Articles: back-pain.
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Bmc Musculoskel Dis · Jan 2008
Randomized Controlled Trial Comparative StudySubacute and chronic, non-specific back and neck pain: cognitive-behavioural rehabilitation versus primary care. A randomized controlled trial.
In the industrial world, non-specific back and neck pain (BNP) is the largest diagnostic group underlying sick-listing. For patients with subacute and chronic (= full-time sick-listed for 43 - 84 and 85 - 730 days, respectively) BNP, cognitive-behavioural rehabilitation was compared with primary care. The specific aim was to answer the question: within an 18-month follow-up, will the outcomes differ in respect of sick-listing and number of health-care visits? ⋯ The results were equivalent over 18 months. However, there were indications that cognitive-behavioural rehabilitation in the longer run might be superior to primary care. For subacute BNP, it might be superior in terms of sick-listing and health-care visits; for chronic BNP, in terms of health-care visits only. More conclusive results concerning this possible long-term effect might require a longer follow-up.
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Bmc Musculoskel Dis · Jan 2008
Randomized Controlled TrialTreatment of chronic back pain by sensory discrimination training. A Phase I RCT of a novel device (FairMed) vs. TENS.
The causes of chronic low back pain (CLBP) remain obscure and effective treatment of symptoms remains elusive. A mechanism of relieving chronic pain based on the consequences of conflicting unpleasant sensory inputs to the central nervous system has been hypothesised. As a result a device was generated to deliver sensory discrimination training (FairMed), and this randomised controlled trial compared therapeutic effects with a comparable treatment modality, TENS. ⋯ FairMed was not inferior to TENS treatment. The findings have implications for further research on current chronic pain theories and treatments. Further work to explore these mechanisms is important to expand our understanding of chronic pain and the role of neuro-modulation.
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Randomized Controlled Trial Comparative Study Clinical Trial
A comparison study between newly-designed pencil-point and cutting needles in spinal anesthesia.
The goal of this single blinded randomized study was to compare the use of routine cutting-tip spinal needle and newly-designed pencil-point Pajunk(AE) in terms of success rate, complications and satisfactions in priests undergoing spinal anesthesia for orthopedic, general and urological surgery at Priest Hospital, Thailand. ⋯ The newly-designed, pencil-point spinal needle was another example on the development of more refined towards quality anesthesia. To be cost-effective, it should be selected for patients at risk of CSF leakage-related complications.
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Painful scoliosis is a well-recognized presentation of spinal osteoid osteoma, especially in adolescents, and is thought to be caused by pain-provoked muscle spasm on the side of the lesion. The diagnosis, however, is often initially missed, and prolonged duration of symptoms and rigid spinal curve may result. In this report, we present two cases of adolescent patients with painful scoliosis, subsequently diagnosed with spinal osteoid osteomas. Complete surgical excision resulted in dramatic symptomatic resolution after surgery and improved spinal curve at 1-year follow-up in both cases.
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Bmc Musculoskel Dis · Jan 2008
Gait analysis does not correlate with clinical and MR imaging parameters in patients with symptomatic lumbar spinal stenosis.
Parameters of MR imaging play a pivotal role in diagnosing lumbar spinal stenosis (LSS), and serve as an important tool in clinical decision-making. Despite the importance of MR imaging, little is known about the correlation between MRI parameters, objective gait analysis, and clinical presentation of patients with lumbar spinal stenosis. ⋯ According to the results of this study MRI findings failed to show a major clinical relevance when evaluating the walking distance in patients with lumbar spinal stenosis and, therefore, should be treated with some caution as a predictor of walking distance. In determining the disease pattern of spinal stenosis functional back capacity and BMI might play a more active role than previously thought.