Articles: low-back-pain.
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Acta Anaesthesiol Scand · May 1997
Clinical Trial Controlled Clinical TrialIntravenous phentolamine test--an aid in the evaluation of patients with persistent pain after low-back surgery?
Persistent pain following surgery in the treatment of chronic low-back pain patients is still relatively frequent. Most of these patients with persistent pain have clinical signs of neuropathic pain. The neuropathic pain might be sympathetically maintained pain (SMP) or sympathetically independent pain (SIP). Systemic administration of phentolamine, a competitive alpha-adrenergic antagonist, has been used as a diagnostic tool to identify patients with SMP. ⋯ SMP is either an uncommon cause of persistent pain in this type of failed back surgery patients or the phentolamine test, as we performed it, was unable to identify SMP.
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The Journal of urology · May 1997
Review Case ReportsAutotransplantation as an effective therapy for the loin pain-hematuria syndrome: case reports and a review of the literature.
The loin pain-hematuria syndrome is a well recognized but poorly understood clinical condition in which patients have progressive loin pain accompanied by hematuria but they maintain stable renal function. We present 2 cases effectively treated with renal autotransplantation, as well as a review of the literature, and a coherent algorithm for the diagnosis and treatment of this condition. ⋯ Renal autotransplantation provides the most durable, nonnarcotic, nephron sparing relief for patients with the loin pain-hematuria syndrome. Further investigation is necessary to elucidate the pathophysiology of this debilitating condition.
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In this 3-year longitudinal study, we studied lumbar mobility and the occurrence of low back pain among 98 adolescents who were free of previous severe low back pain: 33 nonathletes (16 boys, 17 girls), 34 boy athletes (ice hockey and soccer players) and 31 girl athletes (figure skaters and gymnasts). During the followup, low back pain lasting longer than 1 week was reported by 29 athletes (15 boys and 14 girls) and by 6 nonathletes (3 boys and 3 girls). ⋯ The girls in the lowest tertile of maximal lumbar extension at baseline had a relative risk of 3.4 to have future low back pain compared with those in the highest tertile. We conclude that the low individual physiologic maximum of lower segment lumbar extension mobility may cause overloading of the low back among athletes involved in sports with frequent maximal lumbar extension and that it predicts future low back pain.
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To assess whether magnetic resonance (MR) imaging has replaced other diagnostic imaging modalities in the evaluation of persistent low back pain. ⋯ MR imaging was used primarily as an add-on rather than a substitute for other imaging modalities in the evaluation of persistent low back pain. Thus, the volume and cost of diagnostic imaging for persistent low back pain have increased.
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A cross-sectional study. ⋯ When the appropriate technique is used, medial branch blocks are target specific. To guard against false-negative responses due to intravenous up-take, contrast medium must be used before the injection of local anaesthetic.