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J Neurosurg Spine 2019 Nov 29:1-9. Epub 2019 Nov 29.

3Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, Florida.

Kambin's triangle is an anatomical corridor used to access critical structures in a variety of spinal procedures. It is considered a safe space because it is devoid of vascular and neural structures of importance. Nonetheless, there is currently significant variation in the literature regarding the exact dimensions and anatomical borders of Kambin's triangle. Read More

Asian J Neurosurg 2019 Jul-Sep;14(3):657-669

Department of Orthopaedic Surgery, University Hospital of Ioannina, Ioannina, Greece.

Study Design: A systemic review of thermal annular procedures (TAPs) and percutaneous disk decompression procedures (PDDPs) for the treatment of discogenic chronic low back pain (CLBP) was conducted.

Objective: The objective of this review is to evaluate and to compare the effectiveness of TAPs and PDDPs in treating discogenic CLBP and to assess the frequency of complications associated with those procedures.

Materials And Methods: English-language journal articles were identified through computerized searches of the PubMed database and bibliographies of identified articles and review papers. Read More

Pain Physician 2017 09;20(6):447-470

Medical Director of interventional spine El Magdi Military Compound Hospitals, Consultant & Head of Physical Medicine and Rehabilitation Department, Assistant Professor at Egyptian Military Medical Academy, Egypt.

Background: Discogenic low back is a distinct clinic entity characterized by pain arising from a damaged disc. The diagnosis is clouded by the controversy surrounding discography. The treatment options are limited, with unsatisfactory results from both conservative treatment and surgery. Read More

Pain Pract 2018 04 3;18(4):515-522. Epub 2017 Nov 3.

Department of Economics and Related Studies, University of York, York, U.K.

Study Design: Cost-effectiveness analysis.

Objective: To evaluate the cost-effectiveness of intradiscal electrothermal therapy (IDET) relative to circumferential lumbar fusion with femoral ring allograft (FRA) in the United Kingdom.

Summary Of Background Data: Circumferential lumbar fusion is an established treatment for discogenic low back pain. Read More

J Pak Med Assoc 2017 Aug;67(8):1290-1292

Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey.

Intradiscal electrothermal therapy (IDET) is a method applied for treatment of pain caused by the disc and involves reaching spinal disc through a catheter under fluoroscopy and solidifying disc interior by heating. We retrospectively evaluated ten patients treated and followed up with diagnosis of nosocomial spondylodiscitis after IDET. Ten patients, to whom IDET was applied for low back pain treatment in a tertiary healthcare organization, came with complaints of fever and low back pain during postoperative process. Read More

J Korean Neurosurg Soc 2017 Jan 29;60(1):114-117. Epub 2016 Dec 29.

Department of Neurosurgery, Spine Center, Samsung Medical Center Sungkyunkwan University, School of Medicine, Seoul, Korea.

A 42-year-old man was admitted to our hospital with complaints of low back pain and intermittent right thigh pain. Twelve weeks before admission, the patient received intradiscal electrothermal therapy (IDET) at a local hospital. The patient still reported low back pain after the procedure that was managed with narcotic analgesics. Read More

Turk Neurosurg 2017 ;27(4):623-630

Baskent University, Faculty of Medicine, Department of Neurosurgery, Ankara, Turkey.

Aim: Intervertebral disc degeneration can cause severe low back pain. Intradiscal electrothermal therapy (IDET) is a minimally invasive treatment option for patients with symptomatic internal disc disruption unresponsive to conservative medical care. We aimed to evaluate 12-month pain and functional outcomes and predictors of clinical success in patients with discogenic back pain treated with IDET with respect to the Dallas Discogram Scale (DDS). Read More

J Res Med Sci 2015 Dec;20(12):1133-7

Departmentt of Epidemiology, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.

Background: Intervertebral disc herniation is a major cause of low back pain. Several treatment methods are available for lumbar disc herniation including Chemonucleolysis, open surgery, nucleoplasty, laser disc decompression, and intradiscal electrothermal therapy. The high prevalence of lumbar disc herniation necessitates a minimally invasive yet effective treatment method. Read More

Spine (Phila Pa 1976) 2014 Jul;39(16):1314-24

From the Leni and Peter W. May Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY.

Study Design: Systematic review of the literature.

Objective: A systematic evaluation of the literature was performed to investigate current nonoperative management of the treatment of discogenic low back pain.

Summary Of Background Data: Back pain is a major health care concern with up to 39% being discogenic in origin according to one study. Read More

Pain Physician 2013 Apr;16(2 Suppl):S49-283

American Society of Interventional Pain Physicians.

Objective: To develop evidence-based clinical practice guidelines for interventional techniques in the diagnosis and treatment of chronic spinal pain.

Methodology: Systematic assessment of the literature.

Evidence: I. Read More

Prim Care 2012 Sep;39(3):517-23

Southern Regional AHEC, 1601 Owen Drive, Fayetteville, NC 28304, USA.

A variety of nonoperative interventions are available to treat back pain. Careful assessment, discussion, and planning need to be performed to individualize care to each patient. This article discusses good to fair evidence from randomized controlled trials that injection therapy, percutaneous intradiscal radiofrequency thermocoagulation, intradiscal electrothermal therapy, and prolotherapy are not effective. Read More

Korean J Pain 2012 Jul 28;25(3):155-60. Epub 2012 Jun 28.

Pain Management Clinic, Department of Anesthesiology, Shiga University of Medical Science Hospital, Otsu, Shiga, Japan.

Background: We have developed an intradiscal pulsed radiofrequency (Disc PRF) technique, using Diskit II® needles (NeuroTherm, Wilmington, MA, USA), as a minimally invasive treatment option for chronic discogenic low back pain (LBP). The purpose of this study was to compare the representative outcomes of Disc PRF and Intradiscal Electrothermal Therapy (IDET) in terms of pain relief and reduction of disability.

Methods: Thirty-one patients with chronic discogenic LBP who underwent either Disc PRF (n = 15) or IDET (n = 16) were enrolled in the study. Read More

Pain Physician 2012 May-Jun;15(3):E279-304

The Helm Center for Pain Management, Laguna Hills, CA, USA.

Background: Persistent low back pain refractory to conservative treatment is a common problem that leads to widespread impairment, resulting in significant costs to society. The intervertebral disc is a major source of persistent low back pain. Technologies developed to treat this problem, including various surgical instrumentation and fusion techniques, have not reliably provided satisfactory results in terms of either pain relief or increased function. Read More

Acta Anaesthesiol Taiwan 2012 Mar 30;50(1):25-8. Epub 2012 Mar 30.

Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, South Korea.

Severe discogenic pain including axial or radicular pain is not easy to treat properly. Although mechanical correction was made possible to some extent, the high incidence of failed back surgery syndrome frustrates both patients and physicians. For discogenic pain, like other disorders, pain management is the discipline of intervention, principally with the application of certain techniques, such as intradiscal electrothermal therapy, nucleoplasty, Dekompressor and targeted disc decompression (TDD). Read More

Pain Physician 2012 Jan-Feb;15(1):E99-E106

Department of Orthopedic Surgery, Ludwig-Maximilians-University of Munich, Munchen - Germany.

Background: In 2000 the intradiscal electrothermal therapy (IDET) procedure for the treatment of discogenic pain was introduced. The technique involves the positioning of an intradiscal catheter with a temperature-controlled thermal resistive heating coil at the inner posterior annulus. The therapeutic mechanism of IDET combines the thermo-coagulation of native nociceptors and in-grown nonmyelinated nerve fibers with collagen shrinkage, stabilizing annular fissures. Read More

Int J Med Sci 2010 Dec 14;8(1):1-8. Epub 2010 Dec 14.

Pain Management Center, Department of Anesthesiology, Dicle University, Diyarbakir, Turkey.

Study Design: Prospective observational study.

Objective: Our aim is to investigate the efficacy and safety of TransDiscal Biacuplasty.

Summary Of Background Data: Chronic discogenic pain is one of the leading causes of low back pain; however, the condition is not helped by most non-invasive methods. Read More

Pain Manag 2011 Jan;1(1):41-51

Department of Anesthesiology, Vanderbilt University Medical Center, 1301 Medical Center Drive, Nashville, TN 37027, USA.

The intradiscal electrothermal therapy (IDET) procedure is a minimally invasive technique designed to treat discogenic chronic low back pain. The debate surrounding IDET ranges from the concept of the procedure, the technique and patient selection, to its effectiveness. The procedure provides modest improvement; however, it is considered less invasive and destructive than other modalities of treatments available at the present time, and has lower cost. Read More

Acta Neurochir Suppl 2011 ;108:103-5

Department of Neurosurgery Ospedale Fatebenefratelli E Oftalmico, Milano, Italy.

Background: Degeneration of the intervertebral disc can be the source of severe low back pain. Intradiscal electrothermal therapy (IDET) is a minimally invasive treatment option for patients with symptomatic internal disc disruption nonresponsive to conservative medical care.

Methods: Using MRI and discographic findings, 50 patients with lumbar discogenic pain were identified, underwent IDET treatment and were followed for 24 months. Read More

Nan Fang Yi Ke Da Xue Xue Bao 2010 Oct;30(10):2406-7, 2410

Department of Pain, Second Affiliated Hospital of Guangzhou Medical College, Guangzhou 510260, China.

Objective: To observe the clinical efficacy and complications of intradiscal electrothermal therapy for treatment of discogenic low back pain.

Methods: Forty patients with discogenic low back pain were treated with intradiscal electrothermal therapy, and the changes in the VAS, functional status and complications after the treatment were analyzed. RESULTS The VAS score was decreased and the functional status improved obviously after the treatment, which caused no severe complications. Read More

Surg Neurol Int 2010 Aug 4;1:37. Epub 2010 Aug 4.

Department of Neurosurgery, Taichung Veterans General Hospital, 160 Sec3 Chung-Kang Road, Taichung - 407 05, Taiwan, R.O.C.

Background: Low back pain (LBP) has become a main cause of absenteeism and disability in industrialized societies. Chronic LBP is an important health issue in modern countries. Discogenic LBP is one of the causes of chronic low back pain. Read More

Pain Pract 2010 Nov-Dec;10(6):560-79. Epub 2010 Sep 6.

Department of Anesthesiology and Pain Management, Alysis Rijnstate Hospital, Arnhem, The Netherlands.

An estimated 40% of chronic lumbosacral spinal pain is attributed to the discus intervertebralis. Degenerative changes following loss of hydration of the nucleus pulposus lead to circumferential or radial tears within the annulus fibrosus. Annular tears within the outer annulus stimulate the ingrowth of blood vessels and accompanying nociceptors into the outer and occasionally inner annulus. Read More

Pain Physician 2010 Jul-Aug;13(4):E215-64

Pain Management Center of Paducah, Paducah, KY, USA.

Background: Clinical guidelines are a constructive response to the reality that practicing physicians require assistance in assimilating and applying the exponentially expanding, often contradictory, body of medical knowledge. They attempt to define practices that meet the needs of most patients under most circumstances. Ideally, specific clinical recommendations contained within practice guidelines are systematically developed by expert panels who have access to all the available evidence, have an understanding of the clinical problem, and have clinical experience with the procedure being assessed, as well as knowledge of relevant research methods. Read More

Spine (Phila Pa 1976) 2011 Jan;36(2):118-23

Biologics and Spine, Smith and Nephew Inc, Memphis, TN, USA.

Study Design: a silicone material was evaluated as an intervertebral disc thermal phantom. Temperature mapping was performed during the intradiscal electrothermal therapy (IDET) procedure and compared with results from the cadaver studies.

Objective: to determine whether a silicone material can be used as an intervertebral disc thermal phantom for evaluating thermal distributions of intradiscal electrothermal therapies and for reducing the need for cadaver and animal studies. Read More

J Neurosurg Spine 2010 Mar;12(3):320-6

Department of Neurosurgery, Ospedale Fatebenefratelli E Oftalmico, Milano, Italy; and.

Object: Degeneration of the intervertebral disc can be the source of severe low-back pain. Intradiscal electrothermal therapy (IDET) is a minimally invasive treatment option for patients with symptomatic internal disc disruption unresponsive to conservative medical care. This study was undertaken in the neurosurgical setting to evaluate 24-month pain and functional outcomes and predictors of clinical success in patients with discogenic back pain treated with IDET. Read More

BMJ Clin Evid 2010 Oct 8;2010. Epub 2010 Oct 8.

Oregon Health & Science University, Portland, USA.

Introduction: Over 70% of people in developed countries develop low back pain (LBP) at some time. But recovery is not always favourable: 82% of non recent-onset patients still experience pain 1 year later. Many patients with chronic LBP who were initially told that their natural history was good spend months or years seeking relief. Read More

Rofo 2009 Oct 24;181(10):936-44. Epub 2009 Sep 24.

Ludwig-Boltzmann-Institut für Health Technology Assessment, Wien, Osterreich.

We evaluated the efficacy and safety of chemonucleolysis and intradiscal electrothermal therapy (IDET) on the basis of the data presented in recently published papers with respect to pain relief, function, and complication rates. Detailed searches for English and German articles published between 2003 and 2008 were performed in a number of electronic databases. Further publications were identified by manual search. Read More

Pain Physician 2009 Jul-Aug;12(4):699-802

Pain Management Center of Paducah, Paducah, KY, USA.

Background: Comprehensive, evidence-based guidelines for interventional techniques in the management of chronic spinal pain are described here to provide recommendations for clinicians.

Objective: To develop evidence-based clinical practice guidelines for interventional techniques in the diagnosis and treatment of chronic spinal pain.

Design: Systematic assessment of the literature. Read More

Spine (Phila Pa 1976) 2009 May;34(10):1078-93

Department of Medicine, Oregon Evidence-Based Practice Center, Oregon Health and Science University, Portland, OR, USA.

Study Design: Systematic review.

Objective: To systematically assess benefits and harms of nonsurgical interventional therapies for low back and radicular pain.

Summary Of Background Data: Although use of certain interventional therapies is common or increasing, there is also uncertainty or controversy about their efficacy. Read More

Int Anesthesiol Clin 2009 ;47(2):45-55

Department of Anesthesiology, the Mount Sinai Medical Center, 1 Gustave L. Levy Place, New York, NY, USA.

Pain Physician 2009 Jan-Feb;12(1):207-32

Pacific Coast Pain Management Center, Laguna Hills, CA, USA.

Background: Chronic discogenic low back pain is a common problem with significant personal and societal costs. Thermal annular procedures (TAPs) have been developed in an effort to provide a minimally invasive treatment for this disorder. Multiple techniques utilized are intradiscal electrothermal therapy (IDET), radiofrequency annuloplasty, and intradiscal biacuplasty (IDB). Read More

J La State Med Soc 2008 Sep-Oct;160(5):280-5

Spine Institute of Louisiana, USA.

Objective: This prospective study was conducted to evaluate improvements in pain and disability in a series of 53 consecutive worker's compensation patients with discogenic low back pain following treatment with the intradiscal electrothermal therapy (IDET) procedure.

Material And Methods: Between 2002 and 2004, a total of 53 consecutive patients, who were claimants of worker's compensation, were treated using IDET for their discogenic low back pain. The outcomes of these patients were analyzed statistically for the current study by physical exam and self-assessment questionnaires of pain and disability at baseline and at 24-months post-procedure. Read More

Pain Med 2008 Oct;9(7):835-43

Emory Spine Center--Physical Medicine and Rehabilitation, Pain Medicine, Atlanta, Georgia 30329, USA.

Study Design: Single-arm prospective clinical trial.

Objective: To determine the treatment effect and MRI changes of targeted disc decompression using an intradiscal catheter for focal heating of symptomatic lumbar disc protrusions resulting in radicular pain.

Summary Of Background Data: Percutaneous methods for treatment of lumbar disc herniations are potentially attractive alternatives to open surgical discetomies. Read More

Pain Physician 2008 Sep-Oct;11(5):659-68

Connecticut Pain Care, Danbury, CT, USA.

Discogenic low back pain resulting from internal disc disruption can be severely disabling, clinically challenging, and expensive to treat. Previously, when conservative care had been exhausted, open surgical intervention such as spinal fusion or artificial disc replacement was the only treatment option for these patients. Intradiscal electrothermal therapy (IDET), a minimally-invasive technique performed in the outpatient setting, offers an intermediate intervention between conservative care and surgery. Read More

Surg Technol Int 2008 ;17:259-68

Scientific Committee, Back Care Network, Athens, Greece.

This chapter evaluates the current evidence on common minimally invasive therapeutic spinal procedures based on the Levels of Evidence and Grades of Recommendation developed by the Centre for Evidence-Based Medicine (Oxford, United Kingdom). The results of the evaluation of current clinical evidence allow the following recommendations to be made: epidural adhesiolysis performed repeatedly every 3 months to 4 months is effective in the "post lumbar laminectomy" syndrome; epidural steroid injections may provide only short-term relief from pain in lumbar radiculopathy but have no long-term effect; selective nerve root injections of corticosteroids have no therapeutic effect on the long-term natural history of radiculopathy symptoms; intra-articular facet joint injections of corticosteroids have no therapeutic effect on lower back pain (grade of recommendation: A). Furthermore, percutaneous vertebroplasty and balloon kyphoplasty provide immediate pain relief from osteoporotic spinal fractures but no significant long-lasting benefit (grade of recommendation: B). Read More

Pain Physician 2008 Jul-Aug;11(4):393-482

Pain Management Center of Paducah, Paducah, KY, USA.

Background: Appropriately developed practice guidelines present statements of best practice based on a thorough evaluation of the evidence from published studies on the outcomes of treatments, which include the application of multiple methods for collecting and evaluating evidence for a wide range of clinical interventions and disciplines. However, the guidelines are neither infallible, nor a substitute for clinical judgment. While the guideline development process is a complex phenomenon, conflict of interest in guideline development and inappropriate methodologies must be avoided. Read More

Pain Physician 2008 May-Jun;11(3):271-89

Pain Management Center of Paducah, Paducah, KY 42003, USA.

In the modern day environment, workers' compensation costs continue to be a challenge, with a need to balance costs, benefits, and quality of medical care. The cost of workers' compensation care affects all stakeholders including workers, employers, providers, regulators, legislators, and insurers. Consequently, a continued commitment to quality, accessibility to care, and cost containment will help ensure that workers are afforded accessible, high quality, and cost-effective care. Read More

J Spinal Disord Tech 2008 Feb;21(1):55-62

3B Orthopaedics, Pennsylvania Hospital, University of Pennsylvania Health System, 800 Spruce Street, 8th Floor, Philadelphia, PA, USA.

Study Design: Single-arm, prospective clinical trial.

Objective: To evaluate back pain severity, physical function, and quality of life outcomes in highly selected patients with lumbar discogenic pain treated with intradiscal electrothermal therapy (IDET).

Summary Of Background Data: Degeneration and disruption of the intervertebral disc can be the source of severe low back pain and the associated physical dysfunction. Read More

J Spinal Disord Tech 2008 Feb;21(1):11-8

Spine Institute of Louisiana, Shreveport, LA 71101, USA.

Objective: This prospective study was conducted to evaluate improvements in pain and disability in a series of 53 consecutive worker's compensation patients with low back pain (LBP) after treatment with the intradiscal electrothermal therapy (IDET) procedure.

Materials And Methods: All patients seen in the out-patient clinic of the Spine Institute of Louisiana for LBP of discogenic origin were screened for eligibility to receive IDET procedure. A total of 134 patients were treated using IDET for their discogenic LBP during the study period. Read More

Curr Pain Headache Rep 2008 Jan;12(1):14-21

The Centre for Spinal Studies and Surgery, Nottingham University Hospitals NHS Trust, Queen's Medical Centre Campus, Nottingham NG7 2UH, UK.

Over the past decade, there has been a surge of minimally invasive techniques aimed at treating both discogenic low back pain (LBP) and radicular pain. This article assesses the current evidence for three such treatments: intradiscal electrothermal therapy (IDET), percutaneous discectomy, and nucleoplasty. An electronic search of the literature carried out using the Cochrane Library database (2007) and Medline (1966-2007) identified 77 references relating to IDET, 363 to percutaneous discectomy, and 36 to nucleoplasty. Read More

Neurol Res 2008 May 31;30(4):411-6. Epub 2008 Jan 31.

Department of Neurosurgery, Diskapi Hospital, Ankara, Turkey.

Objective: The authors evaluate the efficacy of intradiscal electrothermal therapy (IDET) for discogenic pain on outcome of patients using the Oswestry disability index (ODI) after 18 month follow-up.

Methods: Thirty-nine patients with chronic discogenic low back pain who failed to improve following conservative treatment were considered for this study. Inclusion criteria included the presence of one- or two-level symptomatic disk degeneration without evidence of nerve root compression. Read More

Spine J 2008 Jan-Feb;8(1):80-95

Spinal Diagnostics & Treatments Center, 901 Campus Drive, Suite 312, Daly City, CA 94015-4900, USA.

The management of chronic low back pain (CLBP) has proven very challenging in North America, as evidenced by its mounting socioeconomic burden. Choosing among available nonsurgical therapies can be overwhelming for many stakeholders, including patients, health providers, policy makers, and third-party payers. Although all parties share a common goal and wish to use limited health-care resources to support interventions most likely to result in clinically meaningful improvements, there is often uncertainty about the most appropriate intervention for a particular patient. Read More

Middle East J Anaesthesiol 2007 Oct;19(3):683-92

Department of Anesthesiology, Illinois Masonic Medical Center, Chicago, IL 60657, USA.

Objective: The objective of this article is to provide evidence supporting the idea that intervertebral disc is a source of low back pain.

Summary Of Background Data: Diagnostic tests currently available for diagnosis of a painful disc are inadequate. Treatment protocols for low back pain generally ignore the presence of a painful disc. Read More

Zhonghua Yi Xue Za Zhi 2007 Jul;87(25):1742-5

Department of Radiology, Ruijin Hospital Luwan Branch, Shanghai Jiaotong University, Shanghai 200020, China.

Objective: To assess the effectiveness of intradiscal electrothermal treatment (IDET) combined with epidural steroid injection for discogenic lumbago-leg pain.

Methods: Fifty-nine patients with discogenic lower back pain and radical pain underwent IDET and CT guided spinal cord epidural steroid injection (Limethason). Thirty-eight patients with discogenic lower back pain and radical pain underwent IDET only. Read More

Anesth Analg 2007 Aug;105(2):495-8

Pain Management Division, Department of Anesthesiology and Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA.

Nine consecutive patients with discogenic low back pain who obtained excellent pain relief from intradiscal electrothermal therapy were treated with a repeat procedure after the beneficial effects had diminished. Although 4 of 9 patients obtained > or =50% pain relief and were satisfied with the results, both the degree and duration of benefit were less pronounced than after the first procedure. Prospective studies are needed to identify the best candidates for repeat intradiscal electrothermal therapy. Read More

Spine (Phila Pa 1976) 2007 May;32(10):1146-54

Centro Cochrane Iberoamericano, Servei d'Epidemiologia i Salut Pública, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.

Study Design: Systematic review.

Objective: To systematically review the evidence on the efficacy, effectiveness, and safety of percutaneous thermocoagulation intradiscal techniques for discogenic low back pain.

Summary Of Background Data: The intervertebral disc is thought to be the source of pain in a relevant proportion of cases of low back pain (LBP). Read More

Anaesth Intensive Care 2007 Apr;35(2):289-93

Department of Anesthesiology, Illinois Masonic Medical Center, Chicago, Illinois, USA.

Intradiscal electrothermal therapy is a frequently performed procedure for the pain of internal disc disruption. It is typically performed on one to two discs; the discal treatment is followed by a long period of rest and rehabilitation. In patients with multilevel disc disease, intradiscal electrothermal therapy is either not contemplated or only one to two discs are treated at a time. Read More

Pain Physician 2007 Jan;10(1):7-111

American Society of Interventional Pain Physicians, Paducah, KY 42001, USA.

Background: The evidence-based practice guidelines for the management of chronic spinal pain with interventional techniques were developed to provide recommendations to clinicians in the United States.

Objective: To develop evidence-based clinical practice guidelines for interventional techniques in the diagnosis and treatment of chronic spinal pain, utilizing all types of evidence and to apply an evidence-based approach, with broad representation by specialists from academic and clinical practices.

Design: Study design consisted of formulation of essentials of guidelines and a series of potential evidence linkages representing conclusions and statements about relationships between clinical interventions and outcomes. Read More

Pain Pract 2005 Dec;5(4):303-15

Siskin Hospital's Center for Pain Rehabilitation, Chattanooga, Tennessee 37403, USA.

This is an update to evidence-based practice guidelines for chronic nonmalignant pain syndrome patients first published in 1995 and revised in 1999. The current guidelines recommend interdisciplinary-focused rehabilitation, which is goal-directed and time-limited. Emphasis is placed on educating patients in active self-management techniques that stress maximizing function. Read More

Pain Pract 2005 Sep;5(3):228-43

Department of Anesthesiology and Pain Medicine, Mount Sinai Medical Center, New York, New York 10029-6574, USA.

Low back pain (LBP) is a major physical and socioeconomic entity. A significant percentage of LBP is attributable to internal disc disruption. The management of internal disc disruption has traditionally been limited to either conservative treatment or spinal fusion. Read More