- Title
- Point of view (editorial)
- Creator
- Bogduk, Nikolai
- Relation
- Spine Vol. 33, Issue 12
- Publisher Link
- http://dx.doi.org/10.1097/BRS.0b013e3181732a0d
- Publisher
- Lippincott Williams & Wilkins
- Resource Type
- journal article
- Date
- 2008
- Description
- In an outcome study, Dreyfuss et al demonstrated how good the outcomes could be from lumbar medial branch neurotomy. Yet that study was variously chastised: for having no controls; for being highly selective in its recruitment criteria; for enrolling only a tiny proportion of potential patients; and, therefore, for being too small a study. Subsequently, systematic reviews demanded randomized controlled trials of lumbar medial branch neurotomy, but none of the controlled trials that followed used correct surgical technique for this procedure; and none selected patients on the basis of controlled diagnostic blocks. Dr. Nath answered the call for studies. His is the first study, since Dreyfuss et al, to use controlled diagnostic blocks to select patients, and the first to use correct technique. But Dr. Nath did something unusual. He did not select ideal patients, free of comorbidity, with already good function, and no depression. He drew his patients from a pain clinic population. His patients had other problems; but they were, nevertheless, able to identify a component of their pain that was completely relieved by controlled medial branch blocks. It was this pain that Dr. Nath treated in a placebo-controlled trial of lumbar medial branch neurotomy. Dr. Nath should be commended for his industry both in mounting and concluding a placebo-controlled trial. His results clearly show that the effects of lumbar medial branch neurotomy cannot be attributed, ex cathedra, to placebo effects. The effects are genuine.
- Subject
- lumbar medial branch; controlled diagnostic; placebo-controlled trial
- Identifier
- http://hdl.handle.net/1959.13/43184
- Identifier
- uon:5311
- Identifier
- ISSN:0362-2436
- Language
- eng
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