Ethanol Sclerosis Therapy for Aggressive Vertebral Hemangioma of the Spine: A Narrative Review

Vertebral hemangiomas of the spine are rare benign tumors. They occur primarily in the thoracic region and are often asymptomatic and found incidentally on radiological examination; however, some are symptomatic, aggressive, and gradually increase in size. Various therapeutic approaches have been proposed for their management. This study aimed to review the therapeutic management, focusing on ethanol sclerosis therapy. The PubMed database was searched from inception to January 2023 using the keywords “hemangioma”, “spine OR vertebra”, and “ethanol”. Twenty studies were retrieved, including two letters. The first report of spinal therapy was published in 1994. Ethanol sclerosis therapy is effective in treating vertebral hemangiomas. It is performed independently or in combination with other techniques, such as vertebroplasty using cement and surgery. The therapy is performed under local or general anesthesia with fluoroscopic or computed tomography guidance. A total of 10–15 mL of ethanol is slowly injected via unilateral or bilateral pedicles. Complications of the therapy include hypotension and arrhythmia during the procedure, paralysis immediately after the procedure, and delayed compression fractures. This review could enable the refinement of knowledge regarding ethanol sclerosis therapy, which is a treatment option that could be adopted

Disability due to knee pain and somatising tendency in Japanese adults

Abstract Background Knee pain is common and related to knee osteoarthritis. However, there is a discrepancy between knee pain and radiographic osteoarthritis. In the general population, knee pain is associated with psychological and cognitive factors, which would be one explanation for the discrepancy. Limited evidence demonstrates that somatization is associated with knee pain. This study examined the association between disability due to knee pain and a high somatising tendency. Methods Japanese adults (aged 20–64 years) who had experienced knee pain in the past four weeks were included in this study (n = 14,695, 50% women). Data were extracted from a large internet survey. Somatising tendency was assessed using the Somatic Symptom Scale-8 (SSS-8). Disability due to knee pain was categorized into three levels: 1) knee pain without difficulty with activities of daily living (ADL), 2) knee pain with ADL difficulty but without requiring sick leave, and 3) knee pain requiring sick leave. The association between ≥ high somatising tendency (SSS-8 score ≥ 12) as well as very high somatising tendency (SSS-8 score ≥ 16) and disability due to knee pain was examined using logistic regression models adjusted for age, sex, body mass index, depressive symptoms, education level, regular exercise, chronicity of knee pain (≥3 months), osteoarthritis, rheumatoid arthritis, and fibromyalgia. Results Greater disability due to knee pain was associated with a higher odds ratio for ≥ high somatising tendency (adjusted odds ratio (aOR) = 2.36 [2.10–2.66] in group 2 vs. group 1, aOR = 3.23 [2.66–3.92] in group 3 vs. group 1). Stronger associations were found for a very high somatising tendency (aOR = 2.80 [2.42–3.23] in group 2 vs. group 1, aOR = 4.51 [3.64–5.58] in group 3 vs. group 1). Conclusions Somatization may play a role in disability due to knee pain in the general adult population with knee pain, similar to the role of somatization in low back pain

Association between somatic symptom burden and health-related quality of life in people with chronic low back pain.

Depression is a relevant risk factor for low back pain and is associated with the outcomes of low back pain. Depression also often overlaps with somatisation. As previous studies have suggested that somatisation or a higher somatic symptom burden has a role in the outcomes of low back pain, the aim of the present cross-sectional study was to examine whether somatic symptom burden was associated with health-related quality of life in individuals with chronic low back pain independent of depression. We analyzed internet survey data on physical and mental health in Japanese adults aged 20-64 years with chronic low back pain (n = 3,100). Health-related quality of life was assessed using the EuroQol five dimensions (EQ-5D) questionnaire. Somatic symptom burden and depression were assessed using the Somatic Symptom Scale-8 (SSS-8) and the Patient Health Questionnaire-2 (PHQ-2), respectively. SSS-8 score was categorized as no to minimal (0-3), low (4-7), medium (8-11), high (12-15), and very high (16-32). The association between SSS-8 and EQ-5D was examined using linear regression models, adjusting for depression and other covariates, including age, sex, BMI, smoking, marital status, education, exercise, employment, and the number of comorbid diseases. A higher somatic symptom burden was significantly associated with a lower health-related quality of life independent of depression and the number of comorbid diseases (regression coefficient = 0.040 for SSS-8 high vs. very high and 0.218 for non to minimal vs. very high, p trend <0.0001). In conclusion, somatic symptom burden might be important for the health-related quality of life of individuals with chronic low back pain

Details of the participants of the follow-up study.

<p>Details of the participants of the follow-up study.</p

The associations between magnetic resonance imaging findings and low back pain: A 10-year longitudinal analysis

<div><p>Purpose</p><p>To conduct a 10-year longitudinal analysis of the relationship between magnetic resonance imaging (MRI) findings and low back pain (LBP).</p><p>Materials and methods</p><p>Ninety-one volunteers with a history of LBP, but without current LBP were recruited between 2005 and 2006. Participants’ baseline demographics and MRI findings were recorded. All volunteers were invited for a follow-up MRI in 2016; of these, 49 volunteers (53.8%) participated in the follow-up. We enquired whether they had LBP history during the 10 years between the baseline and follow-up examinations. Sagittal T1 and T2-weighted MRI were used to assess the intervertebral space from T12/L1 to L5/S1. We evaluated the presence of disc degeneration by Pfirrmann’s grading system, disc bulging, high intensity zone (HIZ), spondylolisthesis, and any type of Modic changes in the follow-up MRIs. We compared the follow-up MRI findings with the baseline findings; the progress of each finding over the 10 years were also compared between the groups with (n = 36) and without (n = 13) LBP.</p><p>Results</p><p>Average age of the study participants at follow-up was 44.8 years; 25 were female and 24 were male. Average age, sex, body mass index, and smoking habits of those who did and did not participate in the follow-up study, as well as the demographic characteristics of those who did and did not have LBP history during the 10 years, were not significantly different. Compared with the group without LBP history, the group that had LBP history during the 10 years did not have a significantly increased prevalence of disc degeneration, disc bulging, and HIZ in the follow-up and baseline MRIs. Spondylolisthesis and any type of Modic changes were also not associated with LBP history during the 10 years.</p><p>Conclusions</p><p>Follow-up MRI findings consistent with Pfirrmann grading ≥4, disc bulging, HIZ, spondylolisthesis, and any type of Modic changes were not associated with LBP history during the 10 years between the baseline and follow-up study. The progresses of these findings were also not associated with the LBP history. In addition, baseline MRI findings were not associated with LBP history during the 10 years; therefore, our data suggest that baseline MRI findings cannot predict future LBP.</p></div

Demographic data of the participants who did and did not participate in the follow-up study.

<p>Demographic data of the participants who did and did not participate in the follow-up study.</p

Psychometric Validation of the Japanese Version of the Neuropathic Pain Symptom Inventory.

ObjectiveThis study aimed to evaluate the validity and reliability of the Japanese version of the Neuropathic Pain Symptom Inventory (NPSI-J).DesignCross-sectional study design.Subjects and methodsThe original Neuropathic Pain Symptom Inventory (NPSI) was translated into Japanese according to published guidelines. Subsequently, an observational study of 60 Japanese patients suffering from neuropathic pain was performed to evaluate the validity and reliability of the NPSI-J.ResultsThe NPSI-J exhibited a statistically significant correlation with pain intensity (Numerical Rating Scale). The Cronbach alpha value for Likert items was 0.86. Using the test-retest analysis method, the intraclass correlation coefficient between the two scores was 0.81. Factor analysis revealed that the main component of NPSI-J comprised three determinative factors.ConclusionsThe NPSI-J is a reliable and valid pain assessment tool

Associations between the follow-up magnetic resonance imaging findings and low back pain history during the 10 years according to univariate analyses.

<p>Associations between the follow-up magnetic resonance imaging findings and low back pain history during the 10 years according to univariate analyses.</p

Validity and reliability of the Japanese version of the painDETECT questionnaire: a multicenter observational study.

OBJECTIVES: The aim of this study was to evaluate the validity and reliability of the Japanese version of the painDETECT questionnaire (PDQ-J). MATERIALS AND METHODS: The translation of the original PDQ into Japanese was achieved according to the published guidelines. Subsequently, a multicenter observational study was performed to evaluate the validity and reliability of PDQ-J, including 113 Japanese patients suffering from pain. RESULTS: Factor analysis revealed that the main component of PDQ-J comprises two determinative factors, which account for 62% of the variance observed. Moreover, PDQ-J revealed statistically significant correlation with the intensity of pain (Numerical Rating Scale), Physical Component Score, and Mental Component Score of the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). The Cronbach alpha for the total score was 0.78 and for the main component was 0.80. In the analysis of test-retest method, the intraclass correlation coefficient between the two scores was 0.94. CONCLUSIONS: We demonstrated the validity and reliability of PDQ-J. We encourage researchers and clinicians to use this tool for the assessment of patients who suffer suspected neuropathic pain