Articles: low-back-pain.
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Comparative Study
Temporary external pedicular fixation versus definitive bony fusion: a prospective comparative study on pain relief and function.
Temporary external pedicular fixation is used as a prognostic instrument when treating degenerative conditions with spinal fusion. We studied the validity of the method and whether a functional test could improve the prognostic value of such fixation. Twenty-six patients with long-standing lumbar pain had an external temporary fixation. ⋯ We conclude that with a good outcome ratio of 14 patients out of 19 having a solid fusion, the external frame improved patient selection and can be used as a valid prognostic instrument. The pain relief and function after definitive fusion can not be quantified by the external fixation, probably due to the fact that the stabilisation with an external frame is partial. The value of the functional test design presented is moderate, and an outcome evaluation comprising pain relief at rest and mean pain level during a week in fixation seems adequate.
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Irish medical journal · Feb 2003
Chronic neck pain following road traffic accidents in an Irish setting and it's relationship to seat belt use and low back pain.
Chronic neck pain following road traffic accidents is a highly prevalent condition in developed societies. It constitutes the main element of chronic whiplash syndrome, and is often used synonymously with that term. It is also a highly controversial condition, with debate in the extensive literature as to the nature of the complaint. ⋯ The mean time off work due to the injury was 4.9 months (range 1 week-3 years). 60 patients also complained of accident related low back pain, a statistically significant association with whiplash syndrome (p<0.001). Our study demonstrates a significantly high incidence of reported seatbelt use in patients presenting with chronic neck pain and whiplash syndrome. We also found a significant association between whiplash and chronic lumbar pain, an association having important medico-legal implications and requiring further analysis.
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Randomized Controlled Trial Clinical Trial
The clinical importance of changes in outcome scores after treatment for chronic low back pain.
When measuring treatment effect in chronic low back pain with multi-item outcome instruments, it is necessary, both for clinical decision-making and research purposes, to understand the clinical importance of the outcome scores. The aims of the present study were three-fold. Firstly, it aimed to estimate the minimal clinically important difference of three multi-item outcome instruments (the Oswestry Disability Index, the General Function Score and the Zung Depression Scale) and of the visual analogue scale (VAS) of back pain. ⋯ Improvement after treatment for chronic low back pain tends to occur to a greater extent in sleep disturbance, ability to do usual things and psychological irritability, but to a lesser extent in the ability to sit, stand and lift. We conclude that the VAS of back pain is responsive enough to detect the minimal clinically important difference, whereas the smallest acceptable score changes of the Oswestry Disability Index, the General Function Score and the Zung Depression Scale may require an increase to exceed the 95% tolerance interval when used for clinical decision making and for power calculation. Despite improvement after treatment, the ability to sit, stand and lift, remain notable problems.
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Randomized Controlled Trial Clinical Trial
Pain-drawing does not predict the outcome of fusion surgery for chronic low-back pain: a report from the Swedish Lumbar Spine Study.
Despite a widespread use of pain drawing in the selection of patients for surgical and non-surgical treatment, its value as a predictor of outcome is still not well documented. In a prospective multicentre randomised controlled trial of surgical and non-surgical treatment for chronic low-back pain (CLBP), two hypotheses were tested: (1). Pain drawing predicts outcome of treatment for CLBP, (2). ⋯ The pain drawing was associated with pre-treatment back pain intensity and depressive symptoms. No predictive value of the pain drawing regarding the outcome of treatment of CLPB was demonstrated. The concept of "organic/non-organic" pain in conjunction with chronic low-back pain is not supported by the results of the present study.