Articles: low-back-pain.
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Seminars in neurology · Jun 2002
ReviewThe lumbar zygapophyseal (facet) joints: a role in the pathogenesis of spinal pain syndromes and degenerative spondylolisthesis.
The zygapophyseal joints in the lumbar spine are important structural components contributing to the stability of the lumbar motion segments. Pathology of the zygapophyseal joints in the lumbar spine may be a significant cause of low back pain and segmental instability within the lumbar spine. Management of pathology related to the zygapophyseal joints remains a difficult challenge for the physician caring for patients with spinal disorders. Future investigations with tissue engineering, ligamentous reconstructions, and intervertebral disc replacement or regeneration may have useful applications in the treatment of zygapophyseal joint pathology.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Chronic low back pain and fusion: a comparison of three surgical techniques: a prospective multicenter randomized study from the Swedish lumbar spine study group.
A multicenter randomized study with a 2-year follow-up period and an independent observer was conducted. ⋯ All the fusion techniques used in the study could reduce pain and improve function in this selected group of patients with severe chronic low back pain. There was no obvious disadvantage in using the least demanding surgical technique of posterolateral fusion without internal fixation.
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Randomized Controlled Trial Comparative Study Clinical Trial
Characteristics of patients with chronic low back pain selected for surgery: a comparison with the general population reported from the Swedish lumbar spine study.
A group of surgical candidates with chronic low back pain was compared with a random sample of the general population. ⋯ The surgical candidates in the current study resembled the average Swedish citizen with back pain. Although selected for treatment because of symptom severity, they did not otherwise differ substantially from the general population with back pain. On the contrary they unexpectedly were affected only a little by depressive symptoms, distinguishing them from patients with chronic low back pain in pain clinics and rehabilitation centers. Therefore, the results of the this outcome study are not generally applicable to every patient with chronic low back pain.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Radiography for low back pain: a randomised controlled trial and observational study in primary care.
Lumbar spine radiography has limited use in diagnosing the cause of acute low back pain. Consensus-based guidelines recommend that lumbar spine x-rays are not used routinely. However there have been no studies of the effect of referral for radiography at first presentation with low back pain in primary care. ⋯ Referral for lumbar spine radiography for first presentation of low back pain in primary care is not associated with improved physical functioning, pain or disability. The possibility of minor psychological improvement should be balanced against the high radiation dose involved.
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Randomized Controlled Trial Clinical Trial
Effectiveness and cost-effectiveness analysis of neuroreflexotherapy for subacute and chronic low back pain in routine general practice: a cluster randomized, controlled trial.
A cluster randomized, controlled trial was performed. ⋯ Referral to neuroreflexotherapy intervention improves the effectiveness and cost-effectiveness of the management of nonspecific low back pain.