Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · Jun 2015
ReviewOutcomes of Lumbar Discectomy in Elite Athletes: The Need for High-level Evidence.
Although lumbar discectomy for treatment of lumbar disc herniation in the general population generally improves patients' pain, function, and validated outcomes scores, results of treatment in elite athletes may differ because of the unique performance demands required of competitive athletes. ⋯ A high proportion of elite athletes undergoing lumbar discectomy return to play with variable performance scores on return. Future prospective studies are needed to compare the recovery time, career longevity, and performance for athletes undergoing lumbar discectomy versus nonoperative treatment for lumbar disc herniation.
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Clin. Orthop. Relat. Res. · Jun 2015
ReviewIncidence of Low Back Pain After Lumbar Discectomy for Herniated Disc and Its Effect on Patient-reported Outcomes.
Long-term postdiscectomy degenerative disc disease and low back pain is a well-recognized disorder; however, its patient-centered characterization and quantification are lacking. ⋯ In a systematic literature review and prospective outcomes study, the frequency of same-level disc herniation requiring reoperation was 6%. Two-year recurrent low back pain may occur in 15% to 25% of patients depending on the level of recurrent pain considered clinically important, and this leads to worse PROs at 1 and 2 years postoperatively.
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Clin. Orthop. Relat. Res. · Jun 2015
ReviewDo Epidural Injections Provide Short- and Long-term Relief for Lumbar Disc Herniation? A Systematic Review.
As part of a comprehensive nonsurgical approach, epidural injections often are used in the management of lumbar disc herniation. Recent guidelines and systematic reviews have reached different conclusions about the efficacy of epidural injections in managing lumbar disc herniation. ⋯ The available evidence suggests that epidural injections performed under fluoroscopy by trained physicians offer improvement in pain and function in well-selected patients with lumbar disc herniation.
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Clin. Orthop. Relat. Res. · Jun 2015
Randomized Controlled Trial Multicenter Study Comparative Study Observational StudyWhat Are Long-term Predictors of Outcomes for Lumbar Disc Herniation? A Randomized and Observational Study.
Although previous studies have illustrated improvements in surgical cohorts for patients with intervertebral disc herniation, there are limited data on predictors of long-term outcomes comparing surgical and nonsurgical outcomes. ⋯ Level II, therapeutic study. See Instructions for Authors for a complete description of levels of evidence.
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Clin. Orthop. Relat. Res. · Jun 2015
Comparative Study Observational StudyNonoperative treatment for lumbosacral radiculopathy: what factors predict treatment failure?
Prior studies of nonoperative treatment for lumbosacral radiculopathy have identified potential predictors of treatment failure, defined by persistent pain, persistent disability, lack of recovery, or subsequent surgery. However, few predictors have been replicated, with the exception of higher leg pain intensity, as a predictor of subsequent surgery. ⋯ Level II, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.