Articles: back-pain.
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With 12-month prevalence rates of more than 70%, back pain is currently one of the major health problems for German adults and entails major economic consequences. The aim of this study was to estimate back pain-related costs from a societal perspective and to determine the impact of sociodemographic variables on costs. Based on back pain-related survey data of a large German adult sample (9267 respondents, response rate 60%), costs were assessed using a prevalence-based bottom-up approach. ⋯ Male gender, increasing age, single status, low education, unemployment, and increasing back pain grade had a significant positive impact on the cost magnitude in multivariate analysis. Despite several limitations, this study provides important information concerning the relevance of back pain as a health problem and its socioeconomic consequences. The information may be of value for decision-making and allocation of research fund resources.
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No data for patients with failed back surgery syndrome (FBSS) based on the location of adhesions separated by epiduroscopic adhesiolysis have been reported. ⋯ Progressive epidural imaging after adhesiolysis suggested that pain was caused by re-adhesion around the nerve root. Since re-adhesion of the nerve root required some time, the effect of adhesiolysis was maintained for extended periods in these cases. We suggest that epiduroscopic adhesiolysis is an effective therapy for FBSS patients, and that adhesiolysis of the nerve root may exhibit the long-term (24 weeks) efficacy in patients with pain.
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Chronic back pain and other refractory pain syndromes are a documented burden on our society. They also are a huge cost in quality of life and dollars spent on health care. ⋯ We describe in this article the basic techniques and methods of both the stimulation trial and the permanent implantation of the leads and generator. With advanced imaging and the minimally invasive approach we further explain how to minimize any risk associated with this percutaneous procedure.
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Comparative Study Clinical Trial
Comparison of the effectiveness of interlaminar and bilateral transforaminal epidural steroid injections in treatment of patients with lumbosacral disc herniation and spinal stenosis.
The purpose of this study is to compare the effectiveness of interlaminar (IL) and bilateral transforaminal (TF) epidural steroid injections (ESIs) for pain reduction in patients with axial back pain resulting from herniated intervertebral disc (HIVD) and spinal stenosis (SS). ⋯ Bilateral TF epidural injection allowed the higher concentration of injectates to be delivered into ventral epidural space bilaterally. The IL approach can be more affected by tissue fibrosis, scarring, or hypertrophy, which is more prominently featured in SS than in HIVD; these prevent the injectate delivered via the posterior route from spreading to the ventral epidural space. Consequently, in patients with SS, bilateral TF produces better results than IL.
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A case report describing thoracic intervertebral disc degeneration and spondylolisthesis associated with a Schmorl node in a young athlete, which was successfully treated by anterior interbody fusion (AIF). ⋯ The AIF procedure was effective for lower thoracic symptomatic intervertebral disc degeneration and spondylolisthesis associated with a Schmorl node.