Articles: back-pain.
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Acta Neurochir. Suppl. · Jan 2007
Review Multicenter StudySpinal cord stimulation for failed back surgery syndrome and other disorders.
Chronic pain is a complex condition that requires a multi-disciplinary approach to management. Spinal cord stimulation (SCS) has evolved into a relatively easily implemented, reversible technique with low morbidity for the management of chronic, intractable pain in selected patients. ⋯ Multicenter prospective studies were conducted and demonstrated that SCS. as a neuromodulation procedure, is indeed a superior method for treatment of chronic pain if the patients are selected with caution and a proper strategy. Future development of innovative electrodes and pulse generation systems will continue to improve this therapy.
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Multicenter Study Comparative Study
Prediction of an unfavourable course of low back pain in general practice: comparison of four instruments.
Several instruments can be used to identify patients with an unfavourable course of low back pain in general practice. However, it is unclear which instrument is the predictor of outcome. ⋯ Although the prediction rule performed best with regard to calibration and discrimination, it needs to be externally validated. Risk estimation by GPs performs as well as other instruments and, at present, seems to be the best available option.
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Multicenter Study Controlled Clinical Trial
Effects of a back-pain-reducing program during pregnancy for Korean women: a non-equivalent control-group pretest-posttest study.
Although many pregnant women experience back pain, it has not considered an important health problem. No study has investigated the effects of a back-pain-reducing program (BPRP) during pregnancy for Korean women. ⋯ The findings show that the pain-reducing program developed for this study was effective in reducing the intensity of back pain experienced by pregnant women. Promoting good posture and regular exercise can be recommended as a method to relieve back pain in pregnancy women. Further studies are needed to confirm the effect of the BPRP during pregnancy.
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Practice Guideline
Interventional techniques: evidence-based practice guidelines in the management of chronic spinal pain.
The evidence-based practice guidelines for the management of chronic spinal pain with interventional techniques were developed to provide recommendations to clinicians in the United States. ⋯ These guidelines include the evaluation of evidence for diagnostic and therapeutic procedures in managing chronic spinal pain and recommendations for managing spinal pain. However, these guidelines do not constitute inflexible treatment recommendations. These guidelines also do not represent a "standard of care."
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Objective and Importance. Several previous reports have documented cord compression resulting from the formation of an intrathecal inflammatory mass in patients using intrathecal drug delivery systems. We present the first reported case of an intramedullary abscess and intrathecal inflammatory mass associated with an intrathecal drug delivery system. Clinical Presentation. A 47-year-old man was transferred to our institution from an outside hospital with a 3-week history of the inability to ambulate or move his legs. ⋯ The abscess was linked to infection with Streptococcus anginosus. Conclusion. Generally, inflammatory masses forming along the catheter tip are not associated with infections. We report the first case of an intramedullary abscess associated with an intrathecal drug delivery pump.