Articles: low-back-pain.
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Inappropriate opioid use resulted in 68% of all U.S. drug overdoses in 2017-nearly 75% of all opioid deaths-costing $80 billion per year. It is imperative to understand the impact of opioid use on outcome from surgery for lower back pain disorders. ⋯ This registry finds that younger age and lower functional status scores are associated with higher opioid use before surgery. Opioid use before surgery, younger age, and >4 levels of fusion are associated with higher opioid use after surgery. Overall, opioid use is associated with worse functional outcome and may serve as a marker of disease progression.
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Retrospective cohort study. ⋯ 3.
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Journal of biomechanics · Feb 2020
A braced arm-to-thigh (BATT) lifting technique reduces lumbar spine loads in healthy and low back pain participants.
Despite the common use of one-handed lifting techniques for activities of daily living, these techniques have received little attention in the biomechanics literature. The braced arm-to-thigh technique (BATT) is a one-handed lifting method in which the dominant hand picks up objects, while the free hand braces the trunk on the ipsilateral thigh. The aim of this study was to compare the BATT to two-handed or unsupported one-handed lifting techniques with loads of 2 and 10 kg, by evaluating trunk motion and spine loading at L4/L5. ⋯ However, the BATT also increased asymmetric trunk kinematics and moments at L4/L5. The BATT produced significantly lower moments (28-38%), and compressive (25-32%) and antero-posterior shear (25-45%) forces at L4/L5, compared to unsupported lifting techniques. Bracing the hand on the thigh to support the trunk can substantially reduce low back loading during lifting tasks of 2 to 10 kg.
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For diagnostic procedures to be clinically useful, they must be reliable. The interpretation of lumbar spine MRI scans is subject to variability and there is a lack of studies where reliability of multiple degenerative pathologies are rated simultaneously. The objective of our study was to determine the inter-rater reliability of three independent raters evaluating degenerative pathologies seen with lumbar spine MRI. ⋯ Inter-rater reliability for 3 raters, evaluating 177 disc levels, was found to be overall acceptable for 6 out of 8 degenerative MRI-findings in the lumbar spine. Ratings of facet joint degeneration and disc contour achieved moderate reliability and was considered unacceptable.