Nikolai Bogduk's research while affiliated with The University of Newcastle, Australia and other places

Publications (178)

Article
For professional practice to be responsible, any diagnostic tests used must be reliable. Therefore, the reliability of any diagnostic test needs to have been measured. The classical statistic for quantifying reliability is Kappa. Although Kappa can be promptly determined using a programmed calculator, using an algorithm to derive Kappa provides gre...
Article
For clinical practice to be professionally responsible, any diagnostic tests used need to be valid because, if a test lacks validity the information that it provides is wrong. Of the several subtypes of validity, the crucial one is construct validity, which determines how well a diagnostic test discriminates simultaneously between the presence and...
Article
Background: Estimates of the prevalence of lumbar zygapophysial joint (Z joint) pain differ in the literature, as do case definitions for this condition. No studies have determined the prevalence of "pure" lumbar Z joint pain, defined as complete relief of pain following placebo-controlled diagnostic blocks. Objective: The objective of this stud...
Article
Objectives The study sought to assess the utility of controlled diagnostic blocks in patients with probable cervicogenic headache by determining the prevalence of sources of pain among the upper and lower synovial joints of the cervical spine. Methods Controlled diagnostic blocks were performed in 166 consecutive patients who clinically exhibited...
Article
Objective: To determine the effectiveness of lumbar medial branch thermal radiofrequency neurotomy based on different selection criteria and procedural techniques. Design: Comprehensive systematic review. Methods: A comprehensive literature search was conducted, and all authors screened and evaluated the studies. The Grades of Recommendation,...
Article
Objectives: To determine prevalence rates of hemorrhagic complications in patients who either ceased or continued anticoagulants during interventional pain procedures. Methods: A total of 1,936 consecutive patients were prospectively monitored during a total of 12,723 injection procedures. The prevalence of hemorrhagic complications was tallied...
Article
Objectivesbackground: Objectives To determine the extent and strength of evidence that supports the belief that cervical intervertebral discs are a source of neck pain. Design: Design The evidence from anatomical, laboratory, experimental, diagnostic, and treatment studies was summarized and analyzed for concept validity, face validity, content...
Article
Objective Neck-Tongue syndrome (NTS) is characterized by brief attacks of neck or occipital pain, or both, brought out by abrupt head turning and accompanied by ipsilateral tongue symptoms. As the disorder is rare, we undertook a systematic review of the literature to identify all reported cases in order to phenotype clinically the disorder and sub...
Article
Background. Guidelines have been published that recommend discontinuing anticoagulants in patients undergoing interventional pain procedures. The safety and effectiveness of these guidelines have not been tested. Objectives. The present study was performed to determine if continuing or discontinuing anticoagulants for pain procedures is associated...
Article
There are no established treatments for discogenic low back pain, yet the condition appears to be common among patients with chronic low back pain. Surgery is the mainstay of treatment, but it is a major undertaking and its effectiveness is limited. Therefore, the Journal welcomes the exploration of alternatives for this troublesome condition. In...
Article
In this issue, Gunduz et al. ⇓ report their experience with blocks of the ganglion impar for coccydynia. Critics might ask why this article was published, arguing that it was not a randomized, placebo-controlled trial. In response, a variety of reasons justify its publication. In the first instance, the literature on blocks of the ganglion impar i...
Article
In composing their review of posterior sacroiliac procedures, King et al. [1] responsibly complied with the requirements of the GRADE system for assessing quality of literature [2]. Doing so, however, generates what might be regarded, in some respects, as unexciting reading. King et al. [1] found the literature in general to be of moderate quality....
Article
Physicians in conventional clinical practice are likely to regard outcome assessment instruments as something of interest only to academics undertaking research studies. Outcome data are typically collected only in the context of research studies, and research grants are required to pay for staff who collect those data. However, in a field with fe...
Article
Dear Editor, In their letter, Nampiaparampil and Engel raise a number of concerns about the study of Pinto et al. [1], and their exchange provides us a valuable opportunity to discuss study design and interpretation. Some of their concerns can be questioned, but they do reflect the irritation felt by practitioners who find their procedures being a...
Article
To determine the effectiveness and safety of computerized tomography (CT) guided, lumbar transforaminal injection of steroids in the treatment of radicular pain. Systematic review of published literature. Two reviewers independently assessed 19 publications on the effectiveness and safety of CT-guided, lumbar transforaminal injection of steroids. F...
Chapter
Low back pain is a distinctly different condition from lumbar radicular pain (sometimes called “sciatica”). Radicular pain is lancinating pain that travels into the lower limb along a narrow band [1]. It is caused by disc herniation, foraminal stenosis, lateral recess stenosis, or other space-occupying lesions in the vertebral canal that compromise...
Article
Objective: This study aims to determine the effectiveness of lumbar medial branch radiofrequency neurotomy (RFN) performed by two practitioners trained according to rigorous guidelines. Design: Prospective, outcome study of consecutive patients with chronic back pain treated in a community setting. Interventions: A total of 106 patients, selec...
Article
Introduction Studies examining associations between back pain and degenerated intervertebral disks (IVDs) produced evidence implicating IVDs as a significant factor in chronic back pain. Traditionally, treatment is focused on symptoms instead of at the root of discogenic back pain, the disk itself. Further, invasive treatments range from use of str...
Article
Degenerative changes are the manifestations of metabolic disturbances in the matrix of intervertebral disks and zygapophysial joints. Genetic factors and physical loading contribute, but the strongest correlation is with age. Degenerative changes lack any significant correlation with spinal pain. Therefore, they do not constitute a diagnosis. Inter...
Article
The objective of this study was to determine the effectiveness of cervical medial branch radiofrequency neurotomy (RFN) performed by two practitioners trained according to rigorous guidelines. The study was designed as a prospective, outcome study of consecutive patients with chronic neck pain treated in a community setting. A total of 104 patients...
Article
Objectives Mean axes of rotation [MAR] of cervical joints are an effective measure of spine pathology. Khan Kinetic Treatment [KKT] is known to relieve symptoms, but its biomechanical effects have not been quantified. This study assesses KKT efficacy using MAR correction and its associated effects.Methods The intervention applies vibrations via sty...
Article
Nonsystematic review of cervical spine lesions in whiplash-associated disorders (WAD). To describe whiplash injury models in terms of basic and clinical science, to summarize what can and cannot be explained by injury models, and to highlight future research areas to better understand the role of tissue damage in WAD. The frequent lack of detectabl...
Article
Expert debate and synthesis of research to inform future management approaches for acute whiplash disorders. To identify a research agenda toward improving outcomes for acute whiplash-injured individuals to lessen the incidence of transition to chronicity. International figures are concordant, estimating that 50% of individuals recover from pain an...
Article
To describe and test a model to explain the biomechanical basis for persistent pain after compression fractures of the vertebral body. The biomechanics model was derived axiomatically from a consideration of the anatomy of vertebral column when affected by compression fractures. Proof of principle was provided by performing controlled diagnostic bl...
Article
Many conditions associated with chronic pain have no detectable morphological correlate. Consequently, the source of pain cannot be established by clinical examination or medical imaging. However, for some such conditions, the source of pain can be established using diagnostic blocks. The aim of this paper is to review the available evidence concer...
Article
Case report. To report a previously undescribed association between complex regional pain syndrome (CRPS) and surgery for cervical disc protrusion. Although CRPS has been associated with disc protrusion and lumbar spine surgery, there is no record in the literature of a similar association with cervical disc protrusion. Description of a clinical ca...
Article
In this exploratory study we evaluated sensitivity and target specificity of sinuvertebral nerve block (SVNB) for the diagnosis of lumbar diskogenic pain. Diskography has been the diagnostic gold standard. Fifteen patients with positive diskography underwent SVNB via interlaminar approach to the posterior aspect of the disk. Success was defined as...
Article
Objective: To analyze the motor vehicle crash parameters associated with chronic neck pain outcomes associated with whiplash injury. Method: Police accident data were matched with a clinical database of 273 subjects with chronic neck pain as a result of a motor vehicle crash. These subjects had or were in the process of being objectively investigat...
Article
Objectives: To ascertain the relative and comparable efficacy of various therapies that are promoted for the resolution of whiplash associated disorder. Methods: To review the evidence based scientific literature, including meta-analyses, and from their data to develop a score for each therapy as it compares to another. To discuss from this data th...
Article
Interventional pain medicine faces a crisis. In the interests of bringing relief to their patients, pain specialists practice a variety of invasive procedures that interrupt pain pathways in order to stop pain, or modulate physiological processes in order to reduce pain perception. Few of these interventions have been subjected to randomized contro...
Article
Diagnostic blocks can be a powerful tool for the investigation of spinal pain. However, for their use to be rational, blocks must have diagnostic or therapeutic utility, proven validity, and their use should be efficient. Of the 6 diagnostic blocks available for spinal pain, only some have been fully validated. Others still require particular valid...
Chapter
Introduction 484 Definition 484 Referred pain 485 Whiplash 489 Investigations 491 Treatment 493 Recommendations 495 References 495 Neck pain and cervical radicular pain are different entities, and should not be confused.
Article
Full-text available
Whiplash is neck pain experienced as a result of a motor vehicle collision or similar trauma. Following a motor vehicle collision, 15% to 40% of patients with acute neck pain develop chronic neck pain. The cervical facet joint is the most common source of chronic neck pain after whiplash injury, followed by disk pain. Some patients experience pain...
Article
An abundant clinical literature implicates intra-articular inclusions in various pathological conditions of the elbow, but the anatomical literature offers piecemeal descriptions of these structures. The aim of this study was to determine the prevalence, disposition, and gross morphology of intra-articular inclusions of the entire elbow joint compl...
Article
This editorial focuses on the topic of outcome research and offers alternate views of what may be important to the practitioner.
Article
Psychological and social factors are associated with complaints of back pain. These factors may be risk factors or prognostic factors. Risk factors are associated with a higher likelihood that the individual will experience back pain in the future. Prognostic factors are associated with a higher likelihood that a patient's pain will become chronic....
Article
Chronic neck pain after whiplash injury is caused by cervical zygapophysial joints in 50% of patients. Diagnostic blocks of nerves supplying the joints are performed using fluoroscopy. The authors' hypothesis was that the third occipital nerve can be visualized and blocked with use of an ultrasound-guided technique. In 14 volunteers, the authors pl...
Article
This chapter explores that it is commonly held that the cause of back pain cannot be diagnosed in over 80% of patients. It discusses that spondylolysis or spondylolisthesis cannot be held as the cause of back pain in adults. These conditions occur with equal prevalence in subjects with no symptoms as they do in patients with back pain. Similarly, s...
Article
This chapter describes whiplash injury as the supposed injury that is sustained during a whiplash movement. The symptoms that supposedly result from this injury have been referred to variously as “whiplash symptoms,” “whiplash syndrome” and “whiplash-associated disorder (WAD).” Patients with acute symptoms do not need to be investigated and medical...
Article
The author reviews the concept of musculoskeletal pain including anatomy, physiology, referred pain, nociception of muscle, joints, ligaments and bone, and the pathophysiology of osteoarthritis, muscle pain, trigger points and fibromyalgia. (non-author abstract)
Article
The objectives of this article are to encapsulate the literature on the clinical aspects of cervicogenic headache, in order to help readers understand how cervicogenic headache can be distinguished from other primary headaches, and how it might be treated. Cervicogenic headache has evolved as a contentious and controversial entity. Tensions have de...
Article
To assess the efficacy of a prolotherapy injection and exercise protocol in the treatment of chronic nonspecific low back pain. Randomized controlled trial with two-by-two factorial design, triple-blinded for injection status, and single-blinded for exercise status. General practice. One hundred ten participants with nonspecific low-back pain of av...
Article
In view of the disparities in the anatomical, clinical, and biomechanical literature this study was undertaken to reappraise the gross anatomy of ligamentum nuchae with the objective of providing an accurate anatomical basis for biomechanical studies and for clinical theories and practices. Ligamentum nuchae was studied by gross dissection in ten e...
Article
An audit was conducted to determine if epidural injections for back pain and sciatica were practised in accordance with guidelines prescribed by the National Health and Medical Research Council (NHMRC). More than 80% of injections were used for conditions for which they were not indicated, and which the NHMRC considers experimental. Most commonly,...
Article
A case-control study involving parallel benchmarking audits was conducted. To compare the safety, efficacy, and cost effectiveness of evidence-based medical care and usual care for acute low back pain. Although several sets of guidelines have been promoted for the management of acute low back pain, there is no evidence that following guidelines res...
Article
Cervicogenic headache is pain perceived in the head but referred from a primary source in the cervical spine. The physiologic basis for this pain is convergence between trigeminal afferents and afferents from the upper three cervical spinal nerves. The possible sources of cervicogenic headache lie in the structures innervated by the C1 to C3 spinal...
Article
Minor injuries of the cervical spine are essentially defined as injuries that do not involve a fracture. Archetypical of minor cervical injury is the whiplash injury. Among other reasons, neck pain after whiplash has been controversial because critics do not credit that an injury to the neck can occur in a whiplash accident. In pursuit of the injur...
Article
The developing understanding of the morphology of the cervical spine has revealed the complexity of the system. A review of selected literature reported that a number of the joints have an unusual nature and exhibit complicated and even paradoxical motions. For the practicing therapist, the significance of these observations is that assessment and...
Article
The authors aimed to provide an educational update on the current evidence of the effectiveness of drug therapy in the treatment of musculoskeletal pain and to offer a perspective of possible future developments. The authors used a pragmatic review of data provided by available systematic reviews and seminal controlled studies pertaining to the tre...
Article
Unlabelled: This review constitutes the first of four reviews that systematically address contemporary knowledge about the mechanical behavior of the cervical vertebrae and the soft-tissues of the cervical spine, under normal conditions and under conditions that result in minor or major injuries. This first review considers the normal kinematics o...
Article
Case-control study. To determine the prima facie efficacy of intradiscal electrothermal anuloplasty (IDTA). Although it is being used increasingly as a putative treatment for internal disc disruption, no studies have been published on the efficacy of IDTA. Fifty-three patients with back pain determined by computed tomographic (CT)-discography to be...
Article
OF CONCERN to a neurologist, when faced with a patient with whiplash injury, is whether the patient has a neurological injury and, if not, whether the patient's complaint is genuine.1 +Barnsley LLord SBogduk N The pathophysiology of whiplash. Malanga GAedsCervical Flexion-Extension/Whiplash Injuries. Spine State of the Art Reviews. Vol 12 Philadelp...
Article
To determine the long-term efficacy of percutaneous radiofrequency medial branch neurotomy in the treatment of chronic neck pain. Between 1991 and 1996, radiofrequency neurotomy was performed in 28 patients diagnosed as having cervical zygapophysial joint pain on the basis of controlled diagnostic blocks. The procedure was repeated in patients whos...
Article
Tumours, infections, aneurysms and metabolic and inflammatory diseases are rare causes of neck pain. Most cases involve neck pain of unknown origin or a whiplash-associated disorder. Neck pain is common in the general community and more common in certain occupations. The natural history is relatively benign, but some 10% of patients will suffer chr...
Article
Descriptive, microdissection study. To determine the morphology of the human adult cervical intervertebral disc and its ligaments. Some studies indicate that the cervical disc is distinctly different from the lumbar intervertebral disc, yet most clinical and anatomic texts appear content with extrapolating data from the lumbar spine. A detailed thr...

Citations

... Given the interconnected biomechanical nature of the lumbar spine, nociception arising from only one discrete structure may be less common than recognized clinically. For example, a recent study utilizing a placebo controlled triple block paradigm has suggested that the prevalence of "pure" lumbar facet joint pain may be as low as 15% [40]. Given the robust response to BVN sham treatment seen in the SMART trial, it is difficult to ascertain exactly what the true prevalence of "pure" VEP is in those presenting with CLBP with Modic changes, but it is notable that 31% of participants from the INTRACEPT study reported 100% pain relief at 2 years [28]. ...
... Govind J et al. observed that in patients of CEHs, with headache being the dominant complaint, diagnostic blocks had a 75% positive yield in establishing the source of nociception. [23] Most common source being C2-3 joint (62%) followed by C1-2 (7%) and C3-4 (6%) joints. They concluded that controlled diagnostic blocks can establish the source of pain in the majority of patients presenting with probable cervicogenic headache, with C2-3 being the most common source. ...
... for the treatment of diseases such as cancer and pain relief are rich in terms of categorical variables [2]. Other datasets may represent opinions over controversial issues on social media, which require sentiment analysis and natural language processing to extract useful information [3]. ...
... 26 The rationale of diagnostic blocks is based on the assumption that if a certain structure represents the source of the pain, pain will disappear if that structure is anesthetized. 27 The sensitivity and specificity of this approach varies according to the block type, and there is considerable controversy in the literature over its validity, given the high rate of false positives. However, the problem of false positives may be at least partially overcome by refining such techniques. ...
... Chronic pain syndromes of the sacroiliac joint are very often underestimated, and the data in the literature regarding pain relief after RFA treatments, performed with different techniques, generally report a 50% [7,8] improvement at 6 months. A recent review from 2021 reported variable success rates ranging from 32% to 89% in patients with SIJ pain treated with RFAs [9]. ...
... Some clinicians will stop the warfarin 5-7 days prior to the joint procedure whilst treating with low molecular weight heparin or unfractionated heparin and then restart the warfarin after the procedure. However, such an approach is time and health care resource consuming and may lead to a disturbance in warfarin control that may take several visits to re-establish the target therapeutic range [23,24]. The alternative approach is to continue warfarin whilst carrying [25]. ...
... A variety of treatment for LBP have introduced into clinical practice, including educational interventions, exercise, weight reduction, various classes of analgesics, non-steroidal anti-inf lammator y dr ugs, physical therapy, spinal manipulation, other complementary and alternative 9 therapies and surgery. ...
... Currently, nonsurgical treatments for chronic spinal pain, including nonsteroidal anti-inflammatory drugs, joint manipulation, and exercise therapy, seem to have limited benefits (small to moderate effect sizes). [6,7] This finding may be explained by the fact that such treatments do not comply with recent advances in chronic pain research. ...
... 6 21 The fluoroscopic anteroposterior view and LAT view cannot exactly identify the depth of the needle tip related to the epidural space and discriminate between true and false LOR. 22 According to our previous study about mid-TEA, the visualization of needle tips and laminar margins was poor on the LAT view at the mid-thoracic region. 9 Although the anteroposterior view and LAT view are widely used as standard practice, recent attention has been directed towards using the CLO view for identifying the needle depth during the fluoroscopic-guided interlaminar epidural access. ...
... In a retrospective study of total disc replacement in the treatment of cervical myelopathy and/or radiculopathy, 22.6% (30/133) of patients had tinnitus symptoms. 21 Recent studies have found that a large number of Ruffini corpuscles 22,23 and nociceptors [23][24][25] grow into the degenerative cervical intervertebral disc. It is suggested that the former is related to dizziness, while the latter is related to chronic neck pain. ...