Spine
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Randomized Controlled Trial Multicenter Study
SPORT lumbar intervertebral disk herniation and back pain: does treatment, location, or morphology matter?
Diskectomy candidates with at least 6 weeks of sciatica and confirmatory imaging were enrolled in a randomized or observational cohort. ⋯ Diskectomy resulted in greater improvement in back pain than nonoperative treatment, and this difference was maintained at 2 years for all herniation locations and morphologies.
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Best evidence synthesis. ⋯ The Bone and Joint Decade 2000-2010 Task Force on Neck Pain and its Associated Disorders undertook a best evidence synthesis to establish a baseline of the current best evidence on the epidemiology, assessment and classification of neck pain, as well as interventions and prognosis for this symptom. This article reports the methods used and the outcomes from the review. We found that 46% of the research literature was of acceptable scientific quality to inform clinical practice, policy-making, and future research.
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Best evidence synthesis. ⋯ Surgical treatment and limited injection procedures for cervical radicular symptoms may be reasonably considered in patients with severe impairments. Percutaneous and open surgical treatment for neck pain alone, without radicular symptoms or clear serious pathology, seems to lack scientific support.
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Best evidence synthesis. ⋯ The Neck Pain Task Force undertook a best evidence synthesis to establish a baseline of the current best evidence on the course and prognosis for WAD. Recovery of WAD seems to be multifactorial.
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Randomized Controlled Trial Comparative Study
Economic evaluation of an intensive group training protocol compared with usual care physiotherapy in patients with chronic low back pain.
Economic evaluation from a societal perspective conducted alongside a randomized controlled trial with a follow-up of 52 weeks. ⋯ The results of this economic evaluation showed no difference in total costs between the protocol group and the guideline group. The differences in effects were small and not statistically significant. At present, national implementation of the protocol is not recommended.