bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparative Assessment of Different
Percutaneous Endoscopic Interlaminar Lumbar
Discectomy (PEID) Techniques
Authors: Park Jeong Yoon
Published: March 2021

Background: Percutaneous endoscopic lumbar discectomy is a common surgical treatment for
lumbar disc herniation, and percutaneous endoscopic interlaminar lumbar discectomy (PEID) is
commonly used for direct decompression of L5-S1. Like microdiscectomy, recurrence of herniation
after endoscopic discectomy is an important problem. In this study, we aimed to decrease the
recurrence after PEID using a new surgical technique.
Objectives: We propose a new surgical technique for reducing the recurrence after PEID for
lumbar disc herniation. The new technique uses annular sealing after fragmentectomy. We
compared clinical results and recurrent lumbar disc herniation (had radiculopathy and confirmed
by MRI) between patients who underwent surgery with and without annular sealing during PEID.
Study Design: Retrospective cohort study of patients undergoing PEID.
Methods: A total of 224 patients with radiculopathy due to L5-S1 disc herniation who were
treated by PEID with (91 patients) or without annular sealing (133) were included in this study.
We compared the demographic characteristics (age, sex, height, weight, BMI, smoking status, and
occupation), clinical results, and recurrence rates between the 2 groups. We classified recurrence
according to time period (early recurrence ≤ 6 months, late recurrence > 6 months).
Results: The study groups were demographically similar, and substantial improvement in clinical
results was noted. There were 5 recurrences (5.5%) (2 early, 3 late recurrences) in the group with
annular sealing, and 18 (13.5%) (13 early, 5 late recurrences) in the group without annular sealing.
Early recurrence rates were significantly higher in the group without sealing (2 vs. 13, P = 0.029).
Increasing age was associated with overall recurrence (P = 0.004) and late recurrence (P = 0.008),
while operative technique correlated with early recurrence (P = 0.026).
Limitations: First, this study incorporates a retrospective design. Second, the operations were
performed by 2 surgeons. Additionally, this is relatively a short-term follow-up study (mean 19.5
± 5.0 months).
Conclusions: Though a learning curve is needed in order to become familiar with PEID, recurrence
after PEID was associated with advanced age, and PEID with annular sealing resulted in lower early
recurrence rates than without annular sealing. Thus, PEID with annular sealing may be a useful
technique for reducing early recurrence.
Key words: Percutaneous endoscopic lumbar discectomy, interlaminar approach, fragmentectomy,
recurrence
Computed Tomography Guidance for Spinal
Intervention: Basics of Technique, Pearls, and
Avoiding Pitfalls
Authors: Timpone Dr. Vincent
Published: March 2021

The utilization of spinal interventional pain techniques has grown rapidly over the last
decade. However, practitioners use widely different techniques in these procedures,
particularly in the use of image guidance. The importance of image guidance was
highlighted by the fact that in recent systematic reviews on therapeutic effectiveness
of epidural steroid injections and facet joint interventions, only studies that used image
guidance were included. The choice of image guidance remains a matter of physician
preference with conventional fluoroscopic or Computed Tomography (CT) guidance
most common.
There are many advantages to CT guidance for certain spinal interventional pain
procedures, mainly due to increased needle tip positioning accuracy. CT guidance
provides greater anatomical detail that facilitates accurate needle trajectory planning,
monitoring and final placement. Unlike conventional fluoroscopy that may be hindered
by tissue overlap and lack of surrounding anatomical detail CT guidance offers direct
visualization of the entire needle trajectory and the surrounding soft tissue and bone
structures. Large osteophytes and adjacent vascular structures can be identified and
safely avoided.
The goals of this narrative review are to provide a basic overview of CT techniques
available for spinal interventional pain procedures, to discuss the potential advantages
and disadvantages of CT guidance, to provide a simple step-by-step approach to use
of CT guidance, to share technical pearls, and to discuss methods to avoid potential
pitfalls. This review will provide interventional pain physicians with knowledge of
relevant CT image acquisition techniques and appropriate radiation dose reduction
strategies. This will contribute to increased technical success rates while reducing
radiation dose to the patient and staff.
Key words: Computed tomography, fluoroscopy, analgesia, epidural injection, spinal
injection, back pain, safety
Intracranial Hypotension Headache Caused by a
Massive Cerebrospinal Fluid Leak Successfully
Treated with a Targeted C2 Epidural Blood
Patch: A Case Report
Authors: Yi Xiaobin
Published: March 2021

Cervical epidural steroid injections, administered either intralaminarly or transforaminally, are
common injection therapies used in many interventional pain management practices to treat
cervicalgia or cervicobrachial pain secondary to spondylosis or intervertebral disc displacement
of the cervical spine. Among the risks associated with these procedures are the risk for
inadvertent dural puncture and the development of positional headache from intracranial
hypotension. We report the case of a 31-year-old woman with a history of migraine and
cervicalgia from cervical spine spondylosis and cervical disc degenerative disease that developed
an intractable orthostatic headache accompanied by nausea and vomiting after a therapeutic
high cervical intralaminar epidural steroid injection was administered directly to the C1-C2
spinal level. Although the initial magnetic resonance imaging of the brain was unremarkable, a
computed tomography myelogram study revealed a massive cerebrospinal fluid (CSF) leak from
the cervical spine. Repeated cervical epidural blood patches using a catheter targeted to the
high cervical spine (C2) to inject 15 mL of autologous blood was required to totally alleviate her
symptoms after she failed conservative therapy. Determining the optimal location or approach
to administer an epidural blood patch can be a challenge depending on the location of the
CSF leak. Our case demonstrates that targeted cervical epidural blood patch placement using
an easily manipulated catheter under fluoroscopic guidance is a safe and effective approach to
treat a massive CSF leak in the high cervical spine region caused by prior therapeutic cervical
spine epidural steroid injection.
Key words: Cervical epidural blood patch, intracranial hypotension, intracranial hypotension
headache, spinal headache, orthostatic headache, epidural steroid injection, cerebrospinal fluid
leak, post dural headache
Vertebral Augmentation Versus Conservative
Therapy for Emergently Admitted Vertebral
Compression Deformities: An Economic Analysis
Authors: Flug Jonathan A.
Published: March 2021

Background: Vertebral augmentation (VA) performed on inpatients with painful osteoporotic
vertebral compression fractures (VCFs) has been shown to facilitate discharge, decrease
analgesic requirements, and improve pain.
Objective: The purpose of our study was to compare the overall cost, length of stay, and
readmission data for patients hospitalized with painful osteoporotic VCFs, treated either
medically or with inpatient VA.
Setting: A single academic medical center.
Study Design: Economic analysis
Methods: Patients admitted with VCF over a 30-month period were identified using ICD-9
codes. The total length of stay, hospitalization costs, average daily cost, and 30-day readmission
rates were compared between those who underwent VA and those managed nonoperatively.
A subgroup analysis was performed with an age matched group of controls as well. Two-tailed
t-tests were used for statistical significance.
Results: Thirty-nine inpatients underwent VA; 61 levels were augmented. Their average
age was 81.7 years. There were 209 patients who were treated nonoperatively for VCF. Their
average age was 72.7 years, a significant age difference from the VA group (P < 0.01). The
VA patients’ average length of stay was 13.8 days, compared to 8.1 days in the medically
managed group (P < 0.01). Average total costs were $26,074 in the VA group and $15,507 in
the medically managed group (P < 0.01). The daily costs of admission were $2,040 in the VA
group and $2,069 in the medically managed group (P = 0.85). The readmission rates related to
VCF were 0% in the VA group; 5.2% in the medically managed group; and 7.7% in the agematched control group. Of those who underwent VA, 43% experienced delays in care related
to anticoagulation or medical comorbidities.
Limitations: The study is retrospective and uses billing data as a marker for total cost of care,
The study does not account for cost differences between vertebroplasty and kyphoplasty.
Conclusion: Inpatient VA can be cost effective as demonstrated by the same daily cost
between the VA and medically managed groups. Early identification and consultation can
facilitate VA and rapid discharge. Anticoagulation issues and medical comorbidities can delay
VA and lengthen hospital stays. Hospital admitted patients with painful osteoporotic VCF who
are managed conservatively and discharged are at risk for readmission.
Key words: vertebral augmentation, osteoporotic vertebral compression fracture,
vertebroplasty, kyphoplasty
Autonomic Response to Pain in Patients with
Chronic Whiplash Associated Disorders
Authors: Nijs Jo
Published: March 2021

Background: Patients with chronic whiplash associated disorders (WAD) demonstrate altered
central pain processing and impaired endogenous analgesia. In addition, previous research
reported disturbances in the autonomic nervous system and the presence of post-traumatic
stress reaction in patients with chronic WAD. The autonomic nervous system, in particular the
autonomic stress response, might modulate central pain processing in this population.
Objectives: The goal of this study was to compare the autonomic response to acute painful
stimuli in patients with chronic WAD and healthy controls and to look for associations between
endogenous analgesia and autonomic parameters.
Study design: Case-control study.
Methods: Thirty patients with chronic WAD and 31 healthy controls were subjected to an
experiment evaluating the autonomic nervous system at rest and during experimental painful
stimuli. Skin conductance, heart rate, and heart rate variability parameters were monitored
continuously during the evaluation of conditioned pain modulation. The paradigm of heterotopic
noxious conditioning stimulation was used to assess this conditioned pain modulation effect.
Results: The data revealed no difference in autonomic response to pain between chronic WAD
and healthy controls. The autonomic response was unrelated to pressure pain thresholds or the
effect of conditioned pain modulation in either group.
Limitations: The present study only investigates the autonomic response to a stress caused by
pain.
Conclusion: Results of this study refute autonomic dysfunction in response to pain in patients
with chronic WAD. The autonomic nervous system activity or reactivity to acute pain appears
unrelated to either pain thresholds or endogenous analgesia in patients with chronic WAD.
Key words: chronic whiplash associated disorders, central sensitization, pain modulation;
posttraumatic stress disorder ,sympathetic, heart rate variability
Magnetic Resonance Imaging of the Lumbar
Spine in a Patient with a Spinal Cord Stimulator
Authors: Simopoulos Thomas T.
Published: March 2021

Background: The use of magnetic resonance imaging (MRI) is continuously escalating for the
evaluation of patients with persistent pain following lumbar spine surgery (LSS). Spinal cord
stimulation (SCS) therapy is being clinically applied much more commonly for the management of
chronic pain following LSS. There is an increased probability that these 2 incompatible modalities
may be accidentally used in the same patient.
Objectives: The purpose of this case report is to: (1) summarize a case in which a patient with
a thoracic spinal cord stimulator underwent a diagnostic lumbar MRI, (2) describe the 3 magnetic
fields used to generate images and their interactions with SCS devices, and (3) summarize the
present literature.
Study design: Case report.
Setting: University hospital.
Results: Aside from mild heat sensations in the generator/pocket site and very low intensity
shocking sensations in the back while in the MRI scanner, the patient emerged from the study with
no clinically detected adverse events. Subsequent activation of the SCS device would result in a
brief intense shocking sensation. This persisted whenever the device was activated and required
Implantable Pulse Generator (IPG) replacement. Electrical analysis revealed that some of the output
circuitry switches, which regulate IPG stimulation and capacitor charge balancing, were damaged,
most likely by MRI radiofrequency injected current.
Limitations: Single case of a patient with a thoracic SCS having a lumbar MRI study.
Conclusion: This case demonstrates the lack of compatibility of lumbar MRI and the Precision
SCS system as well as one of the possible patient adverse events that can occur when patients are
exposed to MRI outside of the approved device labeling.
Key words: Spinal cord stimulation devices, magnetic resonance imaging
Using Pulsed Radiofrequency Ablation to Treat
Pain Associated with a Tumor Involving the
Brachial Plexus
Authors: Rana Humair
Published: March 2021

Pain associated with cancer is often difficult to treat, even more so when tumors involve peripheral
nerves. Therapy is complex and often requires a multimodal approach that can include medications,
radiation, and interventional techniques. These components are utilized with variable success, but
are also limited by known complications or adverse effects.
We present the case of a 53-year-old woman with a metastatic axillary tumor that involved her
brachial plexus. Attempts to control her pain with medication were unsuccessful despite escalation
and use of adjunct agents. She was not deemed to be a surgical candidate due to the size and
location of the tumor. Radiation was discussed but, obviously, would not work immediately. Our
team decided to employ a brachial plexus catheter for continuous nerve block, which provided
almost complete relief of pain. Since her pain was deemed to be of peripheral etiology, pulsed
radiofrequency ablation of her brachial plexus was used for more long-term pain relief. The patient
responded very well with minimal pain issues and no apparent complications. On follow-up, the
patient had good relief for almost 2 months.
Pulsed radiofrequency is a poorly understood technology that has increasing evidence for certain
pain conditions; however, for cancer and peripheral nerves the evidence is slim to none. Our
case presents a successful use for pain management of a brachial plexopathy due to a tumor.
We propose that pulsed radiofrequency may present a non-neurodestructive pain management
technique for tumors involving peripheral nerves, though more data is definitely needed.
Key words: Pulsed radiofrequency, brachial plexopathy, brachial plexus, tumor, cancer, pain
Symptomatic Cervical Vertebral Hemangioma
Treated by Percutaneous Vertebroplasty
Authors: Jian Wang
Published: March 2021

Background: Vertebral hemangioma (VH) is considered to be a benign lesion of bone with a
rich vasculature. Most incidentally discovered hemangiomas are asymptomatic. Percutaneous
vertebroplasty (PVP) has demonstrated efficacy in the treatment of symptomatic thoracic and
lumbar VHs. To our knowledge, the reports concerning PVP on symptomatic cervical VHs are
quite rare.
Objective: Our intent was to assess PVP as treatment for symptomatic cervical hemangiomas.
Study Design: Prospective evaluation.
Setting: An inteventional pain management practice, single medical center.
Methods: Eight patients with symptomatic cervical VHs were enrolled between December
2008 and February 2012, all of whom underwent magnetic resonance imaging (MRI) of the
cervical spine. The patients with 8 vertebral bodies of VHs were treated by using PVP. The clinical
and radiological data were collected and analyzed. Postoperative outcomes were determined
using a visual analog scale.
Results: Surgical levels include C3 (2 patients), C4 (3 patients), C5 (2 patients), and C6 (one
patient). The average follow-up period was 27.4 months, with a minimum of 12 months.
Mean operative time and x-ray exposure time were respectively 35 ± 7.1 minutes and 25 ±
7.7 seconds. The visual analogue scale for neck pain decreased significantly from 6.9 ± 0.6
preoperatively to 1.3 ± 0.5 (P < 0.01) on the second day after surgery, with a final score of 1.2 ±
0.5 (P < 0.01). Cement distribution was always diffuse and homogeneous. No cement leakage
was observed in all cases except for 2 patients. There were no other major complications at the
time of last follow-up evaluation.
Limitations: An observational clinical trial with a relatively small sample size.
Conclusion: Short-term results indicate that PVP appears to be an effective and safe treatment
for symptomatic cervical VHs.
Key words: Percutaneous vertebroplasty, symptomatic, cervical vertebral, hemangiomas
Criteria for the Appropriate Treatment of
Osteoporotic Vertebral Compression Fractures
Authors: Anselmetti Giovanni Carlo
Published: March 2021

Background: The heterogeneity of patients with osteoporotic vertebral compression
fractures (VCF) necessitates a tailored approach of balancing the benefits and limitations of
available treatments. Current guidelines are divergent, sometimes contradictory, and often
insufficiently detailed to guide practice decisions.
Objectives: This study aimed at establishing treatment recommendations at the patientspecific level.
Study Design: Using the RAND/UCLA Appropriateness Method (RAM), the appropriateness
of different treatment options for osteoporotic VCFs was assessed.
Setting: The assessment was conducted by a European multidisciplinary panel of 12 experts.
Methods: The appropriateness of non-surgical management (NSM), vertebroplasty (VP), and
balloon kyphoplasty (BKP) was determined for 128 hypothetical patient profiles. These were
unique combinations of clinical factors considered relevant to treatment choice (time since
fracture, MRI findings, impact and evolution of symptoms, spinal deformity, ongoing fracture
process, and pulmonary dysfunction). After 2 individual rating rounds and plenary meetings,
appropriateness statements (appropriate, inappropriate, and uncertain) were calculated for all
clinical scenarios.
Results: Disagreement dropped from 31% in the first round to 7% in the second round.
Appropriateness outcomes showed specific patterns for the 3 treatments. For three-quarters
of the profiles, only one treatment was considered appropriate: NSM 25%, VP 6%, and
BKP 45%. NSM was usually appropriate in patients with a negative MRI or a positive MRI
without other unfavorable conditions (poor outcomes for the other variables). VP was usually
appropriate in patients with a positive MRI, time since fracture ≥ 6 weeks, and no spinal
deformity. BKP was recommended for all patients with an ongoing fracture process, and also
in most patients with a positive MRI and ≥ 1 other unfavorable factor.
Limitations: The prevalence of the patient profiles in daily practice is yet unknown.
Conclusion: The panel results may help to support treatment choice in the heterogeneous
population of patients with osteoporotic VCF.
Key words: Appropriateness criteria, balloon kyphoplasty, non-surgical management,
osteoporosis, RAND/UCLA Appropriateness Method, treatment choice, vertebral compression
fractures, vertebroplasty:
Ultrasound-Guided Trigeminal Nerve Block
via the Pterygopalatine Fossa: An Effective
Treatment for Trigeminal Neuralgia and
Atypical Facial Pain
Authors: Kendall Mark C.
Published: March 2021

Background: Patients presenting with facial pain often have ineffective pain relief with medical
therapy. Cases refractory to medical management are frequently treated with surgical or minimally
invasive procedures with variable success rates. We report on the use of ultrasound-guided
trigeminal nerve block via the pterygopalatine fossa in patients following refractory medical and
surgical treatment.
Objective: To present the immediate and long-term efficacy of ultrasound-guided injections of
local anesthetic and steroids in the pterygopalatine fossa in patients with unilateral facial pain that
failed pharmacological and surgical interventions.
Setting: Academic pain management center.
Design: Prospective case series.
Methods: Fifteen patients were treated with ultrasound-guided trigeminal nerve block with local
anesthetic and steroids placed into the pterygopalatine fossa.
Results: All patients achieved complete sensory analgesia to pin prick in the distribution of the
V2 branch of the trigeminal nerve and 80% (12 out of 15) achieved complete sensory analgesia in
V1, V2, V3 distribution within 15 minutes of the injection. All patients reported pain relief within
5 minutes of the injection. The majority of patients maintained pain relief throughout the 15
month study period. No patients experienced symptoms of local anesthetic toxicity or onset of new
neurological sequelae.
Limitations: Prospective case series.
Conclusion: We conclude that the use of ultrasound guidance for injectate delivery in the
pterygopalatine fossa is a simple, free of radiation or magnetization, safe, and effective percutaneous
procedure that provides sustained pain relief in trigeminal neuralgia or atypical facial pain patients
who have failed previous medical interventions.
Key words: Trigeminal nerve, ultrasound-guided, atypical facial pain, trigeminal neuralgia, tic
douloureux.
Combinations of Low-Dose Antidepressants
and Low-Dose Pregabalin as Useful Adjuvants
to Opioids for Intractable, Painful Bone
Metastases
Authors: Ikeuchi Masahiko
Published: March 2021

Background: Systemic analgesics would not provide good enough pain relief for some kinds
of cancer pain. Metastatic bone pain is characteristic of one of the refractory cancer pains, since
the pain is not only nociceptive but also neuropathic. A low-dose antiepileptic-antidepressant
combination with opioids is effective in the management of neuropathic cancer pain.
Objective: The aim was to see whether a low-dose antiepileptic-antidepressant combination is
effective in the treatment of bone metastases.
Study Design: Randomized, controlled trial
Setting: Pain Clinic in Japan.
Methods: Thirty-seven cancer patients, confirmed to have bone metastases, were allocated
into 3 groups: P group took pregabalin 50 mg every 8 hours orally; P-I group took pregabalin 25
mg every 8 hours orally and imipramine 5 mg every 12 hours orally; P-M group took pregabalin
25 mg every 8 hours orally and mirtazapine 7.5 mg every 12 hours orally. Pain assessments were
performed for 2 weeks.
Results: The total pain score significantly decreased in all 3 groups even one day after the start
of the medication. The decreases in the P-I and P-M groups were significantly greater than those
in the P group from Day 2. Also, the daily paroxysmal pain episodes significantly decreased in all
3 groups at Day 1. The decreases in the P-M groups were significantly greater than those in the
P group from Day 1. The decreases in the P-I group were significantly greater than those in the P
group from Day 3.
Conclusion: Low-dose pregabalin-antidepressant combinations with opioids were effective in
the management of painful bone metastases.
Key words: Cancer pain, painful bone metastases, antidepressant and anticonvulsants,
pregabalin, mirtazapin
Intrathecal Infusion Systems for Long-Term
Management of Chronic Non-Cancer Pain:
An Update of Assessment of Evidence
Authors: Manchikanti Laxmaiah
Published: March 2021

Background: Intrathecal infusion systems are often used for patients with intractable
pain when all else fails, including surgery. There is, however, some concern as to the
effectiveness and safety of this treatment.
Study Design: A systematic review of intrathecal infusion systems for long-term
management of chronic non-cancer pain.
Objective: To evaluate and update the effect of intrathecal infusion systems in managing
chronic non-cancer pain.
Methods: The available literature on intrathecal infusion systems in managing chronic
pain was reviewed. The quality assessment and clinical relevance criteria utilized were the
Cochrane Musculoskeletal Review Group criteria as utilized for interventional techniques
for randomized trials and the Newcastle-Ottawa Scale criteria for observational studies.
The level of evidence was classified as good, fair, and limited or poor based on the quality
of evidence developed by the U.S. Preventative Services Task Force (USPSTF). Data sources
included relevant literature identified through searches of PubMed and EMBASE from
1966 to December 2012, and manual searches of the bibliographies of known primary
and review articles.
Outcome Measures: The primary outcome measure was pain relief with short-term
relief < 12 months and long-term relief ≥ 12 months. Secondary outcome measures were
improvement in functional status, psychological status, return to work, and reduction in
opioid intake.
Results: There were 28 studies identified for this systematic review. Of these, 21
were excluded from further review. A total of 7 non-randomized studies met inclusion
criteria for methodological quality assessment. No randomized trials met the inclusion
requirements.
The evidence is limited based on observational studies.
Limitations: The limitations of this systematic review include the paucity of literature.
Conclusion: The evidence is limited for intrathecal infusion systems.
Key words: Spinal pain, chronic low back pain, intrathecal infusion, intrathecal infusion
systems, intrathecal drug delivery systems, intrathecal pumps, chronic non-cancer pain,
chronic non-malignant pain, morphine, bupivacaine, ziconotide
Percutaneous Lumbar Laser Disc
Decompression: An Update of Current Evidence
Authors: Singh Vijay
Published: March 2021

Background: Since the descriptions by Mixter and Barr of surgical treatment for rupture of
the intervertebral disc in 1934, open surgical procedures have become a common practice. Disc
herniations are often classified as being contained or non-contained. The results of open surgical
discectomy for contained disc herniation have been poor. Consequently, several less invasive
techniques have been developed including percutaneous lumbar laser disc decompression.
Study Design: A systematic review of the literature of percutaneous lumbar laser disc
decompression.
Objective: The objective of this systematic review is to evaluate and update the clinical
effectiveness of percutaneous lumbar laser discectomy in managing radicular pain secondary to
contained disc herniation.
Methods: The available literature on lumbar laser disc decompression in managing chronic
low back and lower extremity pain was reviewed. Quality assessment and clinical relevance of
randomized trials were graded according to the Cochrane Musculoskeletal Review Group criteria
for interventional techniques, and observational studies according to the Newcastle-Ottawa Scale
criteria.
The level of evidence was classified as good, fair, and limited or poor based on the quality of
evidence developed by the U.S. Preventive Services Task Force (USPSTF).
Data sources included relevant literature identified through searches of PubMed and EMBASE
from 1966 to September 2012, and manual searches of the bibliographies of known primary and
review articles.
Outcome Measures: Pain relief was the primary outcome measure. Other outcome measures
were functional improvement, improvement of psychological status, opioid intake, and
return-to-work.
Short-term effectiveness was defined as effectiveness lasting one year or less, whereas, long-term
effectiveness was defined as benefit persisting for greater than one year.
Results: Based on USPSTF criteria, the indicated level of evidence for percutaneous lumbar laser
disc decompression is limited for short- and long-term relief.
Limitations: Although laser discectomy has been utilized for many years, there is a paucity of
randomized clinical trials.
Conclusion: This systematic review shows limited evidence for percutaneous lumbar laser disc
decompression.
Key words: Intervertebral disc disease, chronic low back pain, disc herniation, disc protrusion,
radiculitis, contained disc herniation, mechanical disc decompression, percutaneous lumbar laser
discectomy, laser assisted spinal endoscopy
An Update of the Systematic Assessment of
Mechanical Lumbar Disc Decompression with
Nucleoplasty
Authors: Manchikanti Laxmaiah
Published: March 2021

Background: Lumbar disc prolapse, protrusion, and extrusion account for less than 5% of all low back
problems, but are the most common causes of nerve root pain and surgical interventions. The primary
rationale for any form of surgery for disc prolapse is to relieve nerve root irritation or compression
due to herniated disc material. The primary modality of treatment continues to be either open or
microdiscectomy, although several alternative techniques are also utilized, including nucleoplasty,
automated percutaneous discectomy and laser discectomy. There is a paucity of evidence for all
decompression techniques, specifically alternative techniques including nucleoplasty.
Study Design: A systematic review of the literature of mechanical lumbar disc decompression with
nucleoplasty.
Objective: To determine the effectiveness and update the effectiveness of mechanical lumbar disc
decompression with nucleoplasty.
Methods: The available literature on mechanical lumbar disc decompression with nucleoplasty was
reviewed. The quality assessment and clinical relevance criteria utilized were the Cochrane Musculoskeletal
Review Group criteria as utilized for interventional techniques for randomized trials and the criteria developed
by the Newcastle-Ottawa Scale criteria for observational studies.
The level of evidence was classified as good, fair, and limited or poor based on the quality of evidence
developed by the U.S. Preventive Services Task Force (USPSTF).
Data sources included relevant literature identified through searches of PubMed and EMBASE from 1966 to
September 2012, and manual searches of the bibliographies of known primary and review articles.
Outcome Measures: Pain relief and functional improvement were the primary outcome measures.
Other outcome measures were improvement of psychological status, reduction in opioid intake, and
return to work.
Short-term effectiveness was defined as one year or less, whereas long-term effectiveness was defined
as greater than one year.
Results: For this systematic review, 37 studies were considered for inclusion. Of these, there was one
randomized trial and 14 observational studies meeting inclusion criteria for methodological quality
assessment.
Based on USPSTF criteria, the level of evidence for nucleoplasty is limited to fair in managing radicular
pain due to contained disc herniation.
Limitations: A paucity of literature with randomized trials.
Conclusion: This systematic review illustrates limited to fair evidence for nucleoplasty in managing
radicular pain due to contained disc herniation.
Key words: Intervertebral disc disease, chronic low back pain, disc herniation, disc protrusion,
radiculitis, contained disc herniation, mechanical disc decompression, nucleoplasty, Coblation technology,
nucleotomy
Meningkatkan Kecerdasan Kognitif Anak Usia Dini melalui Pendidikan Seni Melukis
Authors: Hadi Sunandar Azma'ul
Published: February 2021

This type of research is a quasi-experimental which is included in quantitative research with posttest design only control desaign. The subjects in this study were 46 students consisting of experimental and control classes. Class A control (22 people) and class B experiment (24 people). The test instrument used in this study was a multiple choice question sheet. The results were analyzed using the t test. The results of the research analysis show that painting education can be used to improve early childhood cognitive abilities. The analysis conducted using SPSS showed that cognitive intelligence between groups A and B obtained a significant value of 0.762. Because the significant value is > 0.05, the hypothesis of this study is accepted.
Giving Credit Where It's Due - The Complicated Practice of Scientific Authorship
Authors: Rasmussen Seth C.
Published: March 2021

Anyone who has participated in modern scientific publishing has experienced the potentially complex issue of coauthors, both in terms of who merits to be included on a particular paper and in what order should they be listed. During the early years of serial scientific publications in the 17th and 18th centuries, nearly all papers consisted of just a single author.  In contrast, the growing complexity of most present-day studies has required collaborative teams to accomplish the work needed to present a suitable report meriting publication. Unfortunately, there exists no firm, uniform rules for determining authorship and current practices can vary significantly, even to the point that the literature is now plagued with ethically questionable practices.
Pengaruh Komitmen dan Lingkungan kerja Terhadap Engagement Karyawan SMK YASBU Al-Qomariah TASIKMALAYA
Authors: Lestari Suci Putri , Sutrisna Arga
Published: March 2021

The purpose of this study is to find out the commitment and work environment will affect the engagement of YASBU Al-Qomariah Vocational employees. The research method used in this research is explanatory research. The use of this method is because the researcher does not only describe empirical facts found in the field, but also intends to analyze and explain the influence between variables. Data collection is obtained through interviews, questionnaires and literature studies. The population in this study were employees of YASBU Al-Qomariah Vocational High School. Methods Analysis of the data used is the Multiple Regression Analysis, where data is processed with the help of SPSS. The results of testing the data using the regression equation showed the results of a positive and significant effect of commitment to engagement variables with a significant value of 0.001 smaller than 0.05, while the work environment was not significant with a value of 0.563.Keywords: Commitment, work environment, employee engagement.
STRATEGI KESANTUNAN BERBAHASA DALAM TALK SHOW Q&A DAN RELEVANSINYA TERHADAP PEMBELAJARAN BAHASA INDONESIA TINGKAT SMP
Authors: Rika Amalia  , Sri Budi Astuti
Published: February 2021

The purpose of this study to describe the politeness strategies of Brown and Levinson in the Q&A talk show and describe the relevance of politeness-language strategies towards learning Indonesian at the Middle School level. The theory used to solve the problem in this study is the theory of Brown and Levinson. While the approach used is descriptive qualitative approach with data collection techniques namely documentation techniques. The results of this study indicate that the forms of Brown and Levinson's politeness strategy that occurred in the Q & A talk show in August 2018 consisted of Brown and Levinson's first politeness strategy, namely without strategies found that included speech without strategy. The second strategy of brown politeness and Levinson's positive politeness strategy is found to pay attention to the opponent's speech, exaggerate attention, agreement, and sympathy, intensify the opponent's attention by dramatizing facts, intensify using group identity markers, request approval with general topics or repeat part or all, avoiding disagreement by pretending to agree, using jokes, expressing understanding of the wishes of speakers, giving offers or promises, showing optimism, involving speakers in activities, giving questions asking for approval, giving gifts. Where negative politeness strategies are found to be pessimistic, minimize coercion, and apologize. Finally, the Off Record strategy was found which was included in the strategy. The relevance of the results of the study can be applied in learning Indonesian in junior high school class IX 3.9-4.10.
Поиск оптимальных параметров линейного сетевого кода для противодействия перегрузкам в телекоммуникационных системах
Authors: Карпухин Е.О. , Мешавкин К.В.
Published: March 2021

Разработана имитационная модель в среде Simulink для поиска оптимальных параметров линейного сетевого кода. В ней реализовано «узкое» место канала передачи данных, которое приводит к росту задержек и потерь пакетов. Для управления очередями реализованы алгоритмы RED и Tail drop. Оптимизации подвергаются параметры длина кодовой последовательности и корректирующая способность кода. Модель позволяет оценить вероятность потери пакета и определить скорость кода в зависимости от длины кодовой последовательности и корректирующей способности кода при воздействии трафика с различной интенсивностью нагрузки на сеть.
Обзор современных инструментальных средств и методов для автоматизации процессов сбора и анализа геопространственных данных
Authors: Рогачев А.И. , Газов А.И. , Кузмицкий А.А. , Федосенко Д.В. , Труфанов М.И.
Published: March 2021

Постоянный рост количества аппаратов для аэрофотосъемки и, как следствие, увеличение объема геопространственных данных, содержащих высококачественные снимки, позволяет производить разведочный анализ данных (EDA), используя открытые источники и open-source платформы. Одной из ключевых проблем исследования природы тропических циклонов является отсутствие надёжных данных о локальных параметрах тропических циклонов, ибо современные приборы не выдерживают разрушительных воздействий тропического циклона, а дистанционные методы измерения параметров циклонов не позволяют получить необходимую информацию в полной мере.
Анализ проблем криптостойкости нейросетевого алгоритма шифрования
Authors: Евдокимов И.А. , Солодовников В.И.
Published: March 2021

Проводится анализ уязвимостей нейросетевого алгоритма симметричного шифрования по отношению к различного рода атакам. Особое внимание уделено внутреннему представлению информации нейросетью, которое вносит определенную структурированность, что отрицательно сказывается на криптостойкости. Предложен ряд способов улучшения криптостойкости, выявлены их достоинства и недостатки.
PERANAN ORGANISASI KEMAHASISWAAN EKSTRAUNIVERSITER SEBAGAI SARANA PENDIDIKAN POLITIK MAHASISWA DALAM MENUMBUHKAN DAN MENINGKATKAN PARTISIPASI POLITIK WARGA NEGARA INDONESIA (Studi Deskriptif terhadap Organisasi HMI, KAMMI, dan GMNI Komisariat Universitas Pendidikan Indonesia)
Authors: Sanusi Aris Riswandi
Published: February 2021

ABSTRACT Indonesia is one of democratic state which exposed to low levels of citizen participation. But actually, participation is a key concept that must be owned by citizens in a democracy state. Therefore, we need political education as an effort to create citizens who are able to participate with responsibility. This is in accordance with the opinion of Hajer, which states that political education is a form of human effort to be a responsible participant in politics, so that people know about their political rights (Brownhill and Smart in Elly Hasan Sadeli, et al, 2009:19). The political education among college students organized for young people through the organization such as HMI, KAMMI and GMNI. Keywords: Political Education, Political Participation

ABSTRAK Indonesia merupakan salah satu negara demokrasi yang dihadapkan pada rendahnya tingkat partisipasi warga negaranya. Padahal partisipasi merupakan konsep utama yang harus dimiliki warga negara dalam negara demokrasi. Oleh karena itu, perlu adanya pendidikan politik sebagai upaya untuk menciptakan warga negara yang mampu berpartisipasi dengan tanggung jawab. Hal ini sesuai dengan pendapat Hajer yang menyebutkan bahwa pendidikan politik adalah usaha membentuk manusia menjadi partisipan yang bertanggung jawab dalam politik, sehingga masyarakat mengerti tentang hak politiknya (Robert Brownhill dan Patricia Smart dalam Elly Hasan Sadeli, dkk, 2009:19). Adapun pendidikan politik tersebut diantaranya diselenggarakan bagi mahasiswa sebagai generasi muda melalui organisasi HMI, KAMMI, dan GMNI. Kata kunci: Pendidikan Politik, Partisipasi Politik
ORGANISASI EKSTRAKURIKULER SEBAGAI LABORATORIUM PENGEMBANGAN DISIPLIN SISWA (Studi Deskriptif terhadap Ekstrakurikuler Paskibra SMAN 6 Bogor)
Authors: Saylendra Nadya Putri
Published: February 2021

ABSTRACT

This study purposed to describe how is Paskibra extracurricular helps students to developing discipline in Senior High School 6th Bogor. The research method used in this research is descriptive method with qualitative approach. The results of this research is in developing discipline towards Paskibra in SMAN 6 Bogor, some activity had been developed, they are: BTP (Basic Training Program); BINTUR (Bimbingan Instruktur); Demo MOS; and MUSRA (Musyawarah Anggota).

Keywords: extracurricular, discipline

ABSTRAK

Penelitian ini bertujuan menjelaskan bagaimana ekstrakurikuler Paskibra mengembangkan disiplin siswa SMA N 6 Bogor. Metode penelitian yang digunakan dalam penelitian ini adalah metode deskriptif melalui pendekatan kualitatif. Hasil dari penelitian ini dalam mengembangkan disiplin siswa melalui Paskibra adalah terbentuknya beberapa program seperti BTP (Basic Training Program); BINTUR (Bimbingan Instruktur); Demo MOS; and MUSRA (Musyawarah Anggota).

Kata Kunci: ekstrakurikuler, disiplin
PENINGKATAN BERPIKIR KRITIS MAHASISWA MELALUI MODEL PEMBELAJARAN PROJECT CITIZEN
Authors: Saylendra Nadya Putri
Published: February 2021

ABSTRACT This study aims to describe of how Project Citizen plays a role in critical thinking of the students of Pancasila and Civic Education Program at Buana Perjuangan Karawang University in criminal law subject by seeing the response in understanding, and the level of effectiveness in using Project Citizen model. The approach used is a qualitative approach with descriptive study method. The result of this research is Project Citizen demands lecturer to do planning before doing the learning. Implementation of the Project Citizen model in Civics learning also demands to assist and direct the students to self-define a case / issue, to examine the problem, to formulate material related to the problem, to seek information from various sources, to account for the results of collecting the materials and analysis in the form of portfolio as well present the results with the creativity of the group presentation. Learning outcomes obtained through this learning model is the increasing ability of critical thinking students. The constraints and the most perceived factors in critical thinking vary widely both internally and externally such as laziness, lack of mastery of materials, lessons learned processes and learning situations, less challenging topics or issues. Keywords: Critical Thinking, Civic Education, Project Citizen.

ABSTRAK Penelitian ini bertujuan untuk memperoleh gambaran bagaimana Project Citizen berperan dalam berpikir kritis mahasiswa Prodi PPKn di Universitas Buana Perjuangan Karawang dalam mata kuliah hukum pidana dengan melihat respon dalam pemahaman, dan tingkat efektifitas dalam menggunakan model Project Citizen. Pendekatan yang digunakan adakah pendekatan kualititatif dengan metode studi deskriptif. Hasil yang didapatkan dari penelitian ini adalah Project Citizen menuntut dosen untuk melakukan perencanaan sebelum melakukan pembelajaran. Pelaksanaan model Project Citizen dalam pembelajaran PKn juga menuntut untuk membantu dan mengarahkan mahasiswa untuk menentukan sendiri suatu kasus/isu, menelaah masalah, membuat rumusan materi yang berkaitan dengan masalah, mencari informasi dari berbagai sumber, mempertanggungjawabkan hasil pengumpulan materi dan analisis tersebut dalam bentuk portofolio serta mempresentasikan hasil dengan kreativitas penyajian kelompok. Hasil belajar yang didapatkan melalui model pembelajaran ini adalah meningkatnya kemampuan berpikir kritis mahasiswa. Faktor yang menjadi kendala dan yang paling dirasakan dalam berpikir kritis sangat bervariasi baik internal maupun eksternal seperti malas, kurangnya penguasaan materi, proses dan situasi pembelajaran di kelas, topik atau isu yang kurang menantang. Kata Kunci : Berpikir Kritis, Pendidikan Kewarganegaraan, Project Citizen.
Implementasi Model Kooperatif Tipe Student Team Achievement Division (STAD) dalam Pembelajaran PPKn
Authors: Civics  , Nadya Putri Saylendra
Published: February 2021

Penelitian ini dilatarbelakangi oleh pemilihan model pembelajaran yang kurang tepat dalam proses pembelajaran di kelas sehingga pembelajaran kurang diminati siswa dan capaian pembelajaran yang diperoleh kurang maksimal. Penelitian ini bermaksud untuk melihat bagaimana implemenetasi model kooperatif tipe Student Team Achieved Division (STAD) dalam pembelajaran PPKn. Pendekatan yang digunakan dalam penelitian ini adalah kualitatif dengan metode deskriptif. Proses pengumpulan data melalui wawancara, observasi dan studi dokumen. Tahapan analisis data meliputi identifikasi data, reduksi data, dan penarikan kesimpulan. Hasil penelitian menunjukkan bahwa guru memahami model kooperatif tipe STAD dalam pembelajaran PPKn. Perencanaan model kooperatif tipe STAD dalam pembelajaran PPKn telah dilaksanakan dengan baik mengikuti langkah-langkah penyusunan perencanaan pembelajaran. Guru PPKn telah melaksanakan model kooperatif tipe STAD dalam pembelajaran PPKn. Rekomendasi dari penelitian ini meliputi Pertama, pihak sekolah sebagai pemangku kebijakan harus memberikan dukungan dalam menyediakan sarana dan sumber belajar agar tujuan pembelajaran tercapai. Kedua, Guru mampu merenecanakan dan melaksanakan model pembelajaran kooperatif tipe STAD dalam pembelajaran PPKn.
Faktor penghambat kegiatan ekstrakurikuler paskibra dalam menerapkan karakter disiplin siswa
Authors: Nadya Putri Saylendra  , Aris Riswandi Sanusi  , Muhammad Mona Adha
Published: February 2021

Penelitian ini bertujuan untuk menjelaskan bagaimana hambatan dalam menerapkan karakter disiplin siswa pada kegiatan ekstrakurikuler paskibra di SMK Texar Klari. Metode penelitian yang digunakan dalam penelitian ini adalah pendekatan kualitatif melalui metode deskriptif. Subjek dalam penelitian ini adalah  guru pembina, pelatih dan siswa anggota ekstrakurikuler paskibra. Teknik pengumpulan data dengan wawancara, observasi dan dokumentasi. Hasil dalam penelitian ini  adalah masih banyak siswa yang sibuk dalam dunia bermain, kurangnya dukungan dari orangtua, keterbatasan waktu dengan orangtua terbatas, kurangnya kerja sama antara siswa yang satu dengan siswa yang lain, serta adanya perbedaan pendapat antara siswa yang satu dengan siswa yang lain. Dari berbagai hambatan kegiatan ekstrakurikuler paskibra, tentunya terbentuknya kedisiplinan dalam diri siswa. Rekomendasi penelitian kepada sekolah sebagai pembuat kebijakan di harapkan untuk mengembangkan kedisiplinan siswa bukan hanya melalui kegiatan ekstrakurikuler saja, tetapi kegiatan lain harus di terapkan. Kepada guru di harapkan guru Pembina maupun pelatih dapat terus mengembangkan dan menumbuhkan karakter disiplin siswa agar dapat meningkatkan karakter disiplin pada proses belajar peserta didik di dalam kelas, di kehidupan sehari-hari bahkan tertanam karakter disiplin tersebut hingga dimasa depan.