Articles: back-pain.
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Case Reports
SynchroMed II intrathecal pump memory errors due to repeated magnetic resonance imaging.
Cancer patients with severe refractory pain are often managed with implantable drug delivery systems (IDDS). The only drugs with US Food and Drug Administration approval for intrathecal use are morphine, ziconotide, and baclofen. Other drugs used and mixed include, hydromorphone, bupivacaine, sufentanil, and fentanyl. ⋯ The second time, 29 months later, the patient was admitted to the hospital to manage withdrawal symptoms and the pump had to be exchanged with a new device. Post-MRI pump interrogation should be performed on all patients with IDDS to ensure proper functioning of the pump. Special attention should be paid to patients receiving baclofen, as acute withdrawal can be very serious, even deadly.
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There are few studies that have looked at the occurrence of co-morbid conditions amongst patients with back problems. This study assesses the association between of a range of co-morbidities and the labour force participation rates of 45- to 64-year-old Australians with back problems. Logistic regression models were applied to the 2003 Survey of Disability, Ageing and Carers (SDAC) data to look at the relationship between chronic back problems, labour force participation and comorbidities. ⋯ For example, an individual with back problems and heart disease is more than 10 times more likely to be out of the labour force than those with back problems alone (OR=10.90, 95% CI=2.91-40.79, P=.0004). Amongst conditions that have a significant impact on labour force participation rates, back problems and multiple co-morbidities are significantly more likely to cause persons with these conditions to be out of the labour force than those with back problems alone or those with no chronic health condition. It is important to consider which co-morbidities an individual has when assessing the impact of back problems on labour force participation, as co-morbid conditions vary in their association with labour force participation.
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J Spinal Disord Tech · Oct 2012
Cost effectiveness analysis of graft options in spinal fusion surgery using a Markov model.
Statistical decision model. ⋯ RhBMP is the most cost-effective graft option for L4-L5 fusion for degenerative spondylolisthesis largely due to the reduced rate of revision spine surgery. The increased upfront cost and list of complications associated with RhBMP is offset by the reduced rate of revision surgery.