RFA is bad for your back

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drusso

drusso

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Pain. 2024 Sep 1;165(9):2130-2134.
doi: 10.1097/j.pain.0000000000003223. Epub 2024 Mar 22.

Asymmetrical atrophy of the paraspinal muscles in patients undergoing unilateral lumbar medial branch radiofrequency neurotomy​

Ali E Guven 1, Gisberto Evangelisti 1 2, Marco D Burkhard 1, Paul Köhli 1 3, Jan Hambrecht 1, Jiaqi Zhu 4, Erika Chiapparelli 1, Michael Kelly 1, Koki Tsuchiya 1 5, Krizia Amoroso 1, Arman Zadeh 1, Jennifer Shue 1, Ek Tsoon Tan 6, Andrew A Sama 1, Federico P Girardi 1, Frank P Cammisa 1, Alexander P Hughes 1
Affiliations Expand

Abstract​

Lumbar medial branch radiofrequency neurotomy (RFN), a common treatment for chronic low back pain due to facet joint osteoarthritis (FJOA), may amplify paraspinal muscle atrophy due to denervation. This study aimed to investigate the asymmetry of paraspinal muscle morphology change in patients undergoing unilateral lumbar medial branch RFN. Data from patients who underwent RFN between March 2016 and October 2021 were retrospectively analyzed. Lumbar foramina stenosis (LFS), FJOA, and fatty infiltration (FI) functional cross-sectional area (fCSA) of the paraspinal muscles were assessed on preinterventional and minimum 2-year postinterventional MRI. Wilcoxon signed-rank tests compared measurements between sides. A total of 51 levels of 24 patients were included in the analysis, with 102 sides compared. Baseline MRI measurements did not differ significantly between the RFN side and the contralateral side. The RFN side had a higher increase in multifidus FI (+4.2% [0.3-7.8] vs +2.0% [-2.2 to 6.2], P = 0.005) and a higher decrease in multifidus fCSA (-60.9 mm 2 [-116.0 to 10.8] vs -19.6 mm 2 [-80.3 to 44.8], P = 0.003) compared with the contralateral side. The change in erector spinae FI and fCSA did not differ between sides. The RFN side had a higher increase in multifidus muscle atrophy compared with the contralateral side. The absence of significant preinterventional degenerative asymmetry and the specificity of the effect to the multifidus muscle suggest a link to RFN. These findings highlight the importance of considering the long-term effects of lumbar medial branch RFN on paraspinal muscle health.
Copyright © 2024 International Association for the Study of Pain.

1729698675470.png
 
lobelsteve said:
Must be $omething we can do to $ave tho$e mu$cle$.

Fake stim to the rescue.
Click to expand...

I was thinking more of this. Robby to rescue...

Review

Curr Sports Med Rep. 2024 Jun 1;23(6):222-228.
doi: 10.1249/JSR.0000000000001173.

Platelet-Poor versus Platelet-Rich Plasma for the Treatment of Muscle Injuries​

George Raum 1, Charles Kenyon, Robert Bowers 2
Affiliations Expand

Abstract​

Muscle injury in sport results in significant lost time and potential for reinjury for athletes. Autologous blood product, namely, platelet-rich plasma (PRP), has been investigated for possible augmentation of the treatment timeline with prevention of reinjury; however, conflicting results have been identified. A growing body of basic science and clinical literature is forming that supports the use of platelet-poor plasma (PPP) for muscle injury. The purpose of this study was to provide a background of the basic science of PRP versus PPP for muscle injury and to identify and review the clinical evidence for both autologous blood products, including the author's clinical experience utilizing the blood products. At the tissue level, PRP causes myoblast proliferation while PPP has led to myoblast induction, potentially identifying improved native muscle healing. Conflicting studies have been identified for the use of PRP for muscle injury. A growing body of positive results for PPP was identified, but high-quality comparative studies are needed.
Copyright © 2024 by the American College of Sports Medicine.
 
drusso said:
I was thinking more of this. Robby to rescue...

Review

Curr Sports Med Rep. 2024 Jun 1;23(6):222-228.
doi: 10.1249/JSR.0000000000001173.

Platelet-Poor versus Platelet-Rich Plasma for the Treatment of Muscle Injuries​

George Raum 1, Charles Kenyon, Robert Bowers 2
Affiliations Expand

Abstract​

Muscle injury in sport results in significant lost time and potential for reinjury for athletes. Autologous blood product, namely, platelet-rich plasma (PRP), has been investigated for possible augmentation of the treatment timeline with prevention of reinjury; however, conflicting results have been identified. A growing body of basic science and clinical literature is forming that supports the use of platelet-poor plasma (PPP) for muscle injury. The purpose of this study was to provide a background of the basic science of PRP versus PPP for muscle injury and to identify and review the clinical evidence for both autologous blood products, including the author's clinical experience utilizing the blood products. At the tissue level, PRP causes myoblast proliferation while PPP has led to myoblast induction, potentially identifying improved native muscle healing. Conflicting studies have been identified for the use of PRP for muscle injury. A growing body of positive results for PPP was identified, but high-quality comparative studies are needed.
Copyright © 2024 by the American College of Sports Medicine.
Click to expand...
RFA is mostly the medicare crowd, not spending $800 for magic beans. But if stim is covered.....
 
lobelsteve said:
RFA is mostly the medicare crowd, not spending $800 for magic beans. But if stim is covered.....
Click to expand...

Could you tell me how that makes sense? There is more data for regen for muscle injuries than electricity. How many people would be spared the implantation of an expensive IPG if they "failed first" a couple of lumbar paraspinal PRP injections?
 
drusso said:
Could you tell me how that makes sense? There is more data for regen for muscle injuries than electricity. How many people would be spared the implantation of an expensive IPG if they "failed first" a couple of lumbar paraspinal PRP injections?
Click to expand...
PNS for paraspinal atrophy is the new cluneal neuralgia.
 
drusso said:
I was thinking more of this. Robby to rescue...

Review

Curr Sports Med Rep. 2024 Jun 1;23(6):222-228.
doi: 10.1249/JSR.0000000000001173.

Platelet-Poor versus Platelet-Rich Plasma for the Treatment of Muscle Injuries​

George Raum 1, Charles Kenyon, Robert Bowers 2
Affiliations Expand

Abstract​

Muscle injury in sport results in significant lost time and potential for reinjury for athletes. Autologous blood product, namely, platelet-rich plasma (PRP), has been investigated for possible augmentation of the treatment timeline with prevention of reinjury; however, conflicting results have been identified. A growing body of basic science and clinical literature is forming that supports the use of platelet-poor plasma (PPP) for muscle injury. The purpose of this study was to provide a background of the basic science of PRP versus PPP for muscle injury and to identify and review the clinical evidence for both autologous blood products, including the author's clinical experience utilizing the blood products. At the tissue level, PRP causes myoblast proliferation while PPP has led to myoblast induction, potentially identifying improved native muscle healing. Conflicting studies have been identified for the use of PRP for muscle injury. A growing body of positive results for PPP was identified, but high-quality comparative studies are needed.
Copyright © 2024 by the American College of Sports Medicine.
Click to expand...
Bowers is a good guy
 
can you explain the science on how Reactiv8 - multifidus stimulation - is supposed to improve modic changes of the anterior column?
 
but that explanation makes no sense, especially given the fact that our lumbar paraspinals are most definitely stronger than our abdominals.

well at least my patients, who average a bmi of 39+
 
electro acupuncture

speed up to about 5 min you'll get the idea. this works.
do it with US and you can identify where the muscles are atrophic or starting to turn into fat

 
drusso said:
I was thinking more of this. Robby to rescue...

Review

Curr Sports Med Rep. 2024 Jun 1;23(6):222-228.
doi: 10.1249/JSR.0000000000001173.

Platelet-Poor versus Platelet-Rich Plasma for the Treatment of Muscle Injuries​

George Raum 1, Charles Kenyon, Robert Bowers 2
Affiliations Expand

Abstract​

Muscle injury in sport results in significant lost time and potential for reinjury for athletes. Autologous blood product, namely, platelet-rich plasma (PRP), has been investigated for possible augmentation of the treatment timeline with prevention of reinjury; however, conflicting results have been identified. A growing body of basic science and clinical literature is forming that supports the use of platelet-poor plasma (PPP) for muscle injury. The purpose of this study was to provide a background of the basic science of PRP versus PPP for muscle injury and to identify and review the clinical evidence for both autologous blood products, including the author's clinical experience utilizing the blood products. At the tissue level, PRP causes myoblast proliferation while PPP has led to myoblast induction, potentially identifying improved native muscle healing. Conflicting studies have been identified for the use of PRP for muscle injury. A growing body of positive results for PPP was identified, but high-quality comparative studies are needed.
Copyright © 2024 by the American College of Sports Medicine.
Click to expand...

Bingo
Naturopaths doing this all the time, they used to do them blind but now with Ultra$ound guidan$e
 
lobelsteve said:
Always like to see people handling needles without gloves. Tooth fairy science.
Click to expand...
ivan drago fairy

TENS unit?

reacti8910 on a dime

just sending electrical input into the muscle. didn't you see Rocky IV?

 
oreosandsake said:
ivan drago fairy

TENS unit?

reacti8910 on a dime

just sending electrical input into the muscle. didn't you see Rocky IV?

Click to expand...

drago was a beast b/c of steroids. everyone knows that. you see, he's not a machine. he's a man.

if you are not out of your seat and chanting USA at the end of rocky 4, what is the point of life? also, a little support from Adrian would have been nice. she doubts him the whole movie and then right at the very end when drago is barely alive, she comes around? do better, adrian.
 
SSdoc33 said:
drago was a beast b/c of steroids. everyone knows that. you see, he's not a machine. he's a man.

if you are not out of your seat and chanting USA at the end of rocky 4, what is the point of life? also, a little support from Adrian would have been nice. she doubts him the whole movie and then right at the very end when drago is barely alive, she comes around? do better, adrian.
Click to expand...

commies? of course on roids!

ROCKY! ROCKY! ROCKY!

tens hasn't proven to put on muscle or improve bone mineral density... even in patients with paraplegia who cannot feel the high amount of current needed to stimulate the muscles hard enough that it might stimulate muscle/bone
 
oreosandsake said:
commies? of course on roids!

ROCKY! ROCKY! ROCKY!

tens hasn't proven to put on muscle or improve bone mineral density... even in patients with paraplegia who cannot feel the high amount of current needed to stimulate the muscles hard enough that it might stimulate muscle/bone
Click to expand...
Disuse atrophy is all I remember from the PM&R days.

pubmed.ncbi.nlm.nih.gov

Transcutaneous muscle stimulation to retard disuse atrophy after open meniscectomy - PubMed

Immobilization of an extremity inevitably results in disuse muscle atrophy. The effectiveness of transcutaneous muscle stimulation by a portable device in preventing atrophy has been determined. Ten patients treated by open meniscectomy and given the usual isometric training were matched with...
pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov
 
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