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1

Larson, Barbara A. Occupational therapy practice guidelines for adults with low back pain. Bethesda, Md: American Occupational Therapy Association, 1999.

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2

Carl, DeRosa, ed. Mechanical low back pain: Perspectives in functional anatomy. Philadelphia: Saunders, 1991.

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3

Carl, DeRosa, ed. Mechanical low back pain: Perspectives in functional anatomy. 2nd ed. Philadelphia: W.B. Saunders, 1998.

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4

Allen, Sara Elizabeth. What is the evidence for the effectiveness of non-drug pain management on patients with chronic low back pain?. Oxford: Oxford Brookes University, 2002.

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5

Watson, Paul John. The function of the paraspinal muscles in chronic low back pain patients: A comparison of surface electromyography in normal, healthy control group and an evaluation of the effects of a pain management programme. Manchester: University of Manchester, 1995.

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6

Understanding acute low back problems: A patients. U.S Govt. Printing, 1994.

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7

1949-, Tollison C. David, and Kriegel Michael L, eds. Interdisciplinary rehabilitation of low back pain. Baltimore: Williams & Wilkins, 1989.

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8

Fairbank, Jeremy. Surgical management of chronic low back pain. Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780199550647.003.003006.

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♦ A very small proportion of back pain patients respond to surgical treatment♦ Patient selection is poorly defined♦ The rationale of treatment ranges from immobilization (fusion) to claimed restoration of normal movement (disc replacement and flexible fixation).
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9

Brian, D'Orazio, ed. Back pain rehabilitation. Boston: Andover Medical Publishers, 1993.

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10

K, Burton A., and Polytechnic of Huddersfield. School of Computing and Mathematics., eds. Lumbar sagittal mobility and low back symptoms in patients treated with manipulation. Huddersfield: ThePolytechnic of Huddersfield. School of Computing and Mathematics, 1990.

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11

A comparison of isometric strength test results between low back injured patients and normals. 1991.

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12

A comparison of isometric strength test results between low back injured patients and normals. 1992.

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13

Hochman, Michael E. Magnetic Resonance Imaging for Low Back Pain. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780190223700.003.0012.

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This chapter, found in the back pain section of the book, provides a succinct synopsis of a key study examining the use of magnetic resonance imaging (MRI) for low back pain. This summary outlines the study methodology and design, major results, limitations and criticisms, related studies and additional information, and clinical implications. Researchers concluded that although spinal MRIs (compared with plain radiographs) are reassuring for patients with low back pain, they do not lead to improved functional outcomes; also, spinal MRIs detect anatomical abnormalities that would otherwise go undiscovered, possibly leading to spinal surgeries of uncertain value. In addition to outlining the most salient features of the study, a clinical vignette and imaging example are included in order to provide relevant clinical context.
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14

Kleppan, Glenn Stenholm. An investigation into the efficacy of a functional restoration programme including back school in patients with chronic low back pain. 1998.

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15

S, Kerry, and National Co-ordinating Centre for HTA (Great Britain), eds. Routine referral for radiography of patients presenting with low back pain: Is patients' outcome influenced by GP's referral for plain radiography? Alton: Core Research on behalf of the NCCHTA, 2000.

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16

Hanebrekke, Therese Lexau. A postal questionnaire to investigate physiotherapists' views on psychosocial factors in patients with low back pain. 2003.

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17

Norris, Jennifer. A qualitative study into the patients perspective of education and advice in low back pain physiotherapy management. 2002.

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18

Cohen, Jeffrey A., Justin J. Mowchun, Victoria H. Lawson, and Nathaniel M. Robbins. A 39-Year-Old Man with Low Back Pain and Scapular Winging. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780190491901.003.0023.

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Facioscapulohumeral muscular dystrophy (FSHD) is the third most common muscular dystrophy, following Duchenne muscular dystrophy and myotonic dystrophy. The clinical secerity is extremely variable, with symptom onset anywhere from infancy to middle adulthood. The cardinal clinical features of facioscapulohumeral muscular dystrophy include facial weakness and scapular winging. Other important examination findings including scalloping of the trapezius, “Popeye” forearms, horizontal axillary folds, and a positive Beevor’s sign. It can rarely present as a pattern of weakness mimicking limb-girdle muscular dystrophy with approximately 20% of patients eventually requiring a wheelchair for ambulation. Creatine kinase is normal or mildly elevated. Genetic testing for the D4Z4 repeat contraction on chromosome 4q35 detects 95% of cases but may not reflect severity of the disease.
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19

Malik, Tariq M. Back Pain: It’s Not Always Arthritis. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190271787.003.0029.

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Back pain is prevalent in adults, and most often its cause is nonspecific and benign. Imaging and interventions are not always helpful and they are generally expensive and low yield. However, in about 10% or fewer cases, a specific etiology is found. A patient history, physical examination, and testing are the methods for finding the cause. Back pain from malignancy must also be considered. Prolonged survival from better chemotherapy has increased the incidence of metastases to bone, especially the spine. Common sources of spinal metastases are cancers of the prostate, kidneys, thyroid, breast, and lungs. The primary treatment is to address the malignancy. Pain from spinal tumors can be treated with chemotherapy, radiotherapy, radiofrequency, or vertebral augmentation therapy. The chapter reviews the epidemiology of spinal cancer pain, evaluation of malignant spinal pain, and what the interventional pain physician can offer patients to alleviate their pain.
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20

D, Kendrick, and National Co-ordinating Centre for HTA (Great Britain), eds. The Role of radiography in primary care patients with low back pain of at least 6 weeks duration: A randomised (unblinded) controlled trial. Alton: Core Research on behalf of the NCCHTA, 2001.

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21

J, Gilbert F., and National Co-ordinating Centre for HTA (Great Britain), eds. Does early magnetic resonance imaging influence management or improve outcome in patients referred to secondary care with low back pain?: A pragmatic randomised controlled trial. Tunbridge Wells: Gray Publishing on behalf of NCCHTA, 2004.

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22

Development and initial evaluation of an evidence-based in office decision aid to improve the assessment and treatment of patients with acute low back pain in primary care practice: The Peterborough Back Rules Template. Ottawa: National Library of Canada, 1999.

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23

Karan, Lori D. Pain and Addiction in Patients Who Smoke Cigarettes (DRAFT). Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190265366.003.0029.

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Through a discussion of the effects of cigarette smoking on both pain perception and other substance use, this chapter outlines the presentation of the benefits to the patient and reviews smoking cessation strategies. It begins with an epidemiological review of the higher prevalence of smoking among those with chronic pain syndromes, such as fibromyalgia, headache, and low back pain. The many adverse consequences of cigarette smoking for general health are identified, from enhanced osteoporosis to prolonged wound repair. Most strikingly, smoking is demonstrated to both exacerbate the experience of pain and lead to a heightened requirement for opioid analgesia. Its overlap with other substance use disorders has long been recognized, including an association with higher relapse rates to alcohol and other drugs. A table is provided detailing the physiological improvements seen upon smoking cessation.
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24

Exercise-Based Physiotherapy Management of Patients With Persistent, Non-Specific Low Back Pain: A Cognitive-Behavioural Approach to Assessment and Treatment ... Summaries of Uppsala Dissertations, 881). Uppsala Universitet, 1999.

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25

Patient Handling in the Healthcare Sector: A Guide for Risk Management with MAPO Methodology. Taylor & Francis Group, 2014.

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26

Menoni, Olga, Natale Battevi, and Silvia Cairoli. Patient Handling in the Healthcare Sector: A Guide for Risk Management with MAPO Methodology. Taylor & Francis Group, 2014.

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27

Menoni, Olga, Natale Battevi, and Silvia Cairoli. Patient Handling in the Healthcare Sector: A Guide for Risk Management with MAPO Methodology. Taylor & Francis Group, 2014.

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28

Knezevic, Nebojsa Nick, Benjamin Cantu, Ivana Knezevic, and Kenneth D. Candido. Chronic Back Pain in the Elderly: Spinal Stenosis. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190271787.003.0022.

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Chronic low back pain (CLBP) is a common reason for physician office visits among the elderly. Predictive factors for CLBP are female sex, social isolation, hypertension, and joint pain. In the elderly, CLBP may be related to degenerative spinal stenosis with disk degeneration and overall spondylosis. A detailed medical history and a targeted, comprehensive physical examination are the initial approaches to rule out underlying disease that requires urgent attention. Clinical and evidence-based approaches to management suggest avoiding early MRI or CT, as imaging in elderly patients has proven both impractical and uneconomical. Instead, good clinical judgment should be used for making diagnoses. Consensus on the best initial approaches for managing CLBP has not yet been achieved, and conservative therapy is suggested, varying from use of pharmacologic agents, physical therapy, electrical stimulation, and physical manipulations to epidural injections. Surgical alternatives are avoided due to confounding and multiple comorbidities in older patients.
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29

Pangarkar, Sanjog S. Pain and Addiction in Patients with Traumatic Brain Injury (DRAFT). Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190265366.003.0027.

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Distinct from Chapter 24, on co-occurring psychiatric disorders, this chapter addresses common physical comorbidities that give rise to chronic pain and are notorious for associated substance use disorders. The concept of “pseudo-addiction” is explored as one of several contributors to common misperceptions of the analgesic needs of such patients. Examples of entities discussed are chronic low back pain, sleep apnea, chronic pancreatitis, cirrhosis, and HIV infection or AIDS-related pain. While not intrinsically painful, sleep apnea merits inclusion as it arises in conjunction with sedative-hypnotic, opioid, or nicotine use. Cirrhosis likewise creates obstacles to successful pain or addiction management resulting from altered metabolism of medications and enhanced susceptibility to potentially lethal syndromes (hepato-renal syndrome, gastric hemorrhage, etc.). The management of neuropathic pain in HIV infection (Chapter 15) is amplified here.
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30

Colameco, Stephen. Pain and Addiction in Patients with Co-Occurring Medical Disorders (DRAFT). Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190265366.003.0026.

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Distinct from Chapter 24, on co-occurring psychiatric disorders, this chapter addresses common physical comorbidities that give rise to chronic pain and are notorious for associated substance use disorders. The concept of “pseudo-addiction” is explored as one of several contributors to common misperceptions of the analgesic needs of such patients. Examples of entities discussed are chronic low back pain, sleep apnea, chronic pancreatitis, cirrhosis, and HIV infection or AIDS-related pain. While not intrinsically painful, sleep apnea merits inclusion as it arises in conjunction with sedative-hypnotic, opioid, or nicotine use. Cirrhosis likewise creates obstacles to successful pain or addiction management resulting from altered metabolism of medications and enhanced susceptibility to potentially lethal syndromes (hepato-renal syndrome, gastric hemorrhage, etc.). The management of neuropathic pain in HIV infection (Chapter 15) is amplified here.
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31

Siebert, Stefan, Sengupta Raj, and Alexander Tsoukas. The epidemiology of ankylosing spondylitis, axial spondyloarthritis, and back pain. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198755296.003.0003.

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Low back pain is a leading cause of disability worldwide. The prevalence of inflammatory back pain (IBP) has been calculated to be in the range 8–15% in a UK primary care population and 5–7% in a US population-based cohort. IBP rates are significantly higher in patients with psoriasis, uveitis, or inflammatory bowel disease than the general population. There is a paucity of good epidemiological studies to define the true incidence and prevalence of ankylosing spondylitis (AS), axial spondyloarthritis (axSpA), and spondyloarthritis (SpA), with wide variation as a result of geographic, demographic and methodological factors. The global prevalence estimates range from 0.01–0.2% for AS, to 0.32–0.7% for axSpA and around 1% for SpA overall. The global incidence estimates range from 0.44–7.3 cases per 100,000 person-years for AS to 0.48–62.5 cases per 100,000 person-years in SpA. The demographics and natural history of disease progression are also discussed.
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32

Russell, Garth S., and Thomas R. Highland. Care of the Low Back: A Patient Guide. Garth S. Russell Publishing, 1991.

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33

Margareta, Nordin, Vischer Thomas L, and Cedraschi Christine, eds. New approaches to the low back pain patient. London: Baillière Tindall, 1998.

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34

Knezevic, Nebojsa Nick, Teresa M. Kusper, and Kenneth D. Candido. Chronic Low Back Pain in a Young Patient. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190271787.003.0023.

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Chronic low back pain (CLBP) in young adults is a great public health concern. CLBP affects individuals across all age groups with varying frequency, and it is associated with significant disability and morbidity, missed school or work, loss of productivity, and substantial health care expenditures. It can occur suddenly as a result of injury, or develop gradually due to degenerative changes in the spine. Correct diagnosis and proper management, usually involving a multidisciplinary approach, are paramount for optimal pain management. Usually, combinations of conservative management (pharmacologic and nonpharmacologic) with epidural steroid injections can achieve long-term pain relief and relapse prevention.
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35

Understanding acute low back problems. Rockville, Md. (Executive Office Center, Suite 501, 2101 E. Jefferson St., Rockville 20852): U.S. Dept. of Health and Human Services, Public Health Service, Agency for Health Care Policy and Research, 1994.

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36

Drazin, Doniel, Carlito Lagman, Christine Piper, Ari Kappel, and Terrence T. Kim. Surgical Approaches for Degenerative Lumbar Stenosis. Edited by Mehul J. Desai. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199350940.003.0018.

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This chapter discusses the evaluation of patients presenting with low back pain and the surgical management of three common causes of low back pain in adults: stenosis, spondylolisthesis, and scoliosis. Components of the history and physical examination, diagnostic imaging, and ancillary studies are reviewed. Surgical management includes decompression including laminectomy or laminotomy, and instrumented fusion. Indications, contraindications, general procedural steps, and potential complications are covered. Recent published literature is reviewed when appropriate.
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37

Souzdalnitski, Dmitri, Pavan Tankha, and Imanuel R. Lerman. Lumbar Epidural Injections: Fluoroscopy. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199908004.003.0021.

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Lumbar epidural injection is most often performed for patients experiencing low back pain with radicular symptoms. The radicular symptoms can be precipitated by disc herniation or foraminal stenosis. In addition, spinal stenosis with associated neurogenic claudication is another common indication for this injection. These procedures may be effective in treatment of other syndromes that are associated with radiculopathic low back pain, including intervertebral disc degeneration without disc herniation, central spinal stenosis, spondylothesis, and failed lumbar back surgery syndrome. Lumbar epidural steroid injection (LESI) is the most commonly performed intervention. Fluoroscopically guided lumbar epidural injections led to a lower rate of complications than that reported for all lumbar epidural injections.
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38

Von Korff, Michael. Fear and depression as remediable causes of disability in common medical conditions in primary care. Oxford University Press, 2015. http://dx.doi.org/10.1093/med:psych/9780198530343.003.0007.

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This chapter argues that psychological states, in particular fear and depression, are potentially remediable causes of social role disability among primary care patients. Using chronic low back pain as an example, it considers how recognising and treating depression can improve disability and quality of life for primary care patients with this and many other chronic conditions.
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39

Desai, Mehul J., Puneet Sayal, and Michael S. Leong. Lumbar Spondylolisthesis. Edited by Mehul J. Desai. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199350940.003.0015.

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Lumbar spondylolisthesis typically presents as low back and/or lower extremity pain. Spondylolisthesis is most commonly observed in female patients and the elderly. Lumbar spondylolisthesis may result from congenital, isthmic, trauma-related, degenerative, and iatrogenic causes. Diagnostic imaging (radiographs, magnetic resonance imaging) and physical examination are needed to differentiate the categories of lumbar spondylolisthesis, which will assist in selecting the appropriate treatment. A customized interdisciplinary treatment plan tailored to the patient’s presentation and goals will produce clinical improvement. Surgical remediation is typically reserved for recalcitrant cases but can be effective.
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40

Shah, Chirag D., and Maunak V. Rana. Advances in Dorsal Column Stimulation. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190626761.003.0017.

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Spinal cord stimulation (SCS) has been a long established therapy for various pain conditions including low back pain, failed back surgery syndrome, complex regional pain syndrome, and other neuropathic and nociceptive pain states. Since the first report of SCS in 1967 by Shealy, advances have occurred in the technology used to achieve clinical analgesia. Developments in both the hardware and software involved have led to significant improvements in functional specificity, as seen in dorsal root ganglion stimulation, along with increasing breadth and depth of the field of neuromodulation. The patient experience during the implantation of the systems, as well as post-procedurally has been enhanced with improvements in programming. These technological improvements have been validated in quality evidenced-based medicine: what was a static area now is a dynamic field, with neuromodulation poised to allow physicians and patients more viable options for better pain control for chronic painful conditions.
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41

Souzdalnitski, Dmitri, Adam Kramer, and Maged Guirguis. Sacroiliac Joint Injections: Fluoroscopy. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199908004.003.0038.

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Sacroiliac joint (SIJ) injections are valuable tools for diagnosing the source of low back pain and selecting patients for a radiofrequency ablation procedure, which tends to provide long-term relief for low back pain associated with SIJ dysfunction. Sacroiliac joint injections are generally safe and well-tolerated procedures. The most common complication is initial pain from distension of the joint capsule with contrast and local anesthetic. Despite adequate intra-articular needle placement, extravasation of local anesthetic may diffuse to lumbosacral nerve roots and/or the sciatic nerve, causing transient numbness and/or weakness. This chapter reviews the advantages of fluoroscopically guided SIJ injections as well as the step-by-step technique and how to avoid complications.
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42

Micheli and Laura Purcell, Lyle. Injuries to the thoracolumbar spine and thorax. Oxford University Press, 2013. http://dx.doi.org/10.1093/med/9780199533909.003.0026.

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It can be challenging to make a precise diagnosis in patients with pain in the spinal region and chest wall, not least because demonstrable pathology is not always present. Pain originating from the thoracic spine and the chest wall is relatively uncommon. However, low back pain is very common, both in the general population and in athletes....
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43

Katirji, Bashar. Case 2. Edited by Bashar Katirji. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190603434.003.0006.

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Low back pain with or without lumbosacral root compression is an extremely common clinical situation presenting to primary care physicians and specialists. This case illustrates a patient with lumbosacral radiculopathy due to vertebral disc herniation, supplemented by several magnetic resonance imaging images and diagrams that enhance the pathophysiology of this disorder. A discussion of the anatomy is followed by the clinical findings of various individual lumbosacral radiculopathies. The findings on electrodiagnostic studies are detailed with emphasis on myotomal and segmental innervation of muscles in the lower extremity. The advantages and limitations of the electrodiagnostic studies in patients with suspected lumbosacral radiculopathy are thoroughly debated. A discussion of the findings in lumbar canal stenosis completes this section.
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44

Litin, Scott C., Karen F. Mauck, and Alan K. Duncan. General Internal Medicine. Oxford University Press, 2012. http://dx.doi.org/10.1093/med/9780199755691.003.0253.

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The goal of this chapter is to discuss the following important topics in internal medicine that are not covered thoroughly in other chapters: the interpretation of diagnostic tests, preoperative risk assessment, anticoagulation issues, tobacco abuse, acute low back pain, otorhinolaryngology for the internist, and common eye disorders. Diagnostic tests are tools that either increase or decrease the likelihood of disease. When a diagnostic test is applied to a population at risk of a particular disease, patients in the studied population can be assigned to 1 of 4 groups on the basis of disease status and the test result: true positive, true negative, false positive, false negative. Common problems encountered in a general internal medicine practice, such as tobacco abuse, acute low back pain, vision issues, and ear, nose, and throat complaints, are also reviewed.
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45

Gala, Raj J., Lauren Szolomayer, and James Yue. Open Endoscopic Rhizotomy. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190626761.003.0015.

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The etiology of axial low back pain is multifactorial and includes pain arising from lumbar facet joints. The facet joints, capsules, and surrounding tissues are innervated by the medial branches of the dorsal rami. Rhizotomy of these nerves can provide pain relief in patients with lumbar facetogenic pain. The reported benefits of endoscopic approaches to the spine include minimal disruption of nonpathologic anatomy while simultaneously allowing for improved visualization of pathologic anatomy. Endoscopic techniques have been described for spinal stenosis, disc herniation, interbody fusion, infection, as well as dorsal medial branch rhizotomy. The goal of medial branch rhizotomy is to denervate lumbar facet joints that are contributing to axial back pain. The previous chapter focused on percutaneous techniques, while this chapter will describe endoscopic rhizotomy.
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46

Potash, Warren J., and Michael J. Gratch. Your Lower Back: A Patient and His Doctor Answer Questions and Present Exercises to Help You Manage Your Lower Back. Paragon Communications, Inc. (PA), 1993.

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47

Horowitz, Joshua. Cervical Radicular Pain. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190217518.003.0018.

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Cervical radicular pain is a common reason for patients in pain to seek care from a pain physician. Differing from low back pain and lumbar radiculopathy, cervical radicular pain is often not related to disc protrusion alone but, rather, a combination of disc and degenerative pathologies, such as uncovertebral hypertrophy and spondylosis. Likewise, the natural history is quite favorable if no treatments are applied, mandating greater safety for the treatments applied. Indeed, the most recent American Society of Anesthesiologists closed claims database report suggests that adverse occurrences from procedural therapies for cervical radicular pain are increasing. This chapter broadly discusses the anatomy, pathophysiology, and various approaches to treatment of these disorders.
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48

Herman, Mira, Amaresh Vydyanathan, and Allan L. Brook. Sacroiliac Joint Injections: Computed Tomography. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199908004.003.0039.

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Sacroiliac (SI) joint disease is a common cause of low back pain. It is not easily diagnosed by physical examination, as the joint has limited mobility and referral patterns are not sufficiently delineated from other pathological conditions implicated in low back pain. The accuracy of provocative testing of the sacroiliac joint is controversial. Many physicians use injection of the SI joint with local anesthetic and/or steroid as a diagnostic and therapeutic tool in treating SI joint–related pain. Historically, SI joint intra-articular injections have been performed without imaging guidance. Imaging-guided techniques, often using CT fluoroscopy, increase the precision of these procedures and help confirm needle placement while achieving better results and reduced complications rates. Sacroiliac joint injection is routinely performed on an outpatient basis. The patient is questioned regarding previous steroid use (oral, cutaneous, or injected) to avoid iatrogenic Cushing syndrome. Repeat injections can be administered depending on patient’s response.
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49

Schlenzka, Dietrich. Spondylolisthesis and spondylolysis. Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780199550647.003.003017.

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♦ Spondylolysis is a stress fracture of the vertebral arch. It may lead to vertebral slipping, spondylolisthesis.♦ Spondylolysthesis is commonly lytic, isthmic, or degenerative.♦ Spondylolysis and Spondylolysthesis can affect both children and adults.♦ Most common symptoms are low-back pain and/or radiating pain. True neurologic deficit is rare♦ Treating clinicians should be aware of the processes involved and the common consequences.♦ The majority of symptomatic patients are treated nonoperatively♦ Operation is indicated in rare cases with neurologic deficit and in children or adolescents with a slip of 50 per cent or more♦ Most common complications of surgery are nerve root compromise (especially in connection with slip reduction) and non-union.
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50

Klein, Bruce Paul. THE EFFECTS OF TRAINING IN SAFE MANUAL HANDLING ON THE PATIENT LIFTING TECHNIQUES OF NURSING PERSONNEL (LOW BACK INJURY, PREVENTION). 1986.

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