Articles: back-pain.
-
This study set out to investigate in a population-based longitudinal cohort, whether chronification of back pain (BP) is related to structural gray matter changes in corticolimbic brain structures. Gray matter volume (GMV) was measured in participants with chronic BP (CBP, n = 168) and controls without chronic pain (n = 323) at 2 time points with an interval of 7 years (baseline t1, follow-up t2). Over this time period, participants with CBP showed an increase of GMV in the left ventral striatum, whereas controls showed a decrease. ⋯ Those with emerging CBP had less GMV in the right entorhinal area, right amygdala, and left medial frontal cortex. Additional variables differing between those who had BP at t1 and later developed CBP or not were pain intensity, body mass index, and depression score. In sum, these findings are in accordance with the notion that limbic brain properties are both predisposing risk factors and drivers of brain reorganization during the development of CBP.
-
In 2016, Oregon developed an innovative policy to improve care for Medicaid patients with back pain. The objective of this study was to identify the factors associated with dose reduction and discontinuation among Medicaid patients using chronic opioid therapy after implementation of this policy. ⋯ Most Medicaid beneficiaries had a dose reduction after implementation of Oregon's back pain policy. Opioid discontinuation was associated with factors that suggest that providers pursue this strategy for patients at higher overdose risk.
-
Residual back pain (RBP) is one of the complications following percutaneous vertebroplasty (PVP) in older people with osteoporotic vertebral compression fractures (OVCFs). The vertebral bone quality (VBQ) score obtained from magnetic resonance imaging (MRI) can be used to evaluate bone quality. The objective of this study aimed to explore the potential relationship between the VBQ score and RBP after PVP. ⋯ The preoperative high VBQ score was an independent risk factor associated with RBP after PVP. Moreover, other risk factors included low BMD, lumbodorsal fascia contusion, and cement distribution. The MRI-VBQ score may serve as a useful tool for assisting in evaluating patients at risk of RBP following PVP.
-
Radiofrequency ablation is a treatment for facetogenic low back pain that targets medial branches of lumbar dorsal rami to denervate facet joints. Clinical outcomes vary; optimizing cannula placement to better capture the medial branch could improve clinical outcomes. A novel parasagittal technique was proposed from an anatomic model; this technique was proposed to optimize capture of the medial branch. The anatomic feasibility of the novel technique has not been evaluated. ⋯ In this cadaveric simulation study, the feasibility of performing the parasagittal technique for lumbar radiofrequency ablation was evaluated. This study suggests that the parasagittal technique is a feasible option for lumbar medial branch radiofrequency ablation.
-
This was an observational study. ⋯ Globally, LBP remains a notable public health concern, carrying a consistently high burden. To alleviate the future impact of this disease, it is imperative to increase public awareness regarding its risk factors and to implement preventive measures.