Person: Muzin, Stefan
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Muzin
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Stefan
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Muzin, Stefan
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Publication Electrical impedance myography in the diagnosis of radiculopathy(Wiley, 2013) Spieker, Andrew J.; Narayanaswami, Pushpa; Fleming, Laura; Keel, John C.; Muzin, Stefan; Rutkove, SewardWe sought to determine whether elec- trical impedance myography (EIM) could serve as a diagnostic procedure for evaluation of radiculopathy. Methods: Twenty- seven patients with clinically and radiologically diagnosed cervi- cal or lumbosacral radiculopathy who met a “gold standard” defi- nition underwent EIM and standard needle electromyography (EMG) of multiple upper or lower extremity muscles. Results: EIM reactance values revealed consistent reductions in the radic- ulopathy-affected myotomal muscles as compared with those on the unaffected side; the degree of asymmetry was associated strongly with the degree of EMG abnormality (P<0.001). EIM had a sensitivity of 64.5% and a specificity of 77.0%; in compari- son, EMG had a sensitivity of 79.7% but a specificity of 69.7%. Conclusions: These findings support the potential for EIM to serve as a new non-invasive tool to assist in diagnosis of radicu- lopathy; however, further refinement of the technique is needed for this specific application.Publication Utilizing a handheld electrode array for localized muscle impedance measurements(Wiley-Blackwell, 2012) Narayanaswami, Pushpa; Spieker, Andrew J.; Mongiovi, Phillip; Keel, John C.; Muzin, Stefan; Rutkove, SewardIntroduction: Electrical impedance myography (EIM) is a non-invasive technique used for assessment of muscle health in which a high-frequency, low-amplitude electric current is applied to the skin overlying a muscle, and the resulting surface voltage is measured. We have previously used adhesive electrodes, application of which is inconvenient. We present data using a handheld electrode array (HEA) that we devised to expedite the EIM procedure in a clinical setting. Methods: Thirty-four healthy volunteers and 24 radiculopathy subjects underwent EIM testing using the HEA and adhesive electrodes. Results: The HEA was shown to have good test-retest reproducibility, with intraclass correlation coefficients as high as 0.99. HEA data correlated strongly with data from adhesive electrodes, ρ = 0.85 in healthy volunteers (p < 0.001) and ρ = 0.75 in radiculopathy subjects (p < 0.001). Discussion: These data support the potential use of a handheld array for performing rapid localized surface impedance measurements.Publication When Should a Cervical Collar be Used to Treat Neck Pain?(Humana Press Inc, 2007) Muzin, Stefan; Isaac, Zacharia; Walker, Joseph; Abd, Omar El; Baima, Jennifer AnneNeck pain is one of the most prevalent and costly health problems in the United States. It remains a complex, subjective experience with a variety of musculoskeletal causes. Although, cervical collars are a seemingly benign intervention, they can have adverse effects, especially when used for longer periods of time. It is feared that a long period of immobilization, can result in atrophy-related secondary damage. Many physicians cite anecdotal evidence of their clinical utility and soft cervical collars are often prescribed by convention for patients complaining of neck pain. The use of cervical collars to treat neck pain is an area of controversy. This review article examines the current evidence and studies related to recommending cervical collars for neck pain of a variety of etiologies.Publication The Role of Intradiscal Steroids in the Treatment of Discogenic Low Back Pain(Springer Verlag, 2007) Muzin, Stefan; Isaac, Zacharia; Walker, JosephLBP is one of the most common reasons for visiting a doctor and is the most common cause of disability under age 45. Amongst a variety of etiologies, internal disc disruption (IDD) has been postulated as an important cause of low back pain. Treating discogenic low back pain continues to be a challenge to physicians. Inflammation, either from direct chemical irritation or secondary to an autoimmune response to the nucleus pulposus has been implicated as the primary pain source. Both steroids and non-steroidal anti-inflammatory drugs have partial effectiveness in treating pain associated with inflammation. Therefore, the rationale for using intradiscal steroids is to suppress the inflammation within the disc, thereby alleviating the patient’s symptoms. The goal of this article is to review the literature regarding the efficacy of intradiscal steroids to treat low back pain of discogenic origin.Publication Discography in Practice: A Clinical and Historical Review(Humana Press Inc., 2008) Walker, Joseph; El Abd, Omar H.; Isaac, Zacharia; Muzin, StefanChronic low back pain is the most common cause of disability in individuals between the ages of 45 and 65. Given the variety of anatomic and pathophysiologic causes of persistent low back pain, it is a difficult diagnosis for clinicians to treat. Discography is a diagnostic option that may link a patient’s subjective complaints of spinal pain to symptomatic disk disease when non-invasive imaging, such as magnetic resonance imaging (MRI), does not find structural abnormalities. A controversial procedure, discography is only necessary to assess painful discs prior to surgical interventions. For accurate discogram interpretation an experienced spine interventionalist must be careful to exclude false positive results and be aware of the patient’s underlying psychological state. This literature review will discuss the following: anatomy and function of the spine and intervertebral disc, intervertebral disc degeneration and discogenic pain, history of discography, indications and contraindications, a description of the procedure, complications, and the current debate regarding its outcomes.