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At least 73 records · Page 4Linked to original sources

Backache and epidural analgesia: a retrospective survey of mothers 1 year after childbirth.

A questionnaire was sent to 2065 mothers 1 year after delivery as part of a larger study into patient satisfaction with all aspects of their obstetric care. The response rate adjusted for non-delivered mail was 67.1%. There was a high incidence of new long-term backache in mothers who had received epidural analgesia (26.2% at one year) compared to the mothers who had not (1.7%). Further analysis of the data revealed no other significant associated factor.

Journal Article↗

A man with backache and renal failure.

Backache, a common symptom, is rarely caused by infection of the lumbar discs. The authors present the case of a 60-year-old man with a Staphylococcus aureus septicemia and associated lumbar discitis in whom a pauci immune crescentic glomerulonephritis and renal failure developed. Treatment with antibiotics and not immunosuppressive agents resulted in improved renal function with a discharge creatinine level of 1.87 mg/dL (165 micromol/L). This case highlights an association of pauci-immune crescentic glomerulonephritis with discitis that responded to antibiotic therapy alone.

Discitis↗

Postoperative backache: the use of an inflatable wedge.

An inflatable wedge was used to support the lumbo-sacral curve of patients undergoing anaesthesia and surgery in either the supine or lithotomy position. Of the operative factors investigated, the presence of a wedge was the only one found to have a useful influence on the incidence of postoperative backache, which was reduced significantly (P less than 0.001).

Adolescent↗

Backache in pregnancy II: prophylactic influence of back care classes.

Back care advice similar to that used in "low back pain schools' was made available to a group of primiparous women as early in their pregnancy as possible. Subsequently it was shown that they experienced significantly less "troublesome' and "severe' backache (P = less than 0.01) than a control group for whom such advice was not available.

Aging↗

The influence of indemnification by workers' compensation insurance on recovery from acute backache. North Carolina Back Pain Project.

STUDY DESIGN: A prospective observational cohort was recruited from 208 randomly selected North Carolina practices. OBJECTIVE: To compare the course of compensation claimants with gainfully employed patients not so insured from the time when they first sought care for acute back pain. SUMMARY OF BACKGROUND DATA: The human and financial cost attributable to disabling chronic low back pain identified by worker's compensation programs continues to escalate. We explored the antecedents to this phenomenon. METHOD: Consecutive patients with acute low back pain were interviewed by telephone within 1 week of first seeking care and in follow-up calls after 2, 4, 8, 12, and 24 weeks to monitor functional and work status. RESULTS: Of the 1633 patients enrolled, 505 were insured by workers' compensation. These were compared with 861 who had been employed on any job for pay within 3 months of the onset of their backache but whose care was not so underwritten. Those with compensable back pain were more likely to categorize their tasks as physically demanding and had taken more time off work in the month before the baseline interview (P = 0.02). Recovery of the sense of wellness they enjoyed before this episode of back pain was delayed (Cox Model: Hazard Ratio = 0.822; P < 0.001; confidence interval: 0.733, 0.923), but recovery of function or return to work was not. This delay was independent of type of health care and perception of task demand and beyond that which could be ascribed to the quality of back pain. CONCLUSION: Each of these associations is a reproach to the fashion in which workers' compensation insurance for regional back pain serves the ethic that is its raison d'être.

Adult↗

Incidence of postdural puncture headache and backache, and success rate of dural puncture: comparison of two spinal needle designs.

OBJECTIVES: The goal of this randomized study was to compare the incidence of postdural puncture headache (PDPH) and postdural puncture backache (PDPB), and the success rate between two small-gauge spinal needle designs used in women undergoing subarachnoid block anesthesia. METHODS: After Institutional Review Board approval, 215 patients presenting for tubal ligation were randomly assigned to have 26-gauge Atraucan (AT group) or 25-gauge Whitacre (WH group) spinal needles used in their spinal anesthesia. The number of attempts to successful cerebrospinal fluid return and the success rate of the spinal blockade were documented. Postoperatively, an investigator blinded to the study interviewed patients daily. RESULTS: The incidence of PDPH was similar between the AT group (3.9%) and the WH group (4.0%). The total duration of all PDPHs was 5 days for the AT group and 15 days for the WH group. Both groups had a similar one-attempt success rate of 61% (AT group) and 62% (WH group). Failure to obtain cerebrospinal fluid occurred in only one in the AT group and two in the WH group. The incidence of PDPB was similar and the severity was mild in both groups. CONCLUSIONS: The low complication and failure rates make these two types of smaller size spinal needle design good candidates for dural puncture procedures, such as spinal anesthesia, diagnostic lumbar punctures, and myelograms.

Adult↗

Severe backache as a presenting sign of bacterial endocarditis.

We report on two patients whose presenting sign of bacterial endocarditis was a sudden and severe backache. According to the literature, 25-44% of patients with bacterial endocarditis have musculoskeletal symptoms and in about 27% these symptoms are the first sign of the disease. The most probable pathogenetic mechanism of these symptoms is arterial microembolization consisting of bacteria and immune complexes.

Aged↗

Relief of osteoporotic backache with fluoride, calcium, and calciferol.

In a prospective randomized clinical trial comprising 22 postmenopausal women with backache and a halisteretic spine with crush fracture(s), 12 women completed a 12-week therapy with sodium fluoride, calcium and calciferol and 10 with placebo. A statistically significant improvement (p less than 0.05), evaluated by a four-stage scale on pains, infirmity, and consumption of analgesics, was observed in the actively treated patients.

Aged↗

A comparative trial of azapropazone and ketoprofen in the treatment of acute backache.

A double-blind trial of azapropazone (300 mg. 4-times daily) and ketoprofen (50 mg. 4-times daily) was carried out in 50 patients with acute backache sufficiently severe to necessitate hospital admission. Of 39 patients who completed the full 3-weeks' study period, 18 preferred azapropazone therapy, 10 preferred ketoprofen, and 11 showed either preference for the intermediate placebo period or no preference at all. Ten patients suffered from sufficiently severe side-effects with ketoprofen to necessitate their withdrawal from the trial. There were no similar episodes of withdrawal occurring during the azapropazone period.

Acute Disease↗

Iron deficiency anemia, backache, and abdominal pain attacks during sexual intercourse in a 42-year-old woman.

BACKGROUND: Gastrointestinal bleeding is a common diagnostic problem. We describe here a 42-year-old woman who had iron deficiency anemia that went undiagnosed for 8 years. SYMPTOMS AND RESULTS: She had a 'blood spray' when crouching, backache, and abdominal pain attacks during sexual intercourse. Defecography, but neither clinical examination nor endoscopy, demonstrated abnormal mobility of the rectal mucosa associated with other pelvic floor abnormalities. THERAPY: After rectopexy, the bleeding stopped, and the blood values normalized.

Abdominal Pain↗

Sacral and non-spinal tumors presenting as backache. A retrospective study of 17 patients.

Among 1302 cases reported to our tumor registry, 78 presented with backache as primary symptom. 17 of these had non-spinal tumors, 7 pelvic, 6 sacral, 3 femoral, and 1 costal. There were long delays in making the correct diagnosis; some patients even had had spinal surgery. The mistakes were the classic ones: poor history, poor physical examination, poor radiological work-up. Analysis of these 17 cases suggests that standard spinal radiographs should include an AP pelvis film and a lateral sacral projection. Patients with persistent radiating pain and normal radiographs should have a Tc-99 scan. The correct diagnosis would have been made in all the cases if this protocol had been followed.

Adult↗

Histoplasmosis presenting with progressively worsening backache--a case report.

INTRODUCTION: Bilateral adrenal enlargement is often the result of disseminated malignant disease, and this diagnosis is particularly likely in a patient with severe weight loss. We describe a case with bilateral adrenal enlargement presenting with progressively worsening backache as a prominent symptom. CLINICAL PICTURE: A 55-year-old man presented with intermittent low back pain which was progressively worsening, fever, anorexia, low back pain and a 10-kg weight loss. He had underlying diabetes mellitus and ischaemic heart disease. He gave a history of travel to caves for worship. Clinically, the most significant findings included nodular lesions in the anterior fauces and left palatoglossal region. Computed tomographic scan revealed bilateral adrenal masses. Biopsies were taken from the palatal nodules, which revealed histiocytes with numerous histoplasma organisms. TREATMENT: He was commenced on itraconazole 200 mg daily for a period of 9 months. There was a dramatic initial response with settling of his fever and this was followed by subjective improvement in his well-being. OUTCOME: He is presently on follow-up and has completed 9 months of itraconazole therapy with resolution of all his symptoms and has gained about 10 kg of weight.

Antifungal Agents↗

A study of subcutaneous rhizolysis in the treatment of chronic backache.

Subcutaneous rhizolysis is defined as cutting the nerves to the posterior intervertebral joints. Although a blind procedure, it has proved safe in several centres and provides relief of pain in about two thirds of those who suffer from intractable, persistent backache. Some conditions such as ankylosing spondylitis and previous spinal fusion are clinically unsuitable, but this technique, which is described, is recommended for consideration before all major surgical procedures for back pain are undertaken.

Adult↗

[Diagnosis of chronic backache in health resort patients].

Conservative treatment of backache requires an accurate diagnosis because sometimes such patients are suffering from a serious but unrecognised disease of the abdomen or low back region. Diagnoses like cervical syndrome, lumbar syndrome or even cervicodorso-lumbar syndrome are not sufficiently conclusive to start conservative treatment, since they convey nothing in respect of cause, prognosis or aim of treatment. Patients undergoing a course of inpatient curative treatment of, say, four weeks in a hospital, need special therapy programmes that are meaningfully based on precise data on their disorder. It is important to set great store by the physical examination (which is often performed cursorily before the patients are referred to curative inpatients treatment), including a neurological examination and in some cases also EMG, special radiographs, myelography, CT, magnetic resonance imaging and the like to gather more information on the real cause of the low back pain. This will also help the physician in arriving at a fair estimation of the patient's performance rating. A useful classification of patients into two groups would be as follows: a) without neurological symptoms, and b) with signs of a nerve-root compression or even spinal cord symptoms.

Back Pain↗

Percutaneous posterolateral lumbar discectomy. An alternative to laminectomy in the treatment of backache and sciatica.

The evacuation and decompression of the herniated lumbar disc (HLD) through a sheath or cannula inserted dorsolaterally represent a new concept in the treatment of backache and sciatica associated with disc herniation. Under local anesthetic and Valium (Roche, Nutley, New Jersey) sedation, 20 patients with sciatica, restricted straight-leg raising, and neurological impairment were treated by this simple and safe technique. All patients had computed tomographic evidence of L4-L5 protrusion. The introduction of a sheath with an internal diameter of 4.9 mm permitted removal of the nuclear material by means of a small pituitary forcep. Using the self-assessment method of Coventry and Stauffer, it was concluded that 12 of the 20 patients had a good or fair result. Predictably, the compensation patients fared poorly. There were no complications. This technique appears applicable in HLD to properly selected patients, and it would seem that it is safe, effective, and cost efficient.

Adult↗

[Medical imaging and chronic backache].

The different procedures for imaging the lumbar spine are presented within a general review of chronic low back pain. Plain films still represent the main procedure: they are sufficient for common backache, the most frequent pattern of chronic low back pain. They help in determining further investigations in symptomatic low back pain, due either to spinal or non spinal conditions.

Arachnoiditis↗

[Anomalies of the lumbosacral nerve roots with low backache and sciatica].

Nine patients with lumbosacral nerve root anomalies (NRA) were reported. 36 cases were collected from reported papers in addition, seven types of NRA were classified by the author. They were: conjoined root (with the incidence of 31.11%), near roots (26.66%), two roots in same foreman (20%), anastomosis between roots (11.11%), double roots (4.44%), branch root and combined type (6.66%). The rate of finding of NRA by operation was 0.34%, that was far lower than by myelography and autopsy. Careful exploration can increase the finding rate. NRA can induce backache and sciatica by itself. Its clinical distinguishing features were severe symptoms, compression of multiple nerve roots slight or negative Lasegue sign. The principle of treatment of NRA was adequate decompression, but should be careful to avoid injury of displaced and tensile nerve roots. In this paper, the matters needing attention in operation was discussed as well.

Adult↗