STUDY DESIGN: This study was designed to examine the behaviorial immunohistochemical changes of spinal glial cells and spinal Interleukin (IL)-1beta expression after various nerve root injuries used as models of lumbar radiculopathy.

OBJECTIVES: In order to better understand the role of central inflammation in the pathophysiologic mechanisms that give rise to pain associated with lumbar radiculopathy, this research studied the relationship between pain-related behavior associated with ...

CONTEXT: For patients with lumbar disk herniation, the Spine Patient Outcomes Research Trial (SPORT) randomized trial intent-to-treat analysis showed small but not statistically significant differences in favor of diskectomy compared with usual care. However, the large numbers of patients who crossed over between assigned groups precluded any conclusions about the comparative effectiveness of operative therapy vs usual care.

OBJECTIVE: To compare the treatment effects of diskectomy and ...

STUDY DESIGN: Retrospective subgroup analysis of prospectively collected data according to treatment received.

OBJECTIVE: The purpose of this study was to determine whether obesity affects treatment outcomes for lumbar stenosis (SpS) and degenerative spondylolisthesis (DS).

SUMMARY OF BACKGROUND DATA: Obesity is thought to be associated with increased complications and potentially less favorable outcomes after the treatment of degenerative conditions of the lumbar spine. This, however, ...

STUDY DESIGN: As-treated analysis of the Spine Patient Outcomes Research Trial.

OBJECTIVE: To compare baseline characteristics and surgical and nonoperative outcomes in degenerative spondylolisthesis (DS) and spinal stenosis (SpS) patients stratified by predominant pain location (i.e., leg vs. back).

SUMMARY OF BACKGROUND DATA: Evidence suggests that DS and SpS patients with predominant leg pain may have better surgical outcomes than patients with predominant low back pain ...

BACKGROUND CONTEXT: A period of nonsurgical management is advocated before surgical treatment for most patients with lumbar spinal stenosis. Currently, little evidence is available to define optimal nonsurgical management. Physical therapy is often used, however its use and effectiveness relative to other nonsurgical strategies has not been adequately explored.

PURPOSE: Describe the use of physical therapy and other nonsurgical interventions by patients with lumbar spinal stenosis and ...

DESIGN: A prospective, multicenter observational study.

OBJECTIVES: 1) Identify correlates of the decision to perform arthrodesis in patients undergoing laminectomy for lumbar spinal stenosis. 2) Compare symptoms, walking capacity, and satisfaction 6 and 24 months after laminectomy alone and laminectomy with noninstrumented and with instrumented arthrodesis.

BACKGROUND DATA: Few prospective studies have compared outcomes of laminectomy alone or laminectomy with noninstrumented or with ...

BACKGROUND: The SPORT (Spine Patient Outcomes Research Trial) reported favorable surgery outcomes over 2 years among patients with stenosis with and without degenerative spondylolisthesis, but the economic value of these surgeries is uncertain.

OBJECTIVE: To assess the short-term cost-effectiveness of spine surgery relative to nonoperative care for stenosis alone and for stenosis with spondylolisthesis.

DESIGN: Prospective cohort study.

DATA SOURCES: Resource utilization, productivity, ...

CONTEXT: Lumbar diskectomy is the most common surgical procedure performed for back and leg symptoms in US patients, but the efficacy of the procedure relative to nonoperative care remains controversial.

OBJECTIVE: To assess the efficacy of surgery for lumbar intervertebral disk herniation.

DESIGN, SETTING, AND PATIENTS: The Spine Patient Outcomes Research Trial, a randomized clinical trial enrolling patients between March 2000 and November 2004 from 13 multidisciplinary spine clinics in ...

STUDY DESIGN: Subgroup analysis of a prospective, randomized database.

SUMMARY OF BACKGROUND DATA: Reoperation due to recurrence of index level pathology or adjacent segment disease is a common clinical problem. Despite multiple studies on the incidence of reoperation, there have been few comparative studies establishing risk factors for reoperation after spinal stenosis surgery. The hypothesis of this subgroup analysis was that lumbar fusion or particular patient characteristics, such ...

BACKGROUND: The management of degenerative spondylolisthesis associated with spinal stenosis remains controversial. Surgery is widely used and has recently been shown to be more effective than nonoperative treatment when the results were followed over two years. Questions remain regarding the long-term effects of surgical treatment compared with those of nonoperative treatment.

METHODS: Surgical candidates from thirteen centers with symptoms of at least twelve weeks' duration as well as ...

STUDY DESIGN: Subgroup analysis of prospective, randomized database from the Spine Patient Outcomes Research Trial (SPORT).

OBJECTIVE: The hypothesis of this study was that patients who received ESI during initial treatment as part of SPORT (The Spine Patient Outcomes Research Trial) would have improved clinical outcome and a lower rate of crossover to surgery than patients who did not receive ESI.

SUMMARY OF BACKGROUND DATA: The use of epidural steroid injection (ESI) in patients with ...

BACKGROUND: There are large variations in the use of knee arthroplasty among Medicare enrollees according to race or ethnic group and sex. Are racial and ethnic disparities more pronounced in some regions than in others, and if so, why?

METHODS: We used all Medicare fee-for-service claims data for 1998 through 2000 to determine the incidence of knee arthroplasty according to Hospital Referral Region, sex, and race or ethnic group. A total of 430,726 knee arthroplasties were performed ...

STUDY DESIGN: This is an observational study of 3482 patients undergoing lumbar spine surgery from the National Spine Network.

OBJECTIVES: To explore the influence of medical and psychosocial comorbidities on the change in Short-form 36 (SF-36) general health survey and condition-specific Oswestry Disability Index (ODI) scores in patients undergoing lumbar spine surgery.

SUMMARY OF BACKGROUND DATA: It remains unclear as to which type of health instrument is more appropriate for ...

OBJECTIVES: This study was performed to determine 1) the rate of ankle fractures in the elderly in the United States stratified by hospital referral region, and 2) whether the percentage of ankle fractures treated surgically is affected by factors, such as fracture location, hospital referral region, concentration of orthopaedists, presence of a teaching hospital in that region, patient age, race, gender, or the number and type of specific medical comorbidities.

DESIGN: A 20% sample of ...