Articles: back-pain.
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Randomized Controlled Trial Multicenter Study
A randomised sham controlled trial of vertebroplasty for painful acute osteoporotic vertebral fractures (VERTOS IV).
The standard care in patients with a painful osteoporotic vertebral compression fracture (VCF) is conservative therapy. Percutaneous vertebroplasty (PV), a minimally invasive technique, is a new treatment option. Recent randomized controlled trials (RCT) provide conflicting results: two sham-controlled studies showed no benefit of PV while an unmasked but controlled RCT (VERTOS II) found effective pain relief at acceptable costs. The objective of this study is to compare pain relief after PV with a sham intervention in selected patients with an acute osteoporotic VCF using the same strict inclusion criteria as in VERTOS II. Secondary outcome measures are back pain related disability and quality of life. ⋯ The VERTOS IV study is a methodologically sound RCT designed to assess pain relief after PV compared to a sham intervention in patients with an acute osteoporotic VCF selected on strict inclusion criteria.
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Acta Neurochir. Suppl. · Jan 2011
Randomized Controlled TrialLong term intrathecal infusion of opiates for treatment of failed back surgery syndrome.
Failed Back Surgery Syndrome (FBSS) is a multidimensional painful condition and its treatment remains a challenge for the surgeons. Prolonged intrathecal infusion of opiates for treatment of noncancer pain also remains a controversial issue. The authors present a prospective study about the long-term treatment of 30 patients with nonmalignant pain treated with intrathecal infusion of morphine from February, 1996 to May, 2004. ⋯ There was improvement of the quality of life measured by SF-36 (30.8-49.6) and in all dimensions of the Treatment of Pain Survey, except for working capacity. The follow-up period ranged from 18 to 98 months (mean = 46.7 months). It was concluded that intrathecal infusion of morphine is a useful and safe tool for long-term treatment of chronic nonmalignant pain.
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Randomized Controlled Trial
Management of pain of post lumbar surgery syndrome: one-year results of a randomized, double-blind, active controlled trial of fluoroscopic caudal epidural injections.
Post lumbar surgery syndrome represents a cluster of nomenclature and syndromes following spine surgery wherein the expectations of the patient and spine surgeon are not met, with persistent pain following lumbar surgery. Multiple causes have been speculated to cause pain after lumbar surgery. Epidural steroid injections are most commonly used in managing post surgical pain in the lumbar spine. However, there is a paucity of evidence of epidural injections in managing chronic low back pain with or without lower extremity pain in post surgery syndrome. ⋯ NCT00370799.
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Randomized Controlled Trial
A preliminary report of a randomized double-blind, active controlled trial of fluoroscopic thoracic interlaminar epidural injections in managing chronic thoracic pain.
The proportion of patients suffering from thoracic pain secondary to thoracic disorders is relatively small compared to low back and neck pain. Furthermore, thoracic interventions are not performed as often as in cervical and lumbar regions. In addition, there is a paucity of literature regarding thoracic intervertebral discs and thoracic disc herniation as causative structures of thoracic pain. ⋯ NCT01071369.
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Randomized Controlled Trial Comparative Study
Comparative effectiveness of a one-year follow-up of thoracic medial branch blocks in management of chronic thoracic pain: a randomized, double-blind active controlled trial.
Thoracic facet joints have been implicated as the source of chronic pain in the mid back or upper back in 34% to 42% of patients when the modified criteria of the International Association for the Study of Pain (IASP) is utilized. Various therapeutic techniques utilized in managing chronic thoracic pain of facet joint origin include intraarticular injections, medial branch blocks, and radiofrequency neurotomy of thoracic medial branch nerves. ⋯ NCT00355706.