Evidence-Based Orthopaedics   |    
Edward N. Hanley, Jr, MD
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Department of Orthopaedic Surgery, Carolinas Medical Center, Charlotte, North Carolina

J Bone Joint Surg Am, 2001 Aug 01;83(8):1283-a-1283
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Low-back disorders are common and involve complex interactions among physiologic, psychosocial, and environmental factors. Patients with lumbar spine problems are often confused by the ill-defined nature of their condition and the apparent ambiguity in the decision-making process for both diagnosis and treatment. When referral is made for consideration of surgical intervention, the ability of a patient to participate effectively in his or her care is tested. Efforts to educate patients about their conditions and to permit them to participate in a shared decision-making process by providing them with valid scientific information are laudable and would seem likely to influence patient satisfaction and compliance. In fact, this well-designed and well-executed study by Deyo and colleagues shows that the majority of patients in both the video group and the booklet group were satisfied with their care but that no difference existed between the groups. Symptomatic and functional improvement was seen in all patient subgroups (herniated disc, spinal stenosis, and other diagnoses) regardless of the educational subset. This is expected because the natural history of low-back disorders is one of improvement despite the method of treatment.
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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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