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VOLUME 4 , ISSUE 1 ( January-April, 2018 ) > List of Articles

CASE REPORT

Role of Diagnostic Block in S1 Radiculopathy in a Patient of Carcinoma Rectum with Leg Pain

Bablesh Mahawar, Vivek Mahawar, Malvinder Sahi

Keywords : Colorectal cancer, Diagnostic block, Lumbosacral plexus

Citation Information : Mahawar B, Mahawar V, Sahi M. Role of Diagnostic Block in S1 Radiculopathy in a Patient of Carcinoma Rectum with Leg Pain. J Recent Adv Pain 2018; 4 (1):44-46.

DOI: 10.5005/jp-journals-10046-0101

License: CC BY-ND 3.0

Published Online: 01-09-2017

Copyright Statement:  Copyright © 2018; The Author(s).


Abstract

Although the incidence of mortality from colorectal cancer is declining, it is still the fourth most common condition in men and the third most common in women worldwide. Several studies have reported neoplastic involvement of lumbosacral plexus, which results in the patient suffering. The L5-S1 and sciatic nerves are most frequently involved. Clinically, these patients present with pain followed by numbness and weakness. We propose a thorough knowledge of lumbosacral plexus anatomy and diagnostic block, a important tool of pain physician which can be effectively used to diagnose, treat and reduce cancer pain. How to cite this article Mahawar B, Mahawar V, Sahi M. Role of Diagnostic Block in S1 Radiculopathy in a Patient of Carcinoma Rectum with Leg Pain. J Recent Adv Pain 2018;4(1):44-46.


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  1. Babu MA, Spinner RJ, Dyck PJ, Amrami KK, Nathan MA, Kawashima A, Howe BM. Recurrent prostatic adenocarcinoma with perineural spread to the lumbosacral plexus and sciatic nerve, comparing high resolution MRI with torso and endorectal coils and F-18 FDG and C11 choline PET CT. Abdom Imaging 2013 Oct;38(5):1155-1160.
  2. Capek S, Howe BM, Amrami KK, Spinner RJ. Perineural spread of pelvic malignancy to the lumbosacral plexus and beyond, clinical and imaging pattern. Neurosurg Focus 2015 Sep;39(3):E14.
  3. Schwarzer AC, Aprill CN, Derby R, Fortin J, Kine G, Bogduk N. The prevalence and clinical features of internal disc disruption in patients with chronic low back pain. Spine (Phila Pa 1976) 1995 Sep;20(17):1878-1883.
  4. DePalma MJ, Ketchum JM, Saullo T. What is the source of chronic low back pain and does age play a role? Pain Med 2011 Feb;12(2):224-233.
  5. Sehgal N, Fortin JD. Internal disc disruption and low back pain. Pain Physician 2000 Apr;3(2):143-157.
  6. Hendler N. Why chronic pain patients are misdiagnosed 40 to 80% of the time? J Recent Adv Pain 2016 Sep-Dec;2(3):94-98.
  7. Adams MA, McNally DS, Dolan P. Stress distribution inside intervertebral discs. The effects of age and degeneration. J Bone Joint Surg Br 1996 Nov;78(6):965-972.
  8. Adams MA, Dolan P, Hutton WC. The stages of disc degeneration as revealed by discograms. J Bone Joint Surg Br 1986 Jan;68(1):36-41.
  9. Crock HV. Internal disc disruption: a challenge to disc prolapse fifty years on. Spine (Phila Pa 1976) 1986 Jul-Aug;11(6):650-653.
  10. Milette P, Fontaine S, Lepanto L, Cardinal E, Breton G. Differentiating lumbar disc protrusions, disc bulges, and disc with normal contour but abnormal signal intensity. Magnetic resonance imaging with discographic correlations. Spine (Phila Pa 1976) 1999 Jan;24(1):44-53.
  11. Kulkarni R. A case of symptomatic lumbar perineural cyst. J Recent Adv Pain 2015 Sep-Dec;1(2):95-96.
  12. Mooney V. Where is the pain coming from? Spine (Phila Pa 1976) 1987 Oct;12(8):754-759.
  13. Ohnmeiss DD, Vanharanta H, Ekholm J. Degree of disc disruption and lower extremity pain. Spine (Phila Pa 1976) 1997 Jul;22(14):1600-1665.
  14. Villano EQ, Das G, Sharma K, Rijhwani K. A case of piriformis syndrome mimicking radiculopathy. J Recent Adv Pain 2015 May-Aug;1(1):24-25.
  15. Marshall LL, Trethewie ER, Curtain CC. Chemical radiculitis: a clinical, physiological and immunological study. Clin Orthop Relat Res 1977 Nov-Dec;129:61-67.
  16. Rice DA, McNair PJ, Lewis GN, Dalbeth N. Quadriceps arthrogenic muscle inhibition: the effects of experimental knee joint effusion on motor cortex excitability. Arthritis Res Ther 2014 Dec;16(6):502.
  17. Verbunt JA, Seelen HA, Vlaeyen JW, Bousema EJ, van der Heijden GJ, Heuts PH, Knottnerus JA. Pain-related factors contributing to muscle inhibition in patients with chronic low back pain: an experimental investigation based on superimposed electrical stimulation. Clin J Pain 2005 May-Jun;21(3):232-240.
  18. Jang JS, Kwon HK, Lee JJ, Hwang SM, Lim SY. Rami communicans nerve block for the treatment of symptomatic Schmorl's nodes—a case report. Korean J Pain 2010 Dec;23(4):262-265.
  19. Tae HS, Kim SD, Park JY, Kim SH, Lim DJ, Suh JK. Gray ramus communicans nerve block: a useful therapeutic adjuvant for painful osteoporotic vertebral compression fracture. J Korean Neurosurg Soc 2003 Dec;34(6):505-508.
  20. Das G, Dey S, Sharma RS, Sharma K, Dutta D, Roy C. Rami communicans block prior to transforaminal endoscopic discectomy relieves procedure pain significantly and adds safety: a case-control study. J Recent Adv Pain 2017 May-Aug;3(2):90-95.
  21. [cited 2017 Sep 6]. Available from: https://www.researchgate.net/publication/263322952_The_role_of_screening_tools_in_diagnosing_neuropathic_pain.
  22. Sharma K, Das G, Dey S, Villano EQ, Mandal S. Neuropathic pain and depression: a prospective study to find out any association. J Recent Adv Pain 2016 Jan-Apr;2(1):6-10.
  23. Navani A, Li G. Chronic pain challenge: a statistical machine-learning method for chronic pain assessment. J Recent Adv Pain 2016 Sep-Dec;2(3)82-86.
  24. Chemerinski E, Robinson RG. The neuropsychiatry of stroke. Psychosomatics 2000 Jan-Feb;41(1):5-14.
  25. Angelelli P, Paolucci S, Bivona U, Piccardi L, Ciurli P, Cantagallo A, Antonucci G, Fasotti L, Di Santantonio A, Grasso MG, et al. Development of neuropsychiatric symptoms in poststroke patients: a cross-sectional study. Acta Psychiatr Scand 2004 Jul;110(1):55-63.
  26. Almeida OP, Xiao J. Mortality associated with incident mental health disorders after stroke. Aust N Z J Psychiatry 2007 Mar;41(3):274-281.
  27. Smitherman, TA.; Baskin, SM. Depression and anxiety in migraine patients. Mount Royal (NJ): American Migraine Foundation; 2015.
  28. Mehlsteibl D, Schankin C, Hering P, Sostak P, Straube A. Anxiety disorders in headache patients in a specialised clinic: prevalence and symptoms in comparison to patients in a general neurological clinic. J Headache Pain 2011 Jun;12(3):323-329.
  29. Merikangas KR, Angst J, Isler H. Migraine and psychopathology. Results of the Zurich cohort study of young adults. Arch Gen Psychiatry 1990 Sep;47(9):849-853.
  30. Beghi E, Bussone G, D'Amico D, Cortelli P, Cevoli S, Manzoni GC, Torelli P, Tonini MC, Allais G, De Simone R, et al. Headache, anxiety and depressive disorders: the HADAS study. J Headache Pain 2010 Apr;11(2):141-150.
  31. Corchs F, Mercante JP, Guendler VZ, Vieira DS, Masruha MR, Moreira FR, Bernik M, Zukerman E, Peres MF. Phobias, other psychiatric comorbidities and chronic migraine. Arq Neuropsiquiatr 2006 Dec;64(4):950-953.
  32. Song TJ, Cho SJ, Kim WJ, Yang KI, Yun CH, Chu MK. Anxiety and depression in tension-type headache: a population-based study. PLoS One 2016 Oct;11(10):e0165316.
  33. Puca F, Genco S, Prudenzano MP, Savarese M, Bussone G, D'Amico D, Cerbo R, Gala C, Coppola MT, Gallai V, et al. Psychiatric comorbidity and psychosocial stress in patients with tension-type headache from headache centers in Italy. The Italian Collaborative Group for the Study of Psychopathological Factors in Primary Headaches. Cephalalgia 1999 Apr;19(3):159-164.
  34. Holroyd KA, Stensland M, Lipchik GL, Hill KR, O'Donnell FS, Cordingley G. Psychosocial correlates and impact of chronic tension-type headaches. Headache 2000 Jan;40(1):3-16.
  35. Borkovec, TD.; Alcaine, O.; Behar. E. Avoidance theory of worry and generalized anxiety disorder. In: Heimberg RG, Turk CL, Mennin DS, editors. Generalized anxiety disorder in research and practice. New York: Guilford Press; 2004. pp. 77-108.
  36. Behar E, DiMarco ID, Hekler EB, Mohlman J, Staples AM. Current theoretical models of generalized anxiety disorders (GAD): conceptual review and treatment implications. J Anxiety Disord 2009 Dec;23(8):1011-1023.
  37. McWiliams LA, Goodwin RD, Cox BJ. Depression and anxiety associated with three pain conditions: results from a nationally representative sample. Pain 2004 Sep;111(1-2):77-83.
  38. Daniali S, Azadbakht L, Mostafavi F. Relationship between body satisfaction with self esteem and unhealthy body weight management. J Educ Health Promot 2013 Jul;2:29.
  39. Huang JS, Norman GJ, Zabinski MF, Calfas K, Patrick K. Body image and self-esteem among adolescents undergoing an intervention targeting dietary and physical activity behaviors. J Adolesc Health 2007 Mar;40(3):245-251.
  40. Wang, Y.; Wu, Y.; Wilson, RF.; Bleich, S.; Cheskin, L.; Weston, C.; Showell, N.; Fawole, O.; Lau, B.; Segal, J. Childhood obesity prevention programs: comparative effectiveness review and meta-analysis. Rockville (MD): Agency for Healthcare Research and Quality (US); 2013. [cited 2013 Jun]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK148737/.
  41. Khan MA, Mahomed MF, Ashshi AM, Faiz A. Drug resistance patterns of Acinetobacter baumannii in Makkah, Saudi Arabia. Pak J Med Res 2012 Oct-Dec;51(4):127-131.
  42. Shields RK, Clancy CJ, Gillis LM, Kwak EJ, Silveira FP, Massih RC, Eschenauer GA, Potoski BA, Nguyen MH. Epidemiology, clinical characteristics and outcomes of extensively drug-resistant Acinetobacter baumannii infections among solid organ transplant recipients. PLoS One 2012 Dec;7(12):e52349.
  43. Prashanth K, Badrinath S. In vitro susceptibility pattern of Acinetobacter species to commonly used cephalosporins, quinolones and aminoglycosides. Indian J Med Microbiol 2004 Apr-Jun;22(2):97-103.
  44. Armin S, Karimi A, Fallah F, Tabatabaii RS, Alfatemi SM, Khiabanirad P, Shiva F, Fahimzad A, Rahbar M, Mansoorghanaii R, et al Antimicrobial resistance pattern of Acinetobacter baumannii, Pseudomonas aeruginosa and Staphylococcus aureus isolated from patients with nosocomial infection admitted to Tehran hospitals. Arch Pediatr Infect Dis 2015 Oct;3(4):e32554.
  45. Qureshi ZA, Abbasi SA, Mirza IA, Malik N, Amjad A, Sattar A, Ikram A. Antimicrobial susceptibility pattern of Acinetobacter species-one year experience in a tertiary care setting. Infect Dis J 2011 Mar;20(1):269-272.
  46. Spencer L, Bubner T, Bain E, Middleton P. Screening and subsequent management for thyroid dysfunction pre-pregnancy and during pregnancy for improving maternal and infant health. Cochrane Database Syst Rev 2015 Sep;9:CD011263.
  47. Li M, Yao Q, Xing A. A clinical analysis of 188 cases of pregnancy complicated with critical heart disease. Zhong Nan Da Xue Xue Bao Yi Xue Ban 2014 Nov;39(11):1145-1150.
  48. Bhatla N, Lal S, Behera G, Kriplani A, Mittal S, Agarwal N, Talwar KK. Cardiac disease in pregnancy. Int J Gynaecol Obstet 2003 Aug;82(2):153-159.
  49. Gelson E, Curry R, Gatzoulis MA, Swan L, Lupton M, Steer P, Johnson M. Effect of maternal heart disease on fetal growth. Obstet Gynecol 2011 Apr;117(4):886-891.
  50. Arora N, Kausar H, Jana N, Mandal S, Mukherjee D, Mukherjee R. Congenital heart disease in pregnancy in a low-income country. Int J Gynaecol Obstet 2015 Jan;128(1):30-32.
  51. Report of the National High Blood Pressure Education Program Working Group on High Blood Pressure in Pregnancy. Am J Obstet Gynecol 2000 Jul;183(1):S1-S22.
  52. Agency for Healthcare Research and Quality. Management of chronic hypertension during pregnancy. Evidence Report/Technology Assessment no.14. AHRQ publication no. 00-E011. Rockville, MD: Agency for Healthcare Research and Quality; 2000.
  53. Ferrer RL, Sibai BM, Mulrow CD, Chiquette E, Stevens KR, Cornell J. Management of mild chronic hypertension during pregnancy: a review. Obstet Gynecol 2000 Nov;96(5 Pt 2):849-860.
  54. Sridharan R, Murthy BN. Prevalence and pattern of epilepsy in India. Epilepsia 1999 May;40(5):631-636.
  55. Viale L, Allotey J, Cheong-See F, Arroyo-Manzano D, McCorry D, Bagary M, Mignini L, Khan KS, Zamora J, Thangaratinam S, et al. Epilepsy in pregnancy and reproductive outcomes: a systematic review and meta-analysis. Lancet 2015 Nov;386(10006):1845-1852.
  56. Smyth A, Oliveira GH, Lahr BD, Bailey KR, Norby SM, Garovic VD. A systematic review and meta-analysis of pregnancy outcomes in patients with systemic lupus erythematosus and lupus nephritis. Clin J Am Soc Nephrol 2010 Nov;5(11):2060-2068.
  57. Hazes JM, Coulie PG, Geenen V, Vermeire S, Carbonnel F, Louis E, Masson P, De Keyser F. Rheumatoid arthritis and pregnancy: evolution of disease activity and pathophysiological considerations for drug use. Rheumatology (Oxford) 2011 Nov;50(11):1955-1968.
  58. Velu PP, Gravett CA, Roberts TK, Wagner TA, Zhang JS, Rubens CE, Gravett MG, Campbell H, Rudan I. Epidemiology and aetiology of maternal bacterial and viral infections in low- and middle-income countries. J Glob Health 2011 Dec;1(2):171-188.
  59. UNAIDS: UNAIDS report on the global AIDS epidemic. 2010. Available from http://www.unaids.org/globalreport/Global_report.htm
  60. Ioannidis JP, Abrams EJ, Ammann A, Bulterys M, Goedert JJ, Gray L, Korber BT, Mayaux MJ, Mofenson LM, Newell ML, et al. Perinatal transmission of human immunodeficiency virus type 1 by pregnant women with RNA virus loads <1000 copies/ml. J Infect Dis 2001 Feb;183(4):539-545.
  61. Anglemyer A, Rutherford GW, Horvath T, Baggaley RC, Egger M, Siegfried N. Antiretroviral therapy for prevention of HIV transmission in HIV-discordant couples. Cochrane Database Syst Rev 2013 Apr;4:CD009153.
  62. Rimoin DL, Connor JM, Pyeritz RE, Korf BR. Emery and Rimoin's principles and practice of medical genetics. Churchill Livingstone Elsevier; 2007.
  63. Verma IC, Puri RD. Global burden of genetic disease and the role of genetic screening. Semin Fetal Neonatal Med 2015 Oct;20(5):354-363.
  64. White SJ, Boldt KL, Holditch SJ, Poland GA, Jacobson RM. Measles, mumps, and rubella. Clin Obstet Gynecol 2012 Jun;55(2):550-559.
  65. American College of Obstetricians and Gynecologists. ACOG educational bulletin: viral hepatitis in pregnancy. Int J Gynaecol Obstet 1998 Nov;63:195-202.
  66. Geeta MG, Riyaz A. Prevention of mother to child transmission of hepatitis B infection. Indian Pediatr 2013;50:189-192.
  67. Swamy GK, Beigi RH. Maternal benefits of immunization during pregnancy. Vaccine 2015 Nov;33(47):6436-6440.
  68. Sukumaran L, McCarthy NL, Kharbanda EO, McNeil MM, Naleway AL, Klein NP, Jackson ML, Hambidge SJ, Lugg MM, Li R, et al. Association of Tdap vaccination with acute events and adverse birth outcomes among pregnant women with prior tetanus-containing immunizations. JAMA 2015 Oct;314(15):1581-1587.
  69. Singru SA, Tilak VW, Gandham N, Bhawalkar JS, Jadhav SL, Pandve HT. Study of susceptibility towards Varicella by screening for the presence of IgG antibodies among nursing and medical students of a Tertiary Care Teaching Hospital in Pune, India. J Glob Infect Dis 2011 Jan-Mar;3(1):37-41.
  70. Nathwani D, Maclean A, Conway S, Carrington D. Varicella infections in pregnancy and the newborn. A review prepared for the UK Advisory Group on Chickenpox on behalf of the British Society for the Study of Infection. J Infect 1998;36 (Suppl 1):59-71.
  71. Michaan N, Amzallag S, Laskov I, Cohen Y, Fried M, Lessing JB, Many A. Maternal and neonatal outcome of pregnant women infected with H1N1 influenza virus (swine flu). J Matern Fetal Neonatal Med 2012 Feb;25(2):130-132.
  72. Smith NM, Bresee JS, Shay DK, Uyeki TM, Cox NJ, Strikas RA. Prevention and control of influenza: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep 2006 Jul;55(RR-10):1-42.
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