scholarly journals Lumbar fusion did not differ from cognitive therapy plus exercise for reducing disability and pain in chronic low back pain

2004 ◽  
Vol 9 (2) ◽  
pp. 51-51
Author(s):  
K. Margo
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Cognitive Therapy ◽  
Chronic Low Back Pain ◽  
Lumbar Fusion ◽  
Low Back

scholarly journals Guideline update for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 12: Pedicle screw fixation as an adjunct to posterolateral fusion

2014 ◽  
Vol 21 (1) ◽  
pp. 75-78 ◽  
Author(s):  
Michael W. Groff ◽  
Andrew T. Dailey ◽  
Zoher Ghogawala ◽  
Daniel K. Resnick ◽  
William C. Watters ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Clinical Outcome ◽  
Pedicle Screw ◽  
Chronic Low Back Pain ◽  
Screw Fixation ◽  
Lumbar Fusion ◽  
Pedicle Screw Fixation ◽  
Controlled Study ◽  
Low Back

The utilization of pedicle screw fixation as an adjunct to posterolateral lumbar fusion (PLF) has become routine, but demonstration of a definitive benefit remains problematic. The medical evidence indicates that the addition of pedicle screw fixation to PLF increases fusion rates when assessed with dynamic radiographs. More recent evidence, since publication of the 2005 Lumbar Fusion Guidelines, suggests a stronger association between radiographic fusion and clinical outcome, although, even now, no clear correlation has been demonstrated. Although several reports suggest that clinical outcomes are improved with the addition of pedicle screw fixation, there are conflicting findings from similarly classified evidence. Furthermore, the largest contemporary, randomized, controlled study on this topic failed to demonstrate a significant clinical benefit with the use of pedicle screw fixation in patients undergoing PLF for chronic low-back pain. This absence of proof should not, however, be interpreted as proof of absence. Several limitations continue to compromise these investigations. For example, in the majority of studies the sample size is insufficient to detect small increments in clinical outcome that may be observed with pedicle screw fixation. Therefore, no definitive statement regarding the efficacy of pedicle screw fixation as a means to improve functional outcomes in patients undergoing PLF for chronic low-back pain can be made. There appears to be consistent evidence suggesting that pedicle screw fixation increases the costs and complication rate of PLF. High-risk patients, including (but not limited to) patients who smoke, patients who are undergoing revision surgery, or patients who suffer from medical conditions that may compromise fusion potential, may appreciate a greater benefit with supplemental pedicle screw fixation. It is recommended, therefore, that the use of pedicle screw fixation as a supplement to PLF be reserved for those patients in whom there is an increased risk of nonunion when treated with only PLF.

scholarly journals Guideline update for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 8: Lumbar fusion for disc herniation and radiculopathy

2014 ◽  
Vol 21 (1) ◽  
pp. 48-53 ◽  
Author(s):  
Jeffrey C. Wang ◽  
Andrew T. Dailey ◽  
Praveen V. Mummaneni ◽  
Zoher Ghogawala ◽  
Daniel K. Resnick ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Lumbar Fusion ◽  
Signs And Symptoms ◽  
Herniated Disc ◽  
Spinal Instability ◽  
Low Back ◽  
Low Level ◽  
Disc Herniations

Patients suffering from a lumbar herniated disc will typically present with signs and symptoms consistent with radiculopathy. They may also have low-back pain, however, and the source of this pain is less certain, as it may be from the degenerative process that led to the herniation. The surgical alternative of choice remains a lumbar discectomy, but fusions have been performed for both primary and recurrent disc herniations. In the original guidelines, the inclusion of a fusion for routine discectomies was not recommended. This recommendation continues to be supported by more recent evidence. Based on low-level evidence, the incorporation of a lumbar fusion may be considered an option when a herniation is associated with evidence of spinal instability, chronic low-back pain, and/or severe degenerative changes, or if the patient participates in heavy manual labor. For recurrent disc herniations, there is low-level evidence to support the inclusion of lumbar fusion for patients with evidence of instability or chronic low-back pain.

A qualitative comparison of mindfulness meditation, cognitive therapy, and mindfulness-based cognitive therapy for chronic low back pain.

2021 ◽  
Vol 66 (3) ◽  
pp. 317-334
Author(s):  
Brittany K. Cattanach ◽  
Beverly E. Thorn ◽  
Dawn M. Ehde ◽  
Mark P. Jensen ◽  
Melissa A. Day
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Cognitive Therapy ◽  
Chronic Low Back Pain ◽  
Mindfulness Meditation ◽  
Low Back ◽  
Qualitative Comparison

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 Effectiveness of Mindfulness-Based Cognitive Therapy on Hope and Pain Beliefs of Patients With Chronic Low Back Pain

2018 ◽  
Vol 4 (12) ◽  
pp. 18-23
Author(s):  
Marie Abdolghaderi ◽  
Seyed-Mousa Kafi ◽  
Alia Saberi ◽  
Saeed Ariaporan ◽  
◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Cognitive Therapy ◽  
Chronic Low Back Pain ◽  
Low Back ◽  
Pain Beliefs

Change in brain oscillations as a mechanism of mindfulness-meditation, cognitive therapy, and mindfulness-based cognitive therapy for chronic low back pain

Pain Medicine ◽  
2021 ◽  
Author(s):  
Melissa A Day ◽  
Natasha Matthews ◽  
Jason B Mattingley ◽  
Dawn M Ehde ◽  
Aaron P Turner ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Pain Intensity ◽  
Cognitive Therapy ◽  
Chronic Low Back Pain ◽  
Mindfulness Meditation ◽  
Post Treatment ◽  
Alpha Power ◽  
Low Back ◽  
Beta Power

Abstract Objective Psychological treatments for chronic low back pain (CLBP) are effective. However, limited research has investigated their neurophysiological mechanisms. This study examined electroencephalography- (EEG-) assessed brain oscillation changes as potential mechanisms of cognitive therapy (CT), mindfulness-meditation (MM), and mindfulness-based cognitive therapy (MBCT) for CLBP. The a priori bandwidths of interest were changes in theta, alpha and beta power, measured at pre- and post-treatment. Design A secondary analysis of a clinical trial. Setting University of Queensland Psychology Clinic. Subjects Adults (N = 57) with CLBP who completed pre- and post-treatment EEG and pain outcome assessments. Methods EEG data were examined for five regions of interest (ROIs); the primary outcome was pain intensity. Results A significant reduction in theta (p=.015) and alpha (p=.006) power in the left frontal ROI across all treatments was found, although change in theta and alpha power in this region was not differentially associated with outcome across treatments. There were significant reductions in beta power in all five ROIs across all treatments (ps≤.013). Beta power reduction in the central ROI showed a significant association with reduced pain intensity in MBCT only (p=.028). Changes in other regions were not statistically significant. Conclusions These findings provide support for the capacity of psychological CLBP treatments to induce changes in brain activity. The reduced beta power in all five ROIs indicated that all three treatments engendered a state of lowered cortical arousal. The growing body of research in this area could potentially inform novel directions towards remedying central nervous system abnormalities associated with CLBP.

9:14 Cost-effectiveness of lumbar fusion in chronic low back pain

2002 ◽  
Vol 2 (5) ◽  
pp. 51-52
Author(s):  
Peter Fritzell ◽  
Olle Hagg ◽  
Dick Jonsson ◽  
Anders Nordwall
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Cost Effectiveness ◽  
Chronic Low Back Pain ◽  
Lumbar Fusion ◽  
Low Back
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