Articles: low-back-pain.
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Clinical Trial
The significance of multifidus atrophy after successful radiofrequency neurotomy for low back pain.
To determine the presence of lumbar multifidus atrophy and pain after successful lumbar medial branch radiofrequency neurotomy for zygapophysial joint mediated pain. ⋯ This preliminary study provides evidence that successful medial branch RFN for lumbar zygapophysial-mediated pain does cause initial denervation but no discernable segmental atrophy of the multifidus at long-term follow-up. Previous denervation and diffuse atrophy in these subjects was not associated with pain.
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Klinische Neuroradiologie · Aug 2009
Case Reports[Cervical epidural abscess following lumbar epidural steroid injections].
A 49-year-old female with diabetes and chronic low back pain was treated with computed tomography-guided injections after years of unsuccessful pain management. Magnetic resonance imaging (MRI) demonstrated degenerative changes of the lumbar spine with disk herniation, facet joint degeneration, and instability of the presacral segment. Following epidural steroid injection, local infection and sepsis occurred and, finally, tetraparesis developed. ⋯ Legal proceedings were initiated against the radiologists. They were accused of causing damage to the patient. The plaint was defeated with special reference to the report and expertise of the neuroradiologic evidence.
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Review Meta Analysis
Systematic reviews of low back pain prognosis had variable methods and results: guidance for future prognosis reviews.
Systematic reviews of prognostic factors for low back pain vary substantially in design and conduct. The objective of this study was to identify, describe, and synthesize systematic reviews of low back pain prognosis, and explore the potential impact of review methods on the conclusions. ⋯ There is an immediate need for methodological work in the area of prognosis systematic reviews. Because of methodological shortcomings in the primary and review literature, there remains uncertainty about reliability of conclusions regarding prognostic factors for low back pain.
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Analysis of repeated cross-sectional surveys. ⋯ Although the prevalence of neck-shoulder-arm pain and concurrent symptoms decreased in 2006 compared to 2002, it is still too early to conclude that we have reached and passed the peak of the "epidemic" of neck-shoulder-arm pain.
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To examine the relationship between hamstring extensibility by use of the instrumented straight leg raise; mechanical components of muscle contraction, including muscle recruitment, passive torque measures of tissue stiffness, and eccentric strength; and self-reported measures of pain and disability. ⋯ Decreased extensibility of the hamstrings was associated with increased passive stiffness during the common range of motion (20 to 50 degrees ). Impaired stretch tolerance is associated with actual mechanical restriction, not behavioral measures indicating increased pain or fear-avoidant behavior. With no relationship to actual disability and contradictory findings in the literature for the relationship of the hamstrings to the mechanics of the low back, it is unclear whether decreased hamstring extensibility should be targeted in rehabilitation programs for axial lower back pain.