Spine
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Multicenter Study Clinical Trial
Prospective, multicenter study of spinal cord stimulation for relief of chronic back and extremity pain.
This prospective, multicenter study was designed to investigate the efficacy and outcome of spinal cord stimulation using a variety of clinical and psychosocial outcome measures. Data were collected before implantation and at regular intervals after implantation. This report focuses on 70 patients who had undergone 1 year of follow-up treatment at the time of data analysis. ⋯ This prospective, multicenter study confirms that spinal cord stimulation can be an effective therapy for management of chronic low back and extremity pain. Significant improvements in many aspects of the pain condition were measured, and complications were minimal.
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Comparative Study
The prolapsed intervertebral disc. The high-intensity zone with discography correlation.
The study compared the presence of the high-intensity zone on magnetic resonance imaging with the results of awake discography. ⋯ Although the high-intensity zone is present within the posterior anulus of some abnormal discs, it is not necessarily associated with a concordant pain response.
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A prospective study of psychological risk factors for first-time low back pain with repeated use of psychological questionnaires. ⋯ The scores from the Modified Somatic Perception Questionnaire and Zung questionnaire were reproducible over 18 months and were affected little by first episodes of back pain; yet these scores were significant predictors of it. "Abnormal" scores from these questionnaires precede back pain in a small number of people.
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A survey of occupational risks for low back trouble in two police forces discordant for one known physical stressor (wearing body armor weighing approximately 8.5 kg. ⋯ Exposure to occupational physical stress seems detrimental; It reduced survival time to first-onset of low back trouble. Recurrence was associated with time since onset, but persistent trouble was not. Sports participation was a risk if occupational hazards were high.
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This prospective study evaluated the diagnostic utility of historically accepted sacroiliac joint tests. A multidisciplinary expert panel recommended 12 of the "best" sacroiliac joint tests to be evaluated against a criterion standard of unequivocal gain relief after an intra-articular injection of local anesthetic into the sacroiliac joint. ⋯ Sacroiliac joint pain is resistant to identification by the historical and physical examination data from tests evaluated in this study.