Background: Deep gluteal syndrome is a common cause of posterior hip pain. It results from peripheral nerves, such as the sciatic or superior gluteal nerve, being compressed in the deep gluteal space. Hydrodissection ...Background: Deep gluteal syndrome is a common cause of posterior hip pain. It results from peripheral nerves, such as the sciatic or superior gluteal nerve, being compressed in the deep gluteal space. Hydrodissection is a novel technique for the treatment of nerve pain due to entrapment. The use of hydrodissection for the treatment of deep gluteal syndrome has not been reported. Methods: A case report involved a 42-year-old female presenting with deep gluteal syndrome. Case report: We report, with patient consent, an ultrasound-guided superior gluteal nerve hydrodissection method used for treating the deep gluteal syndrome. A previously healthy 42-year-old female patient sought medical attention due to persistent left gluteal pain. Trials of joint injections, physiotherapy, and epidural blocks were unsuccessful. Hydrodissection under ultrasound-guidance allowed separation of the fascial plane in areas with significant neural innervation. We targeted the superior gluteal nerve with hydrodissection offering the patient immediate and persistent relief from her symptoms. Conclusion: Ultrasound-guided hydrodissection of the superior gluteal nerve offers an effective and novel diagnostic and treatment option for deep gluteal syndrome.展开更多
The nucleus accumbens(NAc)is a subcortical brain structure known primarily for its roles in pleasure,reward,and addiction.Despite less focus on the NAc in pain research,it also plays a large role in the mediation of p...The nucleus accumbens(NAc)is a subcortical brain structure known primarily for its roles in pleasure,reward,and addiction.Despite less focus on the NAc in pain research,it also plays a large role in the mediation of pain and is effective as a source of analgesia.Evidence for this involvement lies in the NAc’s cortical connections,functions,pharmacology,and therapeutic targeting.The NAc projects to and receives information from notable pain structures,such as the prefrontal cortex,anterior cingulate cortex,periaqueductal gray,habenula,thalamus,etc.Additionally,the NAc and other pain-modulating structures share functions involving opioid regulation and motivational and emotional processing,which each work beyond simply the rewarding experience of pain offset.Pharmacologically speaking,the NAc responds heavily to painful stimuli,due to its high density ofμopioid receptors and the activation of several different neurotransmitter systems in the NAc,such as opioids,dopamine,calcitonin gene-related peptide,γ-aminobutyric acid,glutamate,and substance P,each of which have been shown to elicit analgesic effects.In both preclinical and clinical models,deep brain stimulation of the NAc has elicited successful analgesia.The multi-functional NAc is important in motivational behavior,and the motivation for avoiding pain is just as important to survival as the motivation for seeking pleasure.It is possible,then,that the NAc must be involved in both pleasure and pain in order to help determine the motivational salience of positive and negative events.展开更多
文摘Background: Deep gluteal syndrome is a common cause of posterior hip pain. It results from peripheral nerves, such as the sciatic or superior gluteal nerve, being compressed in the deep gluteal space. Hydrodissection is a novel technique for the treatment of nerve pain due to entrapment. The use of hydrodissection for the treatment of deep gluteal syndrome has not been reported. Methods: A case report involved a 42-year-old female presenting with deep gluteal syndrome. Case report: We report, with patient consent, an ultrasound-guided superior gluteal nerve hydrodissection method used for treating the deep gluteal syndrome. A previously healthy 42-year-old female patient sought medical attention due to persistent left gluteal pain. Trials of joint injections, physiotherapy, and epidural blocks were unsuccessful. Hydrodissection under ultrasound-guidance allowed separation of the fascial plane in areas with significant neural innervation. We targeted the superior gluteal nerve with hydrodissection offering the patient immediate and persistent relief from her symptoms. Conclusion: Ultrasound-guided hydrodissection of the superior gluteal nerve offers an effective and novel diagnostic and treatment option for deep gluteal syndrome.
文摘The nucleus accumbens(NAc)is a subcortical brain structure known primarily for its roles in pleasure,reward,and addiction.Despite less focus on the NAc in pain research,it also plays a large role in the mediation of pain and is effective as a source of analgesia.Evidence for this involvement lies in the NAc’s cortical connections,functions,pharmacology,and therapeutic targeting.The NAc projects to and receives information from notable pain structures,such as the prefrontal cortex,anterior cingulate cortex,periaqueductal gray,habenula,thalamus,etc.Additionally,the NAc and other pain-modulating structures share functions involving opioid regulation and motivational and emotional processing,which each work beyond simply the rewarding experience of pain offset.Pharmacologically speaking,the NAc responds heavily to painful stimuli,due to its high density ofμopioid receptors and the activation of several different neurotransmitter systems in the NAc,such as opioids,dopamine,calcitonin gene-related peptide,γ-aminobutyric acid,glutamate,and substance P,each of which have been shown to elicit analgesic effects.In both preclinical and clinical models,deep brain stimulation of the NAc has elicited successful analgesia.The multi-functional NAc is important in motivational behavior,and the motivation for avoiding pain is just as important to survival as the motivation for seeking pleasure.It is possible,then,that the NAc must be involved in both pleasure and pain in order to help determine the motivational salience of positive and negative events.
