Articles: low-back-pain.
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Post lumbar laminectomy syndrome with its resultant chronic low back pain is estimated to occur in 20% to 50% of the patients. Among various procedures available, lysis of epidural adhesions is considered as one of the effective therapeutic modalities of management in these patients, and may be performed either non-endoscopically or endoscopically. This retrospective evaluation included 120 post lumbar laminectomy patients who underwent either non-endoscopic adhesiolysis (Group I) or endoscopic adhesiolysis (Group II) with 60 consecutive patients in each group. ⋯ Cost effectiveness analysis showed Group I patients experiencing significant relief at a cost of $40 per week, with one year quality of life improvement for $2,080, whereas it was $135 per week improvement in Group II with a one year quality of life improvement at a cost of $7,020 with significant difference noted in cost effectiveness. In conclusion, non-endoscopic epidural adhesiolysis and administration of corticosteroids and hypertonic saline is a safe and cost effective procedure for relieving chronic intractable pain in post lumbar laminectomy patients who failed to respond to other modalities of treatment. Similarly, endoscopic adhesiolysis with the administration of corticosteroids is also a safe and possibly cost-effective technique for relief of chronic intractable pain failing to respond to other modalities of treatments.
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A 45-year-old woman presented with increasing low back pain, progressive anesthesia in her lower extremities and difficulty ambulating. She had a history of chronic low back pain problems for which, 26 months earlier, she had an intrathecal infusion pump permanently placed for pain and spasm control. ⋯ At surgical laminectomy the compressing lesion was found to be a reactive tissue fibroma. As more patients receive these devices the physician should consider cord compression syndrome in patients presenting with symptoms of increasing low back pain, anesthesia and progressive proprioceptive loss.
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A cross-sectional study of baseline correlates of clinical pain and functional status in consecutive patients being treated for chronic low back pain. ⋯ These pilot data suggest that an individual's experimental pain threshold (a measure of tenderness) is associated with baseline functional status and pain in cases of chronic low back pain and may represent an important domain warranting further investigation.
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Comparative Study Clinical Trial
Management of chronic disabling low back pain with 360 degrees fusion. Results from pain provocation test and concurrent posterior lumbar interbody fusion, posterolateral fusion, and pedicle screw instrumentation in patients with chronic disabling low back pain.
A follow-up study conducted by an independent observer was performed on the authors' first 29 consecutive patients treated with concurrent posterior lumbar interbody fusion, posterolateral fusion, and pedicle screw instrumentation, for whom at least 2 years had transpired since the operation. ⋯ The authors consider posterior lumbar interbody fusion with concurrent posterolateral fusion and pedicle screw instrumentation a possible method for managing chronic disabling low back pain.
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J. Gerontol. A Biol. Sci. Med. Sci. · Oct 1999
Low back pain and disability in older women: independent association with difficulty but not inability to perform daily activities.
Low back pain is a highly prevalent chronic condition, yet little is known about the disabling effects of this common problem in older adults. This study examines the relationship between the presence and severity of low back pain and disability in older women. ⋯ There was a strong association between back pain and functional difficulties in older women, pointing to the need for further research using longitudinal methods.