Document Detail

Trunk muscle strength, cross-sectional area, and density in patients with chronic low back pain randomized to lumbar fusion or cognitive intervention and exercises.
MedLine Citation:
PMID:  14699268     Owner:  NLM     Status:  MEDLINE    
STUDY DESIGN: A randomized study. OBJECTIVES: To compare muscle strength, cross-sectional area, and density of the back muscles in two categories of patients with chronic low back pain, randomized to either lumbar fusion or cognitive intervention and exercises. SUMMARY OF BACKGROUND DATA: In two clinical trials, patients with chronic low back pain plus disc degeneration and postlaminectomy syndrome, respectively, were randomized to either lumbar fusion or cognitive intervention and exercises. We have previously reported that results for the primary outcome were similar at the 1-year follow-up examination. METHODS: As the treatment alternatives and test procedures were identical, the two trials were merged into one. A total of 124 patients 25 to 60 years of age were included. Muscle strength, measured by isokinetic test device and by the Biering-Sørensen Test, was measured in 112 patients, and the cross-sectional area and density of the back muscles were measured in 61 patients at the inclusion and at the 1-year follow-up examination. RESULTS: The exercise group performed significantly better in muscle strength than did the lumbar fusion group, with the mean difference at 184 Nm (95% confidence interval, 64-303 Nm; P = 0.003) and for the Biering-Sørensen Test 21 seconds (95% confidence interval, 6-36 seconds; P = 0.006). The density at L3-L4 decreased in the lumbar fusion group but remained unchanged in the exercise group. The mean difference was 5.3 HU (95% confidence interval, 1.1-9.5 HU; P = 0.01). The cross-sectional area was unchanged in both groups. CONCLUSIONS: Patients with chronic low back pain who followed cognitive intervention and exercise programs improved significantly in muscle strength compared with patients who underwent lumbar fusion. In the lumbar fusion group, density decreased significantly at L3-L4 compared with the exercise group.
Anne Keller; Jens I Brox; Ragnhild Gunderson; Inger Holm; Astrid Friis; Olav Reikerås
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Spine     Volume:  29     ISSN:  1528-1159     ISO Abbreviation:  Spine     Publication Date:  2004 Jan 
Date Detail:
Created Date:  2003-12-30     Completed Date:  2004-04-12     Revised Date:  2009-07-09    
Medline Journal Info:
Nlm Unique ID:  7610646     Medline TA:  Spine (Phila Pa 1976)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  3-8     Citation Subset:  IM    
Department of Physical Medicine and Rehabilitation, Ullevaal University Hospital, N-0407 Oslo, Norway.
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MeSH Terms
Chronic Disease
Cognitive Therapy*
Disability Evaluation
Exercise Therapy*
Follow-Up Studies
Low Back Pain / physiopathology,  therapy*
Lumbar Vertebrae / surgery*
Muscles / physiopathology
Spinal Fusion / methods*
Tensile Strength
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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