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Manipulation of the lumbar spine with the patient under general anesthesia: evaluation by electromyography and clinical-neurologic examination of its use for lumbar nerve root compression syndrome |
Siehl D, Olson DR, Ross HE, Rockwood EE |
The Journal of the American Osteopathic Association 1971;70(5):433-440 |
clinical trial |
1/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: No; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: No; Point estimates and variability: No. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed* |
This study was concerned with the effectiveness of manipulation of the lumbar spine under anesthesia in cases of nerve root compression secondary to herniation of the lumbar disk. Patients complaining of low back pain with radiation into one or both legs underwent clinical-neurologic examination. Those with a clinical diagnosis of nerve root compression were then subjected to electromyography. Some were placed on a regimen of conservative treatment with manipulation, while others received the same regimen without manipulation. Those whose condition necessitated immediate surgical intervention underwent operation. Forty-seven patients were followed for a full year, electromyographically and clinically. The results thus far tend to suggest that manipulation under anesthesia will produce only temporary-clinical improvement in cases with electromyographic evidence of nerve root compression, and operation eventually will be needed. With no evidence of nerve root compression, manipulation will probably bring lasting improvement.
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