Articles: low-back-pain.
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This study was a retrospective-cohort design involving a review of patient medical and cost records and a 2-year postsurgery follow-up outcome survey. ⋯ 3.
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Low back pain (LBP) in older adults is poorly understood because the vast majority of the LBP research has focused on the working aged population. The aim of this study was to compare older adults consulting with chronic LBP to middle aged and young adults consulting with chronic LBP, in terms of their baseline characteristics, and pain and disability outcomes over 1 year. ⋯ Small baseline differences exist in older people with chronic low back pain compared to middle aged and younger adults referred to secondary care for chronic low back pain. Older adults present with slightly less intense low back pain but slightly more intense leg pain. Changes in pain intensity and disability over a 12 month period were similar across all age groups.
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Case Reports
Lumbar Epidural Blood Patch via a Caudal Catheter After Surgical Dural Tear and Failed Repair: A Case Report.
We report a patient who developed a positional headache and pseudomeningocele after multiple lumbar surgeries for low back and radicular pain. An epidural blood patch via a lumbar approach was not feasible as a result of distorted lumbar anatomy after multiple back surgeries. ⋯ The patient had immediate relief after the procedure and at 1 year was still symptom-free. This combination technique may be considered as an alternative approach when a percutaneous lumbar epidural blood patch is disadvantageous.
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Multicenter Study
Back Stiffness Is Associated with Physical Health and Low Back Pain-Related Disability in Community-Dwelling Older Adults.
Back stiffness is a common complaint among older adults with low back pain. Nonetheless, self-reported back stiffness has received little exploration in this patient population. The purpose of this study was to examine the associations of self-reported low back stiffness with physical health and low back pain-related disability among older adults with low back pain. ⋯ Back stiffness in older, community-dwelling adults with low back pain may help explain physical health and low back pain-related disability, above and beyond demographics and pain. Future longitudinal research is needed to evaluate low back stiffness as a predictor of physical health and disability. Ultimately, assessment and treatment of back stiffness in older adults with low back pain may improve patient outcomes.
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Due to uncertain evidence, lumbar fusion for degenerative indications is associated with the greatest measured practice variation of any surgical procedure. ⋯ Positive clinical change was greatest in patients undergoing fusion for spondylolisthesis while complications and the risk of reoperation limited the benefit of fusion for spinal stenosis. The relative safety and efficacy of fusion for chronic low back pain suggests careful patient selection is required (PROSPERO International Prospective Register of Systematic Reviews number, CRD42015020153).