Articles: low-back-pain.
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Successful management of workers on sick leave due to low back pain by the general physician and physiotherapist depends on reliable prognostic information on the course of low back pain and work resumption. ⋯ Knowledge of the predictive value of these indicators by physicians and physiotherapists will help to identify subgroups of patients and will thus enhance clinical decision-making.
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Public and professional health education campaign. ⋯ There was a major shift in public beliefs and professional advice but no change in work-related outcomes.
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Comparative Study
Prevalence of lumbar facet arthrosis and its relationship to age, sex, and race: an anatomic study of cadaveric specimens.
An anatomic, epidemiologic study of facet arthrosis in cadaveric lumbar spines. ⋯ Facet arthrosis is a universal finding in the human lumbar spine. Evidence of arthrosis begins early, with more than one half of adults younger than 30 years demonstrating arthritic changes in the facets. The most common arthritic level appears to be L4-L5. Men have a higher prevalence and degree of facet arthrosis than women.
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In the assessment and treatment of chronic low back pain (CLBP) patients, the biopsychosocial model is used worldwide. Psychological distress has been reported to have a strong relationship with disability as measured with several instruments. The relationship between psychosocial distress measured with the Symptom Checklist-90-Revised (SCL-90-R) and self-reported disability measured with the Roland Morris Disability Questionnaire (RMDQ) has not been investigated. ⋯ The relationship between psychosocial distress measured with the SCL-90-R and self-reported disability measured with the RMDQ in CLBP patients is weak.
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Older patients are often advised that their age is a contraindication to lumbar fusion surgery. There is, however, limited available data to support or contradict this assertion. Although prior studies of surgical treatment for lumbar degenerative disease suggest that older patients obtain symptomatic pain relief, an evaluation of fusion outcomes based on modern Health-Related Quality of Life (HRQOL) measures is lacking. ⋯ The results of this study support the efficacy of lumbar decompression and fusion in selected patients over 65 years of age. Occurrence of a perioperative complication did not adversely affect clinical outcome. Patients undergoing a revision procedure should be counseled with regard to the more limited benefits seen with revision surgery.