Articles: low-back-pain.
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Comparative Study
L5-S3 Compared to L5-S2 Full-Endoscopic Rhizotomy and Ablation Under a Navigation System for Sacroiliac Joint Pain: A Comparative Study.
Chronic low back pain (CLBP) with sacroiliac joint (SIJ) involvement is a prevalent issue in health care. Surgical intervention, employing an endoscopic technique with a navigation system, targets and ablates nociceptive nerve fibers associated with SIJ pain, although the clinical effect of omitting rhizotomy of the lateral sacral branch of S3 remains uncertain. ⋯ L5-S2 FERA demonstrated clinical outcomes similar to those of L5-S3 FERA for pain relief, functional improvement, and satisfaction. Omitting S3 lateral branch rhizotomy did not adversely affect the outcomes. Surgeons may consider omitting S3 lateral branch rhizotomy for SIJ pain treatment, thereby reducing operative time while maintaining patient benefits.
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Observational Study
Predicting Responses to Interventional Pain Management Techniques for Chronic Low Back Pain: A Single-Center Observational Study (PReTi-Back Study).
Exploring factors linked to the outcomes of certain interventional pain management techniques may optimize the selection of candidates for those procedures. Our hypothesis is that factors that influence responses to interventional therapies for chronic low back pain (CLBP) can be identified by analyzing a prospective cohort. ⋯ Patients satisfied with previously performed interventional therapies or who exhibit findings of radicular compression or listhesis on imaging show approximately twice the likelihood of experiencing a positive response to short-term IMPT than do patients without those characteristics. Patients who are obese or have PSPS-2 exhibit approximately a 50% lower likelihood of short-term response than do patients without these conditions.
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To describe the frequency of primary care seeking for neck or back-related conditions among people with chronic neck and low back pain and to develop prediction models of primary care seeking and frequent visits. ⋯ People with chronic neck and low back pain who seek physical therapist care had the highest frequency of care seeking, underscoring the significant burden on healthcare systems. The high frequency of visits and associated healthcare expenditures highlight the critical need for effective and valuable primary care for chronic pain management. To mitigate recurrent visits and reduce costs, it is essential to provide patients with evidence-based treatments and self-management interventions.
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Discogenic chronic low back pain (cLBP) and radiculopathy are the most prevalent causes of disability worldwide. Older spine treatments often lack reliability and are associated with adverse events. Among surgical treatment options, discectomies weaken discs, and fusions cause direct damage to adjacent discs, so both treatments accelerate disc degeneration. Other regenerative medicine treatments, including "stem cell" (centrifuged bone marrow aspirate, BMC), and platelet-rich plasma (PRP), lack fibrin's bio-adhesive properties. Specifically, fibrin is a strong bio-adhesive, so it immediately integrates into disc defects and binds there, becoming a part of the disc and facilitating new disc tissue growth. ⋯ Intra-annular fibrin bio-adhesive sealant demonstrates the ability to be an effective treatment for alleviating discogenic cLBP and radiculopathy for at least 3 years, even in patients who all failed multiple prior treatments, including discectomy, fusion, disc PRP, or BMC. The results suggest the benefits of fibrin sealant. Future investigations to consider include a randomized double-blind controlled trial and further categorical analyses.
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This study aimed to evaluate preoperative and perioperative predictors associated with persistent low back pain (LBP) following lumbar fusion in patients aged >75 years. ⋯ This study showed that a relatively younger age, history of preoperative lumbar decompression, and greater preoperative VAS score for LBP were preoperative predictors of postoperative persistent LBP following lumbar fusion in elderly patients. In contrast, preoperative spinopelvic sagittal parameters were not associated with persistent postoperative LBP. Although lumbar fusion is expected to improve LBP, surgeons should pay attention to age, surgical history, and preoperative back pain intensity.