Articles: low-back-pain.
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Clinical Trial
Percutaneous Peripheral Nerve Stimulation (PNS) for the Treatment of Chronic Low Back Pain Provides Sustained Relief.
The objective of this study was to evaluate the use of percutaneous peripheral nerve stimulation (PNS) for the treatment of chronic low back pain (LBP). Percutaneous PNS offers the potential to provide an effective neuromodulation therapy using a system and fine-wire leads designed specifically for percutaneous use with history of an excellent safety profile. ⋯ This work demonstrates the potential value of percutaneous PNS for the treatment of chronic LBP. Improvements in pain, medication, and patient-centric outcomes, which were sustained long term after the removal of PNS leads, demonstrate the significance of this innovative approach to treat chronic LBP.
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Multicenter Study Clinical Trial
The association between sacroiliac joint-related pain following lumbar spine surgery and spinopelvic parameters: a prospective multicenter study.
To prospectively calculate the incidence of postoperative sacroiliac joint-related pain (SIJP) and investigate the association between spinopelvic parameters and postoperative SIJP after lumbar spine surgery. ⋯ The incidence of postoperative SIJP after lumbar spine surgery was 3.0%. Higher PI values were associated with a higher risk of postoperative SIJP. These slides can be retrieved under Electronic Supplementary Material.
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Randomized Controlled Trial
Short-Term Effects of Kinesio Taping® on Electromyographic Characteristics of Paraspinal Muscles, Pain, and Disability in Patients With Lumbar Disk Herniation.
Context: Kinesio taping® (KT) is a therapeutic modality frequently used in the clinical practice for the treatment of various musculoskeletal disorders. It is often applied in patients with chronic low back pain to decrease pain and improve functional capacity. However, it is not known, whether thoracolumbar fascia KT technique can decrease back pain, restore normal activity of paraspinal muscles, and improve functional capacity in patients with lumbar disk herniation (LDH). ⋯ Results: KT application did not affect the lumbar multifidus and longissimus thoracic muscles flexion-relaxation and extension-relaxation ratios, lower back pressure pain thresholds, back flexion ROM, and back extension force (no group × time interaction [GTI]). KT and placebo taping comparably decreased disability level (time effect: F1,36 = 22.817, P < .001; GTI: F1,36 = 0.189, P = .67), average pain (time effect: F1,36 =39.648, P < .001; GTI: F1,36 = 2.553, P = .12), and the worst pain (time effect: F1,36 = 36.039, P < .001; GTI: F1,36 = 0.003, P = .96) intensity. Conclusion: Seven-day KT does not normalize lumbar paraspinal muscle function and is not superior to placebo in reducing disability and pain intensity in patients with LDH.
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Meta Analysis
Genome-wide meta-analysis identifies genetic locus on chromosome 9 associated with Modic changes.
Low back pain (LBP) is a common disabling condition. Lumbar disc degeneration (LDD) may be a contributing factor for LBP. Modic change (MC), a distinct phenotype of LDD, is presented as a pathological bone marrow signal change adjacent to vertebral endplate on MRI. It is strongly associated with LBP and has heritability around 30%. Our objective was to identify genetic loci associated with MC using a genome-wide meta-analysis. ⋯ PTPRD is a novel candidate gene for MC that may act via the development of cartilage or nervous system; further work is needed to define the mechanisms underlying the pathways leading to development of MC. This is the first genome-wide meta-analysis of MC, and the results pave the way for further studies on the genetic factors underlying the various features of spine degeneration and LBP.
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Although several studies have found that chronic pain is characterized by increased cross-network connectivity between salience network, sensorimotor network, and default mode network (DMN), a large sample-size investigation allowing for a more reliable evaluation of somatotopic specificity and subgroup analyses with linkage to clinical pain intensity has been lacking. We enrolled healthy adults and a large cohort of patients (N = 181) suffering from chronic low back pain (cLBP). To specifically link brain connectivity with clinical pain intensity, patients were scanned at baseline and after performing physical maneuvers that exacerbated pain. ⋯ Hence, increased information transfer between salience processing regions, particularly anterior insula, and DMN may be strongly influenced by pain catastrophizing. Increased information transfer between the salience network and S1 likely plays an important role in shifting nociceptive afference away from self-referential processing, reallocating attentional focus, and affective coding of nociceptive afference from specific body areas. These results demonstrate S1 somatotopic specificity for cross-network connectivity in encoding clinical back pain and moderating influence of catastrophizing for DMN/insula connectivity.