Spine
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Randomized Controlled Trial Multicenter Study Clinical Trial
Efficacy of traction for nonspecific low back pain. 12-week and 6-month results of a randomized clinical trial.
A randomized clinical trial. ⋯ Most common flaws of earlier studies on traction therapy could be overcome. This trial did not support the claim that traction is efficacious for patients with low back pain.
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Multicenter Study
Predictors of outcome in patients with chronic back pain and low-grade spondylolisthesis.
Retrospective case series. ⋯ This investigation, although limited by a number of factors including small sample size and retrospective, unblinded review, suggests that active worker's compensation and litigation issues are associated strongly with poor results of operative management for chronic low back pain in adult patients with low-grade spondylolisthesis.
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Multicenter Study Comparative Study
Lumbar laminectomy alone or with instrumented or noninstrumented arthrodesis in degenerative lumbar spinal stenosis. Patient selection, costs, and surgical outcomes.
A prospective, multicenter observational study. ⋯ Findings were limited by the small number of participating surgeons, modest sample size that produced P values of borderline significance, and nonrandomized design. With these caveats in mind, the authors conclude: (1) The individual surgeon was a more important correlate of the decision to perform arthrodesis than clinical variables such as spondylolisthesis. (2) Noninstrumented arthrodesis resulted in superior relief of back pain after 6 and 24 months. (3) Instrumented arthrodesis was the most costly option. These results highlight the need for randomized controlled trials and cost effectiveness analyses of lumbar arthrodesis and instrumentation in patients with degenerative lumbar spinal stenosis.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Local and remote sustained trigger point therapy for exacerbations of chronic low back pain. A randomized, double-blind, controlled, multicenter trial.
A randomized, double-blind, controlled, multicenter trial was conducted. ⋯ Neuroreflexotherapy intervention seems to be a simple and effective treatment for rapid amelioration of pain episodes in patients with chronic low back pain. At this time, the duration of pain relief beyond 45 days has not been evaluated.
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Multicenter Study Clinical Trial
Threaded titanium cages for lumbar interbody fusions.
This study evaluated safety, fusion success rate, and clinical outcome of a new lumbar interbody hollow, threaded titanium fusion cage in a multicenter, prospective 236-case program adhering to a United States Food and Drug Administration Investigational Device Exemption controlled protocol. ⋯ The Ray titanium fusion cage (Surgical Dynamics, Norwalk, CT) implant method has been found to be an effective, rapid, safe procedure for lumbar spine fusions, demonstrating a high fusion rate and clinical success with rare, serious, or permanent complications.