Surgeon Recommendation and Outcomes of Decompression With vs Without Fusion in Patients With Degenerative Spondylolisthesis.

Importance: The ability of surgeons to choose the right patient for fusion in addition to decompression when operating for degenerative spondylolisthesis with symptomatic spinal stenosis is debated. The addition of fusion increases risk, morbidity, and costs but has been claimed to give better results for selected patients.

Objective: To investigate whether following surgeons' opinions regarding fusion was associated with clinical outcomes.

Adjacent Level Canal Area Changes up to 2 years after Lumbar Spinal Stenosis Decompressive Surgery.

Study Design: A secondary analysis of data from the NORDSTEN-spinal stenosis trial (SST).

Objective: The aim of the present study was to investigate whether the dural sac cross-sectional area (DSCA) on magnetic resonance imaging (MRI) of adjacent segments decreases after decompressive surgery due to lumbar spinal stenosis (LSS) up to 2 years postoperatively, and to investigate possible associations with baseline variables, including preoperative patient and radiological characteristics, and surgical method used.

Summary Of Background Data: Decompressive surgery for LSS is currently the most common spinal surgery procedure; however, there is limited knowledge on changes in the DSCA over time adjacent to a decompressed segment.

Efficacy of a TNF inhibitor in chronic low back pain with Modic changes type 1: The BackToBasic study A randomized controlled trial.

Objective: The efficacy of TNF inhibitors for treating chronic low back pain with Modic changes is uncertain. This study investigated the superiority of infliximab over placebo in patients with Modic changes type 1.

Methods: In this multicenter, randomized, triple-blind, placebo-controlled trial, patients aged 18-65 with moderate to severe chronic low back pain and Modic changes type 1 were enrolled from five Norwegian public hospitals between January 2019 and October 2022.

Healthcare Utilisation in Danish Primary Care Among Patients With Low Back or Neck/Thoracic Spine Pain Before and After Assessment in Secondary Care.

Objectives: To describe characteristics and primary healthcare utilisation in Danish patients with low back pain (LBP) or neck/thoracic spine pain (NTP) 8 years before and 2 years after assessment in secondary care.

Methods: In this cohort study, we included patients aged ≥ 18 who were assessed at an outpatient spine clinic from 2013 to 2021 and linked self-reported information with national registry data. We calculated the prevalence of all-cause healthcare utilisation in primary care.

A randomized trial on three different minimally invasive decompression techniques for lumbar spinal stenosis. Five years follow-up from the NORDSTEN-SST.

Purpose: The short-term clinical outcome for midline-preserving posterior decompression techniques was comparable. The aim of this study was to evaluate long-term clinical results after three different midline-preserving posterior decompression techniques.

Material: In the NORDSTEN spinal stenosis trial (NORDSTEN-SST) 437 patients were randomized to three different midline-retaining posterior decompression techniques: Unilateral laminotomy with crossover (UL), bilateral laminotomy (BL) and spinous process osteotomy (SPO).

Clinical Importance of Redundant Nerve Roots in Patients with Symptomatic Lumbar Spinal Stenosis: A Secondary Analysis of NORDSTEN Spinal Stenosis Trial Data.

Study Design: Post-hoc analysis of data from a randomized clinical trial.

Objective: To compare preoperative symptoms of patients with lumbar spinal stenosis (LSS) with and without redundant nerve roots (RNR), and to compare the change in clinical outcomes between those two groups 2 years after decompression surgery.

Summary Of Background Data: RNR are often seen on MRI in patients with spinal stenosis.

Reducing strain on primary healthcare systems through innovative models of care: the impact of direct access physiotherapy for musculoskeletal conditions-an interrupted time series analysis.

Objectives: To evaluate the longitudinal impact of introducing a national, direct access physiotherapy model of care on the rates of primary and secondary care consultations for musculoskeletal (MSK) conditions.

Design: Interrupted time series analysis using segmented linear regression.

Setting: Norway primary care PARTICIPANTS: A cohort of 82 072 participants was derived from 3 population-based health surveys conducted across separate geographical regions in Norway.

Decompression alone or with fusion for degenerative lumbar spondylolisthesis (Nordsten-DS): five year follow-up of a randomised, multicentre, non-inferiority trial.

Objective: To assess whether decompression alone is non-inferior to decompression with instrumented fusion five years after primary surgery in patients with degenerative lumbar spondylolisthesis.

Design: Five year follow-up of a randomised, multicentre, non-inferiority trial (Nordsten-DS).

Setting: 16 public orthopaedic and neurosurgical clinics in Norway.

Primary care seeking among adults with chronic neck and low back pain in Norway: A prospective study from the HUNT study linked to Norwegian primary healthcare registry.

Background: To describe the frequency of primary care seeking for neck or back-related conditions among people with chronic neck and low back pain and to develop prediction models of primary care seeking and frequent visits.

Methods: We included participants of the Trøndelag Health Study (HUNT4, 2017-19) in Norway who self-reported chronic neck and/or low back pain in the preceding year, and extracted data of primary care visits from the Norwegian primary healthcare registry. We investigated a total of 23 potential predictors and used multivariable logistic regression models to predict primary care seeking for neck or back-related conditions and frequent visits by healthcare provider (i.

Predictive validity of the STarT Back screening tool among older adults with back pain.

Background: The predictive validity of the STarT Back screening tool among older adults is uncertain. This study aimed to assess the predictive validity of the SBT among older adults in primary care.

Methods: This prospective cohort study included 452 patients aged ≥55 years seeking Norwegian primary care with a new episode of back pain.

Change in Lumbar Lordosis After Decompressive Surgery in Lumbar Spinal Stenosis Patients and Associations With Patient-Related Outcomes Two Years After Surgery: Radiologic and Clinical Results From the NORDSTEN Spinal Stenosis Trial.

Study Design: A prospective cohort study.

Objective: The aim was to investigate changes in lumbar lordosis (LL) and its association to changes in patient-reported outcome measures (PROMs) after decompressive surgery for lumbar spinal stenosis (LSS).

Summary Of Background: Few studies have addressed change in LL after decompression surgery for LSS in relation to outcomes.

Bacterial growth in patients with low back pain and Modic changes: protocol of a multicentre, case-control biopsy study.

Introduction: Bacterial infection and Modic changes (MCs) as causes of low back pain (LBP) are debated. Results diverged between two randomised controlled trials examining the effect of amoxicillin with and without clavulanic acid versus placebo on patients with chronic LBP (cLBP) and MCs. Previous biopsy studies have been criticised with regard to methods, few patients and controls, and insufficient measures to minimise perioperative contamination.

Dural Sac Cross-sectional area change from preoperatively and up to 2 years after decompressive surgery for central lumbar spinal stenosis: investigation of operated levels, data from the NORDSTEN study.

Purpose: The aim of the present study was to investigate how canal area size changed from before surgery and up to 2 years after decompressive lumbar surgery lumbar spinal stenosis. Further, to investigate if an area change postoperatively (between 3 months to 2 years) was associated with any preoperative demographic, clinical or MRI variables or surgical method used.

Methods: The present study is analysis of data from the NORDSTEN- SST trial where 437 patients were randomized to one of three mini-invasive surgical methods for lumbar spinal stenosis.

Preoperative fatty infiltration of paraspinal muscles assessed by MRI is associated with less improvement of leg pain 2 years after surgery for lumbar spinal stenosis.

Purpose: Fatty infiltration (FI) of the paraspinal muscles may associate with pain and surgical complications in patients with lumbar spinal stenosis (LSS). We evaluated the prognostic influence of MRI-assessed paraspinal muscles' FI on pain or disability 2 years after surgery for LSS.

Methods: A muscle fat index (MFI) was calculated (by dividing signal intensity of psoas to multifidus and erector spinae) on preoperative axial T2-weighted MRI of patients with LSS.

The association between lumbar lordosis preoperatively and changes in PROMs for lumbar spinal stenosis patients 2 years after spinal surgery: radiological and clinical results from the NORDSTEN-spinal stenosis trial.

Background: Patients with lumbar spinal stenosis (LSS) sometimes have lower lumbar lordosis (LL), and the incidence of LSS correlates closely with the loss of LL. The few studies that have evaluated the association between LL and clinical outcomes after non-instrumented surgery for LSS show conflicting results. This study investigates the association between preoperative LL and changes in PROMs 2 years after decompressive surgery.

Machine Learning Models for Predicting Disability and Pain Following Lumbar Disc Herniation Surgery.

Importance: Lumber disc herniation surgery can reduce pain and disability. However, a sizable minority of individuals experience minimal benefit, necessitating the development of accurate prediction models.

Objective: To develop and validate prediction models for disability and pain 12 months after lumbar disc herniation surgery.

Do patients with lumbar spinal stenosis benefit from decompression of levels with adjacent moderate stenosis? A prospective cohort study from the NORDSTEN study.

Background: Lumbar spinal stenosis (LSS) is characterized by pain that radiates to the buttocks and/or legs, aggravated by walking and relieved by forward flexion. There is poor correlation between clinical symptoms and severity of stenosis on MRI, and multilevel stenosis has not been described to present worse symptoms or treatment outcomes, compared with patients with single-level stenosis. In patients with one level with severe stenosis combined with an adjacent level with moderate stenosis, the surgeon must decide whether to decompress only the narrowest level or both, to achieve the best possible outcome.

Identifying latent subgroups in the older population seeking primary health care for a new episode of back pain - findings from the BACE-N cohort.

Background: Back pain is the number one condition contributing to years lived with disability worldwide, and one of the most common reasons for seeking primary care. Research on this condition in the ageing population is sparse. Further, the heterogeneity of patients with back pain complicates the management in clinical care.

Longitudinal Relationship Between Reduced Modic Change Edema and Disability and Pain in Patients With Chronic Low Back Pain.

Study Design: Secondary analyses of a randomized trial [Antibiotics In Modic changes (MCs) study].

Objective: To assess whether or not reduced MC edema over time is related to reduced disability and pain in patients with chronic low back pain (LBP).

Summary Of Background Data: It is not clear whether or not reduced MC edema implies improved clinical outcomes.

Problematic alcohol use in young adults exposed to childhood trauma: The Trøndelag Health (HUNT) Study.

Problematic alcohol use (PAU) severely impacts the health, functioning, and long-term prospects of young people. Prior research indicates that childhood trauma exposure may be an important risk factor for PAU, but few longitudinal studies have looked at how specific trauma types influence this risk. The aim of this study was to investigate the association between childhood trauma exposure and PAU in a large, population-based cohort of young people.

Killing pain? A prospective population-based study on trauma exposure in childhood as predictor for frequent use of over-the-counter analgesics in young adulthood. The HUNT study.

Frequent and increasing use of over-the-counter analgesics (OTCA) is a public health concern. Pain conditions and psychological distress are related to frequent OTCA use, and as exposure to potentially traumatic events (PTE) in childhood appears to increase risk of experiencing such symptoms, we aimed to assess childhood PTEs and related symptoms in adolescence as predictors for frequent OTCA use in young adulthood. Prospective population survey data were used (n = 2947, 59.