Articles: back-pain.
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Low back pain (LBP) is a public health problem that requires accurate assessment for proper management and predicting prognosis. ⋯ Visual analogue scale and NRS appeared reliable in assessing LBP severity with no significant difference between them. Moreover, either VAS or NRS scores can predict disability of patients with LBP.
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Cauda equina syndrome (CES) may be a devastating disease with the potential for significant patient morbidity. It is essential for emergency clinicians to be aware of how to effectively diagnose and manage this condition. ⋯ Cauda equina syndrome can be a difficult diagnosis. However, knowledge of the history and examination findings, imaging, and treatment can assist the emergency clinician in optimizing management of this condition.
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This study investigated spatial distribution and asymmetry of surface electromyography on lumbar muscles during a sustained contraction in soldiers with and without chronic low back pain. Twenty healthy soldiers and twenty chronic low back pain (CLBP) soldiers had performed the Sorensen test with a duration of 60 seconds. The corresponding muscle fatigue, spatial distribution, and the asymmetry of muscle activity over bilateral paraspinal lumbar regions were measured by the high-density surface electromyography (HDsEMG). ⋯ In addition, the asymmetry of erector spinae activity in the CLBP soldiers was significantly higher than the healthy one. In conclusion, uneven spatial distribution and asymmetry of lumbar muscle activity play significant roles in CLBP patients. The HDsEMG could be used as an objective method in distinguishing the function of the erector spinae between healthy individuals and CLBP patients during 1 min sustained contraction.
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Clinical and radiological data of 204 patients were reviewed. The patients were divided into Group A (PVP alone) and Group B (PVP and FB combined therapy) according to treatments. Back pain was evaluated with Visual Analog Scale (VAS) and Oswestry Disability Index (ODI). The operation, fluoroscopic exposure time, and bone cement leakage were recorded. The χ2 test, Student's t-test, and repeated measures analysis of variance were used to compare the differences between the two groups. ⋯ PVP and FB combined therapy could provide better pain relief than PVP alone in short term after operation in patients with OVCFs associated back pains.
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Randomized Controlled Trial
Effect of supraneural transforaminal epidural steroid injection combined with caudal epidural steroid injection with catheter in chronic radicular pain management: Double blinded randomized controlled trial.
Background: Epidural steroid injection (ESI) has been used in managing chronic radicular pain. Regarding various techniques of ESI, the synergistic effect of caudal ESI (CESI) on transforaminal ESI (TFESI) in chronic lumbosacral radicular pain in prospective randomized controlled trial has not been determined. Methods: A total of 54 eligible patients with lumbosacral radicular pain were randomly allocated to undergo TFESI plus CESI (TC group) or TFESI alone (T group). The effective response to treatment was predefined by at least a 30% reduced verbal numerical rating scale (VNRS) from baseline between group comparison and the functional outcomes as measured by improved Oswestry Disability Index by least 15 points from baseline. All participants were evaluated using a single blinded outcome assessor before the procedure and at 1, 3 and 6 months after the procedure. ⋯ Conclusions: A treatment combining TFESI and CESI showed significant pain relief over TFESI alone at 3 months. No effect was found concerning functional evaluation. Registration: Thai Clinical Trials Registry ID TCTR20171101002 01/11/2017F.