| Predictors of pain and function in persons with spinal stenosis, low back pain, and no back pain. | |
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MedLine Citation:
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PMID: 17139226 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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STUDY DESIGN: Longitudinal masked, double-controlled cohort study. OBJECTIVES: To determine prognosis and predictors of function and pain in persons with spinal stenosis. SUMMARY OF BACKGROUND DATA: The clinical syndrome of spinal stenosis is common and disabling, but not clearly related to anatomic measures. Prognosis not well studied. METHODS: Persons 55 to 80 years of age with and without stenosis on preliminary review of magnetic resonance imaging (MRI), and asymptomatic volunteers underwent screening, questionnaires, physical examination, ambulation testing, masked electromyogram (EMG), and masked MRI scans; these were repeated at >18 months. RESULTS: Twenty-three asymptomatic, 28 back pain, and 32 clinically diagnosed stenosis subjects underwent follow-up. Although initial and follow-up diagnosis tended to agree (kappa = 0.394, P < 001), there were substantial shifts between the three groups. Among persons with clinically diagnosed stenosis, every measure trended for improvement, including significant changes in pain, ambulation, and EMG. Ambulation velocity and Pain Disability Index at follow-up were predicted by initial disability measures. Pain was predicted by initial sleep difficulty but not initial pain. EMG and MRI did not predict function or pain. CONCLUSION: Clinically recognized spinal stenosis is fluctuating and largely improving, and in continuum with back pain and no symptoms. Since anatomic and neurologic deficits do not predict future function, they should not be weighed heavily in surgical risk-benefit discussions. |
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Authors:
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Andrew J Haig; Henry C Tong; Karen S J Yamakawa; Christopher Parres; Douglas J Quint; Anthony Chiodo; Jennifer A Miner; Vaishali C Phalke; Julian T Hoff; Michael E Geisser |
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Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, N.I.H., Extramural |
Journal Detail:
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Title: Spine Volume: 31 ISSN: 1528-1159 ISO Abbreviation: Spine Publication Date: 2006 Dec |
Date Detail:
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Created Date: 2006-12-01 Completed Date: 2007-01-05 Revised Date: 2009-07-09 |
Medline Journal Info:
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Nlm Unique ID: 7610646 Medline TA: Spine (Phila Pa 1976) Country: United States |
Other Details:
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Languages: eng Pagination: 2950-7 Citation Subset: IM |
Affiliation:
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Department of Physical Medicine and Rehabilitation, University of Michigan, 325 E. Eisenhower, Ann Arbor, MI 48108, USA. andyhaig@umich.du |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Aged, 80 and over Cohort Studies Female Humans Longitudinal Studies Low Back Pain / diagnosis*, epidemiology, physiopathology* Lumbar Vertebrae / physiology Male Middle Aged Pain / diagnosis, epidemiology, physiopathology Pain Measurement Predictive Value of Tests Recovery of Function / physiology Spinal Stenosis / diagnosis*, epidemiology, physiopathology* |
| Grant Support | |
ID/Acronym/Agency:
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5 R01 NS41855-02/NS/NINDS NIH HHS |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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