Intradiskal Treatments for Active Degenerative Disk Disease
Publication date: Available online 2 July 2019Source: Joint Bone SpineAuthor(s): Johann BeaudreuilAbstractIntradiskal steroid injections were first used 70 years ago. The initial failure of this treatment method can be ascribed to the absence of preclinical studies and of well-defined criteria for patient selection. Intradiskal calcifications were reported after triamcinolone hexacetonide or cortivazol injections, and proof of clinical benefits remained elusive. The concept of active degenerative disk disease (DDD) then emerged, and cases of incapacitating chronic low back pain with Modic I endplate changes were reported, leading to renewed interest in evaluating intradiskcal steroid injections. Prednisolone acetate was proven effective in providing short-term relief and was well tolerated in patients with incapacitating chronic low back pain and Modic I changes. This development highlights the importance of concomitant advances in identifying diagnostic entities and developing treatment strategies for patients with nonspecific low back pain.
ConclusionsFrom a Dutch national health ‐care context, when the willingness to pay threshold is up to 60.000 Euros per QALY, PNFS as an add‐on therapy to SCS for the treatment of low back pain in FBSS patients has a high probability of being cost‐effective.
Conclusion: In this multicentric observational study, referral to an FRP was linked to pain, self-reported physical activity and sick leave but not medical characteristics assessed. These findings confirm the bio-psycho-social approach of FRPs for cLBP.
Conclusion. These data demonstrate that DM may contribute to IDD by increasing aggrecan degradation and promoting cell apoptosis, which may represent early indicators of the involvement of DM in the pathogenesis of IDD. Level of Evidence: N/A
No abstract available
Condition: Low Back Pain Interventions: Other: HIIT; Other: MICT Sponsors: Cerini Tamara; Schulthess Klinik Recruiting
AbstractPurposeMultivariate analysis of T2-weighted signal, diffusion ADC, and DKI parameters and tractography were used to differentiate chronic non-specific low back pain (CLBP) patients and asymptomatic controls (AC).MethodsA total of 30 patients with CLBP and 23 AC underwent diffusion kurtosis imaging (DKI) of lumbar spine with a 3T MRI scanner to get the ADC values and seven parameters of DKI in the nucleus pulposus (NP) of the intervertebral disc. The tractography and the tract-related parameters as other parameters were also generated to indicate the intactness of annulus fibrosus (AF). T2-grades of the discs were a...
Conclusions: Changes in patients’ attitudes toward adopting a pain self-management approach may serve as one of the therapeutic mechanisms and predict long-term function. This study also revealed that changed attitudes toward chronic pain self-management remain quite stable over time. Adoption of beliefs consistent with chronic pain self-management during treatment may promote sustained benefits.
The objective of this study will be to identify the most effective interventions to relieve pain and reduce disability in acute and sub-acute non-specific LBP.Methods/designWe will search electronic databases (MEDLINE, Embase, CENTRAL) from inception onwards. The eligible population will be individuals with non-specific LBP older than 18 years, both males and females, who experience pain less than 6 weeks (acute) or between 6 and 12 weeks (subacute). Eligible interventions and comparators will include all conservative rehabilitation or pharmacological treatments provided by any health professional; th...
Conclusion: The GPES demonstrated adequate psychometric properties. This study's findings supported its use in clinical and research studies with patients with chronic low back pain. IMPLICATIONS FOR REHABILITATION The European Portuguese version of the Global Perceived Effect Scale demonstrated adequate reliability, validity and responsiveness. This instrument is suitable to evaluate meaningful changes in patients with chronic low back pain. The contribution of baseline status to GPES scores was confirmed by specific and recommended methods. The use of the GPES as external criterion of change in clinimetric studies was su...