Spine
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Review paper of outcome studies among primary care back pain patients. ⋯ Results from existing studies suggest that back pain among primary care patients typically runs a recurrent course characterized by variation and change, rather than an acute, self-limiting course.
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This paper is based on a review, analysis, and discussion of the extensive literature on indications, technique, and complications of discectomy (macro and micro) for lumbar disc herniation. Outcomes for lumbar discectomy for disc herniation depend on patient selection. ⋯ A review of the literature reveals success rates for lumbar discectomy ranging from 80-96%. The outcome of lumbar discectomy does not appear to be affected by the use of a microscope and depends more on patient selection than on surgical technique.
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This is the second of two papers that systematically review available scientific evidence on the causes of disability from occupational low back pain, and the effectiveness of interventions to prevent it after its onset (secondary prevention). This paper reviews the national history of how back pain and the risk factors for its extension into chronic disability, followed by a critical summary of intervention studies attempting to reduce the duration of this disability, and to evaluate the results.
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Criteria-based review. ⋯ In acute back pain, exercise therapy is ineffective, whereas in subacute back pain, exercises with a graded activity program, and in chronic back pain, intensive exercising, deserve attention. More research on McKenzie therapy, on exercises with a graded activity program, and on different types of exercising in patients with chronic back pain is necessary.
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This is the first of two papers that systematically review available scientific evidence on the causes of disability from occupational low back pain, and the effectiveness of interventions to prevent it-before disability begins (primary prevention-Part I) and after its onset (secondary prevention-Part II). This first paper reviews the risk factors for the onset of pain and associated disability followed by a critical summary of intervention studies attempting to achieve prevention and to evaluate the results.