Articles: low-back-pain.
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Dtsch. Med. Wochenschr. · Apr 2022
[Lower back pain in the primary care setting - Non-specific and specific pain].
A systematic survey of the symptoms of back pain in terms of triggering event and onset, nature and the extent of influenceability of the pain (lying or standing, under stress, nocturnal pain, localized percussion tenderness, B- symptoms, etc.), as well as structured clinical examination (segment height, radiance, projection, reflex status, sensitivity and motor function) allows an initial and therefore orienting classification of back pain as non-specific or specific. In the primary care setting many patients can be treated extremely effectively and economically from a cost perspective. In addition to the fastest possible pain relief, it is important to prevent the disease becoming chronic. ⋯ Causes of specific back pain include: fractures, infections, radiculopathy, tumors, axial spondylarthritis as well as extravertebral causes. In the further cause of treatment, it may be necessary to consult medical specialists in the fields of radiology, orthopedics, neurology, neurosurgery, rheumatology, psychotherapy, psychiatry, among others. Treatment is managed by the primary care provider, who should also receive and re-evaluate all findings during the course of the disease.
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Dtsch. Med. Wochenschr. · Apr 2022
[Low back pain from an orthopedic and pain medical point of view].
Low back pain is not a diagnosis but a symptom of various causes. The differentiation between specific and non-specific low back pain is diagnostically difficult and only of limited help with regard to the further therapeutic procedure. ⋯ Early recognition and timely adequate therapy are crucial for the prognosis of chronic low back pain. Low back pain at risk of chronicity or chronic low back pain requires early assessment and the initiation of an interdisciplinary multimodal pain therapy program (IMPT).
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Low back pain is the leading symptom of a family of inflammatory rheumatic diseases grouped under the umbrella term "spondyloarthritides". This paper discusses the main clinical, laboratory, and imaging features of spondyloarthritides in the diagnostic context of low back pain. It also highlights the current therapeutic principles of axial spondyloarthritis.
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Background and Objective: The aim of this review was to analyze the existing literature and investigate the outcomes or complications of lateral lumbar interbody fusion (LLIF) combined with indirect decompression for degenerative lumbar spondylolisthesis (DS). Materials and Methods: A database search algorithm was used to query MEDLINE, COCHRANE, and EMBASE to identify the literature reporting LLIF with indirect decompression for DS between January 2010 and December 2021. Improvements in outcome measures and complication rates were pooled and tested for significance. ⋯ Post-operative complications occurred in 5-40% of patients with thigh symptoms, such as anterior thigh numbness, dysesthesia, discomfort, pain, and sensory deficits. Conclusions: Indirect decompression by LLIF for DS is an effective method for improving pain and dysfunction with less surgical invasion. In addition, it has the effect of significantly improving disc height, foraminal height and area, and segmental lordosis on radiological outcomes compared to the posterior approach.