Articles: back-pain.
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This paper describes the patterns of pain induced from lumbar facet joints, from the posterior primary rami of L5, and from the medial articular branches of the posterior primary rami from T11 to L4 in patients undergoing diagnostic spinal infiltrations for chronic pain. No consistent segmental or sclerotomal pattern was found in 385 observations on 138 patients. Pain radiating to the buttock or trochanteric region occurred mostly from the L4 and L5 levels, while groin pain was produced from L2 to L5. The nerves supplying the facet joints gave rise to distal referral of pain significantly more commonly than the joints themselves.
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Case Reports
A behavioral treatment for sitting and standing intolerance in a patient with chronic low back pain.
This study reports on the effectiveness of an individualized shaping treatment program for sitting and standing intolerance in a patient with chronic low back pain following a laminectomy for removal of an intradural tumor. Functional assessment of sitting and standing tolerance, observation of pain behaviors, and a self-report measure regarding the pain experience were carried out during baseline, treatment, posttreatment, and at a 6-month follow-up. ⋯ The overall pain behavior diminished significantly. These findings underscore the importance of relatively simple and cost-effective individualized behavioral programs for chronic pain patients.
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Regional anesthesia · Sep 1989
Case ReportsSpinal cord compression following labor and delivery with epidural analgesia.
Transient back pain is not uncommon during pregnancy and the postpartum period. Following an epidural anesthetic, back pain persisted in a postpartum patient beyond the expected period of soreness. Further diagnostic evaluation led to diagnosis and surgical decompression of a herniated thoracic disc.
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Clinical Trial Controlled Clinical Trial
Morbidity from subarachnoid spinal anaesthesia--a prospective study on the post-operative morbidity from subarachnoid spinal anaesthesia.
A clinical survey was conducted on 274 patients who had surgery under subarachnoid spinal anaesthesia. The anaesthetic was performed with either a 23 gauge or 25 gauge needle. All patients were interviewed on the second and sixth post-operative days. ⋯ Backache was the most common complaint (20.5%). Using the finer needle did not reduce this aspect of morbidity. Post-dural puncture headache on the other hand was significantly reduced by the use of the finer 25 gauge needle (from 12.3% to 4.9%).
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We have described the process of the initial development of an expert-based decision-support system for the management of patients with low back syndrome. Important considerations for developing decision-support systems are reviewed, both generally and specifically. ⋯ Our work so far involved congregation of a number of experts and compilation of a testing protocol. We are now refining the system for specific populations and purposes.