Temporary external pedicular fixation versus definitive bony fusion: a prospective comparative study on pain relief and function

Axelsson, Paul; Johnsson, Ragnar; Strömqvist, Björn; Andréasson, Håkan

doi:10.1007/s00586-002-0459-x

Cited by 11 publications

(2 citation statements)

References 18 publications

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“…4,12,[29][30][31]37 Several studies have examined the ability of TEPF to predict outcome following lumbar fusion. Axelsson, et al, [4][5][6] described their experience in treating 26 patients with low-back pain (with a variety of diagnoses) who underwent TEPF for 8 days. Patients were selected for lumbar fusion if they reported a decrease in pain while performing five activities of daily living and demonstrated improvement in two functional walking tests.…”

Section: Scientific Foundationmentioning

confidence: 99%

“…The authors concluded that 70% of their patients achieved good outcomes and therefore that a trial of TEPF led to better selection of patients with low-back pain who might benefit from lumbar fusion surgery. 5 Because no comparison was made with a control group (patients who did not have pain relief with TEPF or those who did not undergo TEPF) was described, no meaningful conclusions regarding the efficacy of TEPF in this population can be drawn.…”

Section: Scientific Foundationmentioning

confidence: 99%

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Guidelines for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 14: brace therapy as an adjunct to or substitute for lumbar fusion

Resnick¹,

Choudhri²,

Dailey³

et al. 2005

Journal of Neurosurgery: Spine

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Standards. There is insufficient evidence to recommend a treatment standard. Guidelines. The short-term use of a rigid lumbar support (1-3 weeks) is recommended as a treatment for low-back pain of relatively short duration (Ͻ 6 months). The use of a lumbar brace for patients with chronic low-back pain is not recommended because there is no pertinent medical evidence of any long-term benefit or evidence that brace therapy is effective in the treatment of patients with chronic (Ͼ 6 months) low-back pain. Options. 1) Lumbar braces are recommended as a means of decreasing the number of sick days lost due to low-back pain among workers with a previous lumbar injury. They are not recommended as a means of decreasing low-back pain in the general working population. 2) The use of lumbar brace therapy as a preoperative diagnostic tool to predict outcome following lumbar fusion surgery is not recommended. 3) The use of transpedicular external fixation as a tool to predict outcome following lumbar fusion surgery is not recommended. Rationale Lumbosacral supports or back braces have been used for the prevention and treatment of a wide variety of degenerative disorders of the lumbar spine. 11 The potential mechanisms of action for brace therapy include limiting spinal ROM, correcting posture and deformity, preventing gross trunk motion, increasing the intraabdominal pressure, reducing force exerted by trunk muscles, and providing soft-tissue massage and heat. 23,28,42 Critics of lumbar supports have argued that braces may provide workers with a false sense of support or allow muscles to waste, thereby increasing the incidence of injury. 26 Although the mechanism of action of lumbar supports remains open to debate, their clinical utility in the prevention and treatment of low-back pain must be determined to justify their use. 22 Braces have been used for the preoperative evaluation of patients in an attempt to predict outcome following fusion surgery. They are also applied following lumbar surgery to promote fusion. 9,19 Because lumbar orthoses do not eliminate motion in the lumbar spine, their utility has been questioned. 2,3 The purpose of this review is to exam

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Section: Scientific Foundationmentioning

confidence: 99%

Section: Scientific Foundationmentioning

confidence: 99%

Guidelines for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 14: brace therapy as an adjunct to or substitute for lumbar fusion

Resnick¹,

Choudhri²,

Dailey³

et al. 2005

Journal of Neurosurgery: Spine

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Intervertebral mobility in the progressive degenerative process. A radiostereometric analysis

Axelsson

Karlsson

2004

Eur Spine J

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Three separate stages have previously been defined in the progressive degenerative process. The first stage, characterized as temporary dysfunction with early degenerative findings, transforms into a second period of segmental instability evidenced by a resulting deformity. With the deformity the process has reached a late stage of definitive stabilization induced by osteoligamentary repair mechanisms. To test the validity of this three-stage hypothesis, we assessed the intervertebral mobility for the two most-distal lumbar disc levels in 18 adult patients with low back pain, disc degenerative findings and no prior spinal surgery. Each spinal segment was categorized according to grade of disc degeneration: (IA) normal disc height without dehydration; (IB) normal disc height with dehydration; (II) disc height decreased by less than 50%; (III) disc height decreased by at least 50%; and (IV) disc height obliterated. The intervertebral mobility was measured by radiostereometric analysis (RSA) and compared between the categories. With the patient changing position from supine to sitting, the mean vertical translation across the 11 discs categorized as IA was 2.0 mm. A small increase in mean vertical mobility with progressive loss of disc height through the degenerative stages IB (2.2 mm,

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Chapter 4 European guidelines for the management of chronic nonspecific low back pain

Airaksinen¹,

Brox²,

Cedraschi³

et al. 2006

Eur Spine J

2,240

1,673

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Temporary external pedicular fixation versus definitive bony fusion: a prospective comparative study on pain relief and function

Cited by 11 publications

References 18 publications

Guidelines for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 14: brace therapy as an adjunct to or substitute for lumbar fusion

Guidelines for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 14: brace therapy as an adjunct to or substitute for lumbar fusion

Intervertebral mobility in the progressive degenerative process. A radiostereometric analysis

Chapter 4 European guidelines for the management of chronic nonspecific low back pain

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