The Influence of Baseline Characteristics on Response to a Laser Acupuncture Intervention: An Exploratory Analysis

2010 ◽  
Vol 28 (1) ◽  
pp. 6-11 ◽  
Author(s):  
Gregory Glazov
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Secondary Analysis ◽  
Poor Response ◽  
Analysis Of Covariance ◽  
Laser Acupuncture ◽  
Low Back ◽  
Acupuncture Intervention ◽  
Failed Back Surgery ◽  
Baseline Characteristics

Objectives In clinical practice it is known that subjects vary in their response to acupuncture, but there is little data on what predicts the outcome. The aim of this study was to identify such predictors. Method A secondary analysis was performed on data from 100 participants in a trial of laser and sham laser acupuncture for chronic non-specific low back pain. Multiple regression analysis was used to identify which baseline characteristics predicted pain change in the immediate, short and intermediate term. An analysis of covariance was performed based on these results to re-examine the primary result of the trial. Results Strong predictors of poor response were receipt of disability support pension, headache, the regular use of analgesics or previous failed back surgery. Higher pain scores or exacerbation of pain at baseline predicted a greater proportionate pain relief after the intervention. Adjusted analysis suggested a clinically important effect of laser compared to sham (p<0.05), at short term follow-up only. Conclusion The findings of this study suggest which characteristics of patients with chronic low back pain are more likely to respond to laser acupuncture treatment, but require replication in other studies. The findings may not apply in other acupuncture interventions and treatment of different conditions. They may also be used to set selection criteria for future studies, and to aid interpreting the effect of baseline imbalances on trial results.

scholarly journals Low Back Pain in Adolescents: A Comparison of Clinical Outcomes in Sports Participants and Nonparticipants

2010 ◽  
Vol 45 (1) ◽  
pp. 61-66 ◽  
Author(s):  
Julie M. Fritz ◽  
Shannon N. Clifford
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Physical Therapy ◽  
Treatment Outcomes ◽  
Clinical Outcomes ◽  
Sports Participation ◽  
Mean Difference ◽  
Analysis Of Covariance ◽  
Low Back ◽  
Baseline Characteristics

Abstract Context: Back pain is common in adolescents. Participation in sports has been identified as a risk factor for the development of back pain in adolescents, but the influence of sports participation on treatment outcomes in adolescents has not been adequately examined. Objective: To examine the clinical outcomes of rehabilitation for adolescents with low back pain (LBP) and to evaluate the influence of sports participation on outcomes. Design: Observational study. Setting: Outpatient physical therapy clinics. Patients or Other Participants: Fifty-eight adolescents (age  =  15.40 ± 1.44 years; 56.90% female) with LBP referred for treatment. Twenty-three patients (39.66%) had developed back pain from sports participation. Intervention(s): Patients completed the Modified Oswestry Disability Questionnaire and numeric pain rating before and after treatment. Treatment duration and content were at the clinician's discretion. Adolescents were categorized as sports participants if the onset of back pain was linked to organized sports. Additional data collected included diagnostic imaging before referral, clinical characteristics, and medical diagnosis. Main Outcome Measure(s): Baseline characteristics were compared based on sports participation. The influence of sports participation on outcomes was examined using a repeated-measures analysis of covariance with the Oswestry and pain scores as dependent variables. The number of sessions and duration of care were compared using t tests. Results: Many adolescents with LBP receiving outpatient physical therapy treatment were involved in sports and cited sports participation as a causative factor for their LBP. Some differences in baseline characteristics and clinical treatment outcomes were noted between sports participants and nonparticipants. Sports participants were more likely to undergo magnetic resonance imaging before referral (P  =  .013), attended more sessions (mean difference  =  1.40, 95% confidence interval [CI]  =  0.21, 2.59, P  =  .022) over a longer duration (mean difference  =  12.44 days, 95% CI  =  1.28, 23.10, P  =  .024), and experienced less improvement in disability (mean Oswestry difference  =  6.66, 95% CI  =  0.53, 12.78, P  =  .048) than nonparticipants. Overall, the pattern of clinical outcomes in this sample of adolescents with LBP was similar to that of adults with LBP. Conclusions: Adolescents with LBP due to sports participation received more treatment but experienced less improvement in disability than nonparticipants. This may indicate a worse prognosis for sports participants. Further research is required.

PERCUTANEOUS EPIDURAL NEUROPLASTY (PEN) USING COMBINATION OF HYALURONIDASE AND HYPERTONIC SALINE (NaCl 3%) IN TREATING FAILED BACK SURGERY SYNDROME

2018 ◽  
Vol 1 (1) ◽  
pp. 1
Author(s):  
Wawan Mulyawan ◽  
Yudi Yuwono Wiwoho ◽  
Syaiful Ichwan
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Hypertonic Saline ◽  
Failed Back Surgery Syndrome ◽  
Favourable Outcome ◽  
Lumbar Spine Surgery ◽  
Low Back ◽  
Failed Back Surgery ◽  
Scale Scores

Background: Following surgical treatments for low back pain, lower extremity pain or neurologic symptoms would last or recur, this is defined as failed sack surgery syndrome (FBSS). FBSS usually occurs in 5-40% of these surgical patients. The most common cause is an epidural scar adhesion. Percutaneous epidural neuroplasty is the non-mechanical treatment for this condition. Previously, the use of hyaluronidase and hypertonic saline separately is commonly used for epidurolysis but the combination of hyaluronidase and hypertonic saline 3% has not been explored.Objective: To investigate the two-year outcomes of percutaneous epidural neuroplasty using a combination of hyaluronidase and hypertonic saline 3% in patients with FBSS.Methods: Twelve patients who experience low back pain, with or without radiculopathy, who have underwent lumbar spine surgery previously were assigned to the study. Parameters, such as the visual analogue scale scores for the back (VAS-B) and legs (VAS-L), and the Oswestry disability index (ODI), were recorded and compared between pretreatment, 1 week, 1 month, 3 months, 1 year and 2 years follow-up.Results: For all 12 patients, the postoperative VAS-B, VAS-L, and ODI were significantly different from the preoperative values in all follow-up periods: 1 month, 3 months, 1 year, and 2 years.Conclusion: Based off this study group, percutaneous epidural neuroplasty using a combination of hyaluronidase and hypertonic saline 3% has a favourable outcome in the 2 years follow-up

Efficacy of Transverse Tripolar Spinal Cord Stimulator for the Relief of Chronic Low Back Pain from Failed Back Surgery

2008 ◽  
Vol 3;11 (5;3) ◽  
pp. 333-338
Author(s):  
Asokumar Buvanendran
Keyword(s):  
Spinal Cord ◽  
Low Back Pain ◽  
Back Pain ◽  
Case Report ◽  
Pain Relief ◽  
Failed Back Surgery Syndrome ◽  
Low Back ◽  
Failed Back Surgery ◽  
Back Surgery ◽  
Stimulation Of

Background: Failed back surgery syndrome is a common clinical entity for which spinal cord stimulation has been found to be an effective mode of analgesia, but with variable success rates. Objective: To determine if focal stimulation of the dorsal columns with a transverse tripolar lead might achieve deeper penetration of the electrical stimulus into the spinal cord and therefore provide greater analgesia to the back. Design: Case report. Methods: We describe a 42-year-old female with failed back surgery syndrome that had greater back pain than leg pain. The tripolar lead configuration was achieved by placing percutaneously an octapolar lead in the spinal midline followed by 2 adjacent quadripolar leads, advanced to the T7-T10 vertebral bodies. Results: Tripolar stimulation pattern resulted in more than 70% pain relief in this patient during the screening trial, while stimulation of one or 2 electrodes only provided 20% pain relief. After implantation of a permanent tripolar electrode system with a single rechargeable battery, the pain relief was maintained for one year. Conclusion: This is case report describing a case of a patient with chronic low back pain with a diagnosis of failed back surgery syndrome in which transverse tripolar stimulation using an octapolar and 2 quadripolar leads appeared to be beneficial. The transverse tripolar system consists of a central cathode surrounded by anodes, using 3 leads. This arrangement may contribute to maximum dorsal column stimulation with minimal dorsal root stimulation and provide analgesia to the lower back. Key words: Epidural, low back pain, spinal cord stimulation, failed back surgery syndrome, tripolar stimulation

scholarly journals EFFECT OF SELECTED YOGIC PRACTICES PHYSICAL EXERCISES AND PHYSIOTHERAPY TREATMENT ON SITTING OF LOW BACK PAIN PATIENTS

2017 ◽  
Vol 5 (4(SE)) ◽  
pp. 63-68
Author(s):  
N.T. Lethi ◽  
A.M. Moorthy
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Analysis Of Covariance ◽  
Low Back ◽  
Physiotherapy Treatment ◽  
Group V ◽  
Group Iii ◽  
Physical Exercises ◽  
Group I ◽  
Pain Patients

The purpose of the study was to investigate the effect of selected yogic practices physical exercises and physiotherapy treatment on sitting of low back pain patients. One hundred low back pain patients are taken from the Thavanur town, Kerala. The age, height and weight of the subjects ranged from 30 to 40 years, 158 to 169 centimetres and 55 to 70 kilograms respectively. The selected subjects were randomly assigned into five equal groups of 20 subjects each. Group I underwent Yogic practices, group II underwent physical exercises, group III underwent physiotherapy treatments, group IV yoga and physiotherapy treatments and group V acted as control.  Prior to and after the training the subjects were tested on sitting of low back pain patients through the Oswestry low back pain disability questionnaire. Analysis of covariance was used to determine the significantly difference existing between pretest and posttest on sitting of low back pain patients. The result of the study proved that due to twelve weeks of the experimental training was reduced back pain while sitting for the low back pain patients.

Effect of Multicolumn Lead Spinal Cord Stimulation on Low Back Pain in Failed Back Surgery Patients: A Three-Year Follow-Up

2017 ◽  
Vol 20 (7) ◽  
pp. 668-674 ◽  
Author(s):  
Thibault Yves Remacle ◽  
Vincent Luce Bonhomme ◽  
Henri-Jean Paul Renwart ◽  
Jean Michel Remacle
Keyword(s):  
Spinal Cord ◽  
Low Back Pain ◽  
Back Pain ◽  
Spinal Cord Stimulation ◽  
Low Back ◽  
Failed Back Surgery ◽  
Back Surgery
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