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.A physiological and radiological follow-up of asymptomatic patients with a history of back injury: a single-blinded, randomized, clinical trial.
There is increasing interest in evaluating asymptomatic individuals with a history of back injury for the possible development of chronic back pain. No consensus exists regarding the definition or management of this condition. The goal of the present study was to describe both the physiologic changes and the incidence of low back pain in patients who had suffered a back injury. A randomized, single-blinded study evaluated 105 patients who had suffered a back injury and 46 controls who had had back surgery. The cases were monitored by the surgeon for up to 2 years after a back injury, when the patients were examined on the first day of their annual follow-up visit. The cases had undergone radiological evaluation and had been given physiologic evaluation, including a 24-hour electromyogram (EMG) monitoring. The patients had also been asked to indicate the presence of pain in the lumbar spine. The main outcome measures were the overall prevalence of muscle-generated tenderness, the incidence of lumbar pain, and the results of the EMG. There were no significant differences in the prevalence or incidence of back pain between cases and controls. There was a significant difference in the prevalence of abnormal EMG findings between cases and controls. The distribution of abnormal EMG findings was heterogeneous within cases and between cases. Individuals who had suffered a back injury were as likely to report acute pain in the lumbar spine as controls. The results of the physiologic evaluation of these cases were consistent with previous reports showing that acute back injury causes clinical and electrophysiologic changes that can be present in asymptomatic individuals, with an incidence rate greater than 10%. A majority of individuals who have experienced a back injury or surgery also have significant changes in the distribution of EMG findings. These results are not necessarily diagnostic for the development of chronic back pain. Clinical and radiological studies of such patients should include follow-up that is at least 2 years.// Copyright (c) 2001-2011 Hartmut Kaiser
//
// Distributed under the Boost Software License, Version 1.0. (See accompanying
// file LICENSE_1_0.txt or copy at
#if!defined(BOOST_SPIRIT_Q
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