Spine
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Randomized Controlled Trial Multicenter Study
SPORT lumbar intervertebral disk herniation and back pain: does treatment, location, or morphology matter?
Diskectomy candidates with at least 6 weeks of sciatica and confirmatory imaging were enrolled in a randomized or observational cohort. ⋯ Diskectomy resulted in greater improvement in back pain than nonoperative treatment, and this difference was maintained at 2 years for all herniation locations and morphologies.
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Randomized Controlled Trial Comparative Study
Economic evaluation of an intensive group training protocol compared with usual care physiotherapy in patients with chronic low back pain.
Economic evaluation from a societal perspective conducted alongside a randomized controlled trial with a follow-up of 52 weeks. ⋯ The results of this economic evaluation showed no difference in total costs between the protocol group and the guideline group. The differences in effects were small and not statistically significant. At present, national implementation of the protocol is not recommended.
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Randomized Controlled Trial Comparative Study
Two-year outcome after lumbar microdiscectomy versus microscopic sequestrectomy: part 2: radiographic evaluation and correlation with clinical outcome.
Single-center randomized prospective study at a university hospital. ⋯ Nondiscal pathologies, in particular Modic type endplate changes, seem to play an important role in the etiology of unfavorable clinical outcome after surgery for disc herniations. Sequestrectomy demonstrated significantly less postoperative disc degeneration than standard microdiscectomy after 2 years and may thus represent an attractive treatment alternative.
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Randomized Controlled Trial Comparative Study
Two-year outcome after lumbar microdiscectomy versus microscopic sequestrectomy: part 1: evaluation of clinical outcome.
Single-center randomized prospective study at a university hospital. ⋯ Reherniation rates within 2 years after sequestrectomy and microdiscectomy are comparable. However, outcome after microdiscectomy seems to worsen over time, whereas it remains stable after sequestrectomy. Thus, 2-year follow-up revealed clinical results favoring sequestrectomy. Performing sequestrectomy alone may therefore represent an advantageous alternative to standard microdiscectomy.
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Randomized Controlled Trial Comparative Study
Self-report measures best explain changes in disability compared with physical measures after exercise rehabilitation for chronic low back pain.
Sixteen-week intervention for chronic patients with low back pain (LBP) with 9-month follow-up. Primary randomization at 4 weeks into either supervised Swiss ball exercise or an exercise advice group. ⋯ Supervised exercise is a more successful subsequent to manual treatment compared with exercise advice. The improvements associated with this type of program were primarily manifested in the psychologic self-report measures rather than physical measurements.