S287 S290
Design:
Prospective study on consecutive patients undergoing a fluo-
roscopically guided injection into the SIJ.
Setting:
Academic institution.
Participants:
Patients suspected given history and physical examina-
tion to have SIJ mediated pain.
Interventions:
2 cc mixture of 1cc of 2% lidocaine and 1 cc of triam-
cinolone 40mg/mL was injected into the SIJ after correct needle
placement was confirmed using contrast dye and real time fluoroscopy.
Main Outcome Measures:
An independent physician assessed pain
score on 0-10 scale immediately before and after the injection, and at
2-4 weeks and 6 months after the injection.
Results:
100% immediate pain relief was considered a positive anes-
thetic response, while 50% pain relief at follow-up was considered
positive. 14/34 (41.0%, 95% CI 26.4-57.8%) obtained 100% immediate
relief. 8/14 (57.1%, 95% CI 32.6-78.6%) that had 100% initial relief re-
ported 50% relief at 2-4 weeks, and 5/8 (62.5%, 95% CI 30.6-86.3%)
had 50% relief at 6 months. Of the 6/14 (42.9%, 95% CI 21.4-67.4%)
that had an initial 100% pain relief, but did not achieve 50% pain
relief at 2 weeks, 0/6 (0%, 95% CI 0-39.0%) had 50% pain relief at 6
months. Of those with a negative initial block, only 3/20 (15%, 95% CI
5.2-36.0%) had 50% pain relief at 2 weeks or 6 months.
Conclusions:
This study illustrates a high negative predictive value of
the immediate response at predicting pain relief at 2-4 weeks, but a
much stronger positive predictive value of pain at 2-4 weeks for pre-
dicting continued pain relief at 6 months.
Level of Evidence:
Level II
CATEGORY: PAIN & SPINE MEDICINE
Poster 484:
A Multi-Institutional Randomized, Double-Blind, Placebo-
Controlled, Prospective Study of Intra-Articular Lumbar
Zygapophysial Joint Corticosteroid Injection(s) as Treatment of
Chronic Low Back Pain in a Selected Population
Ryan Fraiser, DO (Stanford University, Campbell, CA, United States),
Patricia Z. Zheng, MD, Byron J. Schneider, MD, FAAPMR, Joshua Levin,
MD, Lisa Huynh, MD, Matthew Smuck, MD, Agnes Ith, MD,
David J. Kennedy, MD
Disclosures:
Ryan Fraiser: I Have No Relevant Financial Relationships
To Disclose
Objective:
To determine if the intra-articular (IA) injection of corti-
costeroids into the lumbar zygapophyseal (Z-joint) joints is effective in
reducing the need for radiofrequency ablation (RF) in those with dual
comparative MBB confirmed z-joint pain.
Design:
Randomized, double blind, placebo-controlled study.
Setting:
2 academic medical centers.
Participants:
Patients with 80% pain relief during an initial screening
MBB.
Interventions:
Intra-articular corticosteroid (triamcinolone 20mg) or
normal saline along with second confirmatory MBB.
Main Outcome Measures:
The primary outcome measure was the
categorical need for RF and the secondary outcome was time to RF.
Results:
56 subjects were enrolled. Of those, 29 received intra-artic-
ular corticosteroid with 24 meeting criteria for positive confirmatory
MBB with 80% pain relief from both MBBs. 27 received IA saline into the
z-joint during the confirmatory MBB, of which 22 also had a positive
confirmatory MBB. There was no statistical significant difference in the
need for a RF between the groups (16/24 steroid (67% [95% CI 47-82%]) vs
15/22 saline (68% [95% CI 47-84%]), p
¼
1.00). The average time to RF was
also not different at 6.5 weeks steroids versus 6.0 weeks saline (p
¼
.82).
Conclusions:
Intra-articular corticosteroids were not effective in
reducing the need for and time to a radiofrequency ablation of the
medial branches in those with dual medial branch block confirmed z-
joint pain.
Level of Evidence:
Level I
CATEGORY: MSK & SPORTS MEDICINE
Poster 485:
Self-Reported Use and Attitudes Toward Performance
Enhancing Drugs in Ultramarathon Running
Michael D. Campian, DO (Univ of Utah Med Ctr, Salt Lake City, Utah,
United States), Daniel Cushman, MD, Alexandra E. Flis, MD,
Masaru Teramoto, PhD, MPH
Disclosures:
Michael Campian: I Have No Relevant Financial Re-
lationships To Disclose
Objective:
There have been no peer-reviewed articles on the use of
PEDs in ultramarathon running. The objective of this study was to
examine the use of PEDs in ultramarathon running and to identify
attitudes and beliefs about the usage of PEDs in the sport.
Design:
An online survey was developed in REDCap (secure, research-
oriented online software system). The survey was distributed to po-
tential participants through Ultrasignup (centralized ultramarathon
running website) and the Western States Endurance Run Facebook
sites. The survey included 9 demographic questions, 11 PED questions
and the previously validated 17-item Performance Enhancement
Attitude Scale (PEAS).
Setting:
Online survey.
Participants:
609 self-identified ultramarathoners.
Interventions:
Not applicable.
Main Outcome Measures:
Self-reported use of PEDs and the PEAS.
Results:
8.4% of responders reported using PEDs during competition or
training. Cannabinoids (13.3% of runners), narcotics (6.4%), and stim-
ulants (3%) were the most frequently reported PEDs. There was no
relationship between gender, age, country of origin, rank, miles/week
of training or longest race with those that reported using PEDs vs. not
using PEDs. However, athletes who knew another ultramarathoner that
used PEDs (not themselves) had significantly higher years of partici-
pation than their counterparts (8.1 6.4 years vs. 6.3 5.7 years,
t(541)
¼
-2.760, P
¼
.006). Furthermore, a significantly greater number
of athletes ranked in the top 20th percentile reported that they knew
another ultramarathoner that used PEDs compared to those ranked in
the bottom 80th percentile (25.4% vs. 16.9%,
c
2(1)
¼
4.9692, P
¼
.026). Additionally, there was an increased PEAS score (suggesting a
more accepting attitude towards PEDs) of individuals who reported
using a PED or individuals that knew an individual who used PEDs.
Conclusions:
PEDs are being used in ultramarathon running. The ul-
tramarathon runners who self-reported or reported knowing an indi-
vidual that used PEDs have higher years of participation, were higher
ranked and have higher PEAS scores.
Level of Evidence:
Level III
CATEGORY: NEUROLOGICAL REHABILITATION
Poster 486:
Marinol and the Treatment of Pediatric Agitation
Gerald H. Clayton, PhD (Dept Phys. Med. and Rehab, The Children’s,
Aurora, Colorado, United States), Pamela E. Wilson, MD,
Alesia Blanchard, BS, Dianne Garcia, RN, Annie Ritchie, RN
Disclosures:
Gerald Clayton: I Have No Relevant Financial Relation-
ships To Disclose
S287
Abstracts / PM R 9 (2017) S131-S290