Articles: low-back-pain.
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Comparative Study
Paired cylindrical interbody cage fit and facetectomy in posterior lumbar interbody fusion in an Asian population.
The intervertebral disc heights and interfacetal distances of normal lower lumbar segments were measured from MRI scans of 150 male subjects. ⋯ Paired cylindrical cage installation in the majority of patients is likely to require near-total or total facetectomy, with implications for potential segmental instability. Among the three lumbar segments studied, L5/S1 had the highest proportion of segments that could accommodate paired cages and at the same time restore intervertebral height.
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While psychosocial factors are known to influence treatment outcomes in low back pain patients, relatively little is known about how they may influence work injury management of low back pain. This study examined medical and psychosocial factors associated with work injury management decisions relative to patients with occupational low back pain. A retrospective review of 132 patients who had settled their injury claims showed that two psychosocial factors, ethnicity and litigation status, were associated with work injury management. ⋯ Having evidence of a specific lesion and legal representation were also associated with claimants' final disability ratings. Results are discussed in terms of a model of social judgment in which properties of the judge, target, and context influence judgments. Implications for work injury management and disability determination, as well as future research are discussed.
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The aim of the present study was to develop a reliable assessment of pain behaviour performed during the execution of a range of functional assessment measures. For the initial reliability study 18 subjects (consecutive referrals) were assessed. Subjects were observed and videotaped during a variety of physical tasks and demonstrations of pain behaviour were recorded; the videotapes were scored by two independent observers on two occasions. ⋯ The total scores for pain behaviour correlate with tasks that involve the back; tests involving upper limbs were not affected. This test is suitable for the assessment of those with pain problems specifically involving the back. Furthermore, in the group studied pain and pain behaviour were the two most important determinants of self-reported disability.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Radiography of the lumbar spine in primary care patients with low back pain: randomised controlled trial.
To test the hypothesis that radiography of the lumbar spine in patients with low back pain is not associated with improved clinical outcomes or satisfaction with care. ⋯ Radiography of the lumbar spine in primary care patients with low back pain of at least six weeks' duration is not associated with improved patient functioning, severity of pain, or overall health status but is associated with an increase in doctor workload. Guidelines on the management of low back pain in primary care should be consistent about not recommending radiography of the lumbar spine in patients with low back pain in the absence of indicators for serious spinal disease, even if it has persisted for at least six weeks. Patients receiving radiography are more satisfied with the care they received. The challenge for primary care is to increase satisfaction without recourse to radiography.