Relief Of Back Pain Research Articles

Updated Meta-analysis Reveals Limited Efficacy of Vitamin D Supplementation in Chronic Low Back Pain.

Chronic low back pain (CLBP) significantly reduces quality of life and increases reliance on healthcare resources. Despite many individuals opting for vitamin D supplementation to alleviate CLBP, its efficacy remains debatable. This meta-analysis aimed to evaluate the potential benefits of vitamin D supplementation in treating this condition. Adhering to PRISMA guidelines, we systematically reviewed the effectiveness of vitamin D supplementation in adults with CLBP, focusing exclusively on randomized controlled trials (RCTs). A comprehensive literature search was conducted up to May 2024 across multiple databases, including PubMed, Scopus, Cochrane Library, and Web of Science. Ten RCTs meeting our inclusion criteria were analyzed. The results indicated that vitamin D supplementation did not significantly reduce pain scores compared to control groups (SMD: -0.130, 95%CI=-0.260 to 0.000; I2=0%), regardless of participants' baseline vitamin D levels. Moreover, long-term supplementation showed no notable improvement in CLBP outcomes (SMD: -0.097, 95%CI=-0.290 to -0.097; I2=19.878%). Additionally, supplementation with active forms of vitamin D (SMD: -0.321, 95%CI=-0.670 to 0.028; I2=0.000%) did not result in significant pain relief for chronic lower back pain. Vitamin D supplementation does not substantially alleviate CLBP. Nevertheless, it may still be considered as part of a comprehensive treatment plan. Further research is necessary to explore its long-term effects and the underlying mechanisms that may explain the observed lack of benefit.

Efficacy of iodized oil in emergency ultraselective arterial embolization for fatal massive hemorrhage due to renal angiomyolipoma: a single-center retrospective cohort study.

In recent years, the area of minimally invasive, targeted therapy for kidney tumors has seen considerable advancement; however, little progress has been made in the evaluation of renal angiomyolipoma (RAML). We aimed to investigate the efficacy of emergency ultraselective arterial embolization for the treatment of fatal massive bleeding caused by RAML. At The First Hospital of Jilin University, a retrospective study was conducted between January 1, 2019 and March 1, 2024. The enrolled patients were those experiencing intense flank pain with a ruptured RAML and hemorrhage as confirmed through computed tomography (CT) and magnetic resonance imaging (MRI) in the emergency department. We performed renal arteriography and vascular ultraselective embolization in patients with ruptured and bleeding RAML. Patient information, including age, sex, tumor size, embolic material, several blood laboratory parameters, and postembolization syndrome (PES) occurrence, was retrospectively analyzed. PES was defined as the occurrence of fever, pain, nausea, or vomiting. This study ultimately enrolled 27 patients. After emergency embolization, 27 patients had 100% stable red blood cells and hemoglobin, and 7 patients had a single lesion and underwent surgical resection after the bleeding was stabilized. After emergency embolization, 22 patients experienced relief of low back pain as compared to pretreatment conditions, and the rate of lower back pain relief was 81.48%. Significantly higher creatinine and urea nitrogen levels were observed in three patients prior to the operation, and these levels reverted to their original state after renal function protection therapy. Despite varying levels of PES, all of the patients' symptoms returned to their normal levels following symptomatic treatment, with no significant impact on their quality of life or recovery period. Emergency ultraselective arterial embolization for the treatment of bleeding in fatal RAML is safe, rapid, and effective and has few complications. The use of iodized oil can not only serve an embolic function but also provide a tracer effect in subsequent reexamination.

Management of spinal deviations in physical medicine and functional rehabilitation

Objectives: To analyze cases of spinal deviations in the Physical Medicine and Rehabilitation (PMR) department at Mohammed VI University Hospital Center in Marrakech, with a focus on the role of rehabilitation in their management. Methods and Patients: We conducted a cross-sectional, observational descriptive study over a six-month period involving 52 patients with spinal deviations, treated in the PMR department. Data were meticulously collected using a questionnaire completed during consultations with patients selected according to specific criteria. Results: The study revealed that the average age of the patients was 21.25 years, with a predominance of females (68%). Among the spinal deviations, scoliosis was the most common (68%), followed by scoliotic posture (18%), hyperkyphosis (11%), and compensatory lumbar hyperlordosis (3%). The primary reason for consultation was aesthetic concern (56%), with the most frequent symptoms being gibbus deformity (54%) and shoulder asymmetry (35%). Rehabilitation was prescribed for all patients, sometimes as the sole treatment or in combination with bracing. Orthoses were used to correct foot deformities and leg length discrepancies. Only one patient underwent surgical intervention. The outcome was positive for 63% of patients, with improvement in the Cobb angle and pain reduction. However, a 5° worsening was observed in one patient (2% of the sample), while the others remained stable. Conclusion: In conclusion, the therapeutic approaches employed in our sample demonstrated their effectiveness in managing spinal deviations. Rehabilitation proved to be particularly essential as an adjunct treatment, enhancing the outcomes of other therapies and contributing to the relief of back pain, which had a positive impact on patients' quality of life.

Prospective comparative analysis of three types of decompressive surgery for lumbar central stenosis: conventional, full-endoscopic, and biportal endoscopic laminectomy

Conventional open laminectomy has long been considered one of the important surgical options for lumbar central stenosis owing to its positive outcomes. However, newer approaches have emerged as alternatives, including full-endoscopic and biportal endoscopic laminectomy. Therefore, a comparison of the outcomes that are associated with each of these surgical methods is warranted. This prospective multicenter trial, initiated in February 2019, compared the outcomes of three lumbar central stenosis surgical approaches: open laminectomy (OPEN), uniportal endoscopy (UNIPORT), and biportal endoscopy (BIPORT). Among 115 participants from seven centers, one-year follow-ups assessed laboratory, radiological, and clinical outcomes. Despite all groups showing adequate decompression and clinical improvement, the OPEN group exhibited less improvement in Visual analog scale (VAS) for back pain scores (p < 0.05) and significant postoperative increases in most laboratory markers. Furthermore, the OPEN group experienced a significant decrease in multifidus muscle cross-sectional area compared to endoscopic groups (p < 0.001). Each surgical techniques produced similar clinical outcomes and dural space expansion. However, endoscopic surgery was associated with better muscle preservation and better relief of back pain. Endoscopic surgery is a reasonable alternative to conventional laminectomy for treating lumbar central stenosis.This trial was registered on CRIS (Clinical Research Information Service, KCT0004355).

A Comparative Study of Endoscopic versus Percutaneous Epidural Neuroplasty in Lower Back Pain: Outcomes at Six-Month Follow Up.

Background and Objectives: Endoscopic epidural neuroplasty (EEN) facilitates adhesiolysis through direct epiduroscopic visualization, offering more precise neural decompression than that exhibited by percutaneous epidural neuroplasty (PEN). We aimed to compare the effects of EEN and PEN for 6 months after treatment with lower back and radicular pain in patients. Methods: This retrospective study compared the visual analog scale (VAS) and Oswestry disability index (ODI) scores in patients with low back and radicular pain who underwent EEN or PEN with a steering catheter. The medical records of 107 patients were analyzed, with 73 and 34 undergoing EEN and PEN, respectively. Results: The VAS and ODI scores decreased at all time points after EEN and PEN. VAS and ODI scores decreased more in the EEN group than those in the PEN group at 1 day and 1- and 6-months post-procedure, indicating superior pain relief for both lower back and radicular pain through EEN. Conclusions: EEN is a superior treatment of pain control than PEN in lower back and radicular pain patients.

Enhanced relief of low back pain following surgical repair of a ventral hernia: A case report

The effectiveness of core muscle strengthening in treating Low Back Pain (LBP) is well-established. The laxity or defect of the important portion of core muscle groups, transverse abdominis muscle, as seen in ventral hernia could be a contributing factor for core weakness and instability and thereafter results in LBP. The contribution of ventral hernia to LBP is scantily documented. Ventral hernias can be easily missed if a thorough physical exam is not performed. A 50-year-old male patient presented to the clinic with a 10- year history of LBP; a physical exam revealed a previously undiscovered ventral hernia. He reported a reduction in LBP and improvement in back support after his ventral hernia repair surgery. This case report highlights the importance of a thorough assessment and treatment of the underlying connection between ventral hernia and chronic LBP.

Biomechanical response of decompression alone in lower grade lumbar degenerative spondylolisthesis--A finite element analysis.

Previous studies have demonstrated the clinical efficacy of decompression alone in lower-grade spondylolisthesis. A higher rate of surgical revision and a lower rate of back pain relief was also observed. However, there is a lack of relevant biomechanical evidence after decompression alone for lower-grade spondylolisthesis. Evaluating the biomechanical characteristics of total laminectomy, hemilaminectomy, and facetectomy for lower-grade spondylolisthesis by analyzing the range of motion (ROM), intradiscal pressure (IDP), annulus fibrosus stress (AFS), facet joints contact force (FJCF), and isthmus stress (IS). Firstly, we utilized finite element tools to develop a normal lumbar model and subsequently constructed a spondylolisthesis model based on the normal model. We then performed total laminectomy, hemilaminectomy, and one-third facetectomy in the normal model and spondylolisthesis model, respectively. Finally, we analyzed parameters, such as ROM, IDP, AFS, FJCF, and IS, for all the models under the same concentrate force and moment. The intact spondylolisthesis model showed a significant increase in the relative parameters, including ROM, AFS, FJCF, and IS, compared to the intact normal lumbar model. Hemilaminectomy and one-third facetectomy in both spondylolisthesis and normal lumbar models did not result in an obvious change in ROM, IDP, AFS, FJCF, and IS compared to the pre-operative state. Moreover, there was no significant difference in the degree of parameter changes between the spondylolisthesis and normal lumbar models after undergoing the same surgical procedures. However, total laminectomy significantly increased ROM, AFS, and IS and decreased the FJCF in both normal lumbar models and spondylolisthesis models. Hemilaminectomy and one-third facetectomy did not have a significant impact on the segment stability of lower-grade spondylolisthesis; however, patients with LDS undergoing hemilaminectomy and one-third facetectomy may experience higher isthmus stress on the surgical side during rotation. In addition, total laminectomy changes the biomechanics in both normal lumbar models and spondylolisthesis models.

Preoperative Adjacent Facet Joint Osteoarthritis Is Associated with the Incidence of Adjacent Segment Degeneration and Low Back Pain after Lumbar Interbody Fusion.

A retrospective cohort study. To analyze the association between preoperative adjacent facet joint osteoarthritis (FJOA) and outcomes of lumbar interbody fusion (LIF). Whether preoperative adjacent FJOA is associated with the incidence of radiological adjacent segment degeneration (RASD) and low back pain (LBP) relief after lumbar fusion remains unknown. The study included patients who underwent LIF. The demographic characteristics and radiographic and surgical data were collected and evaluated. The included patients were divided into control group and FJOA group based on the preoperative adjacent facet joint Pathria grade. Preoperative and last follow-up LBP Visual Analog Scale (VAS) score, leg pain (LP) VAS, Oswestry Disability Index (ODI) and RASD were evaluated and compared. The improvement rates in VAS and ODI were calculated and compared between the two groups. Logistic regression was used to analyze the risk factors of LBP relief and incidence of RASD. In total, 197 patients (control group, 86; FJOA group, 111) were included, and the median follow-up was 46 months. The VAS and ODI in both groups significantly improved after surgery. At the last follow-up, the FJOA group had higher VAS and lower VAS improvement rates of LBP than the control group (p<0.05). However, no significant difference in the LP VAS and ODI was found between the two groups. The incidence of RASD in the FJOA group was significantly higher than that in the control group (48.6% vs. 30.2%, p=0.034). Multivariate logistic regression analysis showed that preoperative adjacent FJOA was significantly associated with LBP relief (odds ratio [OR], 0.691; 95% confidence interval [CI], 0.498-0.958) and the postoperative incidence of RASD (OR, 1.406; 95% CI, 1.020-1.939). The preoperative FJOA in the adjacent segments was significantly associated with LBP following LIF. Patients with preoperative FJOA were more likely to have RASD following lumbar fusion surgery.

Comparison of safety and efficacy of posterior lumbar interbody fusion (PLIF) and modified transforaminal lumbar interbody fusion (M-TLIF) in the treatment of single-segment lumbar degenerative diseases

ObjectiveTo compare modified transforaminal lumbar interbody fusion (M-TLIF) with posterior lumbar interbody fusion (PLIF) in the treatment of single-segment lumbar degenerative disorders in order to assess its safety and effectiveness.MethodsFrom January 2016 to January 2021, 74 patients who received single-segment M-TLIF were examined. A total of 74 patients having single-segment PLIF during the same time period were included in a retrospective controlled study using the same inclusion and exclusion criteria. The two groups were compared in terms of the fusion rate, the Oswestry disability index (ODI), the visual analogue scale of low back pain (VAS), the perioperative condition, the postoperative complications, and the postoperative neighbouring segment degeneration.ResultsAll patients had surgery satisfactorily and were monitored for at least a year afterwards. The baseline values for the two groups did not significantly differ. The interbody fusion rate between PLIF (98.65%) and M-TLIF (97.30%) was not significantly different. In the follow-up, the M-TLIF group's VAS score for low back and leg pain was lower than that of the PLIF group. The ODI score of the M-TLIF group was lower than that of the PLIF group at 7 days and 3 months following surgery. Both groups' post-op VAS and ODI scores for low back and leg pain were much lower than those from before the procedure. In M-TLIF group, the operation time, drainage tube extraction time, postoperative bed rest time and hospital stay time were shorter, and the amount of intraoperative blood loss was less. Compared with those before operation, the height of intervertebral space and intervertebral foramen were significantly increased in both groups during postoperative follow-up (P < 0.05). The postoperative complications and adjacent segment degeneration of M-TLIF were significantly lower than those of PLIF.ConclusionsM-TLIF is a safe and effective treatment for lumbar degenerative disorders, with a high fusion rate and no significant difference between M-TLIF and PLIF. M-TLIF's efficacy and safety are comparable to that of PLIF, particularly in terms of early relief of low back pain and improvement in quality of life following surgery. Therefore, M-TLIF technology can be popularized and applied in clinic.

Literature Review: Efektivitas Elastic Therapeutic Taping (Ett) Terhadap Pengurangan Skala Nyeri Punggung Bawah Pada Kehamilan Trimester Iii

One of the physiological changes in pregnant women in the third trimester is the gradual musculoskeletal changes associated with the occurrence of low back pain due to increased body weight and changes in body posture. One of the new technologies in physical therapy is the use of elastic therapeutic bandages. This literature review aims to determine the effectiveness of elastic therapeutic taping (ett) against LBP in the third trimester of pregnancy. Of the 11 studies reviewed by the authors, it was shown that ETT support for low back pain relief was usually installed in the lumbar region 5 (L5) and sacrum (S1) with a band pattern I. ETT can be done 2 times a week and the ETT is replaced 3 days every 3 weeks for best results. optimally with a duration of 24-72 hours. ETT can reduce pain scores more significantly when combined with other therapies such as Paracetamol plus ETT, TENS plus ETT, ETT with oblique pelvic exercises, back exercises with ETT. The conclusion is that ETT can relieve low back pain and have a very real effect in reducing low back pain intensity in the last trimester of pregnancy.

The Mckenzie Methodwith Interferential Therapy on Acute Low Back Pain (Sciatica) Patients: A Randomised Controlled Clinical Trial

Purpose: To investigate the effect of McKenzie method withInterferential therapy (IFT)when compare to IFTalone on acute low back pain (Sciatica) patients in terms of relieving pain, increasing lumbar extension range of motion and speed of walking.Methods: Randomised controlled clinical trial,fifty seven patients were screened; forty sciatica patients agedfrom 30 to 60 years with no recent injury were selected through the special tests, after randomisation, the experimental group (n-15) was treated with the McKenzie method andInterferential therapy whereas control group (n-15) was treated with the Interferential therapy alone. The primary outcome was the relief of low back pain and increasing the lumbar extension range of motion. The secondary outcome was the speed of walking by measuring the stride length and cadence for 10 meters.Result: The study aimed to compare the pain, lumbar extension range of motion (ROM), stride length, and cadence of two different teams before and after physiotherapy. The experimental team had an average pain score of 7.70 VAS, a lumbar extension range of motion of -3.70 degrees, a stride length of 56.70 cms, and a cadence of 115.35 steps. In post-physiotherapy, the team had an average pain score of 2.20 VAS, a lumbar extension range of motion of 24.85 degrees, a stride length of 58.65 cms, and a cadence of 113.15 steps. The mean difference in pain, ROM, stride length, and cadence was statistically significant. The results suggest that physiotherapy can be a valuable tool for improving pain management and reducing back pain.Conclusion: McKenzie method with Interferential therapy showed greater relief of low back pain, increased lumbar extension range of motion, increased speed of walking in terms of step length and cadence than IFT alone.

LITERATURE REVIEW: EFEKTIVITAS ELASTIC THERAPEUTIC TAPING (ETT) TERHADAP PENGURANGAN SKALA NYERI PUNGGUNG BAWAH PADA KEHAMILAN TRIMESTER III

One of the physiological changes in pregnant women in the third trimester is the gradual musculoskeletal changes associated with the occurrence of low back pain due to increased body weight and changes in body posture. One of the new technologies in physical therapy is the use of elastic therapeutic bandages. This literature review aims to determine the effectiveness of elastic therapeutic taping (ett) against LBP in the third trimester of pregnancy. Of the 11 studies reviewed by the authors, it was shown that ETT support for low back pain relief was usually installed in the lumbar region 5 (L5) and sacrum (S1) with a band pattern I. ETT can be done 2 times a week and the ETT is replaced 3 days every 3 weeks for best results. optimally with a duration of 24-72 hours. ETT can reduce pain scores more significantly when combined with other therapies such as Paracetamol plus ETT, TENS plus ETT, ETT with oblique pelvic exercises, back exercises with ETT. The conclusion is that ETT can relieve low back pain and have a very real effect in reducing low back pain intensity in the last trimester of pregnancy.

Comparison of the Low Back Pain Relief and Spread Level After Upper and Lower Lumbar Erector Spinae Plane Block

BACKGROUND: The erector spinae plane block (ESPB), which was introduced to manage the thoracic pain, is an ultrasound-guided technique that is relatively easy, less invasive, and safer. In spite of its technical ease and safety of ESPB, few studies have explored the analgesic efficacy and the exact spread level of injected local anesthetics. OBJECTIVES: The purpose of this study is to compare the analgesic efficacy and spread level of the upper and lower lumbar ESPBs . STUDY DESIGN: Prospective, randomized design. SETTING: The pain clinic of a tertiary university hospital. METHODS: This study included 84 patients with low back pain with or without leg pain who received lumbar ESPB at L2 (L2 ESPB group) or L4 (L4 ESPB group) using 10 mL of 0.2% ropivacaine mixed with 10 mL of the contrast medium. After finishing 20 mL of the local anesthetic mixture injection, a fluoroscopic examination was performed to evaluate the spread level. Analgesic efficacy was assessed using an 11-point Numeric Rating Scale (NRS-11) and a Back Pain Functional Scale. RESULTS: The number of patients who showed excellent-to-moderate low back pain relief was 35 (83.3%) and 36 (78.5%) in the L2 and L4 ESPB groups, respectively. Significant reductions in pain on the NRS-11 and improvements in disability were found in both groups. The total number of vertebral segments to which the anesthetic drugs spread was significantly higher in the L2 ESPB group than in the L4 ESPB group (2.7 ± 0.5 vs 2.0 ± 0.2, P = 0.002). LIMITATIONS: The analgesic efficacy of lumbar ESPB was evaluated with only short-term outcomes. CONCLUSIONS: Both the L2 and L4 ESPB groups demonstrated a significant reduction in low back pain and improvement in disability. The L2 ESPB group demonstrated a significantly increased spread level compared to the L4 ESPB group. KEY WORDS: Erector spinae plane block, spread level, low back pain, analgesic efficacy

Results From a Prospective, Clinical Study (US-nPower) Evaluating a Miniature Spinal Cord Stimulator for the Management of Chronic, Intractable Pain

BACKGROUND: Chronic, intractable, neuropathic pain is readily treatable with spinal cord stimulation (SCS). Technological advancements, including device miniaturization, are advancing the field of neuromodulation. OBJECTIVES: We report here the results of an SCS clinical trial to treat chronic, low back and leg pain, with a micro-implantable pulse generator (micro-IPG). STUDY DESIGN: This was a single-arm, prospective, multicenter, postmarket, observational study. SETTING: Patients were recruited from 15 US-based comprehensive pain centers. METHODS: This open-label clinical trial was designed to evaluate the performance of the Nalu™ Neurostimulation System (Nalu Medical, Inc., Carlsbad, CA) in the treatment of low back and leg pain. Patients, who provided informed consent and were successfully screened for study entry, were implanted with temporary trial leads. Patients went on to receive a permanent implant of the leads and micro-IPG if they demonstrated a &gt;= 50% reduction in pain during the temporary trial period. Patient-reported outcomes (PROs), such as pain scores, functional disability, mood, patient impression of change, comfort, therapy use profile, and device ease of use, were captured. RESULTS: At baseline, the average pain Visual Analog Scale (VAS) score was 72.1 ± 17.9 in the leg and 78.0 ± 15.4 in the low back. At 90 days following permanent implant (end of study), pain scores improved by 76% (VAS 18.5 ± 18.8) in the leg and 75% (VAS 19.7 ± 20.8) in the low back. Eighty-six percent of both leg pain and low back pain patients demonstrated a &gt;= 50% reduction in pain at 90 days following implant. The comfort of the external wearable (Therapy Disc and Adhesive Clip) was rated 1.16 ± 1.53, on average, at 90 days on an 11-point rating scale (0 = very comfortable, 10 = very uncomfortable). All PROs demonstrated statistically significant symptomatic improvement at 90 days following implant of the micro-IPG. LIMITATIONS: Limitations of this study include the lack of long-term results (beyond 90 days) and a relatively small sample size of 35 patients who were part of the analysis; additionally, there was no control arm or randomization as this was a single-arm study, without a comparator, designed to document the efficacy and safety of the device. Therefore, no direct comparisons to other SCS systems were possible. CONCLUSIONS: This clinical study demonstrated profound leg and low back pain relief in terms of overall pain reduction, as well as the proportion of therapy responders. The study patients reported the wearable aspects of the system to be very comfortable. KEY WORDS: Spinal cord stimulation, chronic pain, radiculopathy, micro-IPG, battery-free, persistent spinal pain syndrome, failed back surgery syndrome, low back pain, leg pain

Clinical Observation, Management and Function Of low back pain Relief Therapies (COMFORT): A cluster randomised controlled trial protocol

IntroductionLow back pain (LBP) is commonly treated with opioid analgesics despite evidence that these medicines provide minimal or no benefit for LBP and have an established profile of harms. International...

Clinical efficacy of minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) in the treatment of II° lumbar isthmic spondylolisthesis: A retrospective cohort study.

Minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) is not suitable for high-grade isthmic spondylolisthesis, whether MIS-TLIF can treat II° lumbar isthmic spondylolisthesis (IS) is still controversial. This retrospective cohort study compared the clinical efficacy of MIS-TLIF and open transforaminal lumbar interbody fusion (OPEN-TLIF) in the treatment of II° lumbar IS. From January 2017 to January 2023, 101 patients with II° lumbar IS were diagnosed in our hospital and underwent surgical treatment, of which 53 received MIS-TLIF surgery and 48 received OPEN-TLIF surgery. The operation time, blood loss and surgical complications were compared between the 2 groups. The pain, function, reduction rate and fusion rate of the patients were evaluated during follow-up. The amount of intraoperative blood loss, postoperative drainage, and postoperative hospital stay in the MIS-TLIF group were significantly lower than those in the OPEN-TLIF group were (P < .01). In the MIS-TLIF group, there were 1 case of dural sac injury and 3 cases of lower limb paralysis. The complication rate of MIS-TLIF was lower than the OPEN-TLIF group (P = .032). In the visual analog scale score of low back pain, the MIS-TLIF group was lower than the OPEN-TLIF group after operation and at the last follow-up. There were no significant differences in postoperative leg pain score, slippage rate, and fusion rate between the 2 groups. Compared with OPEN-TLIF, MIS-TLIF has the advantages of better low back pain relief, less trauma, less bleeding and faster recovery, and is worthy of clinical promotion.

Association of prolonged symptom duration with poor outcomes in lumbar spine surgery: a Michigan Spine Surgery Improvement Collaborative study.

There is a scarcity of large multicenter data on how preoperative lumbar symptom duration relates to postoperative patient-reported outcomes (PROs). The objective of this study was to determine the effect of preoperative and baseline symptom duration on PROs at 90 days, 1 year, and 2 years after lumbar spine surgery. The Michigan Spine Surgery Improvement Collaborative registry was queried for all lumbar spine operations between January 1, 2017, to December 31, 2021, with a follow-up of 2 years. Patients were stratified into three subgroups based on symptom duration: < 3 months, 3 months to < 1 year, and ≥ 1 year. The primary outcomes were reaching the minimal clinically important difference (MCID) for the PROs (i.e., leg pain, Patient-Reported Outcomes Measurement Information System Physical Function (PROMIS PF), EQ-5D, North American Spine Society satisfaction, and return to work). The EQ-5D score was also analyzed as a continuous variable to calculate quality-adjusted life years. Multivariable Poisson generalized estimating equation models were used to report adjusted risk ratios, with the < 3-month cohort used as the reference. There were 37,223 patients (4670 with < 3-month duration, 9356 with 3-month to < 1-year duration, and 23,197 with ≥ 1-year duration) available for analysis. Compared with patients with a symptom duration of < 1 year, patients with a symptom duration of ≥ 1 year were significantly less likely to achieve an MCID in PROMIS PF, EQ-5D, back pain relief, and leg pain relief at 90 days, 1 year, and 2 years postoperatively. Similar trends were observed for patient satisfaction and return to work. With the EQ-5D score as a continuous variable, a symptom duration of ≥ 1 year was associated with 0.04, 0.05, and 0.03 (p < 0.001) decreases in EQ-5D score at 90 days, 1 year, and 2 years after surgery, respectively. A symptom duration of ≥ 1 year was associated with poorer outcomes on several outcome metrics. This suggests that timely referral and surgery for degenerative lumbar pathology may optimize patient outcome.

ID: 220743 Case Report: 10 KHz Stimulation for Lumbar Pain With FPAPA Syndrome

Although the Spinal Cord Stimulation (SCS) tonic has shown good results in the treatment of chronic pain; sometimes patients report incomplete coverage in the painful area, including limited relief of back pain.

ID: 208527 Long-Term Clinical Outcomes of a Low-Energy Derivative Study of Differential Target Multiplexed Spinal Cord Stimulation

Differential Target MultiplexedTM spinal cord stimulation (SCS) is an established therapy that has shown superior back pain relief to traditional SCS.1 Derivatives of the DTMTM waveform are being investigated to understand opportunities for therapy personalization. Energy-conserving approaches altering amplitude, frequency, and pulse width, have the potential to impact patient experience with rechargeable and non-rechargeable devices.

ID: 212058 Modeling the Impact of a DTM(TM) Derivative on Rechargeable and Recharge-Free SCS Systems

Differential Target MultiplexedTM spinal cord stimulation (SCS) is an established therapy that has shown superior back pain relief to traditional SCS.1,2 Derivatives of the DTMTM SCS waveform are being investigated to understand opportunities to further tailor therapy approaches for different patients. A recent feasibility study demonstrated a DTMTM SCS derivative provided significant reduction in energy usage while offering a similar degree of pain relief and therapy satisfaction to patients compared to prior SCS therapy. Data collected to date from an ongoing RCT of the same reduced-energy DTMTM SCS derivative has been used to estimate device longevity for recharge-free devices as well as recharge requirements on rechargeable devices.