Articles: back-pain.
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Opioid prescribing for noncancer pain has increased dramatically. We examined whether the prevalence of unhealthy lifestyles, psychologic distress, health care utilization, and co-prescribing of sedative-hypnotics increased with increasing duration of prescription opioid use. ⋯ Prescription of opioids was common among patients with back pain. The prevalence of psychologic distress, unhealthy lifestyles, and health care utilization increased incrementally with duration of use. Coprescribing sedative-hypnotics was common. These data may help in predicting long-term opioid use and improving the safety of opioid prescribing.
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An 80-year-old female with a history of osteoporosis was evaluated for sudden onset axial low back pain with bilateral lower extremity weakness, hyperreflexia, pain, urinary retention, and decreased rectal tone. Computed tomography of the lumbar spine revealed L1 compression fracture, retropulsion of bone causing spinal canal compromise with associated severe central canal stenosis. ⋯ Chest radiograph and computed tomographic pulmonary angiogram revealed a large collection of hyperdense material within the right lower lobe pulmonary artery, consistent with pulmonary cement emboli. Management and imaging are discussed.
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Randomized Controlled Trial Multicenter Study
Botulinum type A toxin complex for the relief of upper back myofascial pain syndrome: how do fixed-location injections compare with trigger point-focused injections?
This was a prospective, randomized, double-blind, placebo-controlled, 12-week, multicenter study to evaluate the efficacy and tolerability of fixed location injections of botulinum type A toxin (BoNT-A, Dysport) in predetermined injection sites in patients with myofascial pain syndrome of the upper back. ⋯ Fixed-location treatment with BoNT-A of patients with upper back myofascial pain syndrome did not lead to a significant improvement of the main target parameter in week 5 after treatment. Only in week 8 were significant differences found. Several secondary parameters, such as physicians' global assessment and patients' global assessment, significantly favored BoNT-A over placebo at weeks 8 and 12.
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Percutaneous endoscopic lumbar discectomy and annuloplasty (PELDA) is a minimally invasive spinal technique for lumbar disc herniation. Following discectomy, the relief of leg pain is common; however, the relief of back pain is less predictable. The purpose of this study was to evaluate changes in back pain and to examine the predisposing factors for postoperative back pain following PELDA. ⋯ PELDA can relieve back pain as well as leg pain through direct decompression and thermal ablation of the annular defect. Disc degeneration can be expected to influence clinical outcomes following PELDA.
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Vet Radiol Ultrasound · Nov 2011
Comparative StudyComparison of radiographic and scintigraphic findings of the spinous processes in the equine thoracolumbar region.
Back pain is common in horses, but there has been no large-scale in-depth study describing radiographic changes of the spinous processes, the relationship between radiographic and scintigraphic findings, and the effect of size, age, breed, or discipline. The objectives were to investigate the frequency of occurrence in horses with perceived back pain of: (1) radiographic alteration of the spinous process structure; (2) increased radiopharmaceutical uptake (IRU) in the spinous processes; and (3) to compare radiographic and scintigraphic findings; and to determine if there was breed, gender, age, bodyweight, height, or work discipline predisposition for close, impinging, or overriding spinous processes. Radiographic and scintigraphic images of the thoracolumbar spine of 604 horses were graded. ⋯ The severity of the lesions of the spinous processes was significantly associated with the presence of osteoarthritis of the articular process joints. It was concluded that there is a wide range of radiographic abnormalities of the spinous processes seen in horses with or without back pain. There is an association between radiographic and scintigraphic grades of the spinous processes.