Microendoscopic discectomy for recurrent lumbar disc herniation*

Microendoscopic discectomy for recurrent lumbar disc herniation*
The purpose of this study is to elucidate the feasibility of microendoscopic discectomy (MED) for the treatment of recurrent lumbar disc herniation. Thirty-six patients with recurrent lumbar disc herniation were treated using MED (30 men and six women; mean age: 45.7 years, range: 26[ndash]80 years; mean follow-up: 24.4 months, range: 12[ndash]52 months; mean duration between the primary and revision surgery: 65.9 months, range: 1[ndash]320 months) (recurrent group). Sex- and age-matched patients with primary lumbar disc herniation treated by MED served as the control group (primary group). The clinical outcomes were evaluated using the Japanese Orthopaedic Association score for low back pain and questionnaires regarding MED. The average Japanese Orthopaedic Association scores before surge…

Medical Training Related to Musculoskeletal Conditions is Inadequate

Medical Training Related to Musculoskeletal Conditions is Inadequate
From Harvard Medical School in the U.S. to medical schools in Europe, medical education related to musculoskeletal conditions is inadequate. A 2009 survey tested physician’s knowledge related to simple low back pain management. The average survey score of family practitioners was 69.7 and the average score of orthopedists was far less at 44.3. Orthopedists were less likely to make the proper radiological referral and appropriate pharmacological prescription based upon the literature. (Source: ChiroACCESS: Tools for Better Patient Care)

What You Are Eating May Be Causing Your Back Pain

What You Are Eating May Be Causing Your Back Pain
For anyone who is having low back pain and are not aware of where it is coming from, your eating habits could actually be to blame. Far too many of us eat all of the wrong things and it is not necessarily our own faults.

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Locoregional anesthesia and anticoagulation

Locoregional anesthesia and anticoagulation
Abstract: Spinal hematoma is a rare and potentially catastrophic complication of spinal or epidural anesthesia. Risk factors include traumatic needle/catheter placement, sustained anticoagulation in an indwelling neuraxial catheter, and catheter removal during therapeutic levels of anticoagulation. Generally, a patient’s coagulation status should be optimized at the time of spinal or epidural needle/catheter placement, and the level of anticoagulation should be monitored during epidural catheterization. Signs of cord compression, such as severe back pain, progression of numbness or weakness, and bowel and bladder dysfunction, warrant immediate radiographic evaluation. A delay in diagnosis and intervention of spinal hematoma may lead to irreversible cord ischemia. (Source: European Journa…

Do psychological characteristics predict response to exercise and advice for subacute low back pain?

Do psychological characteristics predict response to exercise and advice for subacute low back pain?
To determine whether psychological characteristics predict outcome and/or response to physiotherapist-directed exercise- or advice-based treatment of subacute low back pain.We conducted a secondary analysis of a factorial, placebo-controlled trial (n = 259). The psychological characteristics were catastrophizing, coping, pain self-efficacy, fear of injury/movement, depression, anxiety, and stress. We used mixed models to predict pain and function outcomes (both scored on a 0-10 scale). The models include a term for treatment group, a term for the psychological characteristic (which tested prediction of outcome), and an interaction term between the treatment group and psychological characteristic (which tested treatment effect modification). To aid the interpretation of the magnitude of the…

Acute low back pain: clinical course and prognostic factors.

Acute low back pain: clinical course and prognostic factors.
CONCLUSIONS: Acute LBP patients with disability generally recover in the first weeks. General health perception (NHP) - pain subgroup score was identified in particular as the best prognostic factor for non-recovery in the short term. Hence, pain should be given particular consideration in baseline assessments of acute LBP patients. PMID: 19736660 [PubMed - in process] (Source: Disability and Rehabilitation)

Difference in evaluation of patients with low back pain using the Japanese Orthopaedic Association Score for Back Pain and the Japanese Version of the Roland-Morris Disability Questionnaire

Difference in evaluation of patients with low back pain using the Japanese Orthopaedic Association Score for Back Pain and the Japanese Version of the Roland-Morris Disability Questionnaire
Conclusions  The clinical signs in patients with low back pain and/or lumbar diseases are not associated closely with the Japanese version of the Roland-Morris Disability Questionnaire. Therefore, a combination of the Japanese version of the Roland-Morris Disability Questionnaire and the Japanese Orthopaedic Association score can provide wide-ranging assessment of the level of impairment in patients with low back pain and/or lumbar diseases. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00776-009-1348-5Authors Masao Nakamura, Mino Municipal Hospital Department of Orthopaedic Surgery Mino, Gifu JapanKei Miyamoto, Gifu University Graduate School of Medicine Department of Reconstructive Surgery for Spine, Bone, and Joint 1-1 Yanagido Gifu 501-1194 Jap…

Core Muscles - Balance Between the Back and Abdominals

Core Muscles - Balance Between the Back and Abdominals
Lack of core muscle strength is a primary cause of low back pain, but many people don’t know how to find and strengthen their cores. Exercise usually focuses on “look good” muscles and leaves the core weak and low back unprotected. This article tells you where to find your core muscles, what they do for you, and gives you an easy exercise start to get stronger.

Chronic Pain in Your Lower Back - Core Causes and Alternative Health Treatment Benefits

Chronic Pain in Your Lower Back - Core Causes and Alternative Health Treatment Benefits
A sore lower back (lumbago) might be expected if you strained your muscles, strained a ligament, or slipped a disc. Those causes of low back pain can occur when you use your back muscles in unfamiliar activities, like lifting or doing yard work. Underlying chronic back pain is a more complicated issue. Medical doctors sometimes recommend surgery, but sadly it works in only a small percentage of the patients. All chemical painkillers and drugs will bring short term relief but also poison your body with toxic materials. People who resort to a chiropractor, naturopath, homeopath, or massage therapist who go beyond the physical expression of pain will have the best results.

ORIGINAL CONTRIBUTION: Tubular Diskectomy vs Conventional Microdiskectomy for Sciatica: A Randomized Controlled Trial

ORIGINAL CONTRIBUTION: Tubular Diskectomy vs Conventional Microdiskectomy for Sciatica: A Randomized Controlled Trial
Conclusions  Use of tubular diskectomy compared with conventional microdiskectomy did not result in a statistically significant improvement in the Roland-Morris Disability Questionnaire score. Tubular diskectomy resulted in less favorable results for patient self-reported leg pain, back pain, and recovery. Trial Registration  isrctn.org Identifier: ISRCTN51857546 (Source: JAMA)

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