Articles: low-back-pain.
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Randomized Controlled Trial
ISSLS prize winner: cost-effectiveness of two forms of circumferential lumbar fusion: a prospective randomized controlled trial.
Economic evaluation alongside a prospective, randomized controlled trial from a secondary care National Health Service (NHS) perspective. ⋯ From an NHS perspective, the trial data show that TC is not cost-effective in circumferential lumbar fusion. The use of FRA was both cheaper and generated greater QALY gains. In addition, FRA patients reported a greater return to work rate.
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People aged 65 years and over make up the fastest growing demographic in the United States. By the year 2040 they will comprise approximately one fourth of the US population. ⋯ Practice standards must include a thorough pain assessment and formation of a multimodal care plan, which applies knowledge of pain management in an objective and scientific manner. In this article, a patient case study illustrates how the appropriate management of chronic pain in an elderly patient can lead to better clinical outcomes.
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Complement Ther Med · Dec 2007
Acupuncture for chronic pain within the research program of 10 German Health Insurance Funds--basic results from an observational study.
To investigate which patients receive acupuncture in the framework of statutory health insurance in Germany, how treatment was carried out, and what results were achieved. ⋯ Acupuncture proved a highly demanded treatment option for chronic pain conditions within the German research program. Results indicate that acupuncture provided by qualified therapists is safe, and patients benefited from the treatment.
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Comparative Study
Comparative charge analysis of one- and two-level lumbar total disc arthroplasty versus circumferential lumbar fusion.
This is a retrospective, independent study comparing 2 groups of patients treated surgically for discogenic low back pain associated with degenerative disc disease (DDD) in the lumbosacral spine. ⋯ Patients undergoing 1- and 2-level ProDisc total disc replacement spent significantly less time in the OR and had less EBL than controls. Charges were significantly lower for TDR compared with circumferential fusions in the 1-level patient group, while charges were similar in the 2-level group.
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Arch Orthop Trauma Surg · Dec 2007
The role of sacroiliac joint dysfunction in the genesis of low back pain: the obvious is not always right.
It is a common practice to the link low back pain with protruding disc even when neurological signs are absent. Because pain caused by sacroiliac joint dysfunction can mimic discogenic or radicular low back pain, we assumed that the diagnosis of sacroiliac joint dysfunction is frequently overlooked. ⋯ Sacroiliac joint dysfunction should be considered strongly in the differential diagnosis of low back pain in this group of patients.