Spine Archives

Providing Epidemiologic Data in Lumbar Spine Imaging Reports Did Not Affect Subsequent Utilization of Spine Procedures: Secondary Outcomes from a Stepped-Wedge Randomized Controlled Trial

To evaluate the effect of inserting epidemiological information into lumbar spine imaging reports on subsequent nonsurgical and surgical procedures involving the thoracolumbosacral spine and sacroiliac joints. Analysis of secondary outcomes from the Lumbar Imaging with Reporting of Epidemiology (LIRE) pragmatic…

Pragmatic Trial of Acupuncture for Chronic Low Back Pain in Older Adults

January 21, 2020
Chris Myers
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The goal of this project is to conduct a three-arm parallel-group randomized clinical trial of two acupuncture interventions vs. a usual-care control group for change in low back pain symptoms among adults at least 65 years of age.

Lumbar Spinal Stenosis Severity by CT or MRI Does Not Predict Response to Epidural Corticosteroid versus Lidocaine Injections

Epidural steroid injections may offer little-to-no short-term benefit in the overall population of patients with symptomatic spinal stenosis compared with lidocaine alone. We investigated whether imaging could identify subgroups of patients who might benefit most. A secondary analysis of the…

Long-term outcomes of a large, prospective observational cohort of older adults with back pain

September 1, 2018
Ivan Rivera Caraballo
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Although back pain is common among older adults, there is relatively little research on the course of back pain in this age group. Our primary goals were to report 2-year outcomes of older adults initiating primary care for back pain…

Systemic effects of epidural steroid injections for spinal stenosis

This analysis of the lumbar epidural steroid injections for spinal stenosis multicenter randomized controlled trial data identifies the degree of and risk factors for cortisol suppression after epidural steroid injections in older adults with spinal stenosis. Four hundred patients aged…

Lumbar Imaging With Reporting Of Epidemiology (LIRE)-Protocol for a pragmatic cluster randomized trial

Diagnostic imaging is often the first step in evaluating patients with back pain and likely functions as a "gateway" to a subsequent cascade of interventions. However, lumbar spine imaging frequently reveals incidental findings among normal, pain-free individuals suggesting that treatment…

Clinical decision rule for primary care patient with acute low back pain at risk of developing chronic pain

Primary care clinicians need to identify candidates for early interventions to prevent patients with acute pain from developing chronic pain. We conducted a 2-year prospective cohort study of risk factors for the progression to chronic pain and developed and internally…

Association of early imaging for back pain with clinical outcomes in older adults

In contrast to the recommendations for younger adults, many guidelines allow for older adults with back pain to undergo imaging without waiting 4 to 6 weeks. However, early imaging may precipitate interventions that do not improve outcomes. To compare function…

Study Protocol- Lumbar Epidural Steroid Injections for Spinal Stenosis (LESS): a double-blind randomized controlled trial of epidural steroid injections for lumbar spinal stenosis among older adults

BACKGROUND: Lumbar spinal stenosis is one of the most common causes of low back pain among older adults and can cause significant disability. Despite its prevalence, treatment of spinal stenosis symptoms remains controversial. Epidural steroid injections are used with increasing…

Minimum incidence of primary cervical dystonia in a multiethnic health care population

BACKGROUND: The two existing estimates of the incidence of primary cervical dystonia were based on observations in relatively ethnically homogeneous populations of European descent. OBJECTIVE: To estimate the minimum incidence of primary cervical dystonia in the multiethnic membership of a…