David Vivian - Academia.edu (original) (raw)
Papers by David Vivian
Neuromodulation: Technology at the Neural Interface, 2009
Objective. This study aims to assess peripheral nerve field stimulation as a treatment option for... more Objective. This study aims to assess peripheral nerve field stimulation as a treatment option for chronic pain and test for indicators of outcome. Materials and Methods. We reviewed all patients permanently implanted with peripheral nerve field stimulators over the past 24 months. A questionnaire was used to assess outcomes. Results. Twenty-seven questionnaires were sent out and 23/27 responded. A significant average decrease of 4.02 visual analog scale points was observed. The average pain decrease for the low back was 3.77 points and 5.9 for occipital implants. An age effect was detected; younger patients (<60 years) reported an average pain relief of 4.79 points while older patients (>61 years) reported an average pain relief decrement of only 2.83 points. Most patients reported decreases in analgesic use after treatment. Pain relief was significantly and highly correlated with reduced analgesic intake and patient satisfaction. Conclusion. Peripheral nerve field stimulation is a safe, reversible, and effective treatment option for patients with chronic pain, particularly those under 60 years.
Future Science OA
Aim: To evaluate safety and efficacy of low dose autologous adipose-derived mesenchymal stem cell... more Aim: To evaluate safety and efficacy of low dose autologous adipose-derived mesenchymal stem cells (ADMSCs) for treatment of disc degeneration resulting in low back pain (LBP). Methods: Nine participants with chronic LBP originating from single-level lumbar disc disease underwent intradiscal injection of 10 million ADMSCs with optional repetition after 6 months. Results: No unexpected or serious adverse events were recorded. Seven (78%) of participants reported reductions in pain 12 months after treatment. Five (56%) reported increased work capacity. Three (33%) reduced analgesic medication. Improvements in EQ-5D and Oswestry disability index results were observed. MRI demonstrated no further disc degeneration and improvements to annular fissures and disc protrusions. Conclusion: This study provides initial evidence of safety and efficacy of ADMSCs for discogenic LBP.
Australian Family Physician, 2004
Chronic low back pain presents a major challenge for general practitioners and is a significant d... more Chronic low back pain presents a major challenge for general practitioners and is a significant drain on community resources. Patients often feel frustrated by modern medicine's apparent failure to validate their symptoms with a specific diagnosis and management plan. This article presents an evidence based guide to current interventions, including an algorithm for the interventional diagnostic workup of low back pain that has persisted beyond 3 months. Modern imaging techniques rarely determine the cause of pain. The GP must look for 'red flag' clues in the history. Management of low back pain includes NSAIDs, simple injections of plain local anaesthetic without adrenalin or cortisone, referral to a masseuse, cortisone, physiotherapist and/or a musculoskeletal pain physician. Specific management includes medial branch and sacroiliac joint blocks, and radiofrequency neurotomy. Patients with long term pain may be referred to a psychologist for cognitive behavioural therapy.
Peripheral nerve field stimulation (PNFS) has been used in the treatment of pain since 1965, most... more Peripheral nerve field stimulation (PNFS) has been used in the treatment of pain since 1965, most commonly for chronic neck and back pain.1,2 However, advancements in the field of PNFS have lead to its wider application. We demonstrate that PNFS is an effective treatment for abdominal and pelvic pain, and should be considered as an alternative to traditional pharmacological pain management strategies where suitable. Over a 2.5 year period we assessed 8 consecutive patients who had a successful trial and were subsequently implanted with octrode percutaneous leads within the major area of pain in their abdomen and pelvis. Questionnaires, along with patients ’ histories were used to assess outcomes such as pain (VAS), analgesic use, depression (Zung depression index) anxiety (STAI scale) and disability
Journal of Science and Medicine in Sport, 2017
Journal of Science and Medicine in Sport, 2017
Journal of Science and Medicine in Sport, 2015
Over the last two decades, the sacroiliac joint (SIJ) has increasingly been recognized as an anat... more Over the last two decades, the sacroiliac joint (SIJ) has increasingly been recognized as an anatomical source of pain that figures in the differential diagnosis of a patient presenting with low back pain (LBP) and/or buttock pain with or without more distant referred pain.1-7 The SIJ is innervated and thus has the potential to be a source of pain.
Encyclopedia of Pain, 2013
Pain Procedures in Clinical Practice, 2011
Pain Procedures in Clinical Practice, 2011
Back Pain, 1990
The use of radiofrequency denervation to treat pain of zygapophyseal joint or posterior spinal co... more The use of radiofrequency denervation to treat pain of zygapophyseal joint or posterior spinal compartment origin has been gaining in interest since studies showed that heat lesions selectively block smaller fibres in a nerve — the pain-conducting A-δ and C fibres10 and also since the resurrection of the concept that chronic pain can derive from these posterior structures.
Pain Procedures in Clinical Practice, 2011
Neuromodulation: Technology at the Neural Interface, 2009
Objective. This study aims to assess peripheral nerve field stimulation as a treatment option for... more Objective. This study aims to assess peripheral nerve field stimulation as a treatment option for chronic pain and test for indicators of outcome. Materials and Methods. We reviewed all patients permanently implanted with peripheral nerve field stimulators over the past 24 months. A questionnaire was used to assess outcomes. Results. Twenty-seven questionnaires were sent out and 23/27 responded. A significant average decrease of 4.02 visual analog scale points was observed. The average pain decrease for the low back was 3.77 points and 5.9 for occipital implants. An age effect was detected; younger patients (<60 years) reported an average pain relief of 4.79 points while older patients (>61 years) reported an average pain relief decrement of only 2.83 points. Most patients reported decreases in analgesic use after treatment. Pain relief was significantly and highly correlated with reduced analgesic intake and patient satisfaction. Conclusion. Peripheral nerve field stimulation is a safe, reversible, and effective treatment option for patients with chronic pain, particularly those under 60 years.
Future Science OA
Aim: To evaluate safety and efficacy of low dose autologous adipose-derived mesenchymal stem cell... more Aim: To evaluate safety and efficacy of low dose autologous adipose-derived mesenchymal stem cells (ADMSCs) for treatment of disc degeneration resulting in low back pain (LBP). Methods: Nine participants with chronic LBP originating from single-level lumbar disc disease underwent intradiscal injection of 10 million ADMSCs with optional repetition after 6 months. Results: No unexpected or serious adverse events were recorded. Seven (78%) of participants reported reductions in pain 12 months after treatment. Five (56%) reported increased work capacity. Three (33%) reduced analgesic medication. Improvements in EQ-5D and Oswestry disability index results were observed. MRI demonstrated no further disc degeneration and improvements to annular fissures and disc protrusions. Conclusion: This study provides initial evidence of safety and efficacy of ADMSCs for discogenic LBP.
Australian Family Physician, 2004
Chronic low back pain presents a major challenge for general practitioners and is a significant d... more Chronic low back pain presents a major challenge for general practitioners and is a significant drain on community resources. Patients often feel frustrated by modern medicine's apparent failure to validate their symptoms with a specific diagnosis and management plan. This article presents an evidence based guide to current interventions, including an algorithm for the interventional diagnostic workup of low back pain that has persisted beyond 3 months. Modern imaging techniques rarely determine the cause of pain. The GP must look for 'red flag' clues in the history. Management of low back pain includes NSAIDs, simple injections of plain local anaesthetic without adrenalin or cortisone, referral to a masseuse, cortisone, physiotherapist and/or a musculoskeletal pain physician. Specific management includes medial branch and sacroiliac joint blocks, and radiofrequency neurotomy. Patients with long term pain may be referred to a psychologist for cognitive behavioural therapy.
Peripheral nerve field stimulation (PNFS) has been used in the treatment of pain since 1965, most... more Peripheral nerve field stimulation (PNFS) has been used in the treatment of pain since 1965, most commonly for chronic neck and back pain.1,2 However, advancements in the field of PNFS have lead to its wider application. We demonstrate that PNFS is an effective treatment for abdominal and pelvic pain, and should be considered as an alternative to traditional pharmacological pain management strategies where suitable. Over a 2.5 year period we assessed 8 consecutive patients who had a successful trial and were subsequently implanted with octrode percutaneous leads within the major area of pain in their abdomen and pelvis. Questionnaires, along with patients ’ histories were used to assess outcomes such as pain (VAS), analgesic use, depression (Zung depression index) anxiety (STAI scale) and disability
Journal of Science and Medicine in Sport, 2017
Journal of Science and Medicine in Sport, 2017
Journal of Science and Medicine in Sport, 2015
Over the last two decades, the sacroiliac joint (SIJ) has increasingly been recognized as an anat... more Over the last two decades, the sacroiliac joint (SIJ) has increasingly been recognized as an anatomical source of pain that figures in the differential diagnosis of a patient presenting with low back pain (LBP) and/or buttock pain with or without more distant referred pain.1-7 The SIJ is innervated and thus has the potential to be a source of pain.
Encyclopedia of Pain, 2013
Pain Procedures in Clinical Practice, 2011
Pain Procedures in Clinical Practice, 2011
Back Pain, 1990
The use of radiofrequency denervation to treat pain of zygapophyseal joint or posterior spinal co... more The use of radiofrequency denervation to treat pain of zygapophyseal joint or posterior spinal compartment origin has been gaining in interest since studies showed that heat lesions selectively block smaller fibres in a nerve — the pain-conducting A-δ and C fibres10 and also since the resurrection of the concept that chronic pain can derive from these posterior structures.
Pain Procedures in Clinical Practice, 2011