Pain-drawing does not predict the outcome of fusion surgery for chronic low-back pain: a report from the Swedish Lumbar Spine Study

2003 ◽  
Vol 12 (1) ◽  
pp. 2-11 ◽  
Author(s):  
O. Hägg ◽  
P. Fritzell ◽  
R. Hedlund ◽  
H. Möller ◽  
L. Ekselius ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Lumbar Spine ◽  
Chronic Low Back Pain ◽  
Low Back ◽  
Fusion Surgery ◽  
Pain Drawing

scholarly journals Effect of the duration of chronic low back pain on pain sensitivity of patients undergoing lumbar fusion surgery

Pain medicine ◽  
2021 ◽  
Vol 5 (4) ◽  
pp. 8-15
Author(s):  
Mei-ping Qian ◽  
Mei-rong Dong ◽  
Fang Kang ◽  
Juan Li
Keyword(s):  
Chronic Pain ◽  
Low Back Pain ◽  
Back Pain ◽  
Hospital Stay ◽  
Chronic Low Back Pain ◽  
Pain Sensitivity ◽  
Lumbar Fusion ◽  
Low Back ◽  
Fusion Surgery ◽  
Lumbar Fusion Surgery

Background: chronic low back pain is a serious social problem. In recent years, patients who choose lumbar fusion surgery due to chronic low back pain has been increasing. Pre-existing chronic pain has been associated with severe postoperative pain. In this study, we have sought to prospectively analyze the association between the duration of chronic low back pain and pain sensitivity after lumbar fusion surgery. Methods: 400 patients who underwent lumbar fusion surgery were divided into three groups based on the duration of chronic pain. During the first postoperative day, the maximum pain scores of each patient day and night, the pain scores at the day of discharge, the consumption of postoperative analgesics and the length of hospital stay were recorded. Results: of 400 patients recruited, 369 patients completed the experiment. There was no significant difference in gender, age, height, weight, pre-operative pain at rest, and operation time in the three groups. During the day, the pain sensitivity of the three groups were 1.71 ± 0.66, 2.40 ± 0.74, 2.90 ± 0.80. During the night, the pain sensitivity of the three groups were 3.45 ± 0.81, 4.31 ± 1.06, 4.86 ± 1.05. At the day of discharge, the pain sensitivity of three groups were 1.26 ± 0.46, 1.47 ± 0.58, 1.96 ± 0.64. There were significant differences in pain sensitivity among the three groups during the day and night on the first postoperative day and at the day of discharge (p < 0.05). The length of hospital stay (7.31 ± 1.36 days, 8.82 ± 1.48 days, 9.60 ± 1.61 days) and analgesic consumption (25.04 ± 36.56 mg, 33.52 ± 24.04 mg, 45.15 ± 24.89 mg, morphine equivalent) were also significant differences (p < 0.05). Conclusion: we found the duration of chronic low back pain before lumbar fusion surgery affects patient’ postoperative pain sensitivity, consumption of analgesic drugs and hospital stay. The longer the preoperative chronic pain lasts, the higher the postoperative VAS score is, the more analgesic drugs were consumed, and the longer hospital stay is.

scholarly journals Symptoms and signs possibly indicating segmental, discogenic pain. A fusion study with 18 years of follow-up

2017 ◽  
Vol 16 (1) ◽  
pp. 213-220 ◽  
Author(s):  
Bo Nyström ◽  
Henrik Weber ◽  
Birgitta Schillberg ◽  
Adam Taube
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Clinical Examination ◽  
Prospective Studies ◽  
Chronic Low Back Pain ◽  
Full Time ◽  
Low Back ◽  
Discogenic Pain ◽  
Fusion Surgery ◽  
Symptoms And Signs

AbstractBackgroundOnly two out of the five existing randomized studies have reported better results from fusion surgery for chronic low back pain (CLBP) compared to conservative treatment. In these studies the back symptoms of the patients were described simply as “chronic low back pain”. One possible reason for the modest results of surgery is the lack of a description of specified symptoms that might be related to a painful segment/disc, and patient selection may therefore be more or less a matter of chance. Previous prospective studies including facet joint injections and discography and eventually MRI have failed to identify patients with a painful segment/disc that will benefit from fusion surgery.PurposeOur purpose was to analyse in detail the pre-operative symptoms and signs presented by patients who showed substantial relief from their back pain following spinal fusion surgery with the aim of possibly finding a pain pattern indicating segmental, discogenic pain.MethodsWe analysed 40 consecutive patients, mean age 41 years, with a history of disabling low back pain for a mean of 7.7 years. Before surgery the patients completed a detailed questionnaire concerning various aspects of their back pain, and findings at clinical examination were thoroughly noted. Monosegmental posterior lumbar interbody fusion without internal fixation was performed using microsurgical technique. Outcome was assessed at 1, 2 and 4 years after surgery and finally at 18 years, using selfreporting measures and assessment by an independent examiner. Assessment at 18 years applied the Balanced Inventory for Spinal Disorders Questionnaire and the Roland-Morris Disability Questionnaire.ResultsAccording to the independent observer’s assessment at two years 27 of the 40 patients were much improved. Analysis of the pre-operative depiction of the back symptoms of this group revealed a rather uniform pattern, the most important being: dominating back pain originating in the midline of the spine, with a dull, aching character and stabbing pain in the same area provoked by sudden movements. Most patients in this group also had diffuse pain radiation of various extension down one or both legs and often bladder dysfunction with frequency. At clinical examination, localized interspinal tenderness was observed within the spinal area in question and the patient’s back pain was provoked by pressure in that area and by tapping a neighbouring spinous process.At 18 years after surgery 19 patients assessed themselves as much improved. At that time 5 of them had pension due to age, 7 early pension, one worked full time and six patients part time. Eleven patients were re-operated due to defect bony healing.ConclusionsThe results may suggest that the use of a detailed symptom analysis and clinical examination may make it possible to select a subgroup of patients within the CLBP group likely to have better outcome following fusion surgery.ImplicationsThe next step would be to execute prospective studies and if our findings concerning back pain details and signs among CLPB patients can be confirmed this can provide for more accurate selection of patients suitable for fusion surgery.

scholarly journals SPECT/CT imaging of the lumbar spine in chronic low back pain: a case report

2011 ◽  
Vol 19 (1) ◽  
Author(s):  
Michael H Carstensen ◽  
Mashael Al-Harbi ◽  
Jean-Luc Urbain ◽  
Tarik-Zine Belhocine
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Case Report ◽  
Lumbar Spine ◽  
Chronic Low Back Pain ◽  
Ct Imaging ◽  
Low Back

Clinical Review of Lumbar Spine Fusion for Chronic Low Back Pain Due to Degenerative Disc Disease

2012 ◽  
Vol 12 (9) ◽  
pp. S147-S148 ◽  
Author(s):  
Frank M. Phillips ◽  
Paul J. Slosar ◽  
Jim A. Youssef ◽  
Gunnar B. Andersson ◽  
Frank J. Papatheofanis
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Lumbar Spine ◽  
Clinical Review ◽  
Chronic Low Back Pain ◽  
Degenerative Disc Disease ◽  
Spine Fusion ◽  
Low Back ◽  
Disc Disease ◽  
Lumbar Spine Fusion

scholarly journals Atraumatic Bilateral Lumbar Pedicle Fractures in a Patient with Back Pain and History of Long- Term Bisphosphonate Therapy: A Case Report

2020 ◽  
pp. 97-102
Author(s):  
Alec L. Meleger
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Case Report ◽  
Lumbar Spine ◽  
Conservative Management ◽  
Chronic Low Back Pain ◽  
Bisphosphonate Therapy ◽  
Low Back ◽  
History Of ◽  
Lumbar Pedicle

of atypical femoral fractures is a known complication of chronic bisphosphonate therapy; however, the finding of atraumatic lumbar pedicle fractures without a prior history of spinal surgery or contralateral spondylolysis is rare. While a few cases of osteoporotic pedicle fractures associated with adjacent vertebral compression fractures have been reported, only a single case of isolated atraumatic bilateral pedicle fractures has been published in a patient who had been on chronic risedronate therapy of 10-year duration. Case Report: The present case report illustrates a 63-year-old man who developed isolated atraumatic bilateral lumbar pedicle fractures after 3 years and 5 months on alendronate treatment. The patient’s past medical history had been significant for osteoporosis with a lumbar spine T-score of -2.7. At the time of initial diagnosis, a comprehensive work-up for secondary causes of osteoporosis proved to be negative; this was followed by initiation of bisphosphonate treatment with 70 mg of alendronate once per week. Ten months after starting bisphosphonate therapy, he underwent magnetic resonance imaging (MRI) of the lumbar spine for low back pain that had not responded to conservative management, with imaging not revealing any evidence of pedicle fractures or pedicle stress reaction. He was again seen in the spine clinic, for atraumatic exacerbation of his chronic low back pain with concurrent right lower extremity radiation, 6 months after stopping bisphosphonate therapy. Since the patient failed to respond to conservative management over the ensuing 6 months, a repeat MRI was obtained, which showed new acute/subacute bilateral L5 pedicle fractures. Conclusion: An isolated atraumatic lumbar pedicle fracture may be an additional type of atypical fracture associated with chronic bisphosphonate therapy in an osteoporotic patient. Key words: Chronic low back pain, bisphosphonate, alendronate, pedicle fracture Pain Medicine

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