Diagnosis-Specific Work Disability before and after Lumbar Spine Decompression Surgery-A Register Study from Sweden

Low back pain (LBP) patients undergoing lumbar spine decompression surgery (LSDS) often suffer from multi-comorbidity and experience high work disability. This study aimed to identify diagnosis-specific work disability patterns in all LBP-patients before and after LSDS during 2008–2010, that were aged 19–60 years and living in Sweden (n = 10,800) and compare these patterns to LBP-patients without LSDS (n = 109,179), and to matched individuals without LBP (n = 472,191). Work disability days (long-term sickness absence (LTSA), disability pension (DP)) during the three years before to three years after the cohort’s entry date were identified by generalised estimating equations. LBP-patients undergoing LSDS had higher overall work disability during the three years following surgery (LTSA: 23.6%, DP: 6.3%) than LBP-patients without LSDS (LTSA: 19.5%, DP: 5.9%), and those without LBP (LTSA: 7.9%, DP: 1.7%). Among patients undergoing LSDS, the prevalence of work disability due to dorsopathies increased from 20 days three years before surgery to 70 days in the year after and attenuated to 30 days in the third year following surgery. Work disability for other diagnoses remained stable at a low level in this group (<10 days annually). LBP-patients undergoing LSDS have an unfavourable long-term work disability prognosis, primarily due to dorsopathies. Decompression surgery seemed to restrict further inclines in work disability in the long run.

[The efficacy of the combination of diclofenac and orphenadrine in the treatment of dorsalgia]

The high prevalence of dorsalgia and dorsopathy among the adult population makes a significant contribution to the structure of the financial burden of health care systems. The use of non-steroidal anti-inflammatory drugs (NSAIDs) as the basis for the pharmacotherapy of dorsopathy is recommended by most international clinical guidelines. The pharmacodynamic effects of NSAIDs underlie the clinical efficacy of this group of drugs in patients with pain of musculoskeletal origin, while monotherapy is not always accompanied by the rapid development of a persistent analgesic effect. An urgent direction in the therapy of dorsopathies may include combination of NSAIDs with analgesic drugs of other pharmacological groups capable of additive action. The fixed combination of diclofenac, 75 mg, and orphenadrine, 50 mg, allows achieving an effective analgesic effect in patients with lower back pain of various etiologies. It was demonstrated in a series of clinical cases that included 4 patients with dorsopathy who were treated at the City Clinical Hospital No. 24, Moscow in 2020.

[The assessment of efficacy and tolerability of the complex therapy of low back pain]

OBJECTIVE

To assess the efficacy of the complex therapy of nonspecific low back pain (LBP) with amelotex, calmirex, kompligamB in comparison with the monotherapy with amelotex.

MATERIAL AND METHODS

This observational study included sixty patients, aged 53.73±11.84 53 years, with nonspecific LBP. Patients were divided into 2 groups: the basic group (n=30) received calmirex (150mg 2 times a day during 10 days), amelotex (7.5 mg 2 times a day, 7 days) and kompligamB (1 ml once a day, 10 days). The control group (n=30) received only amelotex (7.5 mg 2 times a day, 7 days). The dynamics of the condition was assessed on a 10-point numerical rating scale (at rest, walking, palpation), the Oswestry functional status questionnaire (Oswestry Disability Index; ODI), as well as indicators of laboratory markers reflecting the severity of the inflammatory process (erythrocyte sedimentation rate, C-reactive protein (CRP)).

RESULTS

The severity of pain syndrome significantly decreased in both groups, to a greater extent in the basic group, and ODI indicators also significantly improved in the basic group. CRP indicators showed more pronounced changes in the basic group.

CONCLUSION

The complex therapy that affects all links in the formation of pain syndrome should be recommended to patients with LBP.