Abstract:
OBJECTIVES:Evidence comparing the effectiveness of surgical and conservative treatment of symptomatic lumbar disc herniation is controversial. We sought to compare short-term and long-term effectiveness of surgical and conservative treatment in sciatica symptom severity and quality of life in patients with lumbar disc herniation in a routine clinical setting. METHODS:A prospective cohort study of a routine clinical practice registry consisting of 370 patients. Outcome measures were the North American Spine Society questionnaire and the 36-Item Short-Form Health Survey to assess patient-reported back pain, physical function, neurogenic symptoms and quality of life. Primary outcomes were back pain at 6 and 12 weeks. Standard open discectomy was assessed versus conservative interventions at 6, 12, 52 and 104 weeks. We filled in missing outcome variable values with multiple imputation, accounted for repeated measures within patients with mixed-effects models and adjusted baseline group differences in relevant prognostic indicators by inverse probability of treatment weighting. RESULTS:Surgical treatment patients reported less back pain at 6 weeks than those receiving conservative therapy (-0.97; 95% CI -1.89 to -0.09), were more likely to report ≥50% decrease in back pain symptoms from baseline to 6 weeks (48% vs 17%, risk difference: 0.34; 95% CI 0.16 to 0.47) and reported less physical function disability at 52 weeks (-3.7; 95% CI -7.4 to -0.1). The other assessments showed minimal between-group differences with CIs, including the null effect. CONCLUSIONS:Compared with conservative therapy, surgical treatment provided faster relief from back pain symptoms in patients with lumbar disc herniation, but did not show a benefit over conservative treatment in midterm and long-term follow-up.
journal_name
BMJ Openjournal_title
BMJ openauthors
Gugliotta M,da Costa BR,Dabis E,Theiler R,Jüni P,Reichenbach S,Landolt H,Hasler Pdoi
10.1136/bmjopen-2016-012938subject
Has Abstractpub_date
2016-12-21 00:00:00pages
e012938issue
12issn
2044-6055pii
bmjopen-2016-012938journal_volume
6pub_type
杂志文章相关文献
BMJ Open文献大全abstract:OBJECTIVE:To identify the most appropriate format for results dissemination to maximise understanding of trial results. DESIGN:Qualitative. SETTING:Of the original 58 4-T trial centres, 34 agreed to take part in this ancillary research. PARTICIPANTS:All participants from these centres were eligible. All 343 particip...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2012-001252
更新日期:2012-09-24 00:00:00
abstract:OBJECTIVES:Dealing with multiple workflow interruptions is a major challenge in emergency department (ED) work. This study aimed to establish a taxonomy of workflow interruptions that takes into account the content and purpose of interruptive communication. It further aimed to identify associations of workflow interrup...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2017-019074
更新日期:2017-12-22 00:00:00
abstract:OBJECTIVE:Health behaviour is one of the major determinants of cardiovascular diseases in working population. This study was tried to investigate the trend of cardiovascular health level, the relationship between continuous health behaviours, and changes in the risk of cardiovascular diseases of male workers by using a...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2020-038446
更新日期:2020-11-05 00:00:00
abstract:OBJECTIVES:The majority (>90%) of new or undiagnosed cases of hepatitis B virus (HBV) in the UK are among individuals born in countries with intermediate or high prevalence levels (≥2%). We evaluate the cost-effectiveness of increased HBV case-finding among UK migrant populations, based on a one-time opt out case-findi...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-030183
更新日期:2019-06-28 00:00:00
abstract:INTRODUCTION:The need for organs is comparatively higher among people of Indian origin due to the higher prevalence of end-stage organ failure. In spite of the higher need, they have a lower number of organ donors. Studies have been carried out among people of Indian origin living globally to understand the reasons for...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-035360
更新日期:2020-06-21 00:00:00
abstract:OBJECTIVES:To derive priority weights for access to bariatric surgery for obese adults, from the perspective of the public. SETTING:Australian public hospital system. PARTICIPANTS:Adults (N=1994), reflecting the age and gender distribution of Queensland and South Australia. PRIMARY AND SECONDARY OUTCOME MEASURES:A d...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2015-008919
更新日期:2015-10-15 00:00:00
abstract:OBJECTIVES:To examine the extent of primary care follow-up and mental health outcomes among women referred for ultrasound assessment of pain and/or bleeding in early pregnancy, including those whose pregnancy is found to be viable on ultrasound assessment. DESIGN:Questionnaire study with prospective follow-up. SETTIN...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2013-002595
更新日期:2013-04-11 00:00:00
abstract:OBJECTIVES:The objective of this study was to investigate the role stressors, sociodemographic characteristics and job tasks of health surveillance assistants (HSAs) and to explore major predictors of role stressors and job satisfaction of HSAs in Malawi. SETTING:Data were collected from health centres and hospitals o...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2020-037000
更新日期:2020-11-14 00:00:00
abstract:OBJECTIVES:We examined impacts and interactions of COVID-19 response involvement, health-related behaviours and health literacy (HL) on anxiety, depression, and health-related quality of life (HRQoL) among healthcare workers (HCWs). DESIGN:A cross-sectional study was conducted. Data were collected 6 April to 19 April ...
journal_title:BMJ open
pub_type: 杂志文章,多中心研究
doi:10.1136/bmjopen-2020-041394
更新日期:2020-12-07 00:00:00
abstract:INTRODUCTION:Distress is experienced by the majority of cardiac patients, yet no cardiac-specific measure of distress exists. The aim of this project is to develop and validate the Cardiac Distress Inventory (CDI). Using the CDI, health professionals will be able to identify key clusters of psychological, emotional and...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-034946
更新日期:2020-06-11 00:00:00
abstract:BACKGROUND:The utilisation of available cross-European data for secondary data analyses on physical activity, sedentary behaviours and their underlying determinants may benefit from the wide variation that exists across Europe in terms of these behaviours and their determinants. Such reuse of existing data for further ...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2017-017489
更新日期:2017-10-22 00:00:00
abstract:OBJECTIVES:French authorities are considering the implementation of a simplified nutrition labelling system on food products to help consumers make healthier food choices. One of the most documented candidates (Five-Colour Nutrition Label/Nutri-score) is based on the British Food Standards Agency Nutrient Profiling Sys...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2016-013718
更新日期:2017-06-08 00:00:00
abstract:INTRODUCTION:Vitamin D is related to resistance to chronic diseases, physiological parameters and functional measures. All of these relationships underscore the potential benefits of cholecalciferol or D3 (nutritional vitamin D) in cancer. This is the first study designed to obtain conclusive evidence on the effect of ...
journal_title:BMJ open
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1136/bmjopen-2014-006128
更新日期:2014-12-31 00:00:00
abstract:OBJECTIVES:To validate the performance of the most commonly used formulas for estimation of glomerular filtration rate (GFR) against measured GFR during the index hospitalisation for ST-elevation myocardial infarction (STEMI). SETTING:Single centre, methodological study. PARTICIPANTS:40 patients with percutaneous cor...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2015-007835
更新日期:2015-09-23 00:00:00
abstract:OBJECTIVE:To investigate sex differences in survival of primary care treated patients with type 2 diabetes (T2D) in the Netherlands. SETTING:Primary care. PARTICIPANTS:A total of 1815 patients who participated in a prospective observational cohort study (Zwolle Outpatient Diabetes Project Integrating Available Care (...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2017-015870
更新日期:2017-10-25 00:00:00
abstract:OBJECTIVE:To investigate how different lay and professional groups perceive and understand the use of routinely collected general practice patient data for research, public health, service evaluation and commissioning. DESIGN, METHOD, PARTICIPANTS AND SETTING:We conducted a multimethod, qualitative study. This entaile...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2017-019378
更新日期:2018-01-08 00:00:00
abstract:OBJECTIVES:In recent years, the involvement of pharmacy technicians in medication reconciliation has increasingly been investigated. The aim of this study was to assess the implications on professional roles and collaboration when a best possible medication history (BPMH) at admission is obtained by pharmacy technician...
journal_title:BMJ open
pub_type: 杂志文章,多中心研究
doi:10.1136/bmjopen-2017-020566
更新日期:2018-05-17 00:00:00
abstract:OBJECTIVES:Few studies of tornado injuries have considered differences related to damage levels and Enhanced-Fujita (EF) scale ratings. This study aimed to evaluate the pattern, spectrum and geographical distribution of injuries related to the Yancheng tornado and provide guidelines for effective emergency medical stra...
journal_title:BMJ open
pub_type: 杂志文章,多中心研究
doi:10.1136/bmjopen-2018-021552
更新日期:2018-06-22 00:00:00
abstract:INTRODUCTION:Post-traumatic stress disorder (PTSD) is a debilitating, highly prevalent condition. Current clinical practice guidelines recommend trauma-focused psychotherapy (eg, cognitive processing therapy; CPT) as the first-line treatment for PTSD. However, while these treatments show clinically meaningful symptom i...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2018-027150
更新日期:2019-04-03 00:00:00
abstract:INTRODUCTION:Labour induction in women with a previous caesarean delivery currently uses vaginal prostaglandin E2 (PGE2), which carries the risks of uterine hyperstimulation and scar rupture. We aim to compare the efficacy of mechanical labour induction using a transcervically applied Foley catheter balloon (FCB) with ...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-028896
更新日期:2019-11-06 00:00:00
abstract:OBJECTIVE:Post-randomisation exclusions in randomised controlled trials are common and may include participants identified as not meeting trial eligibility criteria after randomisation. We report how a decision might be reached and reported on, to include or exclude these participants. We illustrate using a motivating ...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2020-039546
更新日期:2020-12-02 00:00:00
abstract:OBJECTIVES:For characterisation of mineral bone disease in chronic kidney disease (CKD), laboratory surrogates have been suggested. This observational should investigate the association of total and skeletal alkaline phosphatase (AP) with mortality of patients undergoing maintenance renal replacement therapy. SETTING:...
journal_title:BMJ open
pub_type: 杂志文章,多中心研究
doi:10.1136/bmjopen-2013-004275
更新日期:2014-02-27 00:00:00
abstract:OBJECTIVE:This study seeks to describe current e-cigarette users' patterns of use including primary motivation for use, dual use, use with nicotine and principal flavour used, according to individuals' sociodemographic characteristics and conventional tobacco consumption in Barcelona, Spain. DESIGN, SETTING AND PARTIC...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2017-018329
更新日期:2018-03-22 00:00:00
abstract:OBJECTIVE:The aim of this study was to examine whether there is an association between grandparental care and loneliness, social isolation and/or the size of an individual's social network among community-based adults aged ≥40 years. METHODS:Cross-sectional data were drawn from a population-based sample of individuals...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-029605
更新日期:2019-12-17 00:00:00
abstract:OBJECTIVES:This study aimed to measure the burden of work-related upper limb amputation in Korea over a 10-year period and assess its trend. DESIGN:Ecological study. SETTING:National level data in Korea between 2004 and 2013. PARTICIPANTS:49 535 subjects who claimed Korea industrial accident compensation insurance d...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-032793
更新日期:2019-11-19 00:00:00
abstract:INTRODUCTION:Adolescence is a critical period for youths with chronic conditions, when they are supposed to take over the responsibility for their health. Type 1 diabetes (T1D) is one of the most common chronic conditions in childhood and inadequate self-management increases the risk of short-term and long-term complic...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-036496
更新日期:2020-04-14 00:00:00
abstract::Objective To investigate the views and practices of UK medical schools regarding the inclusion (or exclusion) of complementary and alternative medicine (CAM) in undergraduate medical curricula. Design Survey (by email) of UK medical schools offering MBBS (or equivalent) degrees. Results The overall response rate was...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2011-000074
更新日期:2011-06-08 00:00:00
abstract:BACKGROUND:Cervical cancer rates are higher in low-resourced countries than high, partly due to lower rates of screening. Incidence in Thailand is nearly three times higher than in the USA (16.2 vs 6.5 age-standardised incidence), even with Thailand's universal health coverage, which includes screening, suggesting that...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-031957
更新日期:2019-11-03 00:00:00
abstract:OBJECTIVES:To clarify the relationship between social deprivation and age as two factors associated with emergency admissions to hospital. DESIGN:Emergency admissions for 12 months were analysed for patients in the NHS NEW Devon CCG. Social deprivation was measured by the Index of Multiple Deprivation (IMD). Logistic ...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2016-014045
更新日期:2017-02-14 00:00:00
abstract:INTRODUCTION:Despite the frequent use of therapies in acute bronchitis, the evidence of their benefit is lacking, since only a few clinical trials have been published, with low sample sizes, poor methodological quality and mainly in children. The objective of this study is to compare the effectiveness of three symptoma...
journal_title:BMJ open
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1136/bmjopen-2018-028159
更新日期:2019-05-16 00:00:00