Articles: low-back-pain.
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An observational study on the course of chronic and recurrent low back pain and its relation to disability and medication use performed on the basis of daily diary recording. ⋯ Pain intensity can affect disability, but the episodic nature of low back pain also affects the ability to function in both work and personal life. Intermittent increases in pain can markedly alter disability. Chronic low back pain should not be treated as a static phenomenon.
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Internal disc disruption is a common cause of disabling low back pain in a substantial number of young, healthy adults. Crock described this painful entity and reported annular fissures that distort the internal architecture of the disc; Externally the disc appears relatively intact and undeformed. A clinical diagnosis of internal disc disruption, in absence of objective clinical findings, is extremely difficult. ⋯ Recent studies indicate the existence of a biochemical/ biomechanical model of discogenic pain, which explains the disabling low back pain in some subjects with no objective evidence of nerve-root compromise. However, a reluctance to acknowledge internal disc disruption as a valid clinical entity delays diagnosis and treatment. Failure to identify and treat this entity early and aggressively results in longterm disability, thereby perpetuating the enigma of chronic low back pain.
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Rev Chir Orthop Reparatrice Appar Mot · Apr 2000
Comparative Study[Results of lumbar and lumbosacral fusion: clinical and radiological correlations in 113 cases reviewed at 3.8 years].
Spinal fusion requires the use of hardware for reduction and stabilization. We present the clinical and radiological behavior of a population of patients with lumbar and lumbosacral spinal fusion. ⋯ Clinical results of lumbar and lumbosacral fusions are not unsatisfactory, but in our series almost one patient out of three had to be reoperated. One of the reasons for so many reoperations is certainly hardware rigidity. Hardware was not removed without testing the fusion as this is the only means of sure diagnosis of non-union. Reoperation should not be considered a failure in this difficult surgery of back pain which requires long-term surgical follow-up.