European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
-
Randomized Controlled Trial
Transforaminal lumbar interbody fusion vs. posterolateral instrumented fusion: cost-utility evaluation along side an RCT with a 2-year follow-up.
Long-lasting low back pain is an increasing problem, and for some patients surgery is the final option for improvement. Several techniques for spinal fusion are available and the optimal technique remains uncertain. The objective of this study was to assess the cost-effectiveness and cost-utility of transforaminal lumbar interbody fusion (TLIF) compared to posterolateral instrumented fusion (PLF) from the societal perspective. ⋯ TLIF does not seem to be a relevant alternative to PLF from a socioeconomic, societal point of view.
-
Randomized Controlled Trial
Do analgesics improve functioning in patients with chronic low back pain? An explorative triple-blinded RCT.
TREATMENT of patients with chronic low back pain (CLBP) aims to reduce disability, improve functional capacity, and participation. Time contingent prescription of analgesics is a treatment modality in CLBP. The impact of analgesics on functional capacity is unknown. Aim of the study was to explore the effect of analgesics on functioning measured by functional capacity evaluation, and self-reported disability in patients with CLBP. ⋯ Overall treatment effects were small and non-significant. A subgroup, however, reported improved functioning as a result of treatment. Responders had lower catastrophizing scores.
-
Randomized Controlled Trial
A prospective, cluster-randomized controlled trial of exercise program to prevent low back pain in office workers.
The objective of this study was to evaluate the effects of an exercise program focusing on muscle stretching and endurance training on the 12-month incidence of low back pain (LBP) in office workers. ⋯ An exercise program consisting of muscle stretching and endurance training is an effective intervention to reduce incident LBP for office workers with lower-than-normal trunk extension flexibility or trunk muscle endurance.
-
Randomized Controlled Trial
No kidding: low back pain and type of container influence adolescents' perception of load heaviness.
The relationship between low back pain (LBP) and the lifting/carrying of loads is still a matter of great discussion. In teenagers, the weight of the school bag has been considered to play a pathogenic role in LBP but the relationship between the actual weight of the school bag and LBP symptoms does not seem to be a straightforward one. Numerous factors have been identified that influence the perception of weight. This study aimed to evaluate the influence of low back pain and the type of container on the perception of load heaviness by healthy teenagers. ⋯ Our results suggest that several subjective variables significantly influence the perception of load heaviness. Until we have a better understanding of the mechanical role of the backpack weight versus the perception of its weight in the aetiology of LBP, any recommendations about the schoolbag weight limit should be viewed with caution.
-
Randomized Controlled Trial Comparative Study
A comparison of spinal anesthesia characteristics following intrathecal bupivacaine or levobupivacaine in lumbar disc surgery.
While bupivacaine is the most frequently used local anesthetic for spinal anesthesia, use of levobupivacaine in clinical practice has advanced recently. The aim of our study was to compare the clinical and anesthetic effects of isobaric bupivacaine and isobaric levobupivacaine when administered intrathecally in patients undergoing lumbar disc surgery. ⋯ Our results showed that block recovery time was shorter in the levobupivacaine group, this may be a disadvantage for longer operative procedures. But with proper patient selection this can be eliminated. Recovery time was shorter in levobupivacaine group. Therefore, postoperative neurological examination can be done earlier. In addition, early mobilization can be an advantage for postoperative recovery.