Spine
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Randomized Controlled Trial Comparative Study
Effectiveness and cost-effectiveness of three types of physiotherapy used to reduce chronic low back pain disability: a pragmatic randomized trial with economic evaluation.
Pragmatic, randomized, assessor blinded, clinical trial with economic analysis. ⋯ For chronic low back pain, all three physiotherapy regimens improved disability and other relevant health outcomes, regardless of their content. Physiotherapist-led pain management classes offer a cost-effective alternative to usual outpatient physiotherapy and are associated with less healthcare use. A more widespread adoption of physiotherapist-led pain management could result in considerable cost savings for healthcare providers.
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Randomized Controlled Trial Comparative Study
Foraminal stenosis and single-level degenerative disc disease: a randomized controlled trial comparing decompression with decompression and instrumented fusion.
A randomized controlled trial with 5-year outcome data. ⋯ The results are encouraging in that almost all patients had improved by 5 years. However, it is a concern that no significant additional benefit has been noted from the more complex surgery. This suggests that patients are optimally treated by decompression alone, with the proviso that further operations may be required.
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Comparative Study Clinical Trial
Outcome evaluation of surgical and nonsurgical management of lumbar disc protrusion causing radiculopathy.
Prospective cohort study. ⋯ HRQOL after LDPR, as measured in this study by NASS NSS, demonstrated similar improvement in both groups and was not meaningfully associated with the treatment received, within the timeframe of this study. At follow-up, all outcome measures remained lower than population normative scores, suggesting that, irrespective of treatment, an element of disability remained.
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Cross-cultural adaptation and cross-sectional psychometric testing. ⋯ The Moroccan version of the RMDQ has good comprehensibility internal consistency, reliability, and validity for the evaluation of Moroccan-speaking patients with LBP.
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Comparative Study
The response of the nucleus pulposus of the lumbar intervertebral discs to functionally loaded positions.
Asymptomatic volunteers underwent magnetic resonance imaging to investigate how different positions affect lumbar intervertebral discs. ⋯ These results support for the first time the validity of clinical assumptions about disc behavior in functional positions: sitting postures may increase risk of posterior derangement, and prone and supine may be therapeutic for symptoms caused by posterior disc displacement.