Articles: low-back-pain.
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Observational Study
Effectiveness of ultrasonography-guided caudal epidural steroid injection compared to the fluoroscopic application.
Caudal epidural steroid injection (CESI) has been increasingly used for treating lower back pain. However, there is still significant controversy about the efficacy and safety of different imaging techniques used to guide CESI. In this context, the objective of this study is to compare the efficacies of fluoroscopy- and ultrasonography-guided CESI in patients with chronic lower back pain. ⋯ The study findings indicated that ultrasound-guided CESI was as effective as fluoroscopy-guided CESI in treating chroniclower back pain.
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Review Meta Analysis
Intra-Articular Facet Joint Injection of Normal Saline for Chronic Low Back Pain: A Systematic Review and Meta-Analysis.
Objective: This systematic review and meta-analysis compared the patient-reported outcomes of intra-articular facet joint injections of normal saline and selected active substances to identify a more effective agent for treating subacute and chronic low back pain (LBP). Methods: The PubMed, Embase, Scopus, Web of Science, and CENTRAL databases were searched for randomized controlled trials and observational studies published in English. A research quality assessment was performed using ROB2 and ROBINS-I. ⋯ Results: Of the 2467 potential studies, 3 were included (247 patients). The active substances and normal saline had similar therapeutic effects on pain within 1 h, after 1-1.5 months, and after 3-6 months, with MD and 95% CI of 2.43 and -11.61 to 16.50, -0.63 and -7.97 to 6.72, and 1.90 and -16.03 to 19.83, respectively, as well as on the quality of life after 1 and 6 months. Conclusions: The short- and long-term clinical effects of intra-articular facet joint injections of normal saline are comparable to those of other active substances in patients with LBP.
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Physicians' seniority has always been the focus of patients. Silver needle therapy (SNT) has been applied for more than 60 years. It is similar to moxibustion and has a good therapeutic effect on soft tissue pain. This study aimed to determine the influence of physicians' seniority on the efficacy of SNT for patients with low back fasciitis. ⋯ SNT could attenuate the pain of patients with low back fasciitis in the short and long term without severe complications. The physicians' seniority did not influence the efficacy of SNT, but the JP group showed an increased operation time and a higher degree of pain during the operation.
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J. Korean Med. Sci. · May 2023
Effect of Muscularity and Fatty Infiltration of Paraspinal Muscles on Outcome of Lumbar Interbody Fusion.
Lumbar paraspinal muscles play an important role in maintaining global spinal alignment and are associated with lower back pain; however, only a few studies on the effect of the paraspinal muscles on the surgical outcome exist. Therefore, this study aimed to analyze the association of preoperative muscularity and fatty infiltration (FI) of paraspinal muscles with the outcome of lumbar interbody fusion. ⋯ Patients with high LM and mild FI ratio observed on preoperative MRI demonstrated more favorable clinical and radiographic outcomes after lumbar interbody fusion. Therefore, preoperative paraspinal muscle condition should be considered when planning lumbar interbody fusion.