Articles: back-pain.
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If return to work is part of the expected outcome, more and more data indicate that medical care alone does not hold the key to providing success. Our modern physical treatments may seem a humane alternative to no treatment, but they have not been proven to significantly alter the natural course of back problems. Even the results of strongly indicated surgical treatment differ little from doing nothing at all after a 4-year period. ⋯ This humane approach to care has evolved from common frustrations of dealing with patients with back problems, observations in the third world, and information gained from scientific studies. Medical pain, and physical models alone are unsuccessful. To be humane and successful, we can no longer ignore the nonphysical factors that can, and do, influence patients' responses to physical treatment, especially when return to work is part of the expected outcome.
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Orthop. Clin. North Am. · Apr 1991
ReviewMagnetic resonance imaging in the evaluation of low back pain.
Many observers believe that magnetic resonance has become the procedure of choice for lumbar spine imaging. This article includes discussions of technique, normal anatomy, degenerative disc disease, and the use of paramagnetic contrast agents. Numerous figures are provided to illustrate explanations.
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Two hundred fifty patients with low-back pain who underwent lumbar discography followed by computed tomography (CT) are the subject of this prospective study. In 93% of the patients, these combined imaging techniques provided additional useful diagnostic information that affected patient management and the selection of treatment alternatives. Lumbar discography followed by CT proved valuable in determining the significance of equivocal or multiple level abnormalities, determining the type of disc herniation, defining surgical options, and evaluating the previously operated spine. ⋯ The radiographic morphology of the normal herniated and degenerative lumbar discs shown by CT-discography gives unique insight into the pathogenesis of disc degeneration. The complications that followed the 750 discograms were one case of urticaria and one disc space infection. Even with the availability of high resolution CT and MRI, lumbar discography remains the only pain provocation challenge to the lumbar disc.
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Fortschritte der Medizin · Jun 1989
Review[Systemic pharmacotherapy in backache. Indications and practical applications].
The treatment of acute and chronic low back pain is a problem frequently encountered in the doctor's office. Selective drug therapy has a useful role to play within the framework of the overall therapeutic strategy. Indications and practical application of the major analgesic agents in various low back pain conditions are discussed.