The effect of the stay active advice on physical activity and on the course of acute severe low back pain.

Background: Disability due to acute low back pain (ALBP) runs parallel with distress and physical inactivity. If low back pain persists, this may lead to long-term sick leave and chronic back pain. This prospective randomized study evaluated the effect on physical activity and on the course of ALBP of two different treatment advices provided in routine care.

Comparison between pain at discography and morphological disc changes at axial loaded MRI in patients with low back pain.

Purpose: Discogenic pain is induced by axial load, but there are no studies evaluating the influence of dynamic MRI in relation to provoked pain at discography. The aim of this study was to investigate the relationship between discography-induced pain and morphological disc changes, occurring during axial loaded MRI (alMRI). A secondary aim was to compare and register the frequency of provoked concordant pain at alMRI and discography.

Pressure Increase in Adjacent Discs During Clinical Discography Questions the Methods Validity.

Study Design: Observational in vivo clinical study.

Objective: To investigate whether intradiscal pressure is transferred to adjacent discs during clinical discography in subjects with discogenic pain.

Summary Of Background Data: Despite the introduction of pressure registration in discography, the validity of the method remains controversial.

In vivo discography in degenerate porcine spines revealed pressure transfer to adjacent discs.

Study Design: In vivo experimental porcine study.

Objective: To investigate if discography induced pressure increase in adjacent degenerate discs.

Summary Of Background Data: Despite refinements in the past 2 decades, the validity of discography is debated.

HIZ's relation to axial load and low back pain: investigated with axial loaded MRI and pressure controlled discography.

Purpose: The aims were to investigate if the detection of high-intensity zones (HIZ) is affected by axial load, and to study the correlation between HIZ and discogenic pain provoked with pressure controlled discography (PCD).

Methods: 41 consecutive patients with chronic low back pain, referred for discography, were included. Each patient underwent PCD, CT, MRI, and axial loaded MRI (alMRI) within 24 h.

The transfer of disc pressure to adjacent discs in discography: a specificity problem?

Study Design: In vivo experimental study.

Objective: The primary objective of the study was to investigate pressure transmission to adjacent discs during discography. A secondary objective was to quantify the transmitted pressure, both in contrast injected and noninjected porcine intervertebral discs.

Previous vertebral compression fractures add to the deterioration of the disability and quality of life after an acute compression fracture.

Prevalent vertebral compression fracture(s) have been reported as having a negative impact on pain, disability, and quality of life. But no study has evaluated the effect of previous fracture on the course of acute compression fractures. The aim of the present study was to compare the natural course of the acute compression fracture in patients with (n = 51) and without (n = 56) previous vertebral compression fracture(s).

Bulging of the inner and outer annulus during in vivo axial loading of normal and degenerated discs.

Study Design: Comparison of in vivo biomechanical outcomes between experimental and control group animals.

Objective: To quantify the in vivo bulging response of the inner and outer annulus in animals with and without disc degeneration.

Summary Of Background Data: Prior attempts to quantify the load-deformation response of the inner annulus have most often relied on in vitro preparations.

The narrowing of the lumbar spinal canal during loaded MRI: the effects of the disc and ligamentum flavum.

Load and activity changes of the spine typically cause symptoms of nerve root compression in subjects with spinal stenosis. Protrusion of the intervertebral disc has been regarded as the main cause of the compression. The objective was to determine the changes in the size of the lumbar spinal canal and especially those caused by the ligamentum flavum and the disc during loaded MRI.

The prognosis for pain, disability, activities of daily living and quality of life after an acute osteoporotic vertebral body fracture: its relation to fracture level, type of fracture and grade of fracture deformation.

The level of the acute osteoporotic vertebral fracture, fracture type and grade of fracture deformation were determined in 107 consecutive patients and related to pain, disability, activities of daily living (ADL) and quality of life (QoL) after 3 weeks, 3, 6 and 12 months. Two-thirds of the fractured patients were women and with a similar average age, around 75 years, as the men. Fifty-eight of the acute fractures were located in the thoracic spine and 49 in the lumbar spine and predominantly at the Th12 and L1 levels.

Utility of spine surgery: a comparison of common elective orthopaedic surgical procedures.

Study Design: A 1-year prospective observational cohort study.

Objective: To compare the utility before and 1 year after elective spine surgery with some other common orthopaedic surgical procedures.

Summary Of Background Data: By using global measures like EQ-5D and SF-36 for the determination of the utility, the changes in quality of life, quality of life (QoL) after an intervention different diagnoses, and treatments can be compared.

The course of the acute vertebral body fragility fracture: its effect on pain, disability and quality of life during 12 months.

The vertebral body fracture is the most frequent bone fragility fracture. In spite of this there is considerable uncertainty about the frequency, extent and severity of the acute pain and even more about the duration of pain, the magnitude of disability and how much daily life is disturbed in the post-fracture period. The aim of the present study was to follow the course of pain, disability, ADL and QoL in patients during the year after an acute low energy vertebral body fracture.

The relationship between the cross-sectional area of the cauda equina and the preoperative symptoms in central lumbar spinal stenosis.

Study Design: A cross-sectional registry and imaging cohort study.

Objectives: To study the association between typical symptoms and signs of central spinal stenosis and the minimum cross-sectional area (mCSA) of the cauda equina in patients subsequently undergoing surgery.

Summary Of Background Data: Relations between mCSA and the symptoms of spinal stenosis have not been studied before.

Rapid atrophy of the lumbar multifidus follows experimental disc or nerve root injury.

Study Design: Experimental study of muscle changes after lumbar spinal injury.

Objectives: To investigate effects of intervertebral disc and nerve root lesions on cross-sectional area, histology and chemistry of porcine lumbar multifidus.

Summary Of Background Data: The multifidus cross-sectional area is reduced in acute and chronic low back pain.

Prevalence of low back pain and sickness absence: a "borderline" study in Norway and Sweden.

Aims: Low back pain (LBP) is a major public health problem in both Norway and Sweden. The aim of the study was to estimate the prevalence of LBP and sickness absence due to LBP in two neighbouring regions in Norway and Sweden. The two areas have similar socioeconomic status, but differ in health benefit systems.

The cost-utility of lumbar disc herniation surgery.

The cost and utility of surgery for a herniated lumbar disc has not been determined simultaneously in a single cohort. The aim of this study is to perform a cost-utility analysis of surgical and nonsurgical treatment of patients with lumbar disc herniation. Ninety-two individuals in a cohort of 1,146 Swedish subjects underwent lumbar disc herniation surgery during a 2-year study.

Predictors for work ability and disability in men and women with low-back or neck problems.

In many countries back and neck problems are the most common reason for work incapacity. Numerous studies have looked for reliable predictors of return to work (RTW) or not return to work (NRTW) for those incapacitated, but with few exceptions their predictive and detective ability has been limited. We aimed to perform a comparative study of various commonly used health measures ability to predict RTW or NRTW in a cohort of men and women sick-listed for more than 28 days due to low-back pain (LBP) or neck pain (NP).

Swedish Council on Technology Assessment in Health Care (SBU). Chapter 6. Sickness absence due to back and neck disorders.

The scientific evidence on the causes for sick leave attributed to back and neck disorders was reviewed. Categories were established for acute, recurring, and chronic problems based on the duration of the sick leave period. Forty-eight articles were found to be relevant, whereof two were of high quality and 26 were of medium or low quality.

Ankle arthrodesis using dowel bone graft and cancellous-bone screws: a mechanical study in cadavers.

Background: There are numerous techniques for ankle arthrodesis.

Material And Methods: We studied the stability of an ankle arthrodesis with the use of two cross-screws combined with dowel graft technique in 14 fresh-frozen ankles from amputees. The arthrodesis was performed by a dowel graft technique, in the coronal plane in 7 specimens (group 1) and in the diagonal plane in the remaining 7 (group 2).

In vivo porcine intradiscal pressure as a function of external loading.

Background: Spinal loading during daily activity as it relates to the ability of the intervertebral disc to sustain its integrity has been a major issue in spinal research. The purpose of this investigation was to establish the relationship between the intervertebral disc pressure in the nucleus and the load applied to the motion segment in an in vivo porcine model.

Methods: Nine domestic pigs were used in this study.

The costs for persons sick-listed more than one month because of low back or neck problems. A two-year prospective study of Swedish patients.

The total costs for patients who are sick-listed due to back and neck problems have not previously been determined prospectively on an individual basis. This study aimed to determine the total cost to a society, based on individually assessed costs of health services and loss of production in people who are sick-listed 28 days or more for back or neck problems. Detailed data on individuals' health-care consumption due to back or neck problems was collected through prospectively entered diaries and questionnaires, after 4 weeks, 3 months, 1 and 2 years, in a consecutively selected cohort of 1,822 employed persons aged between 18 and 59 years.