Articles: low-back-pain.
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The purpose of this study was to undertake a critical review of the potential role of magnetic resonance imaging (MRI) in the evaluation of low back pain (LBP) and to determine if there were differences in the MRI appearances between various occupational groups. The study group, 149 working men (78 aged 20-30 years and 71 aged 31-58 years) from five different occupations (car production workers, ambulance men, office staff, hospital porters and brewery draymen), underwent MRI of the lumbar spine. Thirty-four percent of the subjects had never experienced LBP. ⋯ During the 12-month follow-up period, 13 subjects experienced LBP for the first time. However, there was no change in the MRI appearances of their lumbar spines that could account for the onset of LBP. Although MRI is an excellent technique for evaluating the lumbar spine, this study shows that it does not provide a suitable pre-employment screening technique capable of identifying those at risk of LBP.
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Thirty-three patients with low back pain underwent spinal fusion following a positively predicting external fixation test. Thirty-two spinal fusions and one sacroiliac joint fusion were performed. ⋯ Multiple variables affect the results of spinal fusion. We feel that the external fixator test in low back pain management is very invasive, and its use cannot be justified.
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Regional anesthesia · Jan 1997
Clinical TrialExtended epidural catheter infusions with analgesics for patients with noncancer pain at their homes.
Patients with severe, noncancer pain unresponsive to epidural steroid injections are frequently referred for implantation of a permanent intraspinal device or for surgery. An alternative approach has been evaluated, which involves extended epidural catheter infusions of analgesics. ⋯ Temporary lumbar epidural catheter infusions represent an option between lumbar epidural steroid injections and more invasive and expensive modalities. The technique is effective in relieving chronic low back pain for extended periods, reducing its long-term intensity, and in some cases abolishing it.
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An analysis of clinical data gathered at an orthopedic outpatient clinic is presented. ⋯ Correlations between the Waddell score and the first three scales of the Minnesota Multiphasic Personality Inventory were not fully replicated. The difference between the high Waddell and low Waddell groups on scale 8, however, was significant for men and women.
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Rev Chir Orthop Reparatrice Appar Mot · Jan 1997
[Long-term outcome at adjacent levels of lumbar arthrodesis].
Posterolateral lumbar fusion is commonly recognized to have a significant effect upon the more proximal unfused segments. Wether these effects are clinically significant remains unclear. Long term studies with standardized follow-up are scarce. ⋯ Degenerative changes were significantly more frequent in group III's patients. However, no significant correlation was found between the roentgenographic findings and the final functional results and only 8 patients required a new surgery. These results may suggest that posterolateral fusion accelerates the development of degenerative changes in adjacent discs if the fusion is performed on a degenerative spine.