[Evaluating the effects of local injections of bupivacaine and triamcinolone acetate on shoulder joint pain and restricted range of motion following cerebrovascular accidents]

Shoulder pain is a common complication of cerebrovascular accidents. This study was conducted to assess the effects of local injections of bupivacaine and triamcinolone acetate on shoulder joint pain and on restricted range of motion following brain events. This single-blind clinical trial study included 35 patients with chronic shoulder pain [the controls] and 35 patients with chronic shoulder pain due to brain events [the case group]. The study was done at Imam Hossein Hospital and Gandhi Day Clinic during the year 2008-2010. The patients in the two groups received bupivacaine and triamcinolone acetate for subacromial bursa injection and suprascapular nerve block by following the protocol described by Dangoisse et al. The patients were followed up for 12 weeks and they were evaluated for pain and range of motion 1, 6, and 12 weeks after the injections. The mean age of the patients was 60.9 +/- 9.07 years. Statistically significant improvements in pain score [P=0.001] and shoulder joint range of motion [P=0.001] were observed in patients with chronic shoulder pain versus patients with brain events 12 weeks after suprascapulare nerve block and subacromial bours injections by bupivacaine and triamcinolone acetate. Suprascapular nerve block and subacromial bursa injections of bupivacaine and triamcinolone acetate is a safe and efficacious treatment for the treatment of chronic shoulder pain and restricted range of motion but it is not efficacious or of significant value for the treatment of shoulder pain in patients with brain events

Prognostic value of preoperative sciatalgia in lumbar disc surgery

All aspects of lumbar disc surgery are being currently commented in pertinent medical literature, but only few studies have dealt with comparative results and the outcome of surgical treatment. To find out the possible correlation between preoperative symptomatic period and postoperative complete recovery time, and fitness to resume normal personal and professional life. In a retrospective study, we evaluated the outcomes of lumbar disc surgery by reviewing records of 153 consecutive patients who were surgically treated for lumbar disc herniation. The endpoint of this study for each case was defined at the time of complete recovery and/or between 4 to 12 months after surgery. A highly significant correlation [r = 0.6] existed between the pre- and postoperative duration of sciatalgic symptoms [P < 0.0001]. Regression analysis showed that postoperative recovery time in months = 1.29 + 0.58 × preoperative duration in months. The duration of preoperative disabling leg pain has a significant predictive value for the overall outcome in lumbar disc herniation surgery