Back Pain Research Papers - Academia.edu (original) (raw)

The knowledge of the onset and cessation timing of the paraspinal muscles that surround the lumbar spine is an important area of research for the understanding of low back pain. This study examined the timing of the erector spinae and... more

The knowledge of the onset and cessation timing of the paraspinal muscles that surround the lumbar spine is an important area of research for the understanding of low back pain. This study examined the timing of the erector spinae and external oblique muscle activity in a group of golfers with and without low back pain. The study compared the results of surface electromyography measurements for two groups of golfers. Twelve male golfers who had reported a mild or greater level of pain in the lower back that was experienced while playing golf were examined. A further fifteen male golfers who had reported no history of lower back pain in the previous 12 months were recruited as controls. The results showed that the low back pain golfers switched-on their erector spinae muscle significantly in advance of the start of the backswing. This finding was not evident in the group who did not have low back pain symptoms. Low back pain golfers therefore, may use the erector spinae muscle as a primary spinal stabiliser instead of the stronger deeper muscles such as transversus abdominis and multifidus. These results may have important implications for conditioning programmes for golfers with low back pain.

WALSH K, VARNES N, OSMOND C, STYLES R, COGGON D. Occupational causes of low-back pain. Scand J Work Environ Health 1989;15:54-59. Associations between occupational activities and low-back pain (LBP) were examined in a retrospective postal... more

WALSH K, VARNES N, OSMOND C, STYLES R, COGGON D. Occupational causes of low-back pain. Scand J Work Environ Health 1989;15:54-59. Associations between occupational activities and low-back pain (LBP) were examined in a retrospective postal survey of 545 randomly ...

PRIMARY AORTOENTERIC FISTULA. REPORT OF A CASE Primary aortoenteric fistulas (PAEF) are rare entities asso - ciated with a high mortality. Although several causes have been reported, their occurrence is usually due to erosion of an... more

PRIMARY AORTOENTERIC FISTULA. REPORT OF A CASE Primary aortoenteric fistulas (PAEF) are rare entities asso - ciated with a high mortality. Although several causes have been reported, their occurrence is usually due to erosion of an abdominal aortic aneurysm into the intestinal tract. The most common sites for the fistula are the third and fourth portions of duodenum. The classical triad of gastrointesti - nal hemorrhage, abdominal mass and abdominal or back pain, though highly suggestive for PAEF, is uncommon. The typical bleeding pattern associated with PAEF is characte - ristically intermittent, starting with a brief "herald blee - ding" followed eventually by major gastrointestinal hemor- rhage, often with fatal outcome. The pre-operative exami - nations are often not helpful and can lead to delayed dia - gnosis and surgery. In a patient with risk factors for athe - rosclerosis and significant upper gastrointestinal bleeding in the absence of an evident source, PAEF sho...

ABSTRACT: Study Design. Propensity-matched case control study.Objective. To evaluate the two year clinical outcomes of patients that have undergone instrumented spinal fusions complicated by deep wound infections and compare them to a... more

ABSTRACT: Study Design. Propensity-matched case control study.Objective. To evaluate the two year clinical outcomes of patients that have undergone instrumented spinal fusions complicated by deep wound infections and compare them to a propensity-matched control group who did not have infectionsSummary of Background Data. Postoperative infection following instrumented spinal fusion is a major complication, often resulting in substantial short term morbidity. However, there is little literature reviewing how these patients do in the longer term, after their infection has been managed.Methods. Thirty patients who underwent instrumented lumbar spinal fusion with complete pre-operative and two-year postoperative outcome measures and had acute (≤3 months) postoperative deep wound infections necessitating irrigation and debridement were identified. Outcome measures included the Oswestry Disability Index (ODI), SF-36 Physical (PCS) and Mental (MCS) composite summaries and Numeric rating sca...

—Mobility impaired people constitute a significant portion of the adult population, which often experience back pain at some point during their lifetime. Such pain is usually characterized by severe implications reflected on both their... more

—Mobility impaired people constitute a significant
portion of the adult population, which often experience back pain
at some point during their lifetime. Such pain is usually
characterized by severe implications reflected on both their
personal lives, as well as on a country’s health and economic
systems. The traditional 2-dimensional (2D) representations of the
human body often used can be limited in their ability to efficiently
visualize such pain for diagnosis purposes. Yet, patients have been
shown to prefer such drawings. However, considering that pain is
a feeling or emotion that is subjective in nature, the pain
drawings could be consequently regarded as a subjective means of
communicating such pain. As a result, the work described in this
paper proposes an alternative, which encompasses a 3-
dimensional (3D) pain visualization solution, developed in a
previous work of ours. This alternative is complemented with the
upcoming technique of pressure mapping for more objectivity in
the pain data collection. The results of this study have shown that
the proposed approach is a promising solution for the purpose
intended, and it could generally prove to be a significant
complementary method in the area of medical practice for the
mobility impaired community.

Pyogenic spondylodiscitis associated with epidural abscess is a rare but serious problem in spinal surgery, because it may cause a severe morbidity or mortality, if the diagnosis is established late and the treatment is inadequate. A case... more

Pyogenic spondylodiscitis associated with epidural abscess is a rare but serious problem in spinal surgery, because it may cause a severe morbidity or mortality, if the diagnosis is established late and the treatment is inadequate. A case of pyogenic thoracic spondylodiscitis associated with epidural abscess whose symptoms progressed over two months from back pain to acute paraplegia was presented. Magnetic resonance imaging of the spine suggested the presence of T9–10 spondylodiscitis with partial destruction of the T9 and T10 vertebral bodies and concomitant epidural abscess. Treatment consisting of surgical debridement of infected vertebrae and disc material, fusion and anterior spinal instrumentation was performed. Microbiological culture of the material revealed infection with Staphylococcus aureus and after 3 months of antibiotic treatment, recovery was almost complete. Based on a thorough review of the literature and the case presented in this report, it is concluded that accurate and prompt diagnosis requires high index of suspicion followed by a combination of adequate surgical and conservative treatment prevents severe morbidity in cases of nonspecific pyogenic spondylodiscitis associated with epidural abscess.

Low back pain and sciatica is a common clinical condition. It is a most common orthopaedic complaint in the Kaski region of Nepal. The reason for its increased incidence may be hilly terrain, difficult working and living environment of... more

Low back pain and sciatica is a common clinical condition. It is a most common orthopaedic complaint in the Kaski region of Nepal. The reason for its increased incidence may be hilly terrain, difficult working and living environment of the region. The initial treatment of Low back pain is conservative. Epidural steroid injection is being slowly established as are liable mode of conservative management in many orthopaedic centres of the world. This is a preliminary report of on-going study of the use of epidural steroid in the management of low back pain cases coming to the orthopaedic department of Manipal Teaching Hospital. Prospective clinical trial was carried out on the patients reporting with low back pain and sciatica not responding to other modes of conservative treatment. Pre and post injection evaluation was done clinically. The level of pain, improvement in physical signs and ability to do activities of daily living were noted. Fifty two patients were observed for the aver...

Introduction: Chronic back pain is the leading cause of disability in the United States. Based on the hypothesis that nonspecific back pain may be rooted in a psychophysiologic etiology, we propose a new approach to chronic back pain.... more

Introduction: Chronic back pain is the leading cause of disability in the United States. Based on the hypothesis that nonspecific back pain may be rooted in a psychophysiologic etiology, we propose a new approach to chronic back pain. Objectives: A pilot study was conducted to assess whether psychophysiologic symptom relief therapy (PSRT) can reduce disability and back pain bothersomeness for patients with chronic back pain. Methods: This was a three-armed, randomized trial for adults with nonspecific chronic back pain that compared PSRT with usual care and an active comparator (mindfulness-based stress reduction [MBSR]). Psychophysiologic symptom relief therapyrandomized participants received a 12-week (36 hours) course based on the psychophysiological model of pain. All groups were administered validated questionnaires at baseline and at 4, 8, 13, and 26 weeks. The primary outcome was the reduction in pain disability measured by the Roland-Morris Disability Questionnaire. Results: The mean Roland-Morris Disability Questionnaire score for the PSRT group (n 5 11) decreased from 9.5 (64.3 SDs) to 3.3 (65.1) after 26 weeks which was statistically significant compared with both MBSR (n 5 12) (P 5 0.04) and usual care (n 5 12) (P 5 0.03). Pain bothersomeness scores and pain-related anxiety decreased significantly over 26 weeks in PSRT compared with MBSR and usual care (data in manuscript). At 26 weeks, 63.6% of the PSRT arm reported being pain free (0/10 pain) compared with 25.0% and 16.7% in MBSR and usual care arms, respectively. Psychophysiologic symptom relief therapy attendance was 76%, and there was 100% follow-up of all groups. Conclusion: Psychophysiologic symptom relief therapy is a feasible and potentially highly beneficial treatment for patients with nonspecific back pain.

Back problems (BPs), with their cost and disability, are a substantial burden for individuals, employers, and society. This systematic review of controlled trials evaluates the effectiveness of interventions to prevent BP episodes in... more

Back problems (BPs), with their cost and disability, are a substantial burden for individuals, employers, and society. This systematic review of controlled trials evaluates the effectiveness of interventions to prevent BP episodes in working age adults. We searched MEDLINE/EMBASE through May 2007, and COCHRANE/Trials Registry through August 22, 2008 using search terms of back pain, back injuries or sciatica, linked to prevention, control, workplace interventions, or ergonomics and searched article bibliographies. For systematic review inclusion, articles had to describe prospective controlled trials of interventions to prevent BPs in working-age adults, with intervention assignment either to individual participants or preexisting groups. Of 185 articles identified as potentially relevant, 20 trials (11%) met inclusion criteria. Researchers extracted relevant information from controlled trials and graded methodological quality. Because of heterogeneity of trials, meta-analysis was no...

BACKGROUND The evidence-based practice guidelines for the management of chronic spinal pain with interventional techniques were developed to provide recommendations to clinicians in the United States. OBJECTIVE To develop evidence-based... more

BACKGROUND The evidence-based practice guidelines for the management of chronic spinal pain with interventional techniques were developed to provide recommendations to clinicians in the United States. OBJECTIVE To develop evidence-based clinical practice guidelines for interventional techniques in the diagnosis and treatment of chronic spinal pain, utilizing all types of evidence and to apply an evidence-based approach, with broad representation by specialists from academic and clinical practices. DESIGN Study design consisted of formulation of essentials of guidelines and a series of potential evidence linkages representing conclusions and statements about relationships between clinical interventions and outcomes. METHODS The elements of the guideline preparation process included literature searches, literature synthesis, systematic review, consensus evaluation, open forum presentation, and blinded peer review. Methodologic quality evaluation criteria utilized included the Agency f...

To assess whether percutaneous vertebroplasty results in more pain relief than a sham procedure in patients with acute osteoporotic compression fractures of the vertebral body. Randomised, double blind, sham controlled clinical trial.... more

To assess whether percutaneous vertebroplasty results in more pain relief than a sham procedure in patients with acute osteoporotic compression fractures of the vertebral body. Randomised, double blind, sham controlled clinical trial. Four community hospitals in the Netherlands, 2011-15. 180 participants requiring treatment for acute osteoporotic vertebral compression fractures were randomised to either vertebroplasty (n=91) or a sham procedure (n=89). Participants received local subcutaneous lidocaine (lignocaine) and bupivacaine at each pedicle. The vertebroplasty group also received cementation, which was simulated in the sham procedure group. Main outcome measure was mean reduction in visual analogue scale (VAS) scores at one day, one week, and one, three, six, and 12 months. Clinically significant pain relief was defined as a decrease of 1.5 points in VAS scores from baseline. Secondary outcome measures were the differences between groups for changes in the quality of life for ...

We report a case of L4–L5 traumatic anterolisthesis. The patient was treated surgically 4 months after the injury. His radiological and operative findings showed L4 inferior facet tip fracture, L4–L5 anterior displacement and left L4–L5... more

We report a case of L4–L5 traumatic anterolisthesis. The patient was treated surgically 4 months after the injury. His radiological and operative findings showed L4 inferior facet tip fracture, L4–L5 anterior displacement and left L4–L5 foraminal disc protrusion. Decompression, reduction with L3, L4, L5 pedicular screw fixation, L4–L5 disc excision and interbody cage insertion with autologous bone grafts were done. Flexion type injury was thought to be the probable mechanism.