Articles: low-back-pain.
-
Systematic review. ⋯ The available evidence does not support the efficacy or effectiveness of percutaneous thermocoagulation intradiscal techniques for the treatment of discogenic low back pain.
-
Although cost-effectiveness is becoming the foremost evaluative criterion within health service management of spine surgery, scientific knowledge about cost-patterns and cost-effectiveness is limited. The aims of this study were (1) to establish an activity-based method for costing at the patient-level, (2) to investigate the correlation between costs and effects, (3) to investigate the influence of selected patient characteristics on cost-effectiveness and, (4) to investigate the incremental cost-effectiveness ratio of (a) posterior instrumentation and (b) intervertebral anterior support in lumbar spinal fusion. We hypothesized a positive correlation between costs and effects, that determinants of effects would also determine cost-effectiveness, and that posterolateral instrumentation and anterior intervertebral support are cost-effective adjuncts in posterolateral lumbar fusion. ⋯ This study reveals useful and hitherto unknown information both about cost-patterns at the patient-level and determinants of cost-effectiveness. The overall conclusion of the present investigation is a recommendation to focus further on determinants of cost-effectiveness. For example, patient characteristics that are modifiable at a relatively low expense may have greater influence on cost-effectiveness than the surgical technique itself--at least from an administrator's perspective.
-
Randomized Controlled Trial
Total dorsal ramus block for the treatment of chronic low back pain: a preliminary study.
To evaluate the use of total dorsal ramus block, which blocks all three major branches (medial, intermediate, and lateral branches) of lumbar dorsal ramus, for chronic low back pain. ⋯ The results of this preliminary study show that the total dorsal ramus block procedure may sufficiently block all three branches of the lumbar dorsal ramus at the targeted level with significant pain reduction.
-
Comparative Study
MRI of paraspinal muscles in lumbar degenerative kyphosis patients and control patients with chronic low back pain.
To compare lumbar musculature in lumbar degenerative kyphosis (LDK) patients and chronic low-back pain (CLBP) patients. ⋯ Evaluation of paraspinal musculature should be considered when assessing MRI images of the lumbar spine. Measurement of the CSA, visual grading of fatty atrophy and the assessment of the fascia may help physician and radiologist reach a more confident diagnosis for the patients with clinically suspicious LDK.
-
Randomized Controlled Trial
Evaluation of lumbar facet joint nerve blocks in the management of chronic low back pain: preliminary report of a randomized, double-blind controlled trial: clinical trial NCT00355914.
The prevalence of persistent low back pain with the involvement of lumbar facet or zygapophysial joints has been described in controlled studies as varying from 15% to 45% based on the criteria of the International Association for the Study of Pain. Therapeutic interventions utilized in managing chronic low back pain of facet joint origin include intraarticular injections, medial branch nerve blocks, and neurolysis of medial branch nerves. ⋯ Therapeutic lumbar facet joint nerve blocks with local anesthetic, with or without Sarapin or steroids, may be effective in the treatment of chronic low back pain of facet joint origin.