Articles: back-pain.
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Clinical Trial
The high-risk discectomy patient: prevention of reherniation in patients with large anular defects using an anular closure device.
With lumbar discectomy for disc herniation, surgeons must choose between limited nucleus removal associated with higher reherniation risk or more aggressive nucleus removal associated with increased back pain and disc degeneration. This trade-off is particularly challenging in patients with large anular defects, which carry the highest risk of reherniation. We examined the effect of an anular closure device on reherniation and clinical outcomes. ⋯ The low reherniation rate in patients at high-risk of reherniation based on anular defect size, despite discectomy being only limited, suggests that an anular closure device may reduce reherniation risk. Clinical outcomes for pain and function at 1 and 2 years post-operatively compared favorably with literature reports. Further study in a randomized controlled trial is required to confirm these results.
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The study was undertaken to determine the prevalence and clinical importance of alternative causes of symptoms discovered in patients undergoing flank pain protocol (FPP) computed tomography (CT) scans in patients with classic symptoms of kidney stone (flank pain, back pain, or both) without evidence of urine infection. ⋯ While a non-kidney stone cause for a patient's symptoms are found in nearly 10% of CTs done using a FPP, acutely important findings occur in less than 3% of scans done in patients with flank or back pain and absence of pyuria.
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The aim of this study was to investigate the frequency of patients with rheumatoid arthritis (RA) who have inflammatory back pain (IBP) and meet the existing classification criteria for ankylosing spondylitis (AS) and spondyloarthritis (SpA). We included 167 patients fulfilling the ACR 1987 revised criteria for RA. After obtaining a medical history and performing a physical examination, standard pelvic X-rays for examination of the sacroiliac joints (SIJ) were ordered in all patients. ⋯ Three patients (1.8 %) fulfilled the mNY criteria for AS, 31 (18.6 %) ESSG and 26 (15.6 %) Amor criteria for SpA. Nine patients (five with MRI sacroiliitis) (5.3 %) were classified as having axial SpA according to new ASAS classification criteria. This study suggests that the prevalence of SpA features in patients with RA may be much higher than expected.
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Comparative Study
Comparison of the EuroQOL-5D with the Oswestry Disability Index, back and leg pain scores in patients with degenerative lumbar spine pathology.
Cross-sectional study. ⋯ The EQ-5D correlated well with established spine outcome measures, including ODI, and back and leg pain scores. EQ-5D correlated best with ODI scores. Correlation with back pain was stronger than leg pain, but all correlations were relatively strong. The EQ-5D can serve spine surgeons as an effective measure of clinical outcome and health utility for economic analysis.
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Modern rheumatology · Apr 2013
Prevalence of low back pain as the primary pain site and factors associated with low health-related quality of life in a large Japanese population: a pain-associated cross-sectional epidemiological survey.
This study aimed to estimate the prevalence, magnitude, and direction of the associations among disability, pain intensity, number of pain sites, and health-related quality of life (HRQoL) in patients reporting low back pain (LBP) as their primary pain. ⋯ Approximately 13.5 % of patients reported LBP as their primary pain. Disability with absence from social activity and ≥7 pain sites were strongly associated with low HRQoL.