Articles: low-back-pain.
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Steroids, drugs with potent antiinflammatory properties on the damaged nervous roots, have been especially used as adjuvants of local anesthetics, by spinal route, in the treatments of low-back pain. Spinal route was chosen to obtain a higher local concentration of drug, with few systemic side effects and to improve drug's action mechanism. Steroids seem to interact with GABA receptors and thus control neural excitability through a stabilising effect on membranes, modification of nervous conduction and membrane hyperpolarization, in supraspinal and spinal site. ⋯ Steroidal toxicity seems to be related to the polyethylenic glycole vehicle. Anyway, slow release formulations contain less concentrated polyethylenic glycole. The epidural administration, a correct dilution of steroid with local anesthetics solution and/or saline solution, and a limited number of injections (no more than three) allows a significant reduction of steroid neurotoxicity.
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This was a prospective study investigating patient expectations of and satisfaction with the outcome of decompression surgery. ⋯ Examination of patients' expectations of and satisfaction with surgery revealed that patients frequently had unrealistic expectations of their surgery and as a consequence tended to have lower levels of satisfaction.
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A study on the quality of life of 82 patients with idiopathic scoliosis treated with Harrington instrumentation. ⋯ In comparison with the age-matched population, the long-term effect of surgery does not affect the physical quality of life. The psychologic health status is, however, significantly impaired. Neither the type of curve, the size of scoliosis, nor the rib cage deformity influences the data.
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Bmc Musculoskel Dis · Jun 2002
Long-term experience with implanted intrathecal drug administration systems for failed back syndrome and chronic mechanical low back pain.
Continuous intrathecal drug delivery has been shown in open studies to improve pain and quality of life in those with intractable back pain who have had spinal surgery. There is limited data on long term effects and and even less for patients with mechanical back pain without prior spinal surgery. ⋯ We conclude that spinal drug administration systems appear to be of benefit in alleviating pain in the failed back syndrome and chronic mechanical low back pain but need to be examined prospectively.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Chronic low back pain and fusion: a comparison of three surgical techniques: a prospective multicenter randomized study from the Swedish lumbar spine study group.
A multicenter randomized study with a 2-year follow-up period and an independent observer was conducted. ⋯ All the fusion techniques used in the study could reduce pain and improve function in this selected group of patients with severe chronic low back pain. There was no obvious disadvantage in using the least demanding surgical technique of posterolateral fusion without internal fixation.