Single-blind randomised controlled trial of chemonucleolysis and manipulation in the treatment of symptomatic lumbar disc herniation

Burton, A. Kim; Tillotson, Malcolm; Cleary, J

doi:10.1007/s005869900113

Cited by 114 publications

(79 citation statements)

References 12 publications

(12 reference statements)

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“…According to one RCT, 208 there was no important difference between chemonucleolysis and osteopathic manipulation at 6 weeks in terms of pain reduction. However, although the randomisation sequence was generated by computer and treatment allocated using envelopes, some patients were not randomised according to the predetermined order because of administrative problems.…”

Section: Pain Intensity At Short-term Follow-upmentioning

confidence: 98%

“…Fewer than half (17/36, 47%) of chemonucleolysis studies were RCTs, and only one of these 206 was good quality (comparator was inactive control). Eleven studies 47,85,88,160,168,170,205,[207][208][209][210] were of moderate quality. One study 206 used both adequate randomisation and allocation concealment (comparator included inactive control).…”

Section: Summary Of Study Design and Quality For Chemonucleolysis Stumentioning

confidence: 99%

“…Chemonucleolysis was compared with inactive control, disc surgery and manipulation. One study 76 included patients with chronic sciatica, three studies 85,207,208 included patients with either acute or chronic sciatica, and the remaining study 88 did not report the duration of symptoms. The duration of follow-up ranged from 4 weeks 88,207 to 6 weeks.…”

Section: Pain Intensity At Short-term Follow-upmentioning

confidence: 99%

See 2 more Smart Citations

The clinical effectiveness and cost-effectiveness of management strategies for sciatica: systematic review and economic model

Lewis

Williams²,

Matar³

et al. 2011

Health Technol Assess

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How to obtain copies of this and other HTA programme reports An electronic version of this title, in Adobe Acrobat format, is available for downloading free of charge for personal use from the HTA website (www.hta.ac.uk). A fully searchable DVD is also available (see below).Printed copies of HTA journal series issues cost £20 each (post and packing free in the UK) to both public and private sector purchasers from our despatch agents.Non-UK purchasers will have to pay a small fee for post and packing. For European countries the cost is £2 per issue and for the rest of the world £3 per issue. How to order:-fax (with credit card details) -post (with credit card details or cheque) -phone during office hours (credit card only).Additionally the HTA website allows you to either print out your order or download a blank order form. Contact details are as follows:Synergie UK (HTA Department) Digital House, The Loddon Centre Wade Road Basingstoke Hants RG24 8QW Email: orders@hta.ac.uk Tel: 0845 812 4000 -ask for 'HTA Payment Services' (out-of-hours answer-phone service) Fax: 0845 812 4001 -put 'HTA Order' on the fax header Payment methods Paying by chequeIf you pay by cheque, the cheque must be in pounds sterling, made payable to University of Southampton and drawn on a bank with a UK address.Paying by credit card You can order using your credit card by phone, fax or post. SubscriptionsNHS libraries can subscribe free of charge. Public libraries can subscribe at a reduced cost of £100 for each volume (normally comprising 40-50 titles). The commercial subscription rate is £400 per volume (addresses within the UK) and £600 per volume (addresses outside the UK). Please see our website for details. Subscriptions can be purchased only for the current or forthcoming volume.How do I get a copy of HTA on DVD?Please use the form on the HTA website (www.hta.ac.uk/htacd/index.shtml). HTA on DVD is currently free of charge worldwide.The website also provides information about the HTA programme and lists the membership of the various committees. HTAThe clinical effectiveness and costeffectiveness of management strategies for sciatica: systematic review and economic model NIHR Health Technology Assessment programmeThe Health Technology Assessment (HTA) programme, part of the National Institute for Health Research (NIHR), was set up in 1993. It produces high-quality research information on the effectiveness, costs and broader impact of health technologies for those who use, manage and provide care in the NHS. 'Health technologies' are broadly defined as all interventions used to promote health, prevent and treat disease, and improve rehabilitation and long-term care. The research findings from the HTA programme directly influence decision-making bodies such as the National Institute for Health and Clinical Excellence (NICE) and the National Screening Committee (NSC). HTA findings also help to improve the quality of clinical practice in the NHS indirectly in that they form a key component of the 'National Knowledge Service' . The HTA pro...

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Section: Pain Intensity At Short-term Follow-upmentioning

confidence: 98%

Section: Summary Of Study Design and Quality For Chemonucleolysis Stumentioning

confidence: 99%

Section: Pain Intensity At Short-term Follow-upmentioning

confidence: 99%

See 1 more Smart Citation

The clinical effectiveness and cost-effectiveness of management strategies for sciatica: systematic review and economic model

Lewis

Williams²,

Matar³

et al. 2011

Health Technol Assess

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“…1,2,4,10,12,16 Posterior-toanterior (PA) mobilization is frequently employed to assess spinal mobility, and involves applying a force to a single vertebral spinous process with the individual lying in the prone position. This technique evaluates passive segmental mobility, which is an indirect reflection of the integrity of periarticular structures (ie, disc, capsule, and ligaments).…”

mentioning

confidence: 99%

“…This technique evaluates passive segmental mobility, which is an indirect reflection of the integrity of periarticular structures (ie, disc, capsule, and ligaments). Even though this and other manual therapy methods have been used with varying levels of success to reduce pain and improve mobility, 1,2,7,9,13,15,16 it is unclear how this particular manual technique influences intervertebral motion of the lumbar spine.…”

mentioning

confidence: 99%

Assessment of Lumbar Spine Kinematics Using Dynamic MRI: A Proposed Mechanism of Sagittal Plane Motion Induced by Manual Posterior-to-Anterior Mobilization

Kulig¹,

Landel²,

Powers³

2004

J Orthop Sports Phys Ther

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Study Design: Descriptive study. Objective: The purpose of this study was to describe the segmental motion of the lumbar spine during a posterior-to-anterior (PA) mobilization procedure using dynamic magnetic resonance imaging and to propose a mechanism of the lumbar spine's motion as a result of a PA force to a lumbar spinous process. Background: Studies reporting kinematic descriptions of PA mobilization are in agreement that motion takes place at all lumbar vertebrae. However, these studies differ in the reported direction of motion. Methods and Measures: Twenty asymptomatic subjects (mean age ± SD, 31.1 ± 7.0 years) participated in this study. For each subject, a PA mobilization force was manually applied at each lumbar spinous process while sagittal plane magnetic resonance images were simultaneously obtained. Intervertebral motion was defined as the change in the intervertebral angle between the resting and end range vertebral positions imparted by the PA pressure. Results: PA force applied at 1 spinous process caused motion at the target vertebra and this motion was propagated caudally and cranially. Motion at the target segment was always into extension. Conclusions: A PA force applied at a single lumbar spinous process caused motion of the entire lumbar region. The magnitude and direction of intervertebral motions varied with the segment at which the PA force was applied. We postulated that the intervertebral motion induced by a PA force on a spinous process could be in part explained by the morphology of the lumbar spine.

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Surgical interventions for lumbar disc prolapse

Gibson

Waddell

2007

Cochrane Database of Systematic Reviews

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Single-blind randomised controlled trial of chemonucleolysis and manipulation in the treatment of symptomatic lumbar disc herniation

Cited by 114 publications

References 12 publications

The clinical effectiveness and cost-effectiveness of management strategies for sciatica: systematic review and economic model

The clinical effectiveness and cost-effectiveness of management strategies for sciatica: systematic review and economic model

Assessment of Lumbar Spine Kinematics Using Dynamic MRI: A Proposed Mechanism of Sagittal Plane Motion Induced by Manual Posterior-to-Anterior Mobilization

Surgical interventions for lumbar disc prolapse

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