Objective: We assessed whether or not pain relief could be achieved with a new system that combines 3D augmented reality system (3DARS) and the principles of mirror visual feedback. Methods: Twenty-two patients between 18 and 75 years of age who suffered of chronic neuropathic pain. Each patient performed five 3DARS sessions treatment of 20 mins spread over a period of one week. The following pain parameters were assessed: (1) visual analogic scale after each treatment session (2) McGill pain scale and DN4 questionnaire were completed before the first session and 24 h after the last session. Results: The mean improvement of VAS per session was 29% (p < 0.001). There was an immediate session effect demonstrating a systematic improvement in pain between the beginning and the end of each session. We noted that this pain reduction was partially preserved until the next session. If we compare the pain level at baseline and 24 h after the last session, there was a significant decrease (p < 0.001) of pain of 37%. There was a significant decrease (p < 0.001) on the McGill Pain Questionnaire and DN4 questionnaire (p < 0.01). Conclusion: Our results indicate that 3DARS induced a significant pain decrease for patients who presented chronic neuropathic pain in a unilateral upper extremity. While further research is necessary before definitive conclusions can be drawn, clinicians could implement the approach as a preparatory adjunct for providing temporary pain relief aimed at enhancing chronic pain patients’ tolerance of manual therapy and exercise intervention. Level of Evidence: 4.

Study Design: This was a prospective study evaluating the Pain Sensitivity Questionnaire (PSQ) in 110 patients undergoing spine surgery. Objective: The purpose of this study was to compare the ability of the PSQ-total and PSQ-minor scores with the Pain Catastrophizing Scale (PCS) in predicting the immediate postoperative pain of patients after spinal surgery and their risk of developing a chronically painful state. Summary of Background Data: Studies evaluating the PSQ as a preoperative determinant for the development of chronic pain are lacking. Therefore, we undertook the following study. Materials and Methods: Patients undergoing lumbar or cervical spine surgery were prospectively included in the study. The PSQ-total and PSQ-minor, the PCS and its subscores, the Oswestry Disability Index (ODI) and the Neck Disability Index were used preoperatively. Preoperative and postoperative Visual Analog Scale scores for pain at rest and movement and analgesics were recorded. At 12 months postoperatively, the Neck Disability Index and the ODI were once more assessed to evaluate pain chronicization. Results: A total of 110 patients scheduled to undergo surgery at our spine center participated in the study. Our results highlighted that Visual Analog Scale scores were increased for high catastrophizers at rest on the first postoperative day when compared with low catastrophizers. Preoperative use of opioids and a high score on the rumination subscale of the PCS were linked to greater postoperative morphine consumption. At 12 months, the PCS, the PSQ-total, and PSQ-minor showed correlations with the development of a chronically painful state for ODI scores >21, indicating a marked persistent disability. Conclusions: Both PSQ and PCS showed an ability to predict a chronically painful state as defined by the persistence of disability after lumbar surgery.

Background. As very strong agreement has been reported between bispectral index (BIS) values measured from the occipital and frontal skull areas, we compared BIS values measured from central and parietal areas with those from frontal area to investigate whether BIS is really a topographically dependent or topographically independent variable. Methods. Twenty patients, ASA I–II, non-obese, aged 18–62 yr and with no neurological disorders were enrolled. Based on the 10–20 international landmarks, five silver dome electrodes were positioned: F7, C3, P7, Cz (common reference) and Fp1 (ground). Using frontal (F7–Cz), central (C3–Cz) and parietal (P7–Cz) electrode montages, the corresponding BIS values were simultaneously recorded with an Aspect A-1000 monitor (software v3.12). The BIS values were recorded at the propofol concentration allowing laryngeal mask insertion, which was maintained during the 10 min data collection period in absence of additional external stimuli. Data were analysed using the Kruskall–Wallis, Wilcoxon paired sign with Bonferroni correction, Bland–Altman and linear correlation tests. Results. At the predicted effect target propofol concentration 4–8 μg ml⁻¹, the 10 min mean BIS (median [min–max]) were 32 [20–44], 46 [28–68] and 58 [41–72] for the frontal, central and parietal leads, respectively. Differences between these BIS recordings were statistically significant (P<0.0001, Kruskall–Wallis; P<0.005, Wilcoxon paired sign test). Conclusions. The present results provide evidence that BIS index is a topographically dependent variable in patients receiving propofol anaesthesia.

To study the long-term evolution of patients with lower-limb Complex Regional Pain Syndrome (CRPS), focusing on functional and proprioceptive aspects and quality of life.In 20 patients suffering fr...