Bmc Musculoskel Dis
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Bmc Musculoskel Dis · Aug 2015
Clinical TrialChronic low back pain clinical outcomes present higher associations with the STarT Back Screening Tool than with physiologic measures: a 12-month cohort study.
Stratification strategies based on identifying patient's prognosis in order to guide patient care constitute one of the most prominent and recent approach in low back pain research. The STarT Back Screening Tool (SBST) although promising, has not been studied in patients with chronic low back pain (cLBP). Considering how challenging it is to translate research into practice, the value of integrating a new tool should be thoroughly assessed. The purpose was therefore to assess associations between the short- and long-terms clinical status and two types of variables, physiologic measures and the SBST, in participants with cLBP. The ability of both types of variables to discriminate between participants with and without higher levels of disability, pain, fear of movement and patient's global impression of change was also investigated. ⋯ Physiologic measures obtained during prone and lateral tests have limited associations with the clinical status over a 12-month period in patients with nonspecific chronic low back pain. On the other hand, the STarT Back Screening Tool is useful for the identification of patients who will present higher levels of disability, pain intensity and fear of movement over a year.
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Bmc Musculoskel Dis · Aug 2015
Randomized Controlled TrialPrediction of pain outcomes in a randomized controlled trial of dose-response of spinal manipulation for the care of chronic low back pain.
No previous studies have created and validated prediction models for outcomes in patients receiving spinal manipulation for care of chronic low back pain (cLBP). We therefore conducted a secondary analysis alongside a dose-response, randomized controlled trial of spinal manipulation. ⋯ Internal validation of prediction models showed that participant characteristics preceding the start of care were poor predictors of at least 50% improvement and the individual's future pain intensity. Pain collected shortly after completion of 6 weeks of study intervention predicted future pain the best.
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Bmc Musculoskel Dis · Aug 2015
Comparative StudyOutcomes after fixation for undisplaced femoral neck fracture compared to hemiarthroplasty for displaced femoral neck fracture among the elderly.
This study compared the rates of mortality, medical complication, and reoperation after fixation surgery for displaced femoral neck fracture with those after hemiarthroplasty surgery for undisplaced femoral neck fracture using competing risk analysis in inpatients aged 60 years and above from a population database in Taiwan. ⋯ The short-term overall mortality and medical complication rate of fixation for undisplaced fracture were slightly lower than those of hemiarthroplasty for displaced fracture. However, the short-term cumulative incidence of first reoperation after fixation was significantly higher than that for hemiarthroplasty. Further prospective studies or clinical trials based on the competing risk model, and which include important risk factors, are necessary to quantify the adjusted effects more precisely.
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Bmc Musculoskel Dis · Aug 2015
Increasing incidence of rotator cuff repairs--A nationwide registry study in Finland.
Rotator cuff repair incidence rates have reportedly increased in the United States and England. Here we analyzed nationwide data relating to rotator cuff repairs recorded in the Finnish National Hospital Discharge Register (NHDR). ⋯ This nationwide analysis revealed a remarkable increase in the incidence of rotator cuff repair from 1998 to 2011 in Finland. This progress can be questioned, since there are not convincing data of the superiority of the operative treatment over non-operative management in all rotator cuff tears.
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Bmc Musculoskel Dis · Aug 2015
One-stage posterior-only approach in surgical treatment of single-segment thoracic spinal tuberculosis with neurological deficits in adults: a retrospective study of 34 cases.
There are quite a few controversies on the surgical management of single-segment thoracic spinal tuberculosis with neurological deficits (STSTND). In this study, the clinical efficacy and feasibility of one-stage posterior-only transpedicular debridement, interbody fusion, and posterior instrumentation for treating STSTND in adults were retrospectively evaluated. ⋯ One-stage posterior-only transpedicular debridement, interbody fusion, and posterior fixation followed by chemotherapy seems to be adequate for obtaining satisfactory healing of single-segment thoracic spinal tuberculosis with neurological deficits. Careful patient selection is critical to the successful outcome with this technique.