Articles: low-back-pain.
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The surgical decompression of a symptomatic lumbar nerve root is generally regarded as effective treatment for radiculopathy. Nevertheless this straightforward surgical procedure is not universally successful, and the results are often independent of technical factors. ⋯ Although psychosocial issues (psychiatric factor, personal injury litigation, compensation claim) are well known to affect outcome, the strength and magnitude of their negative effects was surprising. The short form McGill Pain Questionnaire can be used not only as an outcome tool, but also as a predictor of result. The pain drawing has similar utility, but it should not be used as a substitute for psychiatric evaluation. The numerous issues exerting profound effects on the outcome of a relatively simple operation suggest that specific attention be directed at them when evaluating more complex surgical procedures. Although large randomized samples might obviate this concern, it is possible that some of these factors are too powerful to be ignored.
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There is no widely accepted objective evaluation for lumbar spine disorders. New outcome measures should be patient-oriented and should measure symptoms and self-reported functional status in multiple dimensions. The aim of this study was to identify items to be included in the disease-specific quality of life (QOL) questionnaire for the assessments of patients with lumbar spine disorders. ⋯ This study identified the 25 specific questionnaire items that should be included in the questionnaire to evaluate QOL of patients with various lumbar spine disorders.
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Successful management of workers on sick leave due to low back pain by the general physician and physiotherapist depends on reliable prognostic information on the course of low back pain and work resumption. ⋯ Knowledge of the predictive value of these indicators by physicians and physiotherapists will help to identify subgroups of patients and will thus enhance clinical decision-making.
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Comparative Study
Prevalence of lumbar facet arthrosis and its relationship to age, sex, and race: an anatomic study of cadaveric specimens.
An anatomic, epidemiologic study of facet arthrosis in cadaveric lumbar spines. ⋯ Facet arthrosis is a universal finding in the human lumbar spine. Evidence of arthrosis begins early, with more than one half of adults younger than 30 years demonstrating arthritic changes in the facets. The most common arthritic level appears to be L4-L5. Men have a higher prevalence and degree of facet arthrosis than women.
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Public and professional health education campaign. ⋯ There was a major shift in public beliefs and professional advice but no change in work-related outcomes.