The spine journal : official journal of the North American Spine Society
-
Randomized Controlled Trial Comparative Study
Orthosis versus no orthosis for the treatment of thoracolumbar burst fractures without neurologic injury: a multicenter prospective randomized equivalence trial.
Thoracolumbar burst fractures have good outcomes when treated with early ambulation and orthosis (TLSO). If equally good outcomes could be achieved with early ambulation and no brace, resource utilization would be decreased, especially in developing countries where prolonged bed rest is the default option because bracing is not available or affordable. ⋯ Treating these fractures using early ambulation without a brace avoids the cost and patient deconditioning associated with a brace and complications and costs associated with long-term bed rest if a TLSO or body cast is not available.
-
Randomized Controlled Trial
Type 1 Modic changes was a significant risk factor for 1-year outcome in sick-listed low back pain patients: a nested cohort study using magnetic resonance imaging of the lumbar spine.
It is not clear whether Modic changes (MC) is associated with low back pain (LBP) outcome. ⋯ The only degenerative manifestation negatively associated with outcome was Type 1 MC that affected 18% of the cohort at baseline and implied an increased risk for no improvement in pain and function and for U-RTW, even after adjustment for other prognostic factors.
-
Randomized Controlled Trial
Primary Spinal Tumor Mortality Score (PSTMS): a novel scoring system for predicting poor survival.
Although the surgical and oncological therapies of primary spinal tumors (PSTs) have changed significantly over the last few decades, the prognosis of this rare disease is still poor. The decision-making process in the multidisciplinary management is handicapped by the lack of large-scale population-based prognostic studies. ⋯ The present study identifies six predictive variables for mortality in PSTs. Using these six variables, an easy-to-use scoring system was developed that can be applied to the estimation of postoperative survival in all types of PST patients.
-
Randomized Controlled Trial
Lumbar motion changes in chronic low back pain patients: a secondary analysis of data from a randomized clinical trial.
Several therapies have been used in the treatment of chronic low back pain (LBP), including various exercise strategies and spinal manipulative therapy (SMT). A common belief is that spinal motion changes in particular ways in direct response to specific interventions, such as exercise or spinal manipulation. ⋯ This study provides evidence that spinal motion changes can occur in chronic LBP patients over a 12-week period and that these changes are associated with the type of treatment.
-
Randomized Controlled Trial
Spinal manipulative therapy and exercise for seniors with chronic neck pain.
Neck pain, common among the elderly population, has considerable implications on health and quality of life. Evidence supports the use of spinal manipulative therapy (SMT) and exercise to treat neck pain; however, no studies to date have evaluated the effectiveness of these therapies specifically in seniors. ⋯ SMT with HE resulted in greater pain reduction after 12 weeks of treatment compared with both supervised plus HE and HE alone. Supervised exercise sessions added little benefit to the HE-alone program.