Articles: back-pain.
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Case Reports
[Adrenocortical carcinoma with intratumoral hemorrhage detected from chest and back pain: a case report].
A 55-year-old man visited our hospital with left chest and back pain. Computed tomography (CT) showed left retroperitoneal tumor, which was 6 cm in diameter with intratumoral hemorrhage. Based on abdominal CT, magnetic resonance imaging and blood tests, preoperative diagnosis was adrenocortical carcinoma. ⋯ He rejected adjuvant therapy with mitotane. Bone and liver metastases were recognized 2 months after operation. The patient died three months after operation because of disease progression.
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Controlled Clinical Trial
[Patients with chronic low back pain: the impact of psychosocial features].
Chronic low back pain (CLBP) is often associated with clinical and subclinical levels of psychological problems. A higher stage of chronicity is associated with an increase in co-existing psychological disorders. Previous programmes of inpatient orthopaedic rehabilitation reveal little evidence of sustained rehabilitation effects, a finding which may be attributable to the absence of specific psychological treatment during the programme. ⋯ The new programme with a cognitive-behavioural depression management training revealed beneficial effects on mental health in the mid-term and on depressive symptoms in the long-term. However, the effects need to be further improved by after-care programmes.
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The efficacy of intensive interdisciplinary pain management programs for patients with chronic low back pain has been repeatedly demonstrated. A controversial issue in previous studies is the cost-effectiveness of this treatment. Between 2001 and 2006, a total of 575 patients with chronic nonspecific back pain took part in an outpatient pain management program at the German Red Cross Pain Center (DRK Schmerz-Zentrum Mainz) in Mainz, Germany. ⋯ For employed patients, the number of absent days decreased to almost one-quarter. On the basis of the study by Wenig, who calculated pain-related costs as a function of Von Korff pain grades, the treatment resulted in a savings of euro 3,329.50 per year per patient. Intensive multidisciplinary treatment of chronic back pain is highly effective and, at least for patients with high levels of disability, is also cost-effective.
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Review Historical Article
A narrative review of lumbar medial branch neurotomy for the treatment of back pain.
Confusion persists concerning the nature and efficacy of procedures variously known as facet denervation, lumbar medial branch radiofrequency neurotomy, and radiofrequency neurotomy or denervation for the treatment of back pain. Systematic reviews have not recognized the importance of patient selection and correct surgical technique when appraising the literature. As a result, negative conclusions about procedures have been drawn because lack of efficacy of one procedure has been misattributed to other, cognate, but different procedures. ⋯ Negative results have been reported only in studies that selected inappropriate patients or used surgically inaccurate techniques. All valid studies showed positive outcomes that cannot be attributed to placebo. Inappropriate conclusions have been drawn by systematic reviews that misrepresent invalid studies as providing evidence against the efficacy of lumbar medial branch neurotomy.
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Cross-sectional cohort. ⋯ This regression-based algorithm may be used to predict SF-6D scores in studies of lumbar degenerative disease that have collected ODI but not utility scores.