Articles: low-back-pain.
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Randomized Controlled Trial
A randomized double-blind controlled trial of intra-annular radiofrequency thermal disc therapy--a 12-month follow-up.
The discTRODE probe applies radiofrequency (RF) current, heating the annulus to treat chronic discogenic low back pain. Randomized controlled studies have not been published. We assessed the long-term effect and safety aspects of percutaneous intradiscal radiofrequency thermocoagulation (PIRFT) with the discTRODE probe in a prospective parallel, randomized and gender stratified, double-blind placebo-controlled study. ⋯ Two actively treated and two sham-treated patients reported increased pain levels, and in both groups a higher number was unemployed after 12 months. The study did not find evidence for a benefit of PIRFT, although it cannot rule out a moderate effect. Considering the high number, reporting increased pain in our study, we would not recommend intra-annular thermal therapy with the discTRODE probe.
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Clin. Orthop. Relat. Res. · Oct 2009
Multicenter StudyDoes concomitant low back pain affect revision total knee arthroplasty outcomes?
The number of revision total knee arthroplasties (rev-TKA) is increasing every year. These cases are technically difficult and add considerable burden on the healthcare system. Many patients have concomitant low back pain that may interfere with functional outcome. We asked whether having low back pain at baseline would influence amount and rate of improvement on standardized outcomes measures after rev-TKA. We retrospectively reviewed 308 patients from prospectively collected data in a multicenter study. A minimum 24-month followup was available for 221 patients (71.8%). Patients with low back pain at baseline had worse scores on most instruments than their counterparts at baseline, 12 months postsurgery, and 24 months postsurgery. The data suggest concomitant back pain in patients undergoing rev-TKA affects their outcomes as measured by standardized instruments. Orthopaedic surgeons should counsel their patients with back pain regarding the possibility of slower or less complete recovery. ⋯ Level II, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.
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Randomized Controlled Trial Comparative Study
Corticosteroid injection treatment to the ischiadic spine reduced pain in women with long-lasting sacral low back pain with onset during pregnancy: a randomized, double blind, controlled trial.
Randomized double blind controlled clinical trial. ⋯ The anatomic region around the sacrospinous ligament insertion on the ischial spine is suggested to be one source of long-lasting sacral low back pain with onset during pregnancy. The pain was relieved by slow-release corticosteroid injection treatment to the ischial spine.
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Arthritis and rheumatism · Oct 2009
Prevalence of and screening for serious spinal pathology in patients presenting to primary care settings with acute low back pain.
To determine the prevalence of serious pathology in patients presenting to primary care settings with acute low back pain, and to evaluate the diagnostic accuracy of recommended "red flag" screening questions. ⋯ In patients presenting to a primary care provider with back pain, previously undiagnosed serious pathology is rare. The most common serious pathology observed was vertebral fracture. Approximately half of the cases of serious pathology were identified at the initial consultation. Some red flags have very high false-positive rates, indicating that, when used in isolation, they have little diagnostic value in the primary care setting.