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Erschienen in: Wiener klinische Wochenschrift 19-20/2013

01.10.2013 | original article

Provocative discography screening improves surgical outcome

verfasst von: Petra Margetic, MD, PhD, Assoc. Prof. Roman Pavic, MD, PhD, Prof. Marin F. Stancic, MD, PhD

Erschienen in: Wiener klinische Wochenschrift | Ausgabe 19-20/2013

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Summary

Objective

The objective of this study was to compare the surgical outcomes of patients operated on, with or without discography prior to operation.

Methods

The study was designed as a randomized controlled trial, using power analysis with McNemar’s test on two correlated proportions. The study comprised of 310 patients divided into trial (207) and control (103) groups. Inclusion criteria were low back pain resistant to nonsurgical treatment for more than 6 months and conventional radiological findings showing degenerative changes without a clear generator of pain. Exclusion criteria were red flags (tumor, trauma, and infection). After standard radiological diagnostic imaging (X-ray, CT, and MR), patients filled in the Oswestry Disability Index (ODI), SF-36, Zung, and MSP questionnaires. Depending on their radiological findings, patients were included and randomly placed in the trial or control group. At the 1-year follow-up examination, patients filled in the ODI, SF-36, and Likert scale questionnaires.

Results

The difference between preoperative and postoperative ODI in the control group degenerative disc disease (DDD) subgroup was 22.07 %. The difference between preoperative and postoperative ODI in the trial group DDD subgroup was 35.04 %. Differences between preoperative and postoperative ODI in the control group other indications subgroup was 26.13 %. Differences between preoperative and postoperative ODI in the trial group other indications subgroup was 28.42 %.

Conclusions

DDD treated surgically without discography did not reach the clinically significant improvement of 15 ODI points for the patients treated with fusion. Provocative discography screening with psychological testing in the trial group made improvement following fusion clinically significant.
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Metadaten
Titel
Provocative discography screening improves surgical outcome
verfasst von
Petra Margetic, MD, PhD
Assoc. Prof. Roman Pavic, MD, PhD
Prof. Marin F. Stancic, MD, PhD
Publikationsdatum
01.10.2013
Verlag
Springer Vienna
Erschienen in
Wiener klinische Wochenschrift / Ausgabe 19-20/2013
Print ISSN: 0043-5325
Elektronische ISSN: 1613-7671
DOI
https://doi.org/10.1007/s00508-013-0404-5

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