Are there any screening tools to help diagnose neuropathic pain?

Various screening tools are available to help physicians diagnose neuropathic pain. The European Federation of Neurological Societies (EFNS) has recently published updated guidelines that provide an overview of, and recommendations on, the key screening tools. These tools are: the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS)2; Neuropathic Pain Questionnaire (NPQ)3; Douler Neuropathique en 4 questions (DN4)4; PainDETECT5; ID Pain6; and the standardized evaluation of pain (StEP)7. All these screening tools have been validated in various neuropathic pain populations; the LANSS, DN4 and StEP utilize interview questions and physical examination, while the NPQ, PainDETECT and ID Pain use only interview questions. Of relevance to the Hong Kong population, one of the screening tools – the ID Pain – has been translated to and validated. The validity of the 6-item patient-completed questionnaire was assessed in 92 patients with either neuropathic or nociceptive pain. At a score of 3 or more, the questionnaire correctly classified 71% of cases. While screening tools are useful for identifying patients with possible neuropathic pain, particularly by non-specialist physicians, they do have limitations. As noted in the EFNS guidelines, these tools fail to identify 10–20% of patients with physician-diagnosed neuropathic pain; hence, they should be used together with a thorough patient history and physical examination.

ID pain

1 Did the pain feel like pins and needles? 您的痛楚是否好像被針刺般疼痛？

2 Did the pain feel hot/burning? 您的痛楚是否灼熱或好像被火燒一樣？

3 Did the pain feel numb? 您的痛楚是否帶有麻痺？

4 Did the pain feel like electrical shocks? 您的痛楚是否好像觸電一樣？

5 Is the pain made worse with the touch of clothing or bedsheets? 您的痛楚是否因觸碰衣服或床單而加劇？

6 Is the pain limited to your joints? 您的痛楚是否只限於關節部位？

Reference: http://www.neuropainhk.org

The information provided aims to provide educational purpose, if you have the described conditions as above, please consult your doctor immediately.

Hydrodiscetomy: Cutting with Water

Hydrodiscetomy is solving unmet needs and improving outcomes in spine surgery by providing fluidjet-driven medical devices for use in ‘open’ and ‘minimally
invasive’ spine procedures.

The products empower neurosurgeons to simultaneously cut, ablate, and remove hard and soft tissue quickly, safely, and effectively— without the collateral thermal or mechanical trauma of other surgical modalities. Imagine being able to remove tissue during back
surgery via an opening the size of a straw—with the aid of a hair-thin, 600-miles-per-hour stream of water, instead of a one- to two-inch incision from an ‘open’ surgery with a
scalpel. Although high-pressure water jets have been employed for many years in
industrial cutting applications, this technology is not easily adapted for use in medicine
because of the unique technical requirements of surgery:

(1) the working fluid must be sterile;
(2) the tools must be tiny and easily maneuverable;
(3) the pump system must be small enough to fit in any operating room; and,
(4) the devices must be safe.

Hydrodiscetomy has overcome the major barriers to the transfer of fluidjet technology from industrial to surgical applications with significant technical innovations. As a result, a growing number of neurosurgeons are using Hydrodiscetomy to wash away patients’ pain in a variety of back procedures. Unique to Hydrodiscetomy’s devices is the use of a ‘collector’ tube, not only to capture the fluidjet stream, but also to create a powerful ‘Venturi’- and-morcellation effect at the active site—resulting in tissue being drawn into the collector tube and thus away from the operative site, without the need for an external suction connection. This also allows optimal visibility during operation of the device—particularly important in spine procedures, where the surgical site is surrounded by vital structures such as nerves and blood vessels. A further major advantage of Hydrodiscetomy is the ability to achieve ‘selective’ tissue excision. The tissue selectivity benefit allows spine surgeons to quickly and safely remove appropriate tissue, such as disc nucleus, without damaging the surrounding harder tissue or vertebral endplates. These advantages illustrate the power and versatility of Hydrodiscetomy to provide solutions to the spine surgeon, enabling efficient surgical procedures and optimal patient outcomes.

Reference: http://www.minimally-invasive-centrehk.com/english/resources/resources_neurosurgery.html
http://www.youtube.com/user/HKHealthConcern#p/u/5/pFLIV3UfQgg

The above information serves as educational reference only, you should consult your neurosurgeon for diagnosis, treatments and surgeries.