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Day: May 22, 2018

Prognostic factor analysis in patients with metastatic spine disease depending on surgery and conservative treatment: review of 577 cases.

By London Spine
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Prognostic factor analysis in patients with metastatic spine disease depending on surgery and conservative treatment: review of 577 cases.

Ann Surg Oncol. 2013 Jan;20(1):40-6

Authors: Lee BH, Kim TH, Chong HS, Moon ES, Park JO, Kim HS, Kim SH, Lee HM, Cho YJ, Kim KN, Moon SH

Abstract
BACKGROUND: To date, skillful medical management and advanced surgical techniques have provided increased quality of life with less postoperative morbidity in patients with spinal metastasis. We assessed the survival of patients with spinal metastasis according to two treatment modalities: surgery and conservative treatment.
METHODS: From 2005 to 2010, a total of 577 patients (200 surgery, 377 conservative treatment) who had spinal metastasis were enrolled. Prognostic factors and survival were assessed by Cox regression and Kaplan-Meier analyses in patients receiving either surgery or conservative treatment.
RESULTS: The mean age was 59.7 (range 21-87) years in the surgery group and 59.9 (range 28-90) years in the conservative treatment group. The major primary cancers were of lung, liver, and colorectal origin in the surgery group and lung, liver, and breast in the conservative group. The mean±SD Tokuhashi score in the surgery group was 8.12±3.09 and in the conservative group was 8.0±2.8 (not significant). The hazard ratio of the primary cancer group ranged from 1.870 to 3.217 compared to that of the most favorable primary cancer group in all patients. Survival was affected significantly by sex, adjuvant therapy, and postoperative survival in the surgery group and by clinical symptom, metastasis to major internal organ, and primary cancer origin in the conservative group.
CONCLUSIONS: With this retrospective review of 577 cases of spinal metastasis, different prognostic factors depending on the treatment modality were discovered. Hence, consideration of these factors depending on the treatment modality could be helpful in treating patients with spinal metastasis.

PMID: 22956070 [PubMed – indexed for MEDLINE]

The management of lower back pain.

By London Spine

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The management of lower back pain.
J R Nav Med Serv. 2014;100(3):282-7
Authors: Morrow LJ, Smith S
Abstract
Lower back pain (LBP) is one of the most common musculoskeletal conditions…

Associations Between Serum Biomarkers and Pain and Pain-Related Function in Older Adults with Low Back Pain: A Pilot Study.

By London Spine
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Associations Between Serum Biomarkers and Pain and Pain-Related Function in Older Adults with Low Back Pain: A Pilot Study.

J Am Geriatr Soc. 2014 Nov 3;

Authors: Sowa GA, Perera S, Bechara B, Agarwal V, Boardman J, Huang W, Camacho-Soto A, Vo N, Kang J, Weiner D

Abstract
OBJECTIVES: To examine the relationship between serum biomarkers and self-reported pain intensity and pain-related function, in addition to the contribution of magnetic resonance imaging (MRI) findings of lumbar spine degenerative changes, in older adults with chronic low back pain.
DESIGN: Single-center cross-sectional cohort study.
SETTING: Academic medical center.
PARTICIPANTS: Individuals aged 60 and older with axial low back pain without radiculopathy or previously diagnosed osteoarthritis of the knee or hip or pain outside the low back that is more severe than the back pain (n = 43).
MEASUREMENTS: To examine pain-related impairment, pain was measured on a pain thermometer and the McGill Pain Questionnaire Short Form was administered. To examine pain-related function or activity limitation, the Roland Morris Disability Questionnaire, Short Physical Performance Battery (SPPB), and repetitive trunk rotation were used. Single plasma samples were obtained before and after physical performance tests and analyzed for inflammatory markers (E-selectin and regulated on activation, normal T cell expressed and secreted (RANTES)), inhibitors of catabolic enzymes (tissue inhibitor of metalloproteinases-1 (TIMP-1)), markers of matrix turnover (C- telopeptide of type II collagen (CTX-II) and aggrecan chondroitin sulfate 846 (CS846)), and stress biomarkers (neuropeptide Y (NPY)). Conventional nongadolinium lumbar MRI was performed and analyzed quantitatively and clinically.
RESULTS: Composite MRI measurements did not show significant correlation with pain or pain-related function. Basal levels and changes in serum biomarkers in response to activity, particularly NPY and RANTES, demonstrated associations with pain and pain-related function in addition to the explanatory power of MRI-based results.
CONCLUSION: Serum biomarkers may be a metric for assessment of active disease in older adults, in whom imaging changes are ubiquitous. In addition, changing levels of biomarkers in response to activity suggests that they may be useful as metrics to measure treatment responses in future studies and may reflect potential targets for use in designing personalized treatment for older adults with low back pain.

PMID: 25367206 [PubMed – as supplied by publisher]