Background: This study investigates whether intramuscular electrical stimulation (IMES) with inverse electrode placement (IEP) or conventional electrode placement (CEP) more effectively modulates pain. The current study’s aim was to compare the effects of IMES using IEP and CEP, and sham-IMES on the pressure pain threshold (PPT), EMG activity, upper trapezius (UT) muscle length and pain severity among adults with UT myofascial trigger points (MTrPs). Methods: Thirty-six male adults with UT-MTrPs were allocated into three groups. IEP, CEP and sham groups were respectively treated with a single IMES session using IEP, CEP, and sham-IMES. Pain intensity, PPT, EMG activity (root mean square, RMS) and UT muscle length were measured on day one before the treatment, day one post treatment and at a day three follow-up to determine the immediate and short-term effectiveness of IMES. Results: IMES using both IEP and CEP methods produced significant higher changes in UT-PPT (median, interquartile-interval, IEP group: 3.25, 2.56–3.50 and CEP group: 2.75, 1.75–3.00, vs. sham group: 1.07, 0.89–1.71 kg/cm 2 ), RMS (IEP: 0.31, 0.26–0.35 and CEP: 0.36, 0.23–0.38, vs. sham: 0.21, 0.16–0.25 mV), and UT muscle length (IEP: 9.50, 8–12.75 and CEP: 8, 7–10, vs. 1.5. 1–2.75 degrees) and UT-pain severity (IEP: 3.00, 2.25–4 and CEP: 3, 3–3, vs. sham: 2, 2–2.75 points on VAS) compared to the score change in sham-IMES at day three follow up. Conclusions Pain modulation can be effectively achieved using IMES regardless of electrode placement method, with different electrode configurations.

Background: This study investigates whether intramuscular electrical stimulation (IMES) with inverse electrode placement (IEP) or conventional electrode placement (CEP) more effectively modulates pain. The current study’s aim was to compare the effects of IMES using IEP and CEP, and sham-IMES on the pressure pain threshold (PPT), EMG activity, upper trapezius (UT) muscle length and pain severity among adults with UT myofascial trigger points (MTrPs). Methods: Thirty-six male adults with UT-MTrPs were allocated into three groups. IEP, CEP and sham groups were respectively treated with a single IMES session using IEP, CEP, and sham-IMES. Pain intensity, PPT, EMG activity (root mean square, RMS) and UT muscle length were measured on day one before the treatment, day one post treatment and at a day three follow-up to determine the immediate and short-term effectiveness of IMES. Results: IMES using both IEP and CEP methods produced significant higher changes in UT-PPT (median, interquartile-interval, IEP group: 3.25, 2.56–3.50 and CEP group: 2.75, 1.75–3.00, vs. sham group: 1.07, 0.89–1.71 kg/cm 2 ), RMS (IEP: 0.31, 0.26–0.35 and CEP: 0.36, 0.23–0.38, vs. sham: 0.21, 0.16–0.25 mV), and UT muscle length (IEP: 9.50, 8–12.75 and CEP: 8, 7–10, vs. 1.5. 1–2.75 degrees) and UT-pain severity (IEP: 3.00, 2.25–4 and CEP: 3, 3–3, vs. sham: 2, 2–2.75 points on VAS) compared to the score change in sham-IMES at day three follow up. Conclusions Pain modulation can be effectively achieved using IMES regardless of electrode placement method, with different electrode configurations.

Background: This study investigates whether intramuscular electrical stimulation (IMES) with inverse electrode placement (IEP) or conventional electrode placement (CEP) more effectively modulates pain. The current study’s aim was to compare the effects of IMES using IEP and CEP, and sham-IMES on the pressure pain threshold (PPT), EMG activity, upper trapezius (UT) muscle length and pain severity among adults with UT myofascial trigger points (MTrPs). Methods: Thirty-six male adults with UT-MTrPs were allocated into three groups. IEP, CEP and sham groups were respectively treated with a single IMES session using IEP, CEP, and sham-IMES. Pain intensity, PPT, EMG activity (root mean square, RMS) and UT muscle length were measured on day one before the treatment, day one post treatment and at a day three follow-up to determine the immediate and short-term effectiveness of IMES. Results: IMES using both IEP and CEP methods produced significant higher changes in UT-PPT (median, interquartile-interval, IEP group: 3.25, 2.56–3.50 and CEP group: 2.75, 1.75–3.00, vs. sham group: 1.07, 0.89–1.71 kg/cm 2 ), RMS (IEP: 0.31, 0.26–0.35 and CEP: 0.36, 0.23–0.38, vs. sham: 0.21, 0.16–0.25 mV), and UT muscle length (IEP: 9.50, 8–12.75 and CEP: 8, 7–10, vs. 1.5. 1–2.75 degrees) and UT-pain severity (IEP: 3.00, 2.25–4 and CEP: 3, 3–3, vs. sham: 2, 2–2.75 points on VAS) compared to the score change in sham-IMES at day three follow up. Conclusions Pain modulation can be effectively achieved using IMES regardless of electrode placement method, with different electrode configurations.

Background: This study investigates whether intramuscular electrical stimulation (IMES) with inverse electrode placement (IEP) or conventional electrode placement (CEP) more effectively modulates pain. The current study’s aim was to compare the effects of IMES using IEP and CEP, and sham-IMES on the pressure pain threshold (PPT), EMG activity, upper trapezius (UT) muscle length and pain severity among adults with UT myofascial trigger points (MTrPs). Methods: Thirty-six male adults with UT-MTrPs were allocated into three groups. IEP, CEP and sham groups were respectively treated with a single IMES session using IEP, CEP, and sham-IMES. Pain intensity, PPT, EMG activity (root mean square, RMS) and UT muscle length were measured on day one before the treatment, day one post treatment and at a day three follow-up to determine the immediate and short-term effectiveness of IMES. Results: IMES using both IEP and CEP methods produced significant higher changes in UT-PPT (median, interquartile-interval, IEP group: 3.25, 2.56–3.50 and CEP group: 2.75, 1.75–3.00, vs. sham group: 1.07, 0.89–1.71 kg/cm 2 ), RMS (IEP: 0.31, 0.26–0.35 and CEP: 0.36, 0.23–0.38, vs. sham: 0.21, 0.16–0.25 mV), and UT muscle length (IEP: 9.50, 8–12.75 and CEP: 8, 7–10, vs. 1.5. 1–2.75 degrees) and UT-pain severity (IEP: 3.00, 2.25–4 and CEP: 3, 3–3, vs. sham: 2, 2–2.75 points on VAS) compared to the score change in sham-IMES at day three follow up. Conclusions Pain modulation can be effectively achieved using IMES regardless of electrode placement method, with different electrode configurations.

Background: This study investigates whether intramuscular electrical stimulation (IMES) with inverse electrode placement (IEP) or conventional electrode placement (CEP) more effectively modulates pain. The current study’s aim was to compare the effects of IMES using IEP and CEP, and sham-IMES on the pressure pain threshold (PPT), EMG activity, upper trapezius (UT) muscle length and pain severity among adults with UT myofascial trigger points (MTrPs). Methods: Thirty-six male adults with UT-MTrPs were allocated into three groups. IEP, CEP and sham groups were respectively treated with a single IMES session using IEP, CEP, and sham-IMES. Pain intensity, PPT, EMG activity (root mean square, RMS) and UT muscle length were measured on day one before the treatment, day one post treatment and at a day three follow-up to determine the immediate and short-term effectiveness of IMES. Results: IMES using both IEP and CEP methods produced significant higher changes in UT-PPT (median, interquartile-interval, IEP group: 3.25, 2.56–3.50 and CEP group: 2.75, 1.75–3.00, vs. sham group: 1.07, 0.89–1.71 kg/cm 2 ), RMS (IEP: 0.31, 0.26–0.35 and CEP: 0.36, 0.23–0.38, vs. sham: 0.21, 0.16–0.25 mV), and UT muscle length (IEP: 9.50, 8–12.75 and CEP: 8, 7–10, vs. 1.5. 1–2.75 degrees) and UT-pain severity (IEP: 3.00, 2.25–4 and CEP: 3, 3–3, vs. sham: 2, 2–2.75 points on VAS) compared to the score change in sham-IMES at day three follow up. Conclusions Pain modulation can be effectively achieved using IMES regardless of electrode placement method, with different electrode configurations.

Methods: Twenty-four patients with AIS (Cobb >65°) underwent surgery at a single center between January 2014 and December 2021. The first 10 patients underwent surgery using only IOT (T group), whereas the subsequent 14 patients underwent surgery with a combination of IOT and PO (TP group). Results: The mean preoperative Cobb angles in the T and TP groups were 89.35°±6.05° and 92.32°±9.28°, respectively (p=0.59). The mean flexibility index (FI) of the T and TP groups were 0.31±0.016 and 0.36±0.03, respectively (p=0.41). The mean postoperative Cobb angle in the T and TP groups were 40.25°±5.95° and 19.1°±3.20°, respectively (p=0.041). Apical vertebral rotation improved from mean grade 3.2 (2–4) to grade 2.6 (1–3) in the T group and from mean grade 3.6 (2–4) to mean grade 1.8 (1–3) in the TP group. Postoperatively, the mean thoracic kyphosis was 13.84°±2.10° and 21.02°±1.68° in T and TP groups (p=0.044). Transient signal-loss intraoperatively was noted in two patients, one in each group. No episodes of postoperative neurological deficits were reported. No incidences of pseudarthrosis/implant-related complications were reported at the end of 2 years in either group. Conclusions IOT and PO complement one another and can be safely combined without an attributable risk of neurological injury.

Methods: Twenty-four patients with AIS (Cobb >65°) underwent surgery at a single center between January 2014 and December 2021. The first 10 patients underwent surgery using only IOT (T group), whereas the subsequent 14 patients underwent surgery with a combination of IOT and PO (TP group). Results: The mean preoperative Cobb angles in the T and TP groups were 89.35°±6.05° and 92.32°±9.28°, respectively (p=0.59). The mean flexibility index (FI) of the T and TP groups were 0.31±0.016 and 0.36±0.03, respectively (p=0.41). The mean postoperative Cobb angle in the T and TP groups were 40.25°±5.95° and 19.1°±3.20°, respectively (p=0.041). Apical vertebral rotation improved from mean grade 3.2 (2–4) to grade 2.6 (1–3) in the T group and from mean grade 3.6 (2–4) to mean grade 1.8 (1–3) in the TP group. Postoperatively, the mean thoracic kyphosis was 13.84°±2.10° and 21.02°±1.68° in T and TP groups (p=0.044). Transient signal-loss intraoperatively was noted in two patients, one in each group. No episodes of postoperative neurological deficits were reported. No incidences of pseudarthrosis/implant-related complications were reported at the end of 2 years in either group. Conclusions IOT and PO complement one another and can be safely combined without an attributable risk of neurological injury.

Methods: Twenty-four patients with AIS (Cobb >65°) underwent surgery at a single center between January 2014 and December 2021. The first 10 patients underwent surgery using only IOT (T group), whereas the subsequent 14 patients underwent surgery with a combination of IOT and PO (TP group). Results: The mean preoperative Cobb angles in the T and TP groups were 89.35°±6.05° and 92.32°±9.28°, respectively (p=0.59). The mean flexibility index (FI) of the T and TP groups were 0.31±0.016 and 0.36±0.03, respectively (p=0.41). The mean postoperative Cobb angle in the T and TP groups were 40.25°±5.95° and 19.1°±3.20°, respectively (p=0.041). Apical vertebral rotation improved from mean grade 3.2 (2–4) to grade 2.6 (1–3) in the T group and from mean grade 3.6 (2–4) to mean grade 1.8 (1–3) in the TP group. Postoperatively, the mean thoracic kyphosis was 13.84°±2.10° and 21.02°±1.68° in T and TP groups (p=0.044). Transient signal-loss intraoperatively was noted in two patients, one in each group. No episodes of postoperative neurological deficits were reported. No incidences of pseudarthrosis/implant-related complications were reported at the end of 2 years in either group. Conclusions IOT and PO complement one another and can be safely combined without an attributable risk of neurological injury.

Intracranial non-galenic pial arteriovenous fistula (PAVF) is an extremely rare vascular malformation, where one or more pial arteries feeds directly into a cortical vein without any intervening nidus. Though occasionally they can be asymptomatic, neurological symptoms such as headache, seizure, or focal neurological deficit are more common presenting features. Life threatening or fatal hemorrhage is not uncommon, hence needed to be treated more often than not. Spontaneous occlusion of PAVF is reported only four times before. We report a 49-year-old gentleman, who was diagnosed to have a PAVF, possibly secondary to trauma. He presented 5 months and 22 days from initial digital subtraction angiography (DSA) for treatment, and follow-up angiogram showed complete obliteration. He denied any significant event, medication or alternate treatment during this period. His clinical symptoms were stable as well. We postulate iodinated contrast medium induced vasculopathy as a possible cause, which has been described for other vascular pathologies, but never for PAVF.