Articles: back-pain.
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Review
Identifying potential moderators for response to treatment in low back pain: A systematic review.
Identifying which patients with non-specific low back pain are likely to gain the greatest benefit from different treatments is an important research priority. Few studies are large enough to produce data on sub-group effects from different treatments. Data from existing large studies may help identify potential moderators to use in future individual patient data meta-analyses. ⋯ There are insufficient robust data on moderators to be useful in clinical practice. This review has identified some important potential moderators of treatment effect worthy of testing in future confirmatory analyses.
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Secondary analysis of data from a double-blind randomized controlled trial. ⋯ 2.
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Clin Neurol Neurosurg · Sep 2015
Incomplete resection of lumbar synovial cysts – Evaluating the risk of recurrence.
Synovial cysts are generally located in the lumbar spine adjacent to facet joints. Most studies recommend surgical resection. Adhesions of the lumbar synovial cyst to the dura are common and can result in dural tears with subsequent CSF fistula or nerve injury. The recurrence rate after incomplete resection of lumbar synovial cysts is unclear. For this purpose, we report on our experience of 148 patients who underwent synovial cyst resection from 2000 to 2011. ⋯ Only in case of severe adhesions to the dura complete resection was not enforced to avoid dural tears. In none of the 8 patients symptomatic recurrence of synovial cysts occurred. Aware of the limited numbers, we suggest rather leaving remnants of an attached synovial cyst behind after a sufficient decompression than risking dural tears and surgery-related complications. This trial is registered with DRKS00006133.
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Musculoskeletal pain at several sites (multisite pain) is more common than single-site pain. Little is known on its effects on disability pension (DP) retirement. ⋯ The number of pain sites independently predicted DP retirement. Employees with multisite pain may need specific support to maintain their work ability.