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Back Pain: HELP
Articles by Henning Harke
Based on 2 articles published since 2009
(Why 2 articles?)

Between 2009 and 2019, H. Harke wrote the following 2 articles about Back Pain.
+ Citations + Abstracts
1 Guideline [Epidural spinal cord stimulation for therapy of chronic pain. Summary of the S3 guidelines]. 2011

Tronnier, V / Baron, R / Birklein, F / Eckert, S / Harke, H / Horstkotte, D / Hügler, P / Hüppe, M / Kniesel, B / Maier, C / Schütze, G / Thoma, R / Treede, R D / Vadokas, V / Anonymous40706. ·Neurochirurgische Klinik, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538 Lübeck, Deutschland. volker.tronnier@uk-sh.de ·Schmerz · Pubmed #21938604.

ABSTRACT: Epidural spinal cord stimulation (SCS) is a reversible but invasive procedure which should be used for neuropathic pain, e.g. complex regional pain syndrome I (CRPS) and for mostly chronic radiculopathy in connection with failed back surgery syndrome following unsuccessful conservative therapy. Epidural SCS can also successfully be used after exclusion of curative procedures and conservative therapy attempts for vascular-linked pain, such as in peripheral arterial occlusive disease stages II and III according to Fontaine and refractory angina pectoris. Clinical practice has shown which clinical symptoms cannot be successfully treated by epidural SCS, e.g. pain in complete paraplegia syndrome or atrophy/injury of the sensory pathways of the spinal cord or cancer pain. A decisive factor is a critical patient selection as well as the diagnosis. Epidural SCS should always be used within an interdisciplinary multimodal therapy concept. Implementation should only be carried out in experienced therapy centers which are in a position to deal with potential complications.

2 Review Interventional management of neuropathic pain: NeuPSIG recommendations. 2013

Dworkin, Robert H / O'Connor, Alec B / Kent, Joel / Mackey, Sean C / Raja, Srinivasa N / Stacey, Brett R / Levy, Robert M / Backonja, Miroslav / Baron, Ralf / Harke, Henning / Loeser, John D / Treede, Rolf-Detlef / Turk, Dennis C / Wells, Christopher D / Anonymous4100760. ·Department of Anesthesiology, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642, USA; Department of Neurology, Center for Human Experimental Therapeutics, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642, USA. Electronic address: robert_dworkin@urmc.rochester.edu. ·Pain · Pubmed #23748119.

ABSTRACT: Neuropathic pain (NP) is often refractory to pharmacologic and noninterventional treatment. On behalf of the International Association for the Study of Pain Neuropathic Pain Special Interest Group, the authors evaluated systematic reviews, clinical trials, and existing guidelines for the interventional management of NP. Evidence is summarized and presented for neural blockade, spinal cord stimulation (SCS), intrathecal medication, and neurosurgical interventions in patients with the following peripheral and central NP conditions: herpes zoster and postherpetic neuralgia (PHN); painful diabetic and other peripheral neuropathies; spinal cord injury NP; central poststroke pain; radiculopathy and failed back surgery syndrome (FBSS); complex regional pain syndrome (CRPS); and trigeminal neuralgia and neuropathy. Due to the paucity of high-quality clinical trials, no strong recommendations can be made. Four weak recommendations based on the amount and consistency of evidence, including degree of efficacy and safety, are: 1) epidural injections for herpes zoster; 2) steroid injections for radiculopathy; 3) SCS for FBSS; and 4) SCS for CRPS type 1. Based on the available data, we recommend not to use sympathetic blocks for PHN nor radiofrequency lesions for radiculopathy. No other conclusive recommendations can be made due to the poor quality of available data. Whenever possible, these interventions should either be part of randomized clinical trials or documented in pain registries. Priorities for future research include randomized clinical trials, long-term studies, and head-to-head comparisons among different interventional and noninterventional treatments.