Endoscopic Spinal Decompression: A Retrospective Review of Pain Outcomes at an Academic Medical Center.

INTRODUCTION:  Spinal stenosis is a chronic, debilitating condition that is expected to affect an increasing number of people as the population ages. Symptomatic spinal stenosis, like other spine pathologies, including disc herniation and degenerative disc disease, traditionally required an open decompressive surgical approach if more conservative approaches failed. An emerging alternative has been developed to address the needs of this population of patients in the form of endoscopic spine surgery (ESS). Advantages of ESS include minimal tissue trauma, decreased risk of damage to the neurovascular structures, minimal epidural fibrosis/scarring, reduced hospital stay, early functional recovery, and improved cosmetic outcomes. The purpose of this study was to review the outcomes of patients undergoing transforaminal endoscopic spinal decompression at an academic pain program. METHODS: We conducted a retrospective review of electronic medical records with approval from the University of Florida Institutional Review Board (IRB #202001529). Twenty patients underwent successful transforaminal endoscopic lumbar spinal decompression surgery at UF Health Pain Medicine from July 1, 2019, to June 1, 2020. The majority of cases were performed at L4-5 (n = 14), followed by an equal number (n = 3) of cases at L3-4 and L5-S1. Preoperative and postoperative visual analog scale (VAS) pain scores from patients' pain clinic appointments were obtained from the electronic health records system to assess the intervention as a pain relief strategy. RESULTS:  Patients had an average pain reduction of 82% (SD = 31%), resulting in an average postoperative pain score of 1.8 (SD = 2.8) on a 10-point VAS. CONCLUSION:  This study highlights the benefits of endoscopic spine surgery for patients, including pain reduction and reduced scarring.

Transforaminal Endoscopic Decompression of Facet Cysts by Interventional Pain Physicians.

Lumbar synovial cysts (LSC) can impinge neural structures, causing radicular back pain. Conservative treatment options; however, are often ineffective, and traditional surgical techniques can cause joint instability. We describe two cases in which interventional pain physicians used transforaminal endoscopic spine surgery to treat LSC. The patients reported complete resolution of their lower back and radicular pain and the procedures preserved their motor function and sensation in their bilateral lower extremities. This technique is a viable option for remediation of LSC and can be performed by well-trained pain physicians.

Does a Modified Adhesive Respirator Improve the Face Seal for Health Care Workers Who Previously Failed a Fit Test?: A Pilot Study During the Coronavirus Disease 2019 Pandemic.

Approximately 30% of health care workers (HCWs) fail the respirator fit test. Evidence suggests that addressing face leaks in the 3M respirator enhances its fit and improves its efficacy. Between March 31 and April 9, 2020, HCWs who failed fit tests for 3M 1860 and 1860S respirators were invited to retest with an adhesive modification of the 3M respirator. Sixty-eight percent of HCWs who failed the fit test with their first-choice respirator passed with a modified adhesive respirator. To increase the efficacy and safety of 3M respirators, ineffective face seals need substantial improvement in design.

Association Between Exercise and Low Back Pain Resulting in Modified Duty and Lost Time: A Cross-Sectional Analysis of an Occupational Population.

OBJECTIVE: The aim of the study was to assess the relationship between leisure time exercise and whether workers ever had modified duty or lost time (MD/LT) due to low back pain (LBP) in an occupational cohort. METHODS: Workers (N = 827) completed a structured interview assessing characteristics of their LBP, whether or not the pain caused modified or lost work time, and their participation in leisure time exercise. Odds ratio of modified/lost time and minutes of exercise participation were assessed. RESULTS: Workers who participated in over 316 min/wk of leisure time exercise incurred significantly less modified/lost time, adjusted odds ratio = 0.46 (95% confidence interval, 0.23 to 0.98). There also lies a significant trend between increases in leisure time exercise and reductions in modified/lost time (P = 0.0016). CONCLUSION: These results suggest exercise reduces risk of MD/LT from LBP.