Improvement in low back pain following spinal decompression: observational study of 119 patients. Jones AD, Wafai AM, Easterbrook AL. Eur Spine J, Jan 2014, Volume 23, Issue 1, pp 135-141

Abstract Background and Study Aims Surgical treatment options for lumbar spinal stenosis (LSS) based on adjacent segment disease (ASD) after spinal fusion typically involve decompression, with or without fusion, of the adjacent segment. The clinical benefits of microendoscopic decompression for LSS based on ASD have not yet been fully elucidated. We aimed to investigate the clinical results of microendoscopic spinal decompression surgery for LSS based on ASD. Patients and Methods From 2011 to 2014, consecutive patients who underwent microendoscopic spinal decompression without fusion for LSS based on ASD were enrolled. Data of 32 patients (17 men and 15 women, with a mean age of 70.5 years) were reviewed. Japanese Orthopaedic Association score and low back pain/leg pain visual analog scale score were utilized to measure neurologic and axial pain outcomes, respectively. Additionally, after the surgeries, we analyzed the magnetic resonance imaging (MRI), computed tomography (CT) scans, or radiographs to identify any new instabilities of the decompressed segments or progression of ASD adjacent to the decompressed segments. Results The Japanese Orthopaedic Association recovery rate at the 5-year postoperative visit was 49.2%. The visual analog scale scores for low back pain and leg pain were significantly improved. The minimum clinically important difference for leg pain (decrease by ≥24 mm) and clinically important difference for low back pain (decrease by ≥38 mm) were achieved in 84% (27/32) and 72% (23/32) of cases, respectively. Regarding new instability after microendoscopic decompression, no cases had apparent spinal instability at the decompression segment and adjacent segment to the decompressed segment. Conclusions Microendoscopic spinal decompression is an effective treatment alternative for patients with LSS caused by ASD. The ability to perform neural decompression while maintaining key stabilizing structures minimizes subsequent clinical instability. The substantial clinical and economic benefits of this approach may make it a favorable alternative to performing concurrent fusion in many patients.

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Can patient-reported profiles avoid unnecessary referral to a spine surgeon? An observational study to further develop the Nijmegen Decision Tool for Chronic Low Back Pain

PLoS ONE ◽

10.1371/journal.pone.0203518 ◽

2018 ◽

Vol 13 (9) ◽

pp. e0203518 ◽

Cited By ~ 3

Author(s):

Miranda L. van Hooff ◽

Johanna M. van Dongen ◽

Veerle M. Coupé ◽

Maarten Spruit ◽

Raymond W. J. G. Ostelo ◽

...

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Observational Study ◽

Chronic Low Back Pain ◽

Low Back ◽

Decision Tool ◽

Patient Reported ◽

Spine Surgeon

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An Observational Study Comparing Fibromyalgia and Chronic Low Back Pain in Somatosensory Sensitivity, Motor Function and Balance

Healthcare ◽

10.3390/healthcare9111533 ◽

2021 ◽

Vol 9 (11) ◽

pp. 1533

Author(s):

José Antonio Mingorance ◽

Pedro Montoya ◽

José García Vivas Miranda ◽

Inmaculada Riquelme

Keyword(s):

Chronic Pain ◽

Low Back Pain ◽

Back Pain ◽

Observational Study ◽

Motor Function ◽

Chronic Low Back Pain ◽

Functional Performance ◽

Low Back ◽

Somatosensory Sensitivity ◽

Chronic Pain Conditions

Fibromyalgia (FM) and chronic low back pain (CLBP) have shared pathophysiology and have a considerable impact on patients’ daily activities and quality of life. The main objective of this study was to compare pain impact, somatosensory sensitivity, motor functionality, and balance among 60 patients with FM, 60 patients with CLBP, and 60 pain-free controls aged between 30 and 65 years. It is essential to know the possible differences existing in symptomatology of two of the major chronic pain processes that most affect the population, such as FM and CLBP. The fact of establishing possible differences in sensory thresholds, motor function, and proprioceptive measures among patients with FM and CLBP could bring us closer to a greater knowledge of the chronic pain process. Through an observational study, a comparison was made between the three groups (FM, CLBP, and pain-free controls) evaluating functional performance, postural balance, kinematic gait parameters, strength, depression, fatigue, and sensitivity to pain and vibration. Patients with chronic pain showed worse somatosensory sensitivity (p < 0.001) and motor function (p < 0.001) than pain-free controls. Moreover, patients with FM showed greater pain impact (p < 0.001) and bigger somatosensory (p < 0.001) and motor deficiencies (p < 0.001) than patients with CLBP. Further research should explore the possible reasons for the greater deterioration in patients with FM in comparison with other chronic pain conditions. Our results, showing the multiple areas susceptible of deterioration, make it necessary to adopt interdisciplinary interventions focused both on physical and emotional dysfunction.

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Differences in dynamic and postural stability based on degree of disability in patients with nonspecific chronic lower back pain: an observational study

Journal of MOVE and Therapeutic Science ◽

10.37382/jomts.v3i1.471 ◽

2021 ◽

Vol 3 (1) ◽

Author(s):

Mónica Grande-Alonso ◽

Raquel Pérez-Muñoz ◽

José María Aceña-García ◽

Francisco Fernando Recio-Mateo ◽

Diego Pro-Marín ◽

...

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Observational Study ◽

Chronic Low Back Pain ◽

Postural Stability ◽

Dynamic Balance ◽

Forward Direction ◽

Static Stability ◽

Chronic Lower Back Pain ◽

Low Back

Objetive: The main objective of this study was to analyze whether there were differences in dynamic balance and postural stability in relation to the level of disability in patients with chronic low back pain. Methodss: This is an observational study in which 60 patients with nonspecific chronic low back pain were included. All patients received a sociodemographic questionnaire, the visual analogue scale (VAS) and a series of self-reported psychological scales. To complete the evaluation, physical tests were performed in which dynamic balance and postural stability were measured. Results: Student’s t-test revealed that there were significant differences between the groups in dynamic balance with the right leg and the left leg. In contrast, there were no significant differences between the groups for the reach functional test in forward direction, left direction and right direction. Conclusion: In conclusion, our study demonstrates that patients with chronic low back pain with high levels of disability present significantly poorer dynamic balance compared with those with low levels of disability. In contrast, no significant differences were found between the groups in terms of static stability.

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The Effect of Spinal Decompression Therapy on the Pain and Posture in the Patients with Low back Pain

Journal of international academy of physical therapy research ◽

10.5854/jiaptr.2011.2.2.318 ◽

2011 ◽

Vol 2 (2) ◽

pp. 318-323

Author(s):

Ki-Mai Um ◽

Young-Sook Bae

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Low Back ◽

Spinal Decompression

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Combination of caudal epidural steroids with oral gabapentin for radicular low back pain: a prospective observational study

Journal of Society of Anesthesiologists of Nepal ◽

10.3126/jsan.v5i1.23211 ◽

2019 ◽

Vol 5 (1) ◽

pp. 5-10

Author(s):

Grisuna Singh ◽

Binod Thapa ◽

Kiran Gurung ◽

Nirmal Gyawali

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Observational Study ◽

Prospective Observational Study ◽

Low Back ◽

Socioeconomic Condition ◽

Psychological Burden ◽

Epidural Steroids ◽

Caudal Epidural

Introduction: The physical, socioeconomic and psychological burden of low back pain is enormous. The poor socioeconomic condition and geographical constrains confines people to limited health facilities. The objective of the study was to evaluate whether combination of caudal epidural steroids with local anaesthetics and gabapentin is effective for radicular low back pain in the rural Nepal setting. Methods: It was a prospective observational study including 300 patients with radicular low back pain done over a period of 6 months (13/4/2016 to 30/10/2016). All participants received caudal epidural steroid injection (6ml 2% Xylocaine with adrenaline plus Depomedroxy steroid 80mg plus 12 ml distilled water) and 200 mg gabapentin daily for three months. All patients were followed up for three months and were evaluated. Results: Mean age of presentation was 41.21 years (SD ± 11.02) with majority of farmers (42.31%). Mean Numerical Rating Scale at the baseline was 8.01(SD±1.00) and at the first follow up was 3.98 (SD±0.83) (p <0.001). Mean Oswestry Disability Index at baseline was7.85 (SD±0.98) and at the first follow up was 4.04 (SD±0.80) (p <0.001). Straight Leg Raising Test at baseline was less than 70° in 84.7% which improved to more than 70° in 87.9% of the patients (p-value <0.001). Conclusion: Caudal epidural steroids combined with gabapentin is safe, economical and technically less demanding. This treatment modality can be used with good outcomes in the rural areas with limited diagnostic and therapeutic facilities.

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