Neuropathic Pain Related with Spinal Disorders: A Systematic Review

Systematic literature review. To review the evidence from high-quality studies regarding the treatment of neuropathic pain originating specifically from spinal disorders. In general, treatment guidelines for neuropathic pain cover all its various causes, including medical disease, peripheral neuropathy, and cancer. However, the natural history of neuropathic pain originating from spinal disorders may differ from that of the pain originating from other causes or lesions. An expert research librarian used terms related to neuropathic pain and spinal disorders, disc herniation, stenosis, and spinal cord injury to search in MEDLINE, Embase, and Cochrane CENTRAL for primary research from January 2000 to October 2015. Among 2,313 potential studies of interest, 25 randomized controlled trials (RCTs) and 21 systematic reviews (SRs) were included in the analysis. The selection was decided based on the agreement of two orthopedic surgeons. There was a lack of evidence about medication for radiculopathy arising from disc herniation and stenosis, but intervention procedures, including epidural block, showed positive efficacy in radiculopathy and also limited efficacy in spinal stenosis. There was some evidence based on the short-term follow-up regarding surgery being superior to conservative treatments for radiculopathy and stenosis. There was limited evidence regarding the efficacy of pharmacological and electric or magnetic stimulation therapies for neuropathic pain after spinal cord injury. This review of RCTs and SRs with high-quality evidence found some evidence regarding the efficacy of various treatment modalities for neuropathic pain related specifically to spinal disorders. However, there is a need for much more supportive evidence.

Prevalence of Sarcopenia Adjusted Body Mass Index in the Korean Woman Based on the Korean National Health and Nutritional Examination Surveys

BACKGROUND: The purpose of this study was to determine cut-off point of appendicular skeletal muscle mass (ASM) adjusted body mass index (BMI) for sarcopenia in the Korean women and evaluate the prevalence of sarcopenia in postmenopausal women. METHODS: This study was based on the data obtained from 2008 to 2011 Korean National Health and Nutrition Examination Survey (KNHANES) IV and V. A whole body dual energy X-ray absorptiometry (DXA) scan and measurement of BMI were performed on individuals of ≥10 years old. Five thousand, two hundred and fifteen women older than 50 years were included in the study. ASM was obtained by adding the muscle masses of the four limbs. To determine the young reference group, mean and standard deviation of ASM and ASM/BMI by ages was measured. We calculated the prevalence rate of sarcopenia by each age group according to the cut-off point based on ASM and ASM/BMI. RESULTS: In determining the cut-off values related ASM/BMI, using the value that is two standard deviations below mean values for young reference group (20's and 30's) thus recommends 0.50 m² in women. The overall prevalence among women older than 50 years was 15.6%. Among women older than 65 years prevalence of sarcopenia was 22.9%. CONCLUSIONS: The prevalence of sarcopenia among Korean women obtained in this study is within the proper range of value to research about sarcopenia. Furthermore, using 0.50 m² as the cut-off value can help compare various studies about sarcopenia in Korea.