Assessment of Outcome in Patients with Low-Back Pain

Greenough, C G; Fraser, Robert D.

doi:10.1097/00007632-199201000-00006

Cited by 240 publications

(127 citation statements)

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“…The patients were clinically assessed prior to surgery and at 1 year follow-up using a pain score (Numeric Rating Scale), the Lower Back Outcome Score (LBOS) [23], and the Roland Morris Disability Questionnaire [24].…”

Section: Radiological Studymentioning

confidence: 99%

Do position and size matter? An analysis of cage and placement variables for optimum lordosis in PLIF reconstruction

2017

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Purpose To examine monosegmental lordosis after posterior lumbar interbody fusion (PLIF) surgery and relate lordosis to cage size, shape, and placement. Methods Eighty-three consecutive patients underwent single-level PLIF with paired identical lordotic cages involving a wide decompression and bilateral facetectomies. Cage parameters relating to size (height, lordosis, and length) and placement (expressed as a ratio relative to the length of the inferior vertebral endplate) were recorded. Centre point ratio (CPR) was the distance to the centre of both cages and indicated mean position of both cages. Posterior gap ratio (PGR) was the distance to the most posterior cage and indicated position and cage length indirectly. Relationships between lordosis and cage parameters were explored. Results Mean lordosis increased by 5.98°(SD 6.86°). The cages used varied in length from 20 to 27 mm, in lordosis from 10°to 18°, and in anterior cage height from 10 to 17 mm. The mean cage placement as determined by CPR was 0.54 and by PGR was 0.16. The significant correlations were: both CPR and PGR with lordosis gain at surgery (r = 0.597 and 0.537, respectively, p \ 0.001 both), cage lordosis with the final lordosis (r = 0.234, p \ 0.05), and anterior cage height was negatively correlated with a change in lordosis (r = -0.297, p \ 0.01).Conclusion Cage size, shape, and position, in addition to surgical technique, determine lordosis during PLIF surgery. Anterior placement with sufficient ''clear space'' behind the cages is recommended. In addition, cages should be of moderate height and length, so that they act as an effective pivot for lordosis.

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Section: Radiological Studymentioning

confidence: 99%

Do position and size matter? An analysis of cage and placement variables for optimum lordosis in PLIF reconstruction

2017

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“…In ~986 Prolo et al initiated the EconomicFunctional Rating Scale for assessing the outcome of lumbar spinal operations [19]. Greenough and Fraser (1992) introduced the Low Back Outcome Score. In our opinion this has the advantage that it may be used pre-and postoperatively to estimate the functional starting condition and the operative results in prospective studies [10].…”

Section: Introductionmentioning

confidence: 99%

“…Greenough and Fraser (1992) introduced the Low Back Outcome Score. In our opinion this has the advantage that it may be used pre-and postoperatively to estimate the functional starting condition and the operative results in prospective studies [10]. Up to now none of these scales have been used in a prospective study to assess the outcome of lumbar disc surgery.…”

Section: Introductionmentioning

confidence: 99%

Does the choice of outcome scale influence prognostic factors for lumbar disc surgery?

et al. 1997

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From January to June 1994, we operated conventionally on 121 consecutive herniated lumbar disc patients as part of a prospective study. We analysed general data, case histories, neurological findings on admission and all data from imaging investigations and therapy. In addition, all patients received a questionnaire based on the Low Back Outcome Score. Most of the patients (93%) were followed-up for 1 year postoperatively in the same manner.On the Prolo Scale, we obtained a good result in 70%; 76% had a good Low Back Outcome Score. Predictive factors are different for different outcome scales. The preoperative duration of pain, the preoperative duration of paresis and smoking seem to be general predictive factors.

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“…Each patient had a full neurological examination as well as assessment of peripheral pulses and range of knee/hip movements prior to trial entry. Patients then completed a standard spine assessment questionnaire, including visual analogue score (VAS) for back and leg pain, Oswestry Disability Index (ODI) [3,4] and Low Back Outcome Score (LBOS) [5]. Psychological testing involved use of the modified somatic perception questionnaire (MSPQ) and the modified zung depression score (MZD).…”

Section: Methodsmentioning

confidence: 99%

Randomised placebo-controlled trial on the effectiveness of nasal salmon calcitonin in the treatment of lumbar spinal stenosis

Tafazal

Sell

2006

Eur Spine J

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This is a double blind randomised controlled trial to assess the effectiveness of nasal salmon calcitonin in the treatment of lumbar spinal stenosis. The trial compared the outcome of salmon calcitonin nasal spray to placebo nasal spray in patients with MRI confirmed lumbar spinal stenosis. Lumbar spinal stenosis is one of the commonest conditions encountered by spine surgeons. It more frequently affects elderly patients and lumbar decompression has been used to treat the condition with variable success. Non operative measures have been investigated, but their success ranges from 15% to 43% in patients followed up for 1-5 years (Simotas in Clin Orthop 1(384): [153][154][155][156][157][158][159][160][161] 2001). Salmon calcitonin injections have been investigated in previous trials and may have a treatment effect. Nasal salmon calcitonin has become available and if effective would have advantages over injections. Forty patients with symptoms of neurogenic claudication and MRI proven lumbar spinal stenosis were randomly assigned either nasal salmon calcitonin or placebo nasal spray to use for 4 weeks. This was followed by a 'washout' period of 6 weeks, and subsequent treatment with 6 weeks of nasal salmon calcitonin. Standard spine outcome measures including Oswestry disability index (ODI), low back outcome score, visual analogue score and shuttle walking test were administered at baseline, 4, 10 and 16 weeks. Twenty patients received nasal salmon calcitonin and twenty patients received placebo nasal spray. At 4 weeks post treatment there was no statistically significant difference in the outcome measures between the two groups. The change in ODI was a mean 1.3 points for the calcitonin group and 0.6 points for the placebo group (P = 0.51), the mean change in visual analogue score for leg pain was 10 mm in the calcitonin group and 0 mm in the placebo group (P = 0.51). There was no significant difference in walking distance between the two groups, with a mean improvement in walking distance of 21 m in the calcitonin group and 8 m in the placebo group (P = 0.78). At the end of the trial the ODI had improved by a mean of 3.7 points in the calcitonin group and 3.8 points in the placebo group (P = 0.44). This randomised placebo controlled trial has not shown any treatment effect in patients with lumbar spinal stenosis treated with nasal salmon calcitonin.

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Assessment of Outcome in Patients with Low-Back Pain

Cited by 240 publications

References 0 publications

Do position and size matter? An analysis of cage and placement variables for optimum lordosis in PLIF reconstruction

Do position and size matter? An analysis of cage and placement variables for optimum lordosis in PLIF reconstruction

Does the choice of outcome scale influence prognostic factors for lumbar disc surgery?

Randomised placebo-controlled trial on the effectiveness of nasal salmon calcitonin in the treatment of lumbar spinal stenosis

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