Articles: back-pain.
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Clinical nuclear medicine · Apr 2012
Case ReportsSPECT/CT in differentiation of pseudarthrosis from other causes of back pain in lumbar spinal fusion: report on 10 consecutive cases.
SPECT fused with computed tomography (CT) provides a new approach for more accurate diagnosis of pseudathrosis after spinal fusion procedures. The aim of this study was to compare the findings of SPECT fused with CT (SPECT/CT) with those of CT alone for the diagnosis of pseudarthrosis. ⋯ In the lumbar spine, SPECT/CT seems to increase specificity for detection of nonunion of interbody devices compared with CT alone. It is more sensitive than CT to detect facet joint degeneration, and it can detect screw loosening as well as CT. These findings can be helpful for surgeons in planning appropriate surgical revision strategy.
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In order to define the onset of a new episode of low back pain (LBP), the definition of a "non-episode" must be clear. De Vet et al reviewed the scientific literature but found no evidence-based definitions of episodes or non-episodes of LBP. However, they suggested that pain-based episodes should be preceded and followed by a period of at least one month without LBP. As LBP is an episodic disease, it is not clear whether a sufficient number of patients with LBP will be LBP-free for at least one month ("non-episode") to justify the use of this duration in the definition of pain free episode. ⋯ The vast majority of these secondary care sector patients had a profile of more or less constant LBP. The estimates for non-episodes during the study period and at the end of the study were very similar for participants with LBP who also had Modic changes and those with non-specific LBP. It is possible that a definition of pain-free periods is pointless in patients seeking care in the secondary care sector.
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Revista de neurologia · Mar 2012
Letter Review Case Reports[Spontaneous epidural haematoma, an infrequent cause of cervicodorsal pain].
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Randomized Controlled Trial
Exercise and Auricular Acupuncture for Chronic Low-back Pain: A Feasibility Randomized-controlled Trial.
To evaluate the feasibility of a randomized-controlled trial (RCT) investigating the effects of adding auricular acupuncture (AA) to exercise for participants with chronic low-back pain (CLBP). ⋯ Findings of this study showed that a main RCT is feasible and that 56 participants per group would need to be recruited, using multiple recruitment approaches. AA was safe and demonstrated additional benefits when combined with exercise for people with CLBP, which requires confirmation in a fully powered RCT.
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To identify factors that were predictive of improved pain status among older adults with chronic back pain participating in the Adaptive Physical Activity (APA) program and to identify factors that were predictive of adherence to APA. ⋯ Given that adherence to APA is the key predictor of improved back pain, future efforts should focus on strategies to improve adherence. Our data suggest that enhanced training of exercise trainers, development of separate classes for people with different functional levels, and use of psychosocial interventions to reduce health pessimism and depression may be potential targets for improving adherence.