A Practice-Based Study of Patients with Acute and Chronic Low Back Pain Attending Primary Care and Chiropractic Physicians: Two-Week to 48-Month Follow-Up

AbstractSince pseudoarthrosis or screw loosening is frequently seen in lumbosacral stabilizations ending in S1, S2 screws are used more frequently to support S1 screws. This study aims to describe a new screw placement technique and location from S2. Revision surgery was applied to the patient who had previously undergone surgery with the rigid instrumentation system and encountered pseudoarthrosis during the follow-up period. Instrumentation was performed from S2 to the promontorium. The patient’s chronic low back pain arising due to pseudoarthrosis was reduced and a strong lumbosacral dynamic instrumentation was performed to the patient. Dual screw placement from S2 and/or screw placement in the S2-promontorium direction is a new alternative to provide a powerful instrumentation.

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External Validation of a Referral Rule for Axial Spondyloarthritis in Primary Care Patients with Chronic Low Back Pain

PLoS ONE ◽

10.1371/journal.pone.0131963 ◽

2015 ◽

Vol 10 (7) ◽

pp. e0131963 ◽

Cited By ~ 14

Author(s):

Lonneke van Hoeven ◽

Yvonne Vergouwe ◽

P. D. M. de Buck ◽

Jolanda J. Luime ◽

Johanna M. W. Hazes ◽

...

Keyword(s):

Primary Care ◽

Low Back Pain ◽

Back Pain ◽

Chronic Low Back Pain ◽

Axial Spondyloarthritis ◽

External Validation ◽

Low Back ◽

Primary Care Patients

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A Prospective Randomized Controlled Study of Auricular Point Acupressure to Manage Chronic Low Back Pain in Older Adults: Study Protocol

10.21203/rs.2.15609/v2 ◽

2019 ◽

Author(s):

Chao Hsing Yeh ◽

Cuicui Li ◽

Ronald Glick ◽

Elizabeth A. Schlenk ◽

Kathryn Albers ◽

...

Keyword(s):

Older Adults ◽

Low Back Pain ◽

Back Pain ◽

Chronic Low Back Pain ◽

Comparison Group ◽

Controlled Study ◽

Low Back ◽

Randomized Controlled ◽

Auricular Point

Abstract Background: Chronic low back pain (cLBP) is a major health problem and the most common pain condition among those 60 years of age or older in the US. Despite the development of pharmacological and nonpharmacological interventions, cLBP outcomes have not improved and disability rates continue to rise. This study aims to test auricular point acupressure (APA) as a non-invasive, nonpharmacological self-management strategy to manage cLBP and to address current shortcomings of cLBP treatment. Methods: For this prospective randomized controlled study, participants will be randomly assigned into three groups: (1) APA (active points related to cLBP), (2) Comparison Group -1 (non-active points, unrelated to cLBP), (3) Comparison Group-2 (enhanced educational control, an educational booklet on cLBP will be given and the treatment used by participants for their cLBP will be recorded). The ecological momentary assessment smartphone app will be used to collect real-time cLBP outcomes and adherence to APA practice. Treatment and nonspecific psychological placebo effects will be measured via questionnaires for all participants. This proposed trial will evaluate the APA sustained effects for cLBP at 12-month follow-up. Monthly phone follow-up will be used to collect study outcomes. Blood will be collected during study visits at baseline, post-APA treatment, and follow-up study visits at 1-, 3-, 6-, 9- and 12-months post-completion of treatment for a total of 7 assessments. Appointments will start between 9 and 11 am to control for circadian variation in cytokine levels. Discussion: This study is expected to provide vital information on the efficacy, sustainability, and underlying mechanism of APA on cLBP necessary for APA to gain acceptance from both healthcare providers and patients, which would provide a strong impetus for including APA as part of cLBP management in clinical and home settings. Trial registration: NCT03589703, Registered on May 22, 2018 Keywords: Chronic low back pain, auricular point acupressure, older adults, cytokines

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Targeted Hyaluronidase Injection during Epiduroscopy for Chronic Low Back Pain : Follow-up of Six Cases for Three Months

THE JOURNAL OF JAPAN SOCIETY FOR CLINICAL ANESTHESIA ◽

10.2199/jjsca.34.302 ◽

2014 ◽

Vol 34 (2) ◽

pp. 302-306

Author(s):

Yutaka TAIRA ◽

Yasutoshi HIGA ◽

Junichi KAJISA ◽

Shinobu NAKASONE

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Chronic Low Back Pain ◽

Low Back

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A Pain eHealth Platform for Engaging Obese, Older Adults with Chronic Low Back Pain in Nonpharmacological Pain Treatments: Protocol for a Pilot Feasibility Study

JMIR Research Protocols ◽

10.2196/14525 ◽

2020 ◽

Vol 9 (1) ◽

pp. e14525

Author(s):

Amber K Brooks ◽

David P Miller Jr ◽

Jason T Fanning ◽

Erin L Suftin ◽

M Carrington Reid ◽

...

Keyword(s):

Older Adults ◽

Primary Care ◽

Low Back Pain ◽

Back Pain ◽

Chronic Low Back Pain ◽

Primary Care Providers ◽

Patient Portal ◽

Low Back ◽

Care Providers ◽

Web Based

Background Low back pain is a costly healthcare problem and the leading cause of disability among adults in the United States. Primary care providers urgently need effective ways to deliver evidence-based, nonpharmacological therapies for chronic low back pain. Guidelines published by several government and national organizations have recommended nonpharmacological and nonopioid pharmacological therapies for low back pain. Objective The Pain eHealth Platform (PEP) pilot trial aims to test the feasibility of a highly innovative intervention that (1) uses an electronic health record (EHR) query to systematically identify a phenotype of obese, older adults with chronic low back pain who may benefit from Web-based behavioral treatments; (2) delivers highly tailored messages to eligible older adults with chronic low back pain via the patient portal; (3) links affected patients to a Web app that provides education on the efficacy of evidence-based, nonpharmacological, behavioral pain treatments; and (4) directs patients to existing Web-based health treatment tools. Methods Using a three-step modified Delphi method, an expert panel of primary care providers will define a low back pain phenotype for an EHR query. Using the defined low back pain phenotype, an EHR query will be created to identify patients who may benefit from the PEP. Up to 15 patients with low back pain will be interviewed to refine the tailored messaging, esthetics, and content of the patient-facing Web app within the PEP. Up to 10 primary care providers will be interviewed to better understand the facilitators and barriers to implementing the PEP, given their clinic workflow. We will assess the feasibility of the PEP in a single-arm pragmatic pilot study in which secure patient portal invitations containing a hyperlink to the PEP Web app are sent to 1000 patients. The primary outcome of the study is usability as measured by the System Usability Scale. Results Qualitative interviews with primary care providers were completed in April 2019. Qualitative interviews with patients will begin in December 2019. Conclusions The PEP will leverage informatics and the patient portal to deliver evidence-based nonpharmacological treatment information to adults with chronic low back pain. Results from this study may help inform the development of Web-based health platforms for other pain and chronic health conditions. International Registered Report Identifier (IRRID) DERR1-10.2196/14525

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A Prospective Randomized Controlled Study of Auricular Point Acupressure to Manage Chronic Low Back Pain in Older Adults: Study Protocol

10.21203/rs.2.15609/v1 ◽

2019 ◽

Author(s):

Chao Hsing Yeh ◽

Cuicui Li ◽

Ronald Glick ◽

Elizabeth A. Schlenk ◽

Kathryn Albers ◽

...

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Chronic Low Back Pain ◽

Comparison Group ◽

Randomized Controlled Study ◽

Controlled Study ◽

Low Back ◽

Randomized Controlled ◽

Auricular Point

Abstract Background: Chronic low back pain (cLBP) is a major health problem and the most common pain condition among those 60 years of age or older in the US. Despite the development of pharmacological and nonpharmacological interventions, cLBP outcomes have not improved and disability rates continue to rise. This study aims to test auricular point acupressure (APA) as a non-invasive, nonpharmacological self-management strategy to manage cLBP and to address current shortcomings of cLBP treatment. Methods: For this prospective randomized controlled study, participants will be randomly assigned into three groups: (1) APA (active points related to cLBP), (2) Comparison Group -1 (non-active points, unrelated to cLBP), (3) Comparison Group-2 (enhanced educational control, an educational booklet on cLBP will be given and the treatment used by participants for their cLBP will be recorded). The ecological momentary assessment smartphone app will be used to collect real-time cLBP outcomes and adherence to APA practice. Treatment and nonspecific psychological placebo effects will be measured via questionnaires for all participants. This proposed trial will evaluate the APA sustained effects for cLBP at 12-month follow-up. Monthly phone follow-up will be used to collect study outcomes. Blood will be collected during study visits at baseline, post-APA treatment, and follow-up study visits at 1-, 3-, 6-, 9- and 12-months post-completion of treatment for a total of 7 assessments. Appointments will start between 9 and 11 am to control for circadian variation in cytokine levels. Discussion: This study is expected to provide vital information on the efficacy, sustainability, and underlying mechanism of APA on cLBP necessary for APA to gain acceptance from both healthcare providers and patients, which would provide a strong impetus for including APA as part of cLBP management in clinical and home settings. Trial registration: NCT03589703, Registered on May 22, 2018

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A Pain eHealth Platform for Engaging Obese, Older Adults with Chronic Low Back Pain in Nonpharmacological Pain Treatments: Protocol for a Pilot Feasibility Study (Preprint)

10.2196/preprints.14525 ◽

2019 ◽

Author(s):

Amber K Brooks ◽

David P Miller Jr ◽

Jason T Fanning ◽

Erin L Suftin ◽

M Carrington Reid ◽

...

Keyword(s):

Older Adults ◽

Primary Care ◽

Low Back Pain ◽

Back Pain ◽

Chronic Low Back Pain ◽

Primary Care Providers ◽

Patient Portal ◽

Low Back ◽

Care Providers ◽

Web Based

BACKGROUND Low back pain is a costly healthcare problem and the leading cause of disability among adults in the United States. Primary care providers urgently need effective ways to deliver evidence-based, nonpharmacological therapies for chronic low back pain. Guidelines published by several government and national organizations have recommended nonpharmacological and nonopioid pharmacological therapies for low back pain. OBJECTIVE The Pain eHealth Platform (PEP) pilot trial aims to test the feasibility of a highly innovative intervention that (1) uses an electronic health record (EHR) query to systematically identify a phenotype of obese, older adults with chronic low back pain who may benefit from Web-based behavioral treatments; (2) delivers highly tailored messages to eligible older adults with chronic low back pain via the patient portal; (3) links affected patients to a Web app that provides education on the efficacy of evidence-based, nonpharmacological, behavioral pain treatments; and (4) directs patients to existing Web-based health treatment tools. METHODS Using a three-step modified Delphi method, an expert panel of primary care providers will define a low back pain phenotype for an EHR query. Using the defined low back pain phenotype, an EHR query will be created to identify patients who may benefit from the PEP. Up to 15 patients with low back pain will be interviewed to refine the tailored messaging, esthetics, and content of the patient-facing Web app within the PEP. Up to 10 primary care providers will be interviewed to better understand the facilitators and barriers to implementing the PEP, given their clinic workflow. We will assess the feasibility of the PEP in a single-arm pragmatic pilot study in which secure patient portal invitations containing a hyperlink to the PEP Web app are sent to 1000 patients. The primary outcome of the study is usability as measured by the System Usability Scale. RESULTS Qualitative interviews with primary care providers were completed in April 2019. Qualitative interviews with patients will begin in December 2019. CONCLUSIONS The PEP will leverage informatics and the patient portal to deliver evidence-based nonpharmacological treatment information to adults with chronic low back pain. Results from this study may help inform the development of Web-based health platforms for other pain and chronic health conditions. INTERNATIONAL REGISTERED REPORT DERR1-10.2196/14525

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