Articles: low-back-pain.
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Neuromuscular instability of the lumbar spine resulting from impaired motor control and degeneration of the multifidus muscle is a known root cause of refractory chronic low back pain (LBP). An implantable neurostimulation system that aims to restore multifidus motor control by stimulating the L2 medial branch of the dorsal ramus thereby relieving pain and reducing disability has demonstrated clinically significant benefits in the clinical trial setting. The 1-year results of a single-site real-world cohort study are presented. ⋯ Restorative neurostimulation is a new treatment option for well-selected patients with refractory chronic LBP. Clinically meaningful improvements in pain, disability, and quality of life demonstrated in routine clinical practice are consistent with published results of controlled trials.
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To investigate the incidence, distribution characteristics, risk factors, and clinical outcomes of intraoperative endplate injury (EI) following transforaminal lumbar interbody fusion. ⋯ Rates of EI were 19.6% of patients and 9.9% of endplates. Superior endplates were more susceptible to injury than inferior endplates. Older age, lower disc height index, and taller cage height were independent risk factors for intraoperative EI. Clinical outcomes were not affected by intraoperative EI during early postoperative follow-up.
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We evaluated the association between the chronic severe back pain with disability and participation, in U. S. Adults using data from the US 2019 National Health Interview Survey. ⋯ Identifying factors associated with disability and limitation may help target appropriate management for persons with chronic pain at high risk for disability. PERSPECTIVE: We evaluated the association between the chronic severe back pain with disability and participation, in a representative sample of Americans. Identifying factors associated with a likelihood of disability may help target appropriate pain management for persons at high risk for disability due to chronic severe back pain.
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Observational Study
Impact of a multidisciplinary team meeting on patient-reported outcomes at 2 years after lumbar surgery: A prospective comparative exploratory study.
Failed back surgery syndrome is a challenge. We hypothesized that a multidisciplinary team meeting (MTM) may be useful to select patients who are the most likely to benefit from lumbar surgery. We conducted an observational, prospective, comparative, exploratory study. ⋯ The decrease was -26.8 (41.1) versus -20.8 (30.4) in lumbar pain and -25.5 (43.0) versus -19.5 (27.5) in radicular pain, in participants who attended the MTM versus those who did not, respectively. We found no evidence that core clinical patient-reported outcomes at 2 years after lumbar surgery differed between participants who attended the MTM and those who did not. However, the exploratory design of our study does not allow concluding that MTMs do not have an impact.