Articles: back-pain.
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Transforaminal lumbar interbody fusion (TLIF) for spondylolisthesis-associated back and leg pain is associated with improvement in pain, disability, and quality of life. However, given the rising health care costs associated with spinal fusion procedures and varying results of recent cost-utility studies, the cost-effectiveness of TLIF remains unclear. The authors set out to assess the comprehensive costs of TLIF at their institution and to determine its cost-effectiveness in the treatment of degenerative spondylolisthesis. ⋯ Transforaminal lumbar interbody fusion improved pain, disability, and quality of life in patients with degenerative spondylolisthesis-associated back and leg pain. The total cost per QALY gained for TLIF was $42,854 when evaluated 2 years after surgery with Medicare fees, suggesting that TLIF is a cost-effective treatment of lumbar spondylolisthesis.
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Multicenter Study Comparative Study Controlled Clinical Trial
[Naturopathic and orthopaedic in-patient treatment of chronic back pain--a comparison study].
This study compares orthopaedic and naturopathic inpatient treatment concepts for back pain with regards to therapeutic efficacy. ⋯ Treatment results of naturopathic, complex" inpatient treatment of chronic back pain are comparable to conventional orthopaedic treatment at all points of time T1 to T3. The study design does not allow the conclusion, that the therapeutical concept can be changed forthetwo groups of patients with the same chance of good therapeutical efficacy. The result of the study is limited in this respect as the therapeutic effect cannot be claimed to be the same if the treatment groups were exchanged. Thus the improvement is only comparable.
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The demand-control-support "job strain" model is frequently used in occupational health research. We sought to explore the relationship between job strain and back pain. ⋯ Our results support the findings linking back pain to job strain. Moreover, the relationship between back pain and job strain is much stronger if job strain includes both psychological and physical demands. Results of this study suggest that workplace interventions that aim to reduce job strain may help prevent back pain and may alleviate the personal, social, and economic burden attributable to back pain.
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A year after anterolateral spondylodesis for progressive scoliosis, the patient showed a flexion gait pattern with recurrent deformity, due to late infection. Surgical debridement resolved all symptoms. Whereas most postoperative infections occur after posterior spondylodesis and present with back pain and mild increase of infection parameters, late infection after anterolateral approach is rare. In this case the patient did not present with the classic symptoms.
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STUDY DESIGN.: Longitudinal qualitative interview study, nested within a back pain cohort study. OBJECTIVE.: Enhance the understanding of patients' own perspectives on living with sciatica to inform improvements in care and treatment outcomes. SUMMARY OF BACKGROUND DATA.: Reports of patients' own accounts of sciatica and its impact on daily life are still scarce. ⋯ Our findings emphasize the importance of leg pain in identifying a subgroup of back-pain patients more likely to have severe symptoms, be at risk of poor outcome, and who should be considered a priority for early diagnosis and management. Future management of sciatica needs to include listening to patients' stories, offering a credible physical assessment, explanation, and diagnosis of the condition. Explaining the limits to treatment is seen as positively contributing to the partnership between patients and clinicians.