From: MARK TRAMO

From: MARK TRAMO To: Jeffrey Epstein <[email protected]> Cc: Lesley Groff Subject: Literature re: Spinal Stenosis Date: Fri, 03 Feb 2017 14:40:04 +0000 Attachments: NatureReviewsNeurol2009.pdf Neurallmmunelnteractions.pdf; LSSTxNEJM2008.pdf JE - Yesterday you asked a couple of provocative questions that prompted me to do a literature search: 1. What is the pathophysiology of neurogenic claudication? 2. How does oral corticosteroid treatment improve neurogenic claudication? The attached PDFs address these questions in detail. In short, the pathophysiology of pain caused by nerve-root compression is multi-faceted and includes an inflammatory component that is likely quelled by corticosteroid treatment. The Nature Reviews: Neurology PDF also provides information about treatment options. I'm also resending the informative New England Journal of Medicine paper that led me to recommend Dr Cammisa to you last Fall, as he is among the authors. Hope you find these interesting and helpful. Yours, Mark Mark Jude Tramo, MD PhD Dept of Neurology, David Geffen School of Medicine at UCLA Dept of Musicology, UCLA Herb Alpert School of Music Director, The Institute for Music & Brain Science Co-Director, University of California Multi-Campus Music Research Initiative (UC MERCI) http://www.BrainMusic.org http://merci.ucsd.edu EFTA00445027