Articles: low-back-pain.
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Randomized Controlled Trial
Resource Use and Cost of Subcutaneous Nerve Stimulation Versus Optimized Medical Management in Patients With Failed Back Surgery Syndrome: An Analysis of the SubQStim Study.
To undertake a detailed healthcare resource use and cost analysis of the SubQStim study, which randomized patients with failed back surgery syndrome (FBSS) with low back pain to receive subcutaneous nerve field stimulation in combination with optimized medical management (treatment) or optimized medical management alone (control). ⋯ Subcutaneous nerve field stimulation has the potential to offset the initial costs of the device by reducing analgesic medication and the number of healthcare visits in FBSS patients, alongside potential gains in health-related quality of life. There remains uncertainty in long-term costs and cost-effectiveness of stimulation and longer-term follow-up analyses are needed.
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Case-control study. ⋯ The algorithm can be used in clinical practice to distinguish acute LS from NSLBP in junior high school athletes, although referral to MRI may be necessary for definitive diagnosis considering the algorithm's sensitivity.Level of Evidence: 4.
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Peripheral nerve field stimulation (PNFS) is an effective alternative treatment for patients with chronic low back pain. The treatment of low back pain strongly depends on psychological factors like anxiety, depression, and mental stress. The aim of this study was to evaluate the impact of such factors on outcome measures after lead- and implantable pulse generator-implantation. ⋯ Chronic low back pain is often associated with psychological distress. Our study showed highly elevated levels for anxiety and depression as well as subjective mental stress in patients with chronic low back pain without negative impact on NRS, ODI, and SF12v2 in the whole follow-up after PNFS implantation.
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The objectives of this study were to evaluate the effects of an ultrasound (US)-guided percutaneous neuromodulation (PNM) intervention on the sciatic nerve, regarding pain, hip range of motion (ROM), balance, and functionality in patients with chronic low back pain (LBP); and to determine the optimal anatomical location of sciatic nerve stimulation to obtain therapeutic benefits in such patients. ⋯ The choice of an anatomical location of application of the US-guided PNM on the sciatic nerve by the physiotherapist does not influence the improvement of pain, ROM, balance, and function in patients with chronic LBP.
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Reg Anesth Pain Med · Aug 2021
Multicenter StudyProspective, randomized, multicenter study of intraosseous basivertebral nerve ablation for the treatment of chronic low back pain: 12-month results.
Vertebral endplates, innervated by the basivertebral nerve (BVN), are a source of chronic low back pain correlated with Modic changes. A randomized trial comparing BVN ablation to standard care (SC) recently reported results of an interim analysis. Here, we report the results of the full randomized trial, including the 3-month and 6-month between-arm comparisons, 12-month treatment arm results, and 6-month outcomes of BVN ablation in the former SC arm. ⋯ BVN ablation demonstrates significant improvements in pain and function over SC, with treatment results sustained through 12 months in patients with chronic low back pain of vertebrogenic origin.