Spine

A Regional Analysis of Low Back Pain Treatments in the Military Health System

Spine Health Services Research

Jon D. Lurie, Christopher G. Leggett, Jonathan Skinner, Eugene Carragee, Andrea M. Austin, and William Patrick Luan

Low back pain (LBP) is a common, potentially disabling, condition with an estimated point prevalence of 12% and a lifetime prevalence of 40%.1 LBP is a particular concern for the Military Health System (MHS) and a leading cause of medical separation from service for soldiers.2,3 From 2010 to 2014, LBP was associated with over 6 million outpatient visits and 25,000 hospitalizations among active service members4; much more active-duty personnel might be seen informally and triaged back to training without recorded visits within the MHS.

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A Regional Analysis of Low Back Pain Treatments in the Military Health System

Spine (Phila Pa 1976)

Lurie JD, Leggett CG, Skinner J, Carragee E, Austin AM, Luan WP.

To compare rates of utilization of 5 LBP treatments (physical therapy, manual therapy, behavioral therapies, opioid and benzodiazepine prescription) across catchment areas and assess their association with resolution of LBP.

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The Impact of Workers’ Compensation on Outcomes of Surgical and Nonoperative Therapy for Patients With a Lumbar Disc Herniation

Spine
Atlas SJ, Tosteson TD, Blood EA, Skinner JS, Pransky GS and Weinstein JN

Patients with at least 6 weeks of sciatica and a lumbar IDH were enrolled in either a randomized trial or observational cohort at 13 US spine centers. Patients were categorized as workers’ compensation or nonworkers’ compensation based on baseline disability compensation and work status. Treatment was usual nonoperative care or surgical discectomy. Outcomes included pain, functional impairment, satisfaction and work/disability status at 6 weeks, 3, 6, 12, and 24 months.

Design of the Spine Patient Outcomes Research Trial (SPORT)

Spine
Birkmeyer N.J., Weinstein J.N., Tosteson A.N.A., Tosteson, T.D., Skinner J.S., Lurie J.D., Deyo D.A., Wennberg J.E.

The Spine Patient Outcomes Research Trial (SPORT) was designed to assess the relative efficacy and cost-effectiveness of surgical and nonsurgical approaches to the treatment of common conditions associated with low back and leg pain.

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