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A 40-yr-old woman received a series of three interlaminar epidural steroid injections for the treatment of axial neck pain secondary to degenerative disc disease. Immediately after her third injection, she experienced symptoms of a dural puncture-induced headache. This headache persisted on a daily basis for 3 mos, despite two epidural blood patches using an interlaminar approach, which was finally completely abated with a transforaminal blood patch. The headache was immediately relieved and remained alleviated through the follow-up interval of 1 yr. In this patient, a fluoroscopically guided transforaminal epidural blood patch proved to be more effective than the classic blind interlaminar approach in the treatment of post-dural puncture headache. [ABSTRACT FROM AUTHOR]

Objective. To determine the inciting events leading to the development of sacroiliac joint syndrome (SIJS).Methods. This was a retrospective descriptive cohort series from an academic interdisciplinary spine center. Consecutive patients presenting with low back or buttock pain with or without leg symptoms who met specific inclusion and exclusion criteria for the diagnosis of SIJS were included in the study. Inciting events leading to the development of SIJS in these patients were categorized into traumatic, cumulative, and idiopathic events.Results. Of 194 patients who were included in the study, 54 patients had symptom resolution with one or more therapeutic intraarticular sacroiliac joint injections, following a positive diagnostic injection. Those patients were given the diagnosis of SIJS. Of these, 24 (44%) had had a traumatic event (13 motor vehicle accidents, six falls onto the buttock, three immediately postpartum, one severe football tackle, and one pelvis fracture). Eleven (21%) patients were considered to have a cumulative injury (four lifting, two running, three altered gait due to lower extremity disorder, one crew training injury, and one forceful hip extension injury). Nineteen (35%) patients had spontaneous or idiopathic onset of sacroiliac joint pain.Conclusion. SIJS can occur following a traumatic event or cumulative shear events, or can occur spontaneously. [ABSTRACT FROM AUTHOR]

We report a collegiate field hockey player who sustained a sacral fatigue-type stress fracture that manifested as persistent low back and leg pain. The diagnosis of sacral stress fracture was suggested by history and physical examination and confirmed by magnetic resonance imaging. Our patient experienced complete resolution of symptoms after a 3-mo interval of activity restriction. This article describes the first reported case of a sacral stress fracture in a field hockey player. [ABSTRACT FROM AUTHOR]

Glucocorticosteroid injections into the shoulder are commonly used in the treatment of rotator cuff tendinitis. These injections rarely result in any serious complications and are generally considered a safe therapeutic intervention. Despite the extensive application of this treatment, there have been no reports of dysphonia occurring after corticosteroid injection into the subacromial space. We report the case of a 66-yr-old man with dysphonia after undergoing subacromial glucocorticosteroid injection for treatment of rotator cuff tendinitis. [ABSTRACT FROM AUTHOR]

Low back pain is a common problem, and although the majority of cases of low back pain resolve, a subset of patients will continue to have intractable pain despite appropriate conservative treatments. Intradiscal electrothermal annuloplasty is a minimally invasive spinal procedure that has been proposed to treat provocation discography-proven internal disk disruption syndrome. The early uncontrolled and nonrandomized intradiscal electrothermal annuloplasty literature suggests it may provide some relief in a small proportion of strictly defined patients; however, more recent randomized, placebo-controlled trials have not substantiated these initial findings. This article will review the published literature, indications, contraindications, safety, and efficacy of the intradiscal electrothermal annuloplasty procedure for the treatment of chronic, intractable, axial back pain. [ABSTRACT FROM AUTHOR]