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Back Pain,

Ian A Harris, Adrian Traeger, Ralph Stanford, Christopher G Maher, Rachelle Buchbinder
Lumbar spine fusion is a common procedure associated with a high cost burden and risk of serious complications. We aimed to summarise systematic reviews on the effectiveness of lumbar spine fusion for most diagnoses. We found no high-quality systematic reviews and the risk of bias of the randomised controlled trials in the reviews was generally high. The available evidence does not support a benefit from spine fusion compared to non-operative alternatives for back pain associated with degeneration. The available evidence does not support a clinical benefit from spine fusion compared to non-operative treatment or stabilisation without fusion for thoracolumbar burst fractures...
December 2018: Internal Medicine Journal
Matthias Florian Geiger, Nicola Bongartz, Christian Blume, Hans Clusmann, Christian Andreas Müller
BACKGROUND:  To evaluate whether decompression in lumbar spinal stenosis without fusion leads to sufficient improvement of back pain and leg pain and whether re-decompression alone is sufficient for recurrent lumbar spinal stenosis for patients without signs of instability. MATERIAL AND METHODS:  A successive series of 102 patients with lumbar spinal stenosis (with and without previous lumbar surgery) were treated with decompression alone during a 3-year period...
December 5, 2018: Journal of Neurological Surgery. Part A, Central European Neurosurgery
Arnold Y L Wong, Dino Samartzis, Prudence W H Cheung, Jason Pui Yin Cheung
BACKGROUND: Adolescent idiopathic scoliosis (AIS) is the most common spine deformity in adolescent patients. Although structural deformity may affect spinal biomechanics of patients with AIS, little is known regarding various period prevalence proportions of back pain and chronic back pain and factors associated with back pain in such patients. QUESTIONS/PURPOSES: (1) What are the period prevalence rates of back pain among teenagers with AIS? (2) Is back pain in patients with AIS associated with curve severity? METHODS: A total of 987 patients with AIS who were treated without surgery were recruited from a single center's scoliosis clinic...
November 13, 2018: Clinical Orthopaedics and related Research
Sarah Ziegler, Margareta Schmid, Matthias Bopp, Georg Bosshard, Milo Alan Puhan
BACKGROUND: In the last decade, the use of sedative substances to keep a patient in deep sedation until death increased fourfold in German-speaking Switzerland, where every third patient admitted to hospital, palliative care unit or hospice died continuously deeply sedated. AIM: To investigate sedation practices across healthcare settings and to identify their associations with conventional symptom control. DESIGN: National mortality follow-back study in Switzerland between 2013 and 2014...
December 5, 2018: Palliative Medicine
Uruj Zehra, Jason Pui Yin Cheung, Cora Bow, William Lu, Dino Samartzis
The aim of the current study was to investigate the multi-dimensional characteristics of lumbar endplate defects in humans in relation to disc degeneration and other MRI phenotypes as well as their role with pain and disability. 108 subjects were recruited and underwent 3T MRI of the lumbar spine. Structural endplate defects were identified and their dimensions were measured in terms of maximum width and depth, and were then standardized to the actual width of the endplate and depth of the vertebral body, respectively...
December 4, 2018: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
Serdar Kesikburun, Ümüt Güzelküçük, Ulaş Fidan, Yasin Demir, Ali Ergün, Arif Kenan Tan
Background: Pregnancy-induced hormonal and physiologic changes increase the risk of musculoskeletal problems in pregnancy. The purpose of this report is to provide a comprehensive look at the musculoskeletal pain and symptoms experienced during pregnancy. Methods: A total of 184 women (mean age 30.9 ± 5.0 years) who gave birth in the obstetrics clinic of a tertiary hospital were included in the study. The participants who had given birth at 37-42 weeks of pregnancy (term pregnancy) and aged over 18 years were selected for participation...
December 2018: Therapeutic Advances in Musculoskeletal Disease
Eldad Kaljic, Dijana Avdic, Emira Svraka, Mirsad Muftic, Muris Pecar, Amra Macak-Hadziomerovic, Namik Trtak
Introduction: Lumbar pain syndrome is one of the most common conditions in clinical practice, more common than 290 other pathological conditions, which affect up to 84% of adults in a certain period of their life. The origin of the lower back pain can be classified as mechanical, neuropathic and secondary due to another illness. Patient education and information, muscle strengthening exercises, maintenance of routine daily physical activity and pain therapy are the basis of acute non-specific pain syndrome therapy...
October 2018: Medical Archives
Rose Marie San Juan
Gaetano Giulio Zumbo's anatomical model of a head, executed in the late seventeenth century and now in Florence's La Specola, is the earliest known life-size wax model for use in study and research. The model conjoins experimental wax techniques with human matter such as hair, teeth and bone, and confronts the observer not only with the interior of the head but also with the face, brutally dissected and in the process of decomposing. By contrast, the back of the head offers an entirely different display, an actual human cranium cut across its upper part and revealing carefully dissected and vibrantly modeled sections of the brain...
2018: Progress in Brain Research
Zi-Xuan Wang, You-Gu Hu
BACKGROUND: It is well known that internal disc disruption (IDD) is accelerated by factors such as aging and injury. High- intensity zone (HIZ) on lumbar MRI is usually considered a marker of painful IDD. However, many painful IDD show no HIZ. This suggests that the risk factors of HIZ may be different to these of IDD. The purpose was to clarify the correlation between the HIZ on lumbar MR and the factors, including gender, age, body weight, and low back pain (LBP). METHODS: Characteristics were obtained from the medical record...
December 4, 2018: Journal of Orthopaedic Surgery and Research
Xu-Yu Liao, Lei-Jie Zhou, Wei-Hu Ma, Jin-Ming Han, Guan-Yi Liu, Rong-Ming Xu
OBJECTIVE: To analyze the clinical efficacy of unilateral and bilateral intervertebral space release in the treatment of lower lumbar spondylolisthesis. METHODS: The clinical data of 41 patients with lumbar spondylolisthesis treated by surgery from October 2012 and May 2016 were retrospcetive analyzed. The patients were divided into two groups, 18 cases were enrolled in unilateral intervertebral release group, there were 7 males and 11 females, aged from 47 to 75 years old with an average of (59...
November 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Ratish Singh, Gao Zeng Xin, Mangal Prasad Hirachan, Lin Yu Cheng
No abstract text is available yet for this article.
December 2018: Asian Spine Journal
Siting Zhou, Michael Ciarametaro, Bingcao Wu, Joseph Singer, Robert W Dubois
This study compared utilization patterns of high-cost services and medications for patients receiving care from Accountable Care Organization (ACO)-participating physicians and those receiving care from non-ACO physicians during the initial phases of ACO development in a commercially insured environment. Patients ≥18 years (≥40 years for chronic obstructive pulmonary disease [COPD]) with prevalent rheumatoid arthritis, inflammatory bowel disease, multiple sclerosis, type 2 diabetes, COPD, or chronic low back pain between January 1, 2012, and August 31, 2014 were identified in the HealthCore Integrated Research DatabaseSM ...
December 4, 2018: Population Health Management
Hai H Le, Matthew DeCamp, Amanda Bertram, Minal Kale, Zackary Berger
OBJECTIVE: How outside factors affect physician decision making remains an open question of vital importance. We sought to investigate the importance of various influences on physician decision making when clinical guidelines differ from patient preference. METHODS: An online survey asking 469 primary care providers (PCPs) across four practice sites whether they would order magnetic resonance imaging for a patient with uncomplicated back pain. Participants were randomized to one of four scenarios: a patient's preference for imaging (control), a patient's preference plus a colleague's opinion against imaging (colleague), a patient's preference plus a professional society's recommendation against imaging (profession), or a patient's preference plus an accountable care organization's quality metric that measures physician use of imaging (ACO)...
December 2018: Southern Medical Journal
Lisbeth Storm, Rikke Rousing, Mikkel O Andersen, Leah Y Carreon
INTRODUCTION: The Subgroups for Targeted Treatment (STarT) Back Screening Tool is used in general practice to stratify patients with acute back pain into either a low, medium or a high risk of developing complex pain. This study determines if the STarT Back Screening Tool can identify patients who are at a high risk of developing complex pain after spine surgery. METHODS: The STarT Back Screening Tool was administered pre-operatively to a consecutive series of patients who had lumbar spine surgery between 29 October 2012 and 1 February 2013...
December 2018: Danish Medical Journal
Hanna Iderberg, Carl Willers, Fredrik Borgström, Rune Hedlund, Olle Hägg, Hans Möller, Ewald Ornstein, Bengt Sandén, Holger Stalberg, Hans Torevall-Larsson, Tycho Tullberg, Peter Fritzell
PURPOSE: Lumbar spinal stenosis (LSS) can be surgically treated, with variable outcome. Studies have linked socioeconomic factors to outcome, but no nation-wide studies have been performed. This register-based study, including all patients surgically treated for LSS during 2008-2012 in Sweden, aimed to determine predictive factors for the outcome of surgery. METHODS: Clinical and socioeconomic factors with impact on outcome in LSS surgery were identified in several high-coverage registers, e...
December 3, 2018: European Spine Journal
Tucker C Callanan, Antonio T Brecevich, Craig D Steiner, Fred Xavier, Justin A Iorio, Celeste Abjornson, Frank P Cammisa
PURPOSE: To evaluate the radiographic and clinical outcomes of the combination of platelet-rich fibrin matrix (PRFM) with beta-tricalcium phosphate (β-TCP) and bone marrow aspirate (BMA) as a graft alternative in posterolateral lumbar fusion procedures. METHODS: Researchers evaluated 50 consecutive patients undergoing one-level to three-level posterolateral lumbar fusion procedures, resulting in a total of 66 operated levels. The primary outcome was evidence of radiographic fusion at 1-year follow-up, assessed by three independent evaluators using the Lenke scoring system...
December 3, 2018: European Spine Journal
Eleftherios P Mamounas, Hanna Bandos, Barry C Lembersky, Jong-Hyeon Jeong, Charles E Geyer, Priya Rastogi, Louis Fehrenbacher, Mark L Graham, Stephen K Chia, Adam M Brufsky, Janice M Walshe, Gamini S Soori, Shaker R Dakhil, Thomas E Seay, James L Wade, Edward C McCarron, Soonmyung Paik, Sandra M Swain, D Lawrence Wickerham, Norman Wolmark
BACKGROUND: The optimal duration of extended therapy with aromatase inhibitors in patients with postmenopausal breast cancer is unknown. In the NSABP B-42 study, we aimed to determine whether extended letrozole treatment improves disease-free survival after 5 years of aromatase inhibitor-based therapy in women with postmenopausal breast cancer. METHODS: This randomised, double-blind, placebo-controlled, phase 3 trial was done in 158 centres in the USA, Canada, and Ireland...
November 30, 2018: Lancet Oncology
Davy Vancampfort, Brendon Stubbs, Joseph Firth, Ai Koyanagi
PURPOSE: Handgrip strength provides a clinically validated marker of overall health and mortality risk. There are however, no multi-national population-based studies investigating the associations between handgrip strength, chronic physical conditions, and physical multimorbidity (i.e., ≥2 chronic conditions). We aimed to assess these associations among community-dwelling middle-aged and older adults using nationally representative data from six in low- and middle-income countries (LMICs)...
November 30, 2018: European Journal of Internal Medicine
Andrew J Blackman
The identification of factors associated with inferior postoperative outcomes after hip arthroscopy is critical as we try to further clarify indications for hip arthroscopy. Recent arthroplasty studies have shown worse outcomes after hip and knee replacement in patients with comorbid joint and spine pain. Recent evidence has shown this to be true in patients undergoing hip arthroscopy as well. This evidence helps surgeons counsel patients better preoperatively and manage their expectations postoperatively. Patients with comorbid joint and spine pain should expect improvements in pain and function after hip arthroscopy; however, the overall functional outcomes are worse than those in patients without these comorbid conditions...
December 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Scott C Faucett
Golf is a common recreational and competitive sport that requires full hip rotation to allow for a smooth and effective swing. Therefore hip impingement and hip osteoarthritis, by limiting rotation, could cause pain in golfers and even encourage them to discontinue the sport. In my opinion, the lead hip in golfers is likely what generally drives the symptoms in the hip, back, or knee. After surgical correction, golfers are able to get back to golf and many experience improved performance.
December 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
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