Articles: back-pain.
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Klinische Wochenschrift · Jan 1990
Randomized Controlled Trial Comparative Study Clinical Trial[Reduced diclofenac administration by B vitamins: results of a randomized double-blind study with reduced daily doses of diclofenac (75 mg diclofenac versus 75 mg diclofenac plus B vitamins) in acute lumbar vertebral syndromes].
Pain syndromes of the lumbar spine are one of the main problems in orthopedic practice. The therapeutic effect of NSAIDs is not subject to doubt in this connection. But considering that the application of NSAIDs is frequently associated with side effects, a reduction of dosage would be to the patient's benefit. ⋯ There was the option to terminate therapy in the trial after 3-4 days in the case of total pain relief. 45 patients could stop the treatment due to remission of symptoms. 30 patients belonged to the combination therapy group, the other 15 took diclofenac alone; this difference is statistically significant (p less than 0.05). All parameters concerning pain relief and movement of the vertebral column showed statistically significant differences in favour of the B-vitamin-diclofenac-combination, too. The results document the positive influence of B-vitamins on painful vertebral syndromes and indicate that B-vitamins contribute to saving of NSAIDs by shortening the treatment time and reducing daily NSAID-dosage.
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Klinische Wochenschrift · Jan 1990
Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial[Results of a double-blind study of diclofenac + vitamin B1, B6, B12 versus diclofenac in patients with acute pain of the lumbar vertebrae. A multicenter study].
Several clinical trials have shown that the duration of treatment of painful vertebral syndromes can be shortened by using a combination of vitamins B1, B6, B12 and diclofenac instead of diclofenac. In addition, a more efficient pain relief could be achieved by the combination therapy. In order to confirm these results, we compared the clinical efficacy of diclofenac (25 mg) and a combination preparation with diclofenac (25 mg) plus vitamins B1 (thiamine nitrate 50 mg), B6 (pyridoxine hydrochloride 50 mg) and B12 (cyanocobalamin 0.25 mg) in a multicentric randomized double-blind study including 418 patients. ⋯ The differences in favour of the B-vitamin-diclofenac-combination were statistically significant in patients with severe pain at the beginning of therapy. Considering undesirable side-effects (symptoms in 70 out of 418 patients) there were no significant differences between the two medications. This clinical trial provides further evidence that the combination therapy with diclofenac plus B-vitamins is more effective than diclofenac alone for the treatment of painful vertebral syndromes.
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An attempt was made to determine the effect of pregnancy on the abdominal muscles and to correlate changes in abdominal muscles strength with low-back pain during pregnancy. The study included 328 women. Group A consisted of 164 pregnant women; group B consisted of 164 non-pregnant women. ⋯ Whereas all non-pregnant women could perform a sit-up, 16.6% of pregnant women could not perform a single sit-up. There was no statistically significant correlation between the sit-up performance and backache. It may be concluded that during pregnancy the abdominal muscles become insufficient.
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The author reports on 223 patients who underwent lumbar percutaneous facet rhizotomy for chronic low-back or chronic back and leg pain. The overall success rate was 69%. The procedure is very safe and can offer relief for many patients in whom organic pathology, most commonly a herniated lumbar disc, has been eliminated. The procedure, screening and results are discussed.
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Acta neurochirurgica · Jan 1990
Spinal cord stimulation in 112 patients with epi-/intradural fibrosis following operation for lumbar disc herniation.
A total of 112 patients with epi-/intradural fibrosis following operation for lumbar disc herniation were treated by spinal cord stimulation. Lumbosacral spinal fibrosis is seen particularly often after extensive and repeated operations. Radicular pain responds better to stimulation than back pain. ⋯ Among about 5,000 patients who underwent surgical treatment for lumbar disc herniation, an indication for spinal cord stimulation was found in 1.5%. By comparison, the frequency of the "last resort" procedure of microsurgical cordotomy was 0.3%. We no longer use other ablative methods like extirpation of spinal ganglia.