scholarly journals Functional outcomes of intensive rehabilitation versus fusion surgery among patients with low back pain from lumbar spine degenerative disease: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Tito Guillermo D. Rejante ◽  
Kevin Paul Ferraris ◽  
Jose Carlos Alcazaren ◽  
Joseph Erroll Navarro ◽  
Kenny Seng
Keyword(s):  
Patient Outcome ◽  
Low Back Pain ◽  
Back Pain ◽  
Lumbar Spine ◽  
Functional Outcomes ◽  
Meta Analysis ◽  
Leg Pain ◽  
Low Back ◽  
Fusion Surgery ◽  
Intensive Rehabilitation

Abstract Objective: The aim of this study is to compare the functional outcomes of intensive rehabilitation and lumbar spine fusion surgery among patients with chronic low back pain from lumbar spine degenerative disease.Methods: We did a systematic search of clinical trials on the topic followed by a meta-analysis using random effects model. The functional outcomes that were compared include Oswestry Disability Index score, improvement in low back pain and leg pain, as well as overall patient outcome.Results: Five randomized controlled trials were included in the meta-analysis. There was a 7.25 improvement in change in Oswestry Disability Index (95% CI 1.22-13.17; p=0.02; I2=98%) favoring fusion surgery. All studies showed improvement in low back pain with a VAS score change of 11.49 favoring fusion surgery (95% CI 4.48-18.50; p=0.001; I2=96%). There was a VAS score change of 7.2 improvement in leg pain (95% CI -8.58-22.97; p=0.37; I2=98%) however the effect was not significant. There was no significant difference in terms of overall patient outcome (95% CI 0.23-1.08; p=0.08; I2=78%).Conclusion: Among patients with chronic low back pain, lumbar spine fusion surgery showed improvement in functional outcomes of change in disability and low back pain when compared with intensive rehabilitation. However, the two treatment options showed no differences in terms of improvement of leg pain and overall patient outcome.

To Flex or Not to Flex? Is There a Relationship Between Lumbar Spine Flexion During Lifting and Low Back Pain? A Systematic Review With Meta-analysis

2020 ◽  
Vol 50 (3) ◽  
pp. 121-130 ◽  
Author(s):  
Nic Saraceni ◽  
Peter Kent ◽  
Leo Ng ◽  
Amity Campbell ◽  
Leon Straker ◽  
...  
Keyword(s):  
Systematic Review ◽  
Low Back Pain ◽  
Back Pain ◽  
Lumbar Spine ◽  
Meta Analysis ◽  
Low Back

scholarly journals Posterior osteosynthesis of a spontaneous bilateral pedicle fracture of the lumbar spine

2016 ◽  
Vol 24 (3) ◽  
pp. 398-401 ◽  
Author(s):  
Sang-Hyun Han ◽  
Seung-Jae Hyun ◽  
Tae-Ahn Jahng ◽  
Ki-Jeong Kim
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Surgical Treatment ◽  
Lumbar Spine ◽  
Pedicle Screws ◽  
Leg Pain ◽  
Low Back ◽  
Pedicle Fracture ◽  
Effective Option ◽  
Radiological Studies

Spontaneous bilateral pedicle fractures of the lumbar spine are rare, and an optimal surgical treatment has not been suggested. The authors report the case of a 50-year-old woman who presented with low-back pain and right leg radiating pain of 1 year’s duration. Radiological studies revealed a spontaneous bilateral pedicle fracture of L-5. All efforts at conservative treatment failed, and the patient underwent surgery for osteosynthesis of the fractured pedicle using bilateral pedicle screws connected with a bent rod. Her low-back and right leg pain were relieved postoperatively. A CT scan performed 3 months postoperatively revealed the disappearance of the pedicle fracture gap and presence of newly formed bony trabeculation. In rare cases of spontaneous bilateral pedicle fracture of the lumbar spine, osteosynthesis of the fractured pedicle using bilateral pedicle screws and a bent rod is a motion-preserving technique that may be an effective option when conservative management has failed.

scholarly journals Comparison of Decompression Alone and Decompression Combined with Fusion for Treating Lumbar Degenerative Spondylolisthesis

2019 ◽  
Author(s):  
wenqiang xin ◽  
Qi-qiang Xin ◽  
xinyu yang
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Meta Analysis ◽  
Degenerative Spondylolisthesis ◽  
Leg Pain ◽  
Cochrane Library ◽  
Low Back ◽  
Vas Score ◽  
Negative Results ◽  
Lumbar Degenerative Spondylolisthesis

Abstract Background To assess the necessity or not of the addition of fusion to decompression for lumber degenerative spondylolisthesis patients.Method Potential publications were selected from PubMed, Web of Science and Cochrane Library. Gray relevant studies were manually searched. We set the searching time spanning from the creating date of electronic engines to August 2019. STATA version 11.0 was exerted to process the pooled data.Results Six RCTs were selected in our analysis. A total of 650 participants were divided into 275 in the decompression group and 375 in the fusion group. Our meta-analysis showed negative results generally. No statistic differences were found in VAS score for low back pain (WMD, -0.045; 95%CI, -1.259 to 1.169; P=0.942) and leg pain (WMD, 0.075; 95% CI, -1.201 to 1.35; P=0.908), ODI score (WMD, 1.489; 95% CI, -7.232 to 10.211; P=0.738), EQ-5D score (WMD, 0.03; 95% CI, -0.05 to 0.12; P=0.43), Odom’s classification (OR, 0.353; 95%CI 0.113, 1.099; P=0.072), postoperative complications (OR, 0.437; 95% CI, 0.065 to 2.949; P=0.395), secondary operation (OR, 2.541; 95% CI 0.897, 7.198; P=0.079) and postoperative degenerative spondylolisthesis (OR=8.59,P=0.27). Subgroup analysis in VAS score on low back pain (OR=0.77, 95% CI, 0.36 to 1.65; P=0.50) was demonstrated as no meaning as well.Conclusion The overall efficacy of the combination of decompression and fusion is not found to be superior to decompression alone. At the same time, more evidence-based performance is needed to supplement this opinion.

The association between lumbar spine radiographic features and low back pain: A systematic review and meta-analysis

2015 ◽  
Vol 44 (5) ◽  
pp. 571-585 ◽  
Author(s):  
Joachim Raastad ◽  
Michael Reiman ◽  
Remy Coeytaux ◽  
Leila Ledbetter ◽  
Adam P. Goode
Keyword(s):  
Systematic Review ◽  
Low Back Pain ◽  
Back Pain ◽  
Lumbar Spine ◽  
Meta Analysis ◽  
Low Back ◽  
Radiographic Features

Is there a relationship between lumbar spine proprioception and non-specific low back pain? A systematic review with meta-analysis

Physiotherapy ◽  
2015 ◽  
Vol 101 ◽  
pp. e1524-e1525
Author(s):  
M.H. Tong ◽  
S.J. Mousavi ◽  
H. Kiers ◽  
P. Ferreira ◽  
K. Refshauge ◽  
...  
Keyword(s):  
Systematic Review ◽  
Low Back Pain ◽  
Back Pain ◽  
Lumbar Spine ◽  
Meta Analysis ◽  
Low Back

Low Back Pain Versus Back-Related Leg Pain: How Do Patient Expectations and Outcomes of Lumbar Spine Surgery Compare?

2021 ◽  
pp. 155633162110104
Author(s):  
Christopher M. Brusalis ◽  
Roland Duculan ◽  
Frank P. Cammisa ◽  
Andrew A. Sama ◽  
Alexander P. Hughes ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Lumbar Spine ◽  
Spine Surgery ◽  
Patient Expectations ◽  
Leg Pain ◽  
Pain Patient ◽  
Lumbar Spine Surgery ◽  
Low Back ◽  
Preoperative Expectations

Background: An increasing number of lumbar spine conditions are treated surgically. Such intervention, however, is commonly thought to be more effective in addressing leg pain than low back pain. Patient expectations may also contribute to self-reported surgical outcomes. Questions/Purposes: We sought to compare the expectations of patients in 2 groups undergoing lumbar spine surgery: those with predominantly low back pain and those with predominantly leg pain. We also sought to evaluate how these expectations were fulfilled for each group. Methods: We carried out a retrospective analysis of prospectively collected data from a prior study in which patients scheduled for lumbar spine surgery at a single institution completed validated surveys preoperatively and at 2 years postoperatively, including a 20-item survey on expectations for lumbar spine surgery. The patients were enrolled in the study between February 2010 and August 2012, and were divided into 2 cohorts: a “Back > Leg” group that consisted of patients with back pain that was isolated or greater than leg pain, and a “Leg ≥ Back” group that consisted of patients with leg pain that equaled or exceeded back pain. The primary analysis compared composite expectation scores (range, 0–100) between groups. Results: A total of 366 patients were deemed eligible for the study; of these, 162 patients were allocated to the Back > Leg group and 204 patients were allocated to the Leg ≥ Back group. Patients in the Leg ≥ Back group had a greater mean preoperative expectation score compared with those in the Back > Leg group. Multivariate analysis demonstrated that higher preoperative expectations were associated with leg pain symptoms after controlling for disease diagnosis. Both groups reported similar proportions of fulfilled expectations. Conclusion: Patients with predominantly leg pain hold greater preoperative expectations for lumbar spine surgery than do patients with predominantly back pain. That these patient groups reported similar fulfillment of their expectations at 2 years postoperatively illustrates the greater clinical outcomes achieved among patients who presented with predominantly leg pain.

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
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