Articles: low-back-pain.
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This review was undertaken to outline the procedural limitations of the randomized controlled trials (RCTs) of radiofrequency (RF) neurotomy for low back pain. Second, the literature related to patient selection, diagnostic testing, and the technique of performing lumbar spine RF neurotomy will be critically reviewed and analyzed. Based on these analyses, diagnostic and procedural guidelines will be proposed. ⋯ The evidence-based procedural guidelines provide consistent criteria for multisite studies that could enroll a sufficiently large homogenous study cohort.
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Multicenter Study Comparative Study
A comparison of patient characteristics and rehabilitation treatment content of chronic low back pain (CLBP) and stroke patients across six European countries.
So far no studies have been conducted on the issue of comparability of rehabilitation treatment profiles and patient characteristics across countries. These aspects might have implications for the feasibility of treating patients abroad but also for the comparison of treatment outcome on an international level. ⋯ International treatment and outcome assessment of CLBP patients is not possible unless standardisation is considered of treatment content and patient selection. For stroke treatment international traffic and multi-centre outcome assessment might be more feasible.
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Spinal trunk list is a common occurrence in clinical practice, but few conservative methods of spinal rehabilitation have been reported. This study is a non-randomized clinical control trial of 63 consecutive retrospective subjects undergoing spinal rehabilitation and 23 prospective volunteer controls. All subjects presented with lateral thoracic-cage-translation posture (trunk list) and chronic low back pain. ⋯ For the control group, no significant radiographic and NRS differences were found, except in trunk-list displacement of T12 to S1, worsened by 2.4 mm. Mirror image (opposite posture) postural corrective exercises and a new method of trunk-list traction resulted in 50% reduction in trunk list and were associated with nearly resolved pain intensity in this patient population. The findings warrant further study in the conservative treatment of chronic low back pain and spinal disorders.
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Comparative Study
The effect of surgical weight reduction on functional status in morbidly obese patients with low back pain.
Although low back (LBP) pain is not a life-threatening disease, it is a source of significant discomfort and disability and accounts for work absences. It has been shown previously that morbid obesity is associated with increased frequency of LBP and that surgical weight loss improves the symptomatology. However, there are no studies to quantitatively assess the exact degree of functional disability caused by severe obesity and the degree of improvement of LBP that follows weight loss from bariatric surgery. ⋯ Surgical weight loss significantly improves the degree of functional disability of morbidly obese patients suffering from LBP.
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Cross-sectional analysis. ⋯ A small but significant number of injured workers do not seek care for their back pain. Medical physicians treat all but a small fraction of the workers who receive care. The decision to seek care and the choice of providers is associated with injury severity, occupation, and employer actions.