Non-Operative Treatment of the Lumbar Spine
Bridging the gap between the medical literature and the practice of lumbar spine medicine, this user-friendly, accessible text describes the causes of lower back pain and associated “sciatic” pathologies and how these problems can be successfully treated
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Non-Operative Treatment of the Lumbar Spine
Grant Cooper
Non-Operative Treatment of the Lumbar Spine
Grant Cooper Princeton Spine & Joint Center Princeton, NJ, USA
ISBN 978-3-319-21442-9 ISBN 978-3-319-21443-6 DOI 10.1007/978-3-319-21443-6
(eBook)
Library of Congress Control Number: 2015946605 Springer Cham Heidelberg New York Dordrecht London © Springer International Publishing Switzerland 2015 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, express or implied, with respect to the material contained herein or for any errors or omissions that may have been made. Printed on acid-free paper Springer International Publishing AG Switzerland is part of Springer Science+Business Media (www.springer.com)
For Ana, Mimi, Laki, Luki, and the relentless pursuit of MSA.
Preface
About a year ago, a patient walked into my office with a history of having undergone a one-sided four-level radiofrequency procedure for lumbar facet joint pain. When asked, he said that he had never had a medial branch block or a facet joint injection prior to the radiofrequency procedure. He had never even heard of a pain diary. The four-level radiofrequency rhizotomy procedure had taken approximately 15–20 min to complete and of course it did not help him at all. In the twenty-first century, I wondered how this could have happened. How could the standards of evidence-based medicine be so willfully disregarded? Was it expedience, ignorance, or both? And to make matters more troubling, and what will likely come as no surprise to the reader, is that his case is not unique in having been substandard of care. Further, when put to the test, all too many doctors don’t know when they are practicing evidence-based medicine and when they are practicing out of simple dogma. Certainly there are times when evidence-based medicine does not have an answer to our patients’ needs or when the answer is not in our patients’ interests, but in these times, it is our duty to explain to our patients what treatments are evidence based and what treatments are being offered from clinical experience, anecdotal evidence, or even dogma. Ye
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