Spine
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Economic evaluation provides a framework to explicitly measure and compare the value of alternative medical interventions in terms of their clinical, health-related quality-of-life, and economic outcomes. Computerized economic models can help inform the design of future prospective studies by identifying the cost-drivers, the most uncertain parameter estimates, and the parameters with the greatest impact on the results and inferences. ⋯ Future research should focus on quantifying the health-related quality-of-life impact of bone morphogenetic protein relative to autogenous iliac crest bone graft, as well as the impact on lost productivity.
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Individuals with low back pain were classified by cluster analysis of their responses to the Dallas Pain Questionnaire. These results enabled development of an alternative simple classification tool that yielded results close to those obtained by the cluster analysis. ⋯ The Dallas Pain Questionnaire discriminated between different groups of persons with low back pain. The proposed classification uses a short, simple practical tool to assess different levels of low back pain.
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Case Reports
Severe erosion of lumbar vertebral body because of abdominal aortic false aneurysm: report of two cases.
Two cases of lumbar vertebral erosion resulting from abdominal aortic false aneurysm are reported. ⋯ In patients with endovascular prostheses, false aneurysm should be considered when lytic lesions of vertebral bodies are differentially diagnosed because these patients can present with only spinal symptoms.
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Randomized Controlled Trial Comparative Study Clinical Trial
The effect of McKenzie therapy as compared with that of intensive strengthening training for the treatment of patients with subacute or chronic low back pain: A randomized controlled trial.
A randomized controlled comparative trial with an 8-month follow-up period was conducted. ⋯ The McKenzie method and intensive dynamic strengthening training seem to be equally effective in the treatment of patients with subacute or chronic low back pain.
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Review Comparative Study
The cochrane review of advice to stay active as a single treatment for low back pain and sciatica.
A systematic review was conducted within the Cochrane Collaboration Back Review Group. ⋯ The best available evidence suggests that advice to stay active alone has little beneficial effect for patients with acute, simple low back pain, and little or no effect for patients with sciatica. There is no evidence that advice to stay active is harmful for either acute low back pain or sciatica. Because there is no considerable difference between advice to stay active and advice for bed rest, and there are potential harmful effects of prolonged bed rest, it is reasonable to advise people with acute low back pain and sciatica to stay active. These conclusions are based on single trials.