper by Tsantoulas and McMahon entitled “Opening paths to novel analgesics: the role of potassium channels in chronic pain” evaluates the membrane neurochemistry of the neural cells governing the transmission of pain impulses in the spinal cord and trigeminal systems. As potassium membrane potentials diminish excitability in the nociceptive pain pathways, damage to these pathways may result in excessive transmission of impulses that contribute to “chronic pain”. Haneder et al. analyzed degeneration in lumbar discs utilizing 23Na magnetic resonance (MR) imaging to determine whether this would help analyze low back pain versus standard 1H MR imaging. As degenerated discs lose glycosaminoglycan, which attracts 23Na, this imaging could potentially be useful in detecting degenerating intervertebral discs. Mroz et al. analyzed how 445 spinal surgeons handled recurrent lumbar discs (first and second recurrences) herniations in the United States. Surgeons in practice for more than 15 years were more likely to select simple disc revision, while those with fewer years experience and performing more than 200 cases per year were more likely to select revision surgery that included some form of inter-body fusion. Lee et al. performed a multivariate analysis of more than 1532 patients to validate a predictive model of the risk of surgical site infection after various spine surgeries. Outcomes analyzed the frequency of reoperations for irrigation/debridement, and evaluated how patients’ comorbidities helped predict the risk of infection (e.g. obesity, rheumatoid arthritis, and the number of levels/extent of surgery).
Keywords: Chronic pain, degenerated discs, potassium channels, recurrent discs, spine surgery, surgical site infection, 23Na MR imaging
COMMENTARY ON “OPENING PATHS TO NOVEL ANALGESICS: THE ROLE OF POTASSIUM CHANNELS IN CHRONIC PAIN” BY TSANTOULAS AND MCMAHON
The first and perhaps the most exciting paper from an experimental standpoint was the manuscript by Tsantoulas and McMahon on potassium channels in chronic pain.[
COMMENTARY ON 23NA-MR OF THE HUMAN LUMBAR VERTEBRAL DISCS: IN-VIVO MEASUREMENTS AT 3.0T IN HEALTHY VOLUNTEERS AND PATIENTS WITH LOW BACK PAIN BY HANEDER ET AL.
Haneder et al. analyzed degeneration in lumbar discs utilizing 23Na MR imaging to determine whether this study provided additional useful clinical information in the analysis of low back pain versus standard 1H MR imaging.[
III. COMMENTARY ON DIFFERENCES IN THE SURGICAL TREATMENT OF RECURRENT LUMBAR DISC HERNIATION AMONG SPINE SURGEONS IN THE UNITED STATES BY MROZ ET AL.
Mroz et al. analyzed the differences in handling recurrent lumbar disc herniations among spine surgeons in the United States.[
COMMENTARY ON ‘PREDICTING SURGICAL SITE INFECTION AFTER SPINE SURGERY: A VALIDATED MODEL USING A PROSPECTIVE SURGICAL REGISTRY BY LEE ET AL.
Utilizing a large prospective surgical registry from two institutions, Lee et al. performed a multivariate analysis of more than 1532 patients to validate a predictive model for the risk of surgical site infection after various spine surgeries.[
1. Haneder S, Ong M, Budjan J, Schmidt R, Konstandin S, Morelli JN. 23 Na-MR of the human lumbar vertebral discs: In-vivo measurements at 3.0T in healthy volunteers and patients with low back pain. Spine J. 2014. p. S1529-9430
2. Lee MJ, Cizik AM, Hamilton D, Chapman JR. Predicting Surgical Site Infection after Spine Surgery: A validated model using a prospective surgical registry. Spine J. 2014. p. S1529-9430
3. Mroz TE, Lubelski D, Williams SK, O’Rourke C, Obuchowski NA, Wang JC. Differences in the Surgical Treatment of Recurrent Lumbar Disc Herniation Among Spine Surgeons in the United States. Spine J. 2014. p. S1529-9430
4. Tsantoulas C, McMahon SB. Opening paths to novel analgesics: The role of potassium channels in chronic pain. Trends Neurosci. 2014. p. S0166-2236