scholarly journals The Effectiveness and Safety of Utilizing Mobile Phone–Based Programs for Rehabilitation After Lumbar Spinal Surgery: Multicenter, Prospective Randomized Controlled Trial (Preprint)

2018 ◽  
Author(s):  
Jingyi Hou ◽  
Rui Yang ◽  
Yaping Yang ◽  
Yiyong Tang ◽  
Haiquan Deng ◽  
...  
Keyword(s):  
Mobile Phone ◽  
Spinal Surgery ◽  
Short Form ◽  
Controlled Trial ◽  
Future Research ◽  
Clinical Trial Registry ◽  
Pain Status ◽  
Significant Difference ◽  
Lumbar Spinal Surgery ◽  
Lumbar Spinal

BACKGROUND Rehabilitation is crucial for postoperative patients with low back pain (LBP). However, the implementation of traditional clinic-based programs is limited in developing countries, such as China, because of the maldistribution of medical resources. Mobile phone–based programs may be a potential substitute for those who have no access to traditional rehabilitation. OBJECTIVE The aim of this study was to examine the efficacy of mobile phone–based rehabilitation systems in patients who underwent lumbar spinal surgery. METHODS Patients who accepted spinal surgeries were recruited and randomized into 2 groups of rehabilitation treatments: (1) a mobile phone–based eHealth (electronic health) program (EH) or (2) usual care treatment (UC). The primary outcomes were (1) function and pain status assessed by the Oswestry Disability Index (ODI) and (2) the visual analog scale (VAS). Secondary outcomes were (1) general mental health and (2) quality of life (Likert scales, EuroQol-5 Dimension health questionnaire, and 36-item Short-Form Health Survey). All the patients were assessed preoperatively and then at 3, 6, 12, and 24 months postoperatively. RESULTS A total of 168 of the 863 eligible patients were included and randomized in this study. Our analysis showed that the improvement of primary outcomes in the EH group was superior to the UC group at 24 months postoperatively (ODI mean 7.02, SD 3.10, P<.05; VAS mean 7.59, SD 3.42, P<.05). No significant difference of primary outcomes was found at other time points. A subgroup analysis showed that the improvements of the primary outcomes were more significant in those who completed 6 or more training sessions each week throughout the trial (the highest compliance group) compared with the UC group at 6 months (ODI mean 17.94, SD 5.24, P<.05; VAS mean 19.56, SD 5.27, P<.05), 12 months (ODI mean 13.39, SD 5.32, P<.05; VAS mean 14.35, SD 5.23, P<.05), and 24 months (ODI mean 18.80, SD 5.22, P<.05; VAS mean 21.56, SD 5.28, P<.05). CONCLUSIONS This research demonstrated that a mobile phone–based telerehabilitation system is effective in self-managed rehabilitation for postoperative patients with LBP. The effectiveness of eHealth was more evident in participants with higher compliance. Future research should focus on improving patients’ compliance. CLINICALTRIAL Chinese Clinical Trial Registry ChiCTR-TRC-13003314; http://www.chictr.org.cn/showproj.aspx?proj=6245 (Archived by WebCite at http://www.webcitation.org/766RAIDNc)

Use of Intrathecally Administered Morphine in the Treatment of Postoperative Pain after Lumbar Spinal Surgery: A Prospective, Double-Blind, Placebo-Controlled Study

Neurosurgery ◽  
1991 ◽  
Vol 28 (5) ◽  
pp. 700-704 ◽  
Author(s):  
Donald A. Ross ◽  
Kenneth Drasner ◽  
Philip R. Weinstein ◽  
John F. Flaherty ◽  
Nicholas M. Barbaro
Keyword(s):  
Postoperative Pain ◽  
Spinal Surgery ◽  
Controlled Trial ◽  
Controlled Study ◽  
Control Group ◽  
Double Blind ◽  
Hospitalization Period ◽  
Lumbar Spinal Surgery ◽  
Lumbar Spinal ◽  
Length Of Hospitalization

Abstract Improved control of postoperative pain is now known to reduce the incidence of morbidity. Although spinally administered narcotics have found a clear role in chest and abdominal surgery, their role in lumbar spinal surgery is debated. We conducted a prospective, double-blind, randomized, placebo-controlled trial of intrathecally administered morphine sulfate after lumbar spinal surgery in 56 patients. Patients received 0, 0.125, 0.25, or 0.5 mg of intrathecally administered morphine during extradural lumbar spinal operations, and the effects on postoperative analog pain scores, narcotic consumption, complications, and length of hospitalization were assessed. As compared with systemic narcotic administration, intrathecally administered morphine provided superior analgesia in a dose-dependent fashion without an increase in narcotic side effects. Consumption of parenteral narcotics on the first postoperative day and over the total hospitalization period decreased in correlation with increasing doses of intrathecally administered morphine. Mean length of hospitalization was significantly decreased, as compared with the control group, in patients receiving 0.25 or 0.5 mg of intrathecally administered morphine. When proper precautions are observed, intrathecally administered morphine can improve the postoperative care of patients undergoing lumbar spinal surgery.

scholarly journals Comparative effectiveness research on incision healing after lumbar spinal surgery with different TDP irradiation durations

2018 ◽  
Vol 5 (4) ◽  
pp. 273-276
Author(s):  
Feng Xiao ◽  
Ren-Lian Jiang ◽  
Jun-Ru Chen ◽  
Xue-Mei Long
Keyword(s):  
Patient Satisfaction ◽  
Treatment Group ◽  
Spinal Surgery ◽  
Subjective Experience ◽  
Control Group ◽  
Significant Difference ◽  
Before And After ◽  
Hospital Stays ◽  
Lumbar Spinal Surgery ◽  
Lumbar Spinal

Abstract Objective This research aims to investigate the best “Te Ding Dian Ci Bo Pu Zhi Liao Qi” (TDP) irradiation duration to enhance the efficacy of nursing and patient satisfaction. Methods A total of 34 eligible patients were randomly divided into the treatment group (n=18) and the control group (n=16) between December 2015 and December 2016. Qualitative and quantitative studies were combined to create an impersonal evaluation of incision pain score, time of stitches removal, duration of hospital stays, patient satisfaction, and subjective experience due to different TDP irradiation durations. Results The incision pain scores of the treatment group were 3.06±0.899 and 1.35±0.493 before and after treatment, respectively (P< 0.05), whereas those of the control group were 2.46±1.127 and 1.0±0.707 before and after treatment, respectively (P<0.05). No significant difference was found between the treatment group and the control group (P>0.05). The time of stitches removal and the duration of hospital stays of the treatment group were 14.85±4.070 and 19.08±6.652, respectively, whereas those of the control group were 14.08±0.641 and 23.15±10.72 (P>0.05), respectively. The patient satisfaction degree score of the treatment group was 2.77±0.439, whereas that of the control group was 2.08±0.954 (P< 0.05). Conclusions TDP irradiation can effectively relieve the incision pain of patients after lumbar spinal surgery. The treatment group is superior to the control group in patient satisfaction.

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