European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
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This population-based cohort study investigated the association between a lifetime history of a work-related low back injury, in those who had recovered to have no or mild low back pain, and the development of troublesome low back pain (LBP). A secondary analysis explored the possible effects of misclassification of the exposure by examining the association between a lifetime history of having taken time off work or performed light duties at work because of a work-related low back injury. Current evidence from cross-sectional studies suggests that individuals with a history of a work-related low back injury are more likely to experience future LBP. However, there is a need to examine this association prospectively in a large population-based cohort with adequate control of known confounders. ⋯ Our study suggests that a history of work-related low back injury or taking time off work or having to perform light duties at work due to a work-related low back injury may be a risk factor for the development of troublesome LBP. Residual confounding may account for some of the observed associations, but this was less in the group who took time off work or had to work light duties due to a work-related low back injury.
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Observational Study
The added prognostic value of MRI findings for recovery in patients with low back pain in primary care: a 1-year follow-up cohort study.
Information on the prognostic value of MRI findings in low back pain patients in primary care is lacking. The objective of this study is to investigate the added prognostic value of baseline MRI findings over known prognostic factors for recovery at 12-month follow-up in patients with low back pain referred to MRI by their general practitioner. ⋯ At 12-months follow-up, only 53% of these patients with low back pain referred for MRI in general practice reported recovery. Five clinic baseline characteristics were associated with recovery at 12-months follow-up; adding the MRI findings did not result in a stronger prediction of recovery.
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The goal of the current study is to establish a surgical algorithm to accompany the AOSpine thoracolumbar spine injury classification system. ⋯ The current algorithm uses a meaningful injury classification and worldwide surgeon input to determine the initial treatment recommendation for thoracolumbar injuries. This allows for a globally accepted surgical algorithm for the treatment of thoracolumbar trauma.
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Comparative Study
Anterior versus posterior approach in surgical treatment of tuberculous spondylodiscitis of thoracic and lumbar spine.
The aim of this study is to compare the clinical, radiological and functional outcome of anterior versus posterior surgical debridement and fixation in patients with thoracic and lumbar tuberculous spondylodiscitis. ⋯ Both anterolateral and posterolateral approaches are sufficient for achieving the goals of surgical treatment of thoracic and lumbar Pott's disease but posterolateral approach allows significant better kyphotic angle correction, less angle loss, better improvement in back pain but unfortunately more operative time and blood loss.
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Facet joint dislocation is a traumatic injury, which frequently results in devastating clinical outcomes. In Western Australia (WA), Royal Perth Hospital (RPH) provides a statewide Spinal Trauma Service and accepts all referrals from the entirety of the state. The economies of distance in WA mean that there is often a considerable delay between initial presentation at the peripheral hospital and enlocation of the dislocation in Perth. This study aims to identify any prejudicial clinical outcomes as a consequence of this delay. ⋯ This study confirms the challenges of management of these injuries in a large geographical area, with a centralised spinal trauma service. Generally, facet joint dislocations that had delayed reductions had a poorer outcome. We hope that the proposed protocol would deliver better management of these injuries.