Thursday, 26 December 2013

Evidence-based guidelines developed for disc herniation




Evidence-based guidelines developed for disc herniation


(HealthDay)—Evidence-based clinical guidelines have been developed for management of lumbar disc herniation with radiculopathy; the guidelines have been published in the Jan. 1 issue of The Spine Journal.


D. Scott Kreiner, M.D., from Ahwatukee Sports and Spine in Phoenix, and colleagues conducted a systematic literature review and developed evidence-based guidelines to assist in the diagnosis and treatment of lumbar disc herniation with radiculopathy.


The researchers formulated 29 clinical questions relating to natural history, diagnosis and imaging, outcome measures, medical intervention/treatment, surgical treatment, and value of spinal care. The guidelines emphasize that is the most appropriate noninvasive test for confirming the presence of lumbar disc herniation. Computed tomography (CT) scans, myelography, and/or CT myelography are recommended for confirming herniation in patients with consistent history and physical examination findings. Insufficient evidence limited recommendations relating to medical/interventional treatment; transforaminal epidural steroid injection is recommended for short-term pain relief, and endoscopic percutaneous discectomy is recommended for carefully selected patients. Patients should undergo preoperative psychological assessment, as those with signs of psychological distress have worse outcomes after surgery. Earlier surgery is associated with faster recovery and improved long-term outcomes. For patients whose symptoms warrant surgical intervention, discectomy provides more effective relief than medical/interventional care, while for those with less severe symptoms, short and long-term relief are provided by surgery or medical/interventional care.


"The has been created using the techniques of evidence-based medicine and best available evidence to aid practitioners in the care of with symptomatic lumbar with radiculopathy," the authors write.


Several authors disclosed financial ties to the medical device and medical technology industries.



More information: Abstract

Full Text (subscription or payment may be required)



Journal reference: Spine Journal



Copyright © 2013 HealthDay. All rights reserved.


Medical Xpress on facebook

Related Stories


Improved driving reaction times after lumbar disc sx


Jan 15, 2013



(HealthDay)—Driving reaction times (DRTs), which are increased for patients with radiculopathy, improve after lumbar disc surgery, according to a study published in the November issue of the European Sp ...



MRI findings linked to effect of lumbar spine surgery


Jun 26, 2013



(HealthDay)—Certain findings on magnetic resonance imaging (MRI) are linked with surgical outcome in patients with lumbar intervertebral disc herniation, according to research published in the June 15 issue ...



Updated guidelines available for lumbar spinal stenosis


Aug 08, 2013



(HealthDay)—Updated evidence-based guidelines on the diagnosis and treatment of degenerative lumbar spinal stenosis are now available, according to report published in the July issue of The Spine Journal.



Less benefit for obese with lumbar disc herniation tx


Feb 08, 2013



(HealthDay)—Obese patients derive less benefit from both operative and non-operative lumbar disc herniation treatment, according to a study published in the Jan. 2 issue of The Journal of Bone & Joint Su ...



Neurological testing limited in diagnosing disc herniation


Jun 17, 2013



(HealthDay)—Neurological testing procedures have limited diagnostic accuracy for detecting disc herniation with suspected radiculopathy, according to a review and meta-analysis published in the June issue ...



Recommended for you




Don't let migraines ruin your holidays


29 minutes ago



(HealthDay)—The holidays can challenge the estimated 30 million migraine sufferers in the United States as they try to deal with crowds, travel delays, stress and other potential headache triggers.



New drug candidates show promise for cure for Chagas disease


1 hour ago



A team of researchers from Canada has developed a class of compounds which may help eradicate a neglected tropical disease that is currently hard to kill in its chronic form. The research was published ahead of print in Antimicrobial Ag ...



New MERS death raises Saudi toll to 57


1 hour ago



Saudi health authorities announced Thursday a new MERS death, bringing to 57 the number of people killed by the coronavirus in the country with the most fatalities.



Hong Kong reports first H7N9 death


7 hours ago



A Hong Kong man infected with the H7N9 strain of bird flu died on Thursday, the first such death in the city since the virus emerged there this month.



Adding cognitive behavioral therapy to treatment of pediatric migraine improves relief of symptoms


Dec 24, 2013



Among children and adolescents with chronic migraine, the use of cognitive behavioral therapy (CBT) resulted in greater reductions in headache frequency and migraine-related disability compared with headache education, according ...



Use of antidepressant does not improve symptoms from stomach disorder


Dec 24, 2013



Among patients with idiopathic (of unknown cause) gastroparesis, use of the antidepressant nortriptyline compared with placebo for 15 weeks did not result in improvement in overall symptoms, according to a study appearing ...



User comments








Evidence-based guidelines developed for disc herniation


(HealthDay)—Evidence-based clinical guidelines have been developed for management of lumbar disc herniation with radiculopathy; the guidelines have been published in the Jan. 1 issue of The Spine Journal.


D. Scott Kreiner, M.D., from Ahwatukee Sports and Spine in Phoenix, and colleagues conducted a systematic literature review and developed evidence-based guidelines to assist in the diagnosis and treatment of lumbar disc herniation with radiculopathy.


The researchers formulated 29 clinical questions relating to natural history, diagnosis and imaging, outcome measures, medical intervention/treatment, surgical treatment, and value of spinal care. The guidelines emphasize that is the most appropriate noninvasive test for confirming the presence of lumbar disc herniation. Computed tomography (CT) scans, myelography, and/or CT myelography are recommended for confirming herniation in patients with consistent history and physical examination findings. Insufficient evidence limited recommendations relating to medical/interventional treatment; transforaminal epidural steroid injection is recommended for short-term pain relief, and endoscopic percutaneous discectomy is recommended for carefully selected patients. Patients should undergo preoperative psychological assessment, as those with signs of psychological distress have worse outcomes after surgery. Earlier surgery is associated with faster recovery and improved long-term outcomes. For patients whose symptoms warrant surgical intervention, discectomy provides more effective relief than medical/interventional care, while for those with less severe symptoms, short and long-term relief are provided by surgery or medical/interventional care.


"The has been created using the techniques of evidence-based medicine and best available evidence to aid practitioners in the care of with symptomatic lumbar with radiculopathy," the authors write.


Several authors disclosed financial ties to the medical device and medical technology industries.



More information: Abstract

Full Text (subscription or payment may be required)



Journal reference: Spine Journal



Copyright © 2013 HealthDay. All rights reserved.


Medical Xpress on facebook

Related Stories


Improved driving reaction times after lumbar disc sx


Jan 15, 2013



(HealthDay)—Driving reaction times (DRTs), which are increased for patients with radiculopathy, improve after lumbar disc surgery, according to a study published in the November issue of the European Sp ...



MRI findings linked to effect of lumbar spine surgery


Jun 26, 2013



(HealthDay)—Certain findings on magnetic resonance imaging (MRI) are linked with surgical outcome in patients with lumbar intervertebral disc herniation, according to research published in the June 15 issue ...



Updated guidelines available for lumbar spinal stenosis


Aug 08, 2013



(HealthDay)—Updated evidence-based guidelines on the diagnosis and treatment of degenerative lumbar spinal stenosis are now available, according to report published in the July issue of The Spine Journal.



Less benefit for obese with lumbar disc herniation tx


Feb 08, 2013



(HealthDay)—Obese patients derive less benefit from both operative and non-operative lumbar disc herniation treatment, according to a study published in the Jan. 2 issue of The Journal of Bone & Joint Su ...



Neurological testing limited in diagnosing disc herniation


Jun 17, 2013



(HealthDay)—Neurological testing procedures have limited diagnostic accuracy for detecting disc herniation with suspected radiculopathy, according to a review and meta-analysis published in the June issue ...



Recommended for you




Don't let migraines ruin your holidays


29 minutes ago



(HealthDay)—The holidays can challenge the estimated 30 million migraine sufferers in the United States as they try to deal with crowds, travel delays, stress and other potential headache triggers.



New drug candidates show promise for cure for Chagas disease


1 hour ago



A team of researchers from Canada has developed a class of compounds which may help eradicate a neglected tropical disease that is currently hard to kill in its chronic form. The research was published ahead of print in Antimicrobial Ag ...



New MERS death raises Saudi toll to 57


1 hour ago



Saudi health authorities announced Thursday a new MERS death, bringing to 57 the number of people killed by the coronavirus in the country with the most fatalities.



Hong Kong reports first H7N9 death


7 hours ago



A Hong Kong man infected with the H7N9 strain of bird flu died on Thursday, the first such death in the city since the virus emerged there this month.



Adding cognitive behavioral therapy to treatment of pediatric migraine improves relief of symptoms


Dec 24, 2013



Among children and adolescents with chronic migraine, the use of cognitive behavioral therapy (CBT) resulted in greater reductions in headache frequency and migraine-related disability compared with headache education, according ...



Use of antidepressant does not improve symptoms from stomach disorder


Dec 24, 2013



Among patients with idiopathic (of unknown cause) gastroparesis, use of the antidepressant nortriptyline compared with placebo for 15 weeks did not result in improvement in overall symptoms, according to a study appearing ...



User comments








Categories:

0 comments:

Post a Comment