Jens Ivar Brox

• Hagerup, Sondre; Brox, Jens Ivar; BANITALEBI, HASAN; Indrekvam, Kari; Myklebust, Tor Åge & Hermansen, Erland (2024). The Influence of Spinous Process Union on Clinical Outcomes After Spinous Process Osteotomy for Lumbar Spinal Stenosis After 2 Years: A Secondary Analysis From the NORDSTEN-Study. International journal of spine surgery. ISSN 2211-4599. 18(1), p. 47–53. doi: 10.14444/8576.
• Bjørneboe, John Andreas; Bratsberg, Andrea Mathisen; Brox, Jens Ivar; Skatteboe, Sigrid; Wilhelmsen, Maja & Samuelsen, Kjetil Magne [Show all 10 contributors for this article] (2024). Symptom burden and follow-up of patients with neck and back complaints in specialized outpatient care: a national register study. Scientific Reports. ISSN 2045-2322. 14(1). doi: 10.1038/s41598-024-53879-3.
• Tronstad, Sara; Haug, Knut Jørgen; Myklebust, Tor Åge; Weber, Clemens; Brisby, Helena & Austevoll, Ivar Magne [Show all 16 contributors for this article] (2024). Do patients with lumbar spinal stenosis benefit from decompression of levels with adjacent moderate stenosis? A prospective cohort study from the NORDSTEN study. The spine journal. ISSN 1529-9430. p. 1–7. doi: 10.1016/j.spinee.2024.01.010.
• Heide, Marte; Mørk, Marianne; Hoksrud, Aasne Fenne; Brox, Jens Ivar & Røe, Cecilie (2023). Responsiveness of specific and generic patient-reported outcome measures in patients with plantar fasciopathy. Disability and Rehabilitation. ISSN 0963-8288. doi: 10.1080/09638288.2023.2267438. Full text in Research Archive
• Sveinall, Håkon; Wenstad, Per Kristian; Fearon, Angela M.; Skyttemyr, Gjermund; Thornes, Elisabeth & Skaara, Helene Engberg [Show all 10 contributors for this article] (2023). The reliability and validity of the Norwegian version of the Victorian Institute of Sports Assessment for gluteal tendinopathy questionnaire (VISA-G-Norwegian) for patients with greater trochanteric pain syndrome. BMC Musculoskeletal Disorders. ISSN 1471-2474. 24. doi: 10.1186/s12891-023-06901-0. Full text in Research Archive
• Moosmeyer, Stefan; Ekeberg, Ole Marius; Hallgren, Hanna Bjørnsson; Heier, Ingar; Kvalheim, Synnøve Kristin & Juel, Niels Gunnar [Show all 9 contributors for this article] (2023). Ultrasound guided lavage with corticosteroid injection versus sham lavage with and without corticosteroid injection for calcific tendinopathy of shoulder: randomised double blinded multi-arm study. The BMJ. ISSN 1756-1833. 383. doi: 10.1136/bmj-2023-076447.
• Mikkelsen, Eirik; Ingebrigtsen, Tor; Thyrhaug, Anette Moltu; Olsen, Lena Ringstad; Nygaard, Øystein Petter & Austevoll, Ivar Magne [Show all 11 contributors for this article] (2023). The Norwegian registry for spine surgery (NORspine): cohort profile. European spine journal. ISSN 0940-6719. 32(11). doi: 10.1007/s00586-023-07929-5. Full text in Research Archive Show summary

  Purpose: To review and describe the development, methods and cohort of the lumbosacral part of the Norwegian registry for spine surgery (NORspine). Methods: NORspine was established in 2007. It is government funded, covers all providers and captures consecutive cases undergoing operations for degenerative disorders. Patients' participation is voluntary and requires informed consent. A set of baseline-, process- and outcome-variables (3 and 12 months) recommended by the International Consortium for Health Outcome Measurement is reported by surgeons and patients. The main outcome is the Oswestry disability index (ODI) at 12 months. Results: We show satisfactory data quality assessed by completeness, timeliness, accuracy, relevance and comparability. The coverage rate has been 100% since 2016 and the capture rate has increased to 74% in 2021. The cohort consists of 60,647 (47.6% women) cases with mean age 55.7 years, registered during the years 2007 through 2021. The proportions > 70 years and with an American Society of Anaesthesiologists' Physical Classification System (ASA) score > II has increased gradually to 26.1% and 19.3%, respectively. Mean ODI at baseline was 43.0 (standard deviation 17.3). Most cases were operated with decompression for disc herniation (n = 26,557, 43.8%) or spinal stenosis (n = 26,545, 43.8%), and 7417 (12.2%) with additional or primary fusion. The response rate at 12 months follow-up was 71.6%. Conclusion: NORspine is a well-designed population-based comprehensive national clinical quality registry. The register's methods ensure appropriate data for quality surveillance and improvement, and research.

• Indrekvam, Kari; Bånerud, Ingrid Fjeldheim; Hermansen, Erland; Austevoll, Ivar Magne; Rekeland, Frode Gurvin & Guddal, Maren Hjelle [Show all 10 contributors for this article] (2023). The Norwegian degenerative spondylolisthesis and spinal stenosis (NORDSTEN) study: study overview, organization structure and study population. European spine journal. ISSN 0940-6719. 32(12), p. 4162–4173. doi: 10.1007/s00586-023-07827-w. Full text in Research Archive
• Bråten, Lars Christian Haugli; Gjefsen, Elisabeth; Gervin, Kristina; Pripp, Are Hugo; Skouen, Jan Sture & Schistad, Elina Iordanova [Show all 16 contributors for this article] (2023). Cytokine Patterns as Predictors of Antibiotic Treatment Effect in Chronic Low Back Pain with Modic Changes: Subgroup Analyses of a Randomized Trial (AIM Study). Journal of Pain Research. ISSN 1178-7090. 16, p. 1713–1724. doi: 10.2147/JPR.S406079. Full text in Research Archive
• Hellum, Christian; Rekeland, Frode Gurvin; Småstuen, Milada Cvancarova; Solberg, Tore; Hermansen, Erland & Storheim, Kjersti [Show all 17 contributors for this article] (2023). Surgery in Degenerative Spondylolisthesis: Does fusion improve outcome in subgroups? A secondary analysis from a randomized trial (NORDSTEN trial). The spine journal. ISSN 1529-9430. 23(11), p. 1613–1622. doi: 10.1016/j.spinee.2023.06.386. Full text in Research Archive Show summary

  Background context: Patients with spinal stenosis and degenerative spondylolisthesis are treated surgically with decompression alone or decompression with fusion. However, there is debate regarding which subgroups of patients may benefit from additional fusion. Purpose: To investigate possible treatment effect modifiers and prognostic variables among patients operated for spinal stenosis and degenerative spondylolisthesis. Design: A secondary exploratory study using data from the Norwegian Degenerative Spondylolisthesis and Spinal Stenosis (NORDSTEN-DS) trial. Patients were randomized to decompression alone or decompression with instrumented fusion. Patient sample: The sample in this study consists of 267 patients from a randomized multicenter trial involving 16 hospitals in Norway. Patients were enrolled from February 12, 2014, to December 18, 2017. The study did not include patients with degenerative scoliosis, severe foraminal stenosis, multilevel spondylolisthesis, or previous surgery. Outcome measures: The primary outcome was an improvement of ≥ 30% on the Oswestry Disability Index score (ODI) from baseline to 2-year follow-up. Methods: When investigating possible variables that could modify the treatment effect, we analyzed the treatment arms separately. When testing for prognostic factors we analyzed the whole cohort (both treatment groups). We used univariate and multiple regression analyses. The selection of variables was done a priori, according to the published trial protocol. Results: Of the 267 patients included in the trial (183 female [67%]; mean [SD] age, 66 [7.6] years), complete baseline data for the variables required for the present analysis were available for 205 of the 267 individuals. We did not find any clinical or radiological variables at baseline that modified the treatment effect. Thus, none of the commonly used criteria for selecting patients for fusion surgery influenced the chosen primary outcome in the two treatment arms. For the whole cohort, less comorbidity (American Society of Anesthesiologists Classification [ASA], OR = 4.35; 95% confidence interval (CI [1.16-16.67]) and more preoperative leg pain (OR = 1.23; CI [1.02-1.50]) were significantly associated with an improved primary outcome. Conclusions: In this study on patients with degenerative spondylolisthesis, neither previously defined instability criteria nor other pre-specified baseline variables were associated with better clinical outcome if fusion surgery was performed. None of the analyzed variables can be applied to guide the decision for fusion surgery in patients with degenerative spondylolisthesis. For both treatment groups, less comorbidity and more leg pain were associated with improved outcome 2 years after surgery. Trial registration: NORDSTEN-DS ClinicalTrials.gov, NCT02051374.

• Holtedahl, Robin; Bøe, Berte Marie Grimsmo & Brox, Jens Ivar (2023). The clinical impact of retears after repair of posterosuperior rotator cuff tears: a systematic review and meta-analysis. Journal of shoulder and elbow surgery. ISSN 1058-2746. 32(6), p. 1333–1346. doi: 10.1016/j.jse.2023.01.014. Full text in Research Archive
• Hermansen, Erland; Myklebust, Tor Åge; Weber, Clemens; Brisby, Helena; Austevoll, Ivar Magne & Hellum, Christian [Show all 15 contributors for this article] (2023). Postoperative Dural Sac Cross-Sectional Area as an Association for Outcome After Surgery for Lumbar Spinal Stenosis: Clinical and Radiological Results From the NORDSTEN-Spinal Stenosis Trial. Spine. ISSN 0362-2436. 48(10), p. 688–694. doi: 10.1097/BRS.0000000000004565. Full text in Research Archive
• Riksaasen, Anniken; Kaur, Simran; Solberg, Tore; Austevoll, Ivar Magne; Brox, Jens Ivar & Dolatowski, Filip Celestyn [Show all 11 contributors for this article] (2023). Impact of the number of previous lumbar operations on patient-reported outcomes after surgery for lumbar spinal stenosis or lumbar disc herniation. The Bone & Joint Journal. ISSN 2049-4394. 105-B(4), p. 422–430. doi: 10.1302/0301-620X.105B4.BJJ-2022-0704.R1. Full text in Research Archive Show summary

  Repeated lumbar spine surgery has been associated with inferior clinical outcomes. This study aimed to examine and quantify the impact of this association in a national clinical register cohort. This is a population-based study from the Norwegian Registry for Spine surgery (NORspine). We included 26,723 consecutive cases operated for lumbar spinal stenosis or lumbar disc herniation from January 2007 to December 2018. The primary outcome was the Oswestry Disability Index (ODI), presented as the proportions reaching a patient-acceptable symptom state (PASS; defined as an ODI raw score ≤ 22) and ODI raw and change scores at 12-month follow-up. Secondary outcomes were the Global Perceived Effect scale, the numerical rating scale for pain, the EuroQoL five-dimensions health questionnaire, occurrence of perioperative complications and wound infections, and working capability. Binary logistic regression analysis was conducted to examine how the number of previous operations influenced the odds of not reaching a PASS. The proportion reaching a PASS decreased from 66.0% (95% confidence interval (CI) 65.4 to 66.7) in cases with no previous operation to 22.0% (95% CI 15.2 to 30.3) in cases with four or more previous operations (p < 0.001). The odds of not reaching a PASS were 2.1 (95% CI 1.9 to 2.2) in cases with one previous operation, 2.6 (95% CI 2.3 to 3.0) in cases with two, 4.4 (95% CI 3.4 to 5.5) in cases with three, and 6.9 (95% CI 4.5 to 10.5) in cases with four or more previous operations. The ODI raw and change scores and the secondary outcomes showed similar trends. We found a dose-response relationship between increasing number of previous operations and inferior outcomes among patients operated for degenerative conditions in the lumbar spine. This information should be considered in the shared decision-making process prior to elective spine surgery. © 2023 Author(s) et al.

• Olsen, Unni ; Lindberg, Maren Falch; Rose, Christopher James; Denison, Eva Marie-Louise; Gay, Caryl & Aamodt, Arild [Show all 11 contributors for this article] (2023). Factors correlated with pain after total knee arthroplasty: A systematic review and meta-analysis. PLOS ONE. ISSN 1932-6203. 18(3). doi: 10.1371/journal.pone.0283446. Full text in Research Archive
• Kristoffersen, Per Martin; Vetti, Nils; Grøvle, Lars; Brox, Jens Ivar; Bråten, Lars Christian Haugli & Grotle, Margreth [Show all 17 contributors for this article] (2022). Amoxicillin did not Reduce Modic Change Oedema in Patients with Chronic Low Back pain - subgroup Analyses of a Randomised Trial (the AIM study). Spine. ISSN 0362-2436. doi: 10.1097/BRS.0000000000004513. Full text in Research Archive
• Bråten, Lars Christian Haugli; Grøvle, Lars; Wigemyr, Monica; Wilhelmsen, Maja; Gjefsen, Elisabeth & Espeland, Ansgar [Show all 13 contributors for this article] (2022). Minimal important change was on the lower spectrum of previous estimates and responsiveness was sufficient for core outcomes in chronic low back pain. Journal of Clinical Epidemiology. ISSN 0895-4356. 151, p. 75–87. doi: 10.1016/j.jclinepi.2022.07.012. Full text in Research Archive
• Taso, Mirad; Sommernes, Jon Håvard; Bjorland, Siri; Zwart, John Anker Henrik; Engebretsen, Kaia Beck & Sundseth, Jarle Østberg [Show all 9 contributors for this article] (2022). What is success of treatment? Expected outcome scores in cervical radiculopathy patients were much higher than the previously reported cut-off values for success. European spine journal. ISSN 0940-6719. doi: 10.1007/s00586-022-07234-7. Full text in Research Archive
• Dagestad, Magnhild Hammersland; Vetti, Nils; Kristoffersen, Per M; Zwart, John Anker Henrik; Storheim, Kjersti & Bakland, Gunnstein [Show all 12 contributors for this article] (2022). Apparent diffusion coefficient values in Modic changes – interobserver reproducibility and relation to Modic type. BMC Musculoskeletal Disorders. ISSN 1471-2474. 23, p. 1–12. doi: 10.1186/s12891-022-05610-4. Full text in Research Archive Show summary

  Background Modic Changes (MCs) in the vertebral bone marrow were related to back pain in some studies but have uncertain clinical relevance. Diffusion weighted MRI with apparent diffusion coefficient (ADC)-measurements can add information on bone marrow lesions. However, few have studied ADC measurements in MCs. Further studies require reproducible and valid measurements. We expect valid ADC values to be higher in MC type 1 (oedema type) vs type 3 (sclerotic type) vs type 2 (fatty type). Accordingly, the purpose of this study was to evaluate ADC values in MCs for interobserver reproducibility and relation to MC type. Methods We used ADC maps (b 50, 400, 800 s/mm2) from 1.5 T lumbar spine MRI of 90 chronic low back pain patients with MCs in the AIM (Antibiotics In Modic changes)-study. Two radiologists independently measured ADC in fixed-sized regions of interests. Variables were MC-ADC (ADC in MC), MC-ADC% (0% = vertebral body, 100% = cerebrospinal fluid) and MC-ADC-ratio (MC-ADC divided by vertebral body ADC). We calculated mean difference between observers ± limits of agreement (LoA) at separate endplates. The relation between ADC variables and MC type was assessed using linear mixed-effects models and by calculating the area under the receiver operating characteristic curve (AUC). Results The 90 patients (mean age 44 years; 54 women) had 224 MCs Th12-S1 comprising type 1 (n = 111), type 2 (n = 91) and type 3 MC groups (n = 22). All ADC variables had higher predicted mean for type 1 vs 3 vs 2 (p < 0.001 to 0.02): MC-ADC (10− 6 mm2/s) 1201/796/576, MC-ADC% 36/21/14, and MC-ADC-ratio 5.9/4.2/3.1. MC-ADC and MC-ADC% had moderate to high ability to discriminate between the MC type groups (AUC 0.73–0.91). MC-ADC-ratio had low to moderate ability (AUC 0.67–0.85). At L4-S1, widest/narrowest LoA were for MC-ADC 20 ± 407/12 ± 254, MC-ADC% 1.6 ± 18.8/1.4 ± 10.4, and MC-ADC-ratio 0.3 ± 4.3/0.2 ± 3.9. Difference between observers > 50% of their mean value was less frequent for MC-ADC (9% of MCs) vs MC-ADC% and MC-ADC-ratio (17–20%). Conclusions The MC-ADC variable (highest mean ADC in the MC) had best interobserver reproducibility, discriminated between MC type groups, and may be used in further research. ADC values differed between MC types as expected from previously reported MC histology.

• Banitalebi, Hasan; Aaen, Jørn Ståle; Storheim, Kjersti; Negård, Anne; Myklebust, Tor Åge & Grotle, Margreth [Show all 14 contributors for this article] (2022). A novel MRI index for paraspinal muscle fatty infiltration: reliability and relation to pain and disability in lumbar spinal stenosis: results from a multicentre study. European Radiology Experimental. 6, p. 1–10. doi: 10.1186/s41747-022-00284-y. Full text in Research Archive Show summary

  Background Fatty infiltration of the paraspinal muscles may play a role in pain and disability in lumbar spinal stenosis. We assessed the reliability and association with clinical symptoms of a method for assessing fatty infiltration, a simplified muscle fat index (MFI). Methods Preoperative axial T2-weighted magnetic resonance imaging (MRI) scans of 243 patients aged 66.6 ± 8.5 years (mean ± standard deviation), 119 females (49%), with symptomatic lumbar spinal stenosis were assessed. Fatty infiltration was assessed using both the MFI and the Goutallier classification system (GCS). The MFI was calculated as the signal intensity of the psoas muscle divided by that of the multifidus and erector spinae. Observer reliability was assessed in 102 consecutive patients for three independent investigators by intraclass correlation coefficient (ICC) and 95% limits of agreement (LoA) for continuous variables and Gwet’s agreement coefficient (AC1) for categorical variables. Associations with patient-reported pain and disability were assessed using univariate and multivariate regression analyses. Results Interobserver reliability was good for the MFI (ICC 0.79) and fair for the GCS (AC1 0.33). Intraobserver reliability was good or excellent for the MFI (ICC range 0.86–0.91) and moderate to almost perfect for the GCS (AC1 range 0.55–0.92). Mean interobserver differences of MFI measurements ranged from -0.09 to -0.04 (LoA -0.32 to 0.18). Adjusted for potential confounders, none of the disability or pain parameters was significantly associated with MFI or GCS. Conclusion The proposed MFI demonstrated high observer reliability but was not associated with preoperative pain or disability.

• Olsen, Unni ; Lindberg, Maren Falch; Rose, Christopher James; Denison, Eva Marie-Louise; Gay, Caryl & Aamodt, Arild [Show all 11 contributors for this article] (2022). Factors Correlated with Physical Function 1 Year after Total Knee Arthroplasty in Patients with Knee Osteoarthritis: A Systematic Review and Meta-analysis. JAMA Network Open. ISSN 2574-3805. 5(7), p. 1–15. doi: 10.1001/jamanetworkopen.2022.19636. Full text in Research Archive
• Hott, Alexandra Christine; Pripp, Are Hugo; Juel, Niels Gunnar; Liavaag, Sigurd & Brox, Jens Ivar (2022). Self-efficacy and Emotional Distress in a Cohort With Patellofemoral Pain. Orthopaedic Journal of Sports Medicine (OJSM). ISSN 2325-9671. 10(3), p. 1–10. doi: 10.1177/23259671221079672. Full text in Research Archive
• Hermansen, Erland; Austevoll, Ivar Magne; Hellum, Christian; Storheim, Kjersti; Myklebust, Tor Åge & Aaen, Jørn Ståle [Show all 17 contributors for this article] (2022). Comparison of 3 Different Minimally Invasive Surgical Techniques for Lumbar Spinal Stenosis: A Randomized Clinical Trial. JAMA Network Open. ISSN 2574-3805. 5(3), p. 1–13. doi: 10.1001/jamanetworkopen.2022.4291. Full text in Research Archive Show summary

  Importance Operations for lumbar spinal stenosis is the most often performed surgical procedure in the adult lumbar spine. This study reports the clinical outcome of the 3 most commonly used minimally invasive posterior decompression techniques. Objective To compare the effectiveness of 3 minimally invasive posterior decompression techniques for lumbar spinal stenosis. Design, Setting, and Participants This randomized clinical trial used a parallel group design and included patients with symptomatic and radiologically verified lumbar spinal stenosis without degenerative spondylolisthesis. Patients were enrolled between February 2014 and October 2018 at the orthopedic and neurosurgical departments of 16 Norwegian public hospitals. Statistical analysis was performed in the period from May to June 2021. Interventions Patients were randomized to undergo 1 of the 3 minimally invasive posterior decompression techniques: unilateral laminotomy with crossover, bilateral laminotomy, and spinous process osteotomy. Main Outcomes and Measures Primary outcome was change in disability measured with Oswestry Disability Index (ODI; range 0-100), presented as mean change from baseline to 2-year follow-up and proportions of patients classified as success (>30% reduction in ODI). Secondary outcomes were mean change in quality of life, disease-specific symptom severity measured with Zurich Claudication Questionnaire (ZCQ), back pain and leg pain on a 10-point numeric rating score (NRS), patient perceived benefit of the surgical procedure, duration of the surgical procedure, blood loss, perioperative complications, number of reoperations, and length of hospital stay. Results In total, 437 patients were included with a median (IQR) age of 68 (62-73) years and 230 men (53%). Of the included patients, 146 were randomized to unilateral laminotomy with crossover, 142 to bilateral laminotomy, and 149 to spinous process osteotomy. The unilateral laminotomy with crossover group had a mean change of −17.9 ODI points (95% CI, −20.8 to −14.9), the bilateral laminotomy group had a mean change of −19.7 ODI points (95% CI, −22.7 to −16.8), and the spinous process osteotomy group had a mean change of –19.9 ODI points (95% CI, −22.8 to –17.0). There were no significant differences in primary or secondary outcomes among the 3 surgical procedures, except a longer duration of the surgical procedure in the bilateral laminotomy group. Conclusions and Relevance No differences in clinical outcomes or complication rates were found among the 3 minimally invasive posterior decompression techniques used to treat patients with lumbar spinal stenosis.

• Banitalebi, Hasan; Espeland, Ansgar; Anvar, Masoud D; Hermansen, Erland; Hellum, Christian & Brox, Jens Ivar [Show all 14 contributors for this article] (2022). Reliability of preoperative MRI findings in patients with lumbar spinal stenosis. BMC Musculoskeletal Disorders. ISSN 1471-2474. 23(1), p. 1–9. doi: 10.1186/s12891-021-04949-4. Full text in Research Archive Show summary

  Background Magnetic Resonance Imaging (MRI) is an important tool in preoperative evaluation of patients with lumbar spinal stenosis (LSS). Reported reliability of various MRI findings in LSS varies from fair to excellent. There are inconsistencies in the evaluated parameters and the methodology of the studies. The purpose of this study was to evaluate the reliability of the preoperative MRI findings in patients with LSS between musculoskeletal radiologists and orthopaedic spine surgeons, using established evaluation methods and imaging data from a prospective trial. Methods Consecutive lumbar MRI examinations of candidates for surgical treatment of LSS from the Norwegian Spinal Stenosis and Degenerative Spondylolisthesis (NORDSTEN) study were independently evaluated by two musculoskeletal radiologists and two orthopaedic spine surgeons. The observers had a range of experience between six and 13 years and rated five categorical parameters (foraminal and central canal stenosis, facet joint osteoarthritis, redundant nerve roots and intraspinal synovial cysts) and one continuous parameter (dural sac cross-sectional area). All parameters were re-rated after 6 weeks by all the observers. Inter- and intraobserver agreement was assessed by Gwet’s agreement coefficient (AC1) for categorical parameters and Intraclass Correlation Coefficient (ICC) for the dural sac cross-sectional area. Results MRI examinations of 102 patients (mean age 66 ± 8 years, 53 men) were evaluated. The overall interobserver agreement was substantial or almost perfect for all categorical parameters (AC1 range 0.67 to 0.98), except for facet joint osteoarthritis, where the agreement was moderate (AC1 0.39). For the dural sac cross-sectional area, the overall interobserver agreement was good or excellent (ICC range 0.86 to 0.96). The intraobserver agreement was substantial or almost perfect/ excellent for all parameters (AC1 range 0.63 to 1.0 and ICC range 0.93 to 1.0). Conclusions There is high inter- and intraobserver agreement between radiologists and spine surgeons for preoperative MRI findings of LSS. However, the interobserver agreement is not optimal for evaluation of facet joint osteoarthritis.

• Aaen, Jørn; Austevoll, Ivar Magne; Hellum, Christian; Storheim, Kjersti; Myklebust, Tor Åge & Banitalebi, Hasan [Show all 14 contributors for this article] (2021). Clinical and MRI findings in lumbar spinal stenosis: baseline data from the NORDSTEN study. European spine journal. ISSN 0940-6719. doi: 10.1007/s00586-021-07051-4. Full text in Research Archive Show summary

  Purpose The aim was to describe magnetic resonance imaging fndings in patients planned for lumbar spinal stenosis surgery. Further, to describe possible associations between MRI fndings and patient characteristics with patient reported disability or pain. Methods The NORDSTEN spinal stenosis trial included 437 patients planned for surgical decompression of LSS. The following MRI fndings were evaluated before surgery: morphological (Schizas) and quantitative (cross-sectional area) grade of stenosis, disk degeneration (Pfrrmann), facet joint tropism and fatty infltration of the multifdus muscle. Patients were dichotomized into a moderate or severe category for each radiological parameter classifcation. A multivariable linear regression analysis was performed to investigate the association between MRI fndings and preoperative scores for Oswestry Disability Index, Zurich Claudication Questionnaire and Numeric rating scale for back and leg pain. The following patient characteristics were included in the analysis: gender, age, smoking and weight. Results The percentage of patients with severe scores was as follows: Schizas (C+D) 71.3%, cross-sectional area (<75 mm2 ) 86.8%, Pfrrmann (4+5) 58.1%, tropism (≥15°) 11.9%, degeneration of multifdus muscle (2–4) 83.7%. Regression coefcients indicated minimal changes in severity of symptoms when comparing the groups with moderate and severe MRI fndings. Only gender had a signifcant and clinically relevant association with ODI score. Conclusion In this cross-sectional study, the majority of the patients had MRI fndings classifed as severe LSS changes, but the fndings had no clinically relevant association with patient reported disability and pain at baseline. Patient characteristics have a larger impact on disability and pain than radiological fndings. Trial registration www.ClinicalTrials.gov identifer: NCT02007083, registered December 2013. Keywords Lumbar spinal stenosis · Schizas · DSCA · Pfrrmann · Tropism

• Austevoll, Ivar Magne; Hermansen, Erland; Fagerland, Morten Wang; Storheim, Kjersti; Brox, Jens Ivar & Solberg, Tore [Show all 16 contributors for this article] (2021). Decompression with or without Fusion in Degenerative Lumbar Spondylolisthesis. New England Journal of Medicine. ISSN 0028-4793. 385(6), p. 526–538. doi: 10.1056/NEJMoa2100990. Full text in Research Archive Show summary

  BACKGROUND In patients with lumbar spinal stenosis and degenerative spondylolisthesis, it is uncertain whether decompression surgery alone is noninferior to decompression with instrumented fusion. METHODS We conducted an open-label, multicenter, noninferiority trial involving patients with symptomatic lumbar stenosis that had not responded to conservative management and who had single-level spondylolisthesis of 3 mm or more. Patients were randomly assigned in a 1:1 ratio to undergo decompression surgery (decompressionalone group) or decompression surgery with instrumented fusion (fusion group). The primary outcome was a reduction of at least 30% in the score on the Oswestry Disability Index (ODI; range, 0 to 100, with higher scores indicating more impairment) during the 2 years after surgery, with a noninferiority margin of −15 percentage points. Secondary outcomes included the mean change in the ODI score as well as scores on the Zurich Claudication Questionnaire, leg and back pain, the duration of surgery and length of hospital stay, and reoperation within 2 years. RESULTS The mean age of patients was approximately 66 years. Approximately 75% of the patients had leg pain for more than a year, and more than 80% had back pain for more than a year. The mean change from baseline to 2 years in the ODI score was −20.6 in the decompression-alone group and −21.3 in the fusion group (mean difference, 0.7; 95% confidence interval [CI], −2.8 to 4.3). In the modified intentionto- treat analysis, 95 of 133 patients (71.4%) in the decompression-alone group and 94 of 129 patients (72.9%) in the fusion group had a reduction of at least 30% in the ODI score (difference, −1.4 percentage points; 95% CI, −12.2 to 9.4), showing the noninferiority of decompression alone. In the per-protocol analysis, 80 of 106 patients (75.5%) and 83 of 110 patients (75.5%), respectively, had a reduction of at least 30% in the ODI score (difference, 0.0 percentage points; 95% CI, −11.4 to 11.4), showing noninferiority. The results for the secondary outcomes were generally in the same direction as those for the primary outcome. Successful fusion was achieved with certainty in 86 of 100 patients (86.0%) who had imaging available at 2 years. Reoperation was performed in 15 of 120 patients (12.5%) in the decompression- alone group and in 11 of 121 patients (9.1%) in the fusion group. CONCLUSIONS In this trial involving patients who underwent surgery for degenerative lumbar spondylolisthesis, most of whom had symptoms for more than a year, decompression alone was noninferior to decompression with instrumented fusion over a period of 2 years. Reoperation occurred somewhat more often in the decompressionalone group than in the fusion group. (NORDSTEN-DS ClinicalTrials.gov number, NCT02051374.)

• Holtedahl, Robin; Bøe, Berte Marie Grimsmo & Brox, Jens Ivar (2021). Better Short-Term Outcomes After Rotator Cuff Repair in Studies with Poorer Mean Shoulder Scores and Predominantly Small to Medium-Sized Tears at Baseline. A Systematic Review and Meta-Analysis. Arthroscopy: The Journal of Arthroscopy And Related. ISSN 0749-8063. doi: 10.1016/j.arthro.2021.08.019.
• Schmidt, Malte; Enger, Martine; Pripp, Are Hugo; Nordsletten, Lars; Moosmeyer, Stefan & Melhuus, Knut [Show all 7 contributors for this article] (2021). Interrater reliability of physical examination tests in the acute phase of shoulder injuries. BMC Musculoskeletal Disorders. ISSN 1471-2474. 22(1), p. 1–9. doi: 10.1186/s12891-021-04659-x. Full text in Research Archive
• Skare, Øystein; Brox, Jostein Skranes; Schrøder, Cecilie Piene & Brox, Jens Ivar (2021). Responsiveness of five shoulder outcome measures at follow-ups from 3 to 24 months. BMC Musculoskeletal Disorders. ISSN 1471-2474. 22(1), p. 1–10. doi: 10.1186/s12891-021-04483-3. Full text in Research Archive
• Garratt, Andrew M.; Furunes, Håvard; Hellum, Christian; Solberg, Tore; Brox, Jens Ivar & Storheim, Kjersti [Show all 7 contributors for this article] (2021). Evaluation of the EQ-5D-3L and 5L versions in low back pain patients. Health and Quality of Life Outcomes. ISSN 1477-7525. 19. doi: 10.1186/s12955-021-01792-y. Full text in Research Archive Show summary

  Background The EuroQol EQ-5D is one of the most widely researched and applied patient-reported outcome measures worldwide. The original EQ-5D-3L and more recent EQ-5D-5L include three and five response categories respectively. Evidence from healthy and sick populations shows that the additional two response categories improve measurement properties but there has not been a concurrent comparison of the two versions in patients with low back pain (LBP). Methods LBP patients taking part in a multicenter randomized controlled trial of lumbar total disc replacement and conservative treatment completed the EQ-5D-3L and 5L in an eight-year follow-up questionnaire. The 3L and 5L were assessed for aspects of data quality including missing data, floor and ceiling effects, response consistency, and based on a priori hypotheses, associations with the Oswestry Disability Index (ODI), Pain-Visual Analogue Scales and Hopkins Symptom Checklist (HSCL-25). Results At the eight-year follow-up, 151 (87%) patients were available and 146 completed both the 3L and 5L. Levels of missing data were the same for the two versions. Compared to the EQ-5D-5L, the 3L had significantly higher floor (pain discomfort) and ceiling effects (mobility, self-care, pain/discomfort, anxiety/depression). For these patients the EQ-5D-5L described 73 health states compared to 28 for the 3L. Shannon’s indices showed the 5L outperformed the 3L in tests of classification efficiency. Correlations with the ODI, Pain-VAS and HSCL-25 were largely as hypothesized, the 5L having slightly higher correlations than the 3L. Conclusion The EQ-5D assesses important aspect of health in LBP patients and the 5L improves upon the 3L in this respect. The EQ-5D-5L is recommended in preference to the 3L version, however, further testing in other back pain populations together with additional measurement properties, including responsiveness to change, is recommended. © The Author(s) 2021. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made.

• Major, Daniel Høgli; Grotle, Margreth; Littlewood, Chris; Brox, Jens Ivar; Matre, Dagfinn & Gallet, Heidi Marie Veeser [Show all 7 contributors for this article] (2021). Adherence to self-managed exercises for patients with persistent subacromial pain: The Ad-Shoulder feasibility study. BMC Pilot and Feasibility Studies. ISSN 2055-5784. 7(1). doi: 10.1186/s40814-021-00767-6. Full text in Research Archive Show summary

  Background Exercise is recommended for patients with subacromial pain. It has been suggested that good exercise adherence improves clinical outcomes. Despite this, little attention has been paid to the need for behavioural frameworks to enhance adherence to home exercise programmes for patients with subacromial pain. Methods A feasibility study with pre-post design was used. Participants aged > 18 years, with subacromial pain, who had received conservative treatment during the past 6 months, were recruited. The Ad-Shoulder intervention consisted of 1–5 individual sessions provided over 3 months and was based on 5 self-management skills, which aimed to enhance the patients’ self-efficacy and adherence to self-managed exercises. The primary objectives were assessed according to predefined progression criteria: (1) the recruitment rate (10 patients enrolled within 12 weeks), (2) follow-up rate (≥ 80% on all self-reported measures), (3) objective physical activity measures (≥ 80% of participants would contribute valid data at each time point), (4) adherence with the self-managed exercises (≥ 80% of the participants would adhere to ≥ 80% of the assigned home exercise programme), (5) fidelity of the delivery of the intervention (the therapists delivered the intervention according to the protocol) and (6) adverse events (< 30% would report adverse events (including mild)). The results were reported using descriptive statistics. Results Eleven patients were recruited during 16 weeks. Ten patients completed the self-reported measures at baseline and week 12. Objective physical activity measures were successfully obtained for 100% (11/11) at baseline, 64% (7/11) at week six and 82% at week 12. Fifty-five percent (6/11) of the participants satisfactorily completed at least 80% of their home exercise programme. All sessions were delivered according to the protocol. None of the patients reported any adverse events. Conclusions Objective physical activity data measures at baseline and week 12, follow-up, the physiotherapists’ fidelity to the intervention and adverse events met our pre-specified progression criteria. Recruitment and adherence to the self-managed exercise programme were both below the anticipated level. Further intervention development is necessary to understand whether adherence to the self-managed exercises could be enhanced and additional methods of recruitment would need to be considered, including additional recruitment sites, in any planning for a future main trial.

• Heide, Marte; Mørk, Marianne; Røe, Cecilie; Brox, Jens Ivar & Hoksrud, Aasne Fenne (2020). The effectiveness of radial extracorporeal shock wave therapy (rESWT), sham-rESWT, standardized exercise program or usual care for patients with plantar fasciopathy: study protocol for a double-blind, randomized, sham-controlled trial. Trials. ISSN 1745-6215. 21. doi: 10.1186/s13063-020-04510-z. Full text in Research Archive
• Steen, Harald; Pripp, Are Hugo; Lange, Johan Emil & Brox, Jens Ivar (2020). Predictors for long-term curve progression after Boston brace treatment of idiopathic scoliosis. European Journal of Physical and Rehabilitation Medicine. ISSN 1973-9087. p. 1–25. doi: 10.23736/S1973-9087.20.06190-0. Full text in Research Archive
• Brox, Jens Ivar; Skare, Øystein; Mowinckel, Petter; Brox, Jostein Skranes; Reikerås, Olav & Schrøder, Cecilie Piene (2020). Sick leave and return to work after surgery for type II SLAP lesions of the shoulder: a secondary analysis of a randomized sham-controlled study. BMJ Open. ISSN 2044-6055. 10(4), p. 1–9. doi: 10.1136/bmjopen-2019-035259. Full text in Research Archive
• Bråten, Lars Christian Haugli; Schistad, Ellina Iordanova; Espeland, Ansgar; Kristoffersen, Per M; Haugen, Anne Julsrud & Marchand, Gunn Hege [Show all 15 contributors for this article] (2020). Association of Modic change types and their short tau inversion recovery signals with clinical characteristics : a cross sectional study of chronic low back pain patients in the AIM-study. BMC Musculoskeletal Disorders. ISSN 1471-2474. 21. doi: 10.1186/s12891-020-03381-4. Full text in Research Archive
• Furunes, Håvard; Berg, Linda; Espeland, Ansgar; Thoresen, Hanne; Neckelmann, Gesche F & Brøgger, Helga Maria [Show all 10 contributors for this article] (2020). Facet arthropathy following disc replacement versus rehabilitation: A prospective study with 8-year follow-up. Spine. ISSN 0362-2436. 45(21), p. 1467–1475. doi: 10.1097/BRS.0000000000003600. Show summary

  Study design: A prospective study of patients originally randomized to total disc replacement (TDR) or multidisciplinary rehabilitation. Objective: To assess the long-term development of facet arthropathy (FA) after TDR versus nonoperative treatment, and to analyze the association between FA and clinical outcome. Summary of background data: FA may appear or increase following TDR, but the natural course of FA is unclear, and no previous study has evaluated the long-term development of FA following TDR compared with nonoperative treatment. Methods: The study included 126 patients with chronic low back pain and degenerative changes in the lumbar intervertebral discs. The patients underwent pretreatment and 8-year follow-up magnetic resonance imaging (MRI) and 8-year follow-up computed tomography (CT) of the lumbar spine. The primary outcome measure was FA development (yes/no) on MRI at index level L4/L5 or L5/S1, defined as increased FA grade value from pretreatment to follow-up according to Weishaupt grading system. Secondary outcomes included the association between FA (on MRI and CT) and Oswestry Disability Index (ODI) or back pain as well as reoperations. Results: Increased index level FA grade was more frequent after TDR versus nonoperative treatment (36%, 25/69 vs. 2%, 1/57 of patients, P < 0.001), but was not related to change in ODI or back pain. At follow-up, index level FA grades were higher after TDR versus nonoperative treatment (odds ratio 4.0 MRI and 5.9 CT), but were not related to ODI less than or equal to 22. Four patients (6%) treated with TDR and no patients treated nonoperatively were operated for lateral recess stenosis with posterior decompression at the index level during follow-up. Conclusion: Index level FA development was more likely after TDR compared with nonoperative treatment but was not associated with the 8-year clinical outcome. Index level FA may have contributed to reoperations in the TDR group. Level of evidence: 2.

• Gjefsen, Elisabeth; Bråten, Lars Christian Haugli; Goll, Guro Løvik; Wigemyr, Monica; Bolstad, Nils & Valberg, Morten [Show all 27 contributors for this article] (2020). The effect of infliximab in patients with chronic low back pain and Modic changes (the BackToBasic study): study protocol of a randomized, double blind, placebo-controlled, multicenter trial. BMC Musculoskeletal Disorders. ISSN 1471-2474. 21:698, p. 1–14. doi: 10.1186/s12891-020-03720-5. Full text in Research Archive
• Engebretsen, Kaia B.; Brox, Jens Ivar & Juel, Niels Gunnar (2020). Patients with shoulder pain referred to specialist care; treatment, predictors of pain and disability, emotional distress, main symptoms and sick-leave: a cohort study with a six-months follow-up. Scandinavian Journal of Pain. ISSN 1877-8860. 20(4), p. 775–783. doi: 10.1515/sjpain-2020-0044.
• Austevoll, Ivar Magne; Gjestad, Rolf; Solberg, Tore; Storheim, Kjersti; Brox, Jens Ivar & Hermansen, Erland [Show all 9 contributors for this article] (2020). Comparative effectiveness of microdecompression alone vs decompression plus instrumented fusion in lumbar degenerative spondylolisthesis. JAMA Network Open. ISSN 2574-3805. 3:e2015015(9), p. 1–13. doi: 10.1001/jamanetworkopen.2020.15015. Full text in Research Archive
• Olsen, Unni Solveig Johansen; Lindberg, Maren Falch; Denison, Eva Marie-Louise; Rose, Christopher James; Gay, Caryl & Aamodt, Arild [Show all 11 contributors for this article] (2020). Predictors of chronic pain and level of physical function in total knee arthroplasty: a protocol for a systematic review and meta-analysis. BMJ Open. ISSN 2044-6055. 10, p. 1–9. doi: 10.1136/bmjopen-2020-037674. Full text in Research Archive Show summary

  Abstract Introduction One in five patients undergoing total knee arthroplasty (TKA) experience unchanged or worse pain and physical function 1 year after surgery. Identifying risk factors for unfavourable outcomes is necessary to develop tailored interventions to minimise risk. There is a need to review more current literature with updated methodology that addresses the limitations of earlier systematic reviews and meta-analyses. We present a Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols compliant protocol for a systematic review and meta-analysis of predictors of chronic pain and impaired function after TKA. Methods and analysis This review will include prospective longitudinal observational studies, or randomised trials (including cluster and crossover designs) that report arm-wise predictors of chronic postsurgical pain or impaired physical function at 3 months, 6 months or 12 months. A comprehensive literature search of studies published between 2000 and 2019 will be performed in Medline, Embase, CINAHL, Cochrane Library and PEDro. Blinded assessment with consensus agreement will be applied for inclusion of studies, data extraction and assessment of bias risk (Quality in Prognosis Studies tool). The co-primary outcomes, pain and impaired function, at 12 months after TKA will be analysed separately. Estimates of association between each outcome and any preoperative or intraoperative factor that may predict chronic pain or impaired physical function will be extracted from the included studies, where possible. For randomised studies, results will only be extracted from TKA arms (or the first period of crossover trials). Estimates of association from the primary evidence will be synthesised narratively, and quantitatively using multivariate meta-analysis to provide ‘pooled’ estimates of association. Subgroup and sensitivity analyses will be performed. Certainty of evidence for each predictor will be derived from the Grading of Recommendations Assessment, Development and Evaluation framework. Ethics and dissemination No ethical issues are associated with this project. The results from this review will be published in peer-reviewed journals and presented at international conferences.

• Bråten, Lars Christian Haugli; Grøvle, Lars; Espeland, Ansgar; Pripp, Are Hugo; Grotle, Margreth & Hellum, Christian [Show all 18 contributors for this article] (2020). Clinical effect modifiers of antibiotic treatment in patients with chronic low back pain and Modic changes - Secondary analyses of a randomised, placebo-controlled trial (the AIM study). BMC Musculoskeletal Disorders. ISSN 1471-2474. 21, p. 1–11. doi: 10.1186/s12891-020-03422-y. Full text in Research Archive Show summary

  Background: Randomised trials on antibiotic treatment for patients with chronic low back pain and vertebral endplate changes visible on MRI (Modic changes) have shown mixed results. A possible explanation might be a real treatment effect in subgroups of the study populations. The purpose of the present study was to explore potential clinical effect modifiers of 3-months oral amoxicillin treatment in patients with chronic low back pain and type I or II Modic changes at the level of a previous lumbar disc herniation. Methods: We performed analyses of effect modifiers on data from AIM, a double-blind parallel-group multicentre trial. One hundred eighty patients with chronic low back pain, previous disc herniation, Modic change type I (n = 118) or type II (n = 62) were randomised to 3-months oral treatment with 750 mg amoxicillin (n = 89) or placebo (n = 91) three times daily. The primary outcome was the Roland-Morris Disability Questionnaire (RMDQ) score (possible values 0–24) at 1-year follow-up in the intention-to-treat population. The predefined minimal clinically important between-group mean difference was 4 RMDQ points (not reached in the primary analysis of AIM). Predefined baseline characteristics were analysed as potential effect modifiers, four primary (type I Modic changes, previous disc surgery, positive pain provocation test, high CRP) and five exploratory (disturbed sleep, constant low back pain, short duration of low back pain, younger age, and male) using ANCOVA with interaction terms. Results: None of the four primary potential effect modifiers had strong evidence of modifying the treatment effect. In patients younger than 40 years the difference in mean RMDQ score between the treatment groups was − 4.0 (95%CI, − 6.9 to − 1.2), compared to − 0.5 (95%CI, − 2.3 to 1.3) in patients 40 years or older, both in favour of amoxicillin treatment (exploratory analysis). Conclusions: We did not find evidence for convincing clinical effect modifiers of antibiotic treatment in patients with chronic low back pain and Modic changes. Our results for younger age in these explorative analyses should not affect clinical treatment decisions without confirmation in future studies.

• Hermansen, Erland; Austevoll, Ivar Magne; Hellum, Christian; Storheim, Kjersti; Myklebust, Tor Åge & Aaen, Jørn Ståle [Show all 17 contributors for this article] (2020). Comparable increases in dural sac area after three different posterior decompression techniques for lumbar spinal stenosis: radiological results from a randomized controlled trial in the NORDSTEN study. European spine journal. ISSN 0940-6719. 29, p. 2254–2261. doi: 10.1007/s00586-020-06499-0. Full text in Research Archive Show summary

  Purpose: To investigate changes in dural sac area after three different posterior decompression techniques in patients undergoing surgery for lumbar spinal stenosis. Summary of background data: Decompression of the nerve roots is the main surgical treatment for lumbar spinal stenosis. The aim of this study was to radiologically investigate three commonly used posterior decompression techniques. Methods: The present study reports data from one of two multicenter randomized trials included in the NORDSTEN study. In the present trial, involving 437 patients undergoing surgery, we report radiological results after three different midline retaining posterior decompression techniques: unilateral laminotomy with crossover (UL) (n = 146), bilateral laminotomy (BL) (n = 142) and spinous process osteotomy (SPO) (n = 149). MRI was performed before and three months after surgery. The increase in dural sac area and Schizas grade at the most stenotic level was evaluated. Three different predefined surgical indicators of substantial decompression were used: (1) postoperative dural sac area of > 100 mm2, (2) increase in the dural sac area of at least 50% and (3) postoperative Schizas grade A or B. Results: No differences between the three surgical groups were found in the mean increase in dural sac area. Mean values were 66.0 (SD 41.5) mm2 in the UL-group, 71.9 (SD 37.1) mm2 in the BL-group and 68.1 (SD 41.0) mm2 in the SPO-group (p = 0.49). No differences in the three predefined surgical outcomes between the three groups were found. Conclusion: For patients with lumbar spinal stenosis, the three different surgical techniques provided the same increase in dural sac area.

• Grotle, Margreth; Bråten, Lars Christian Haugli; Brox, Jens Ivar; Espeland, Ansgar; Zolic-Karlsson, Zinajda & Killingmo, Rikke Munk [Show all 14 contributors for this article] (2020). Cost–utility analysis of antibiotic treatment in patients with chronic low back pain and Modic changes: results from a randomised, placebo-controlled trial in Norway (the AIM study) . BMJ Open. ISSN 2044-6055. 10(6), p. 1–10. doi: 10.1136/bmjopen-2019-035461. Full text in Research Archive
• Skjaker, Stein Arve; Enger, Martine; Engebretsen, Lars; Brox, Jens Ivar & Bøe, Berte Marie Grimsmo (2020). Young men in sports are at highest risk of acromioclavicular joint injuries: a prospective cohort study. Knee Surgery, Sports Traumatology, Arthroscopy. ISSN 0942-2056. doi: 10.1007/s00167-020-05958-x. Full text in Research Archive
• Taso, Mirad; Sommernes, Jon Håvard; Kolstad, Frode; Sundseth, Jarle Østberg; Bjorland, Siri & Pripp, Are Hugo [Show all 8 contributors for this article] (2020). A randomised controlled trial comparing the effectiveness of surgical and nonsurgical treatment for cervical radiculopathy. BMC Musculoskeletal Disorders. ISSN 1471-2474. 21(1), p. 1–9. doi: 10.1186/s12891-020-3188-6. Full text in Research Archive
• Hott, Alexandra Christine; Brox, Jens Ivar; Pripp, Are Hugo; Juel, Niels Gunnar & Liavaag, Sigurd (2019). Patellofemoral pain: One year results of a randomized trial comparing hip exercise, knee exercise, or free activity. Scandinavian Journal of Medicine & Science in Sports. ISSN 0905-7188. p. 1–13. doi: 10.1111/sms.13613.
• Molland, Ragnhild Susanne; Brox, Jens Ivar; Stuge, Britt; Holm, Inger; Riise, Rolf Bjarne & Kibsgård, Thomas (2019). Health related quality of life and physical activity after multiple-surgeries in patients with early onset scoliosis. Spine Deformity. ISSN 2212-134X. 7(6), p. 1010–1010. doi: 10.1016.
• Hott, Alexandra Christine; Brox, Jens Ivar; Pripp, Are Hugo; Juel, Niels Gunnar & Liavaag, Sigurd (2019). Predictors of Pain, Function, and Change in Patellofemoral Pain. American Journal of Sports Medicine. ISSN 0363-5465. 48(2), p. 351–358. doi: 10.1177/0363546519889623.
• Hott, Alexandra Christine; Liavaag, Sigurd; Juel, Niels Gunnar; Brox, Jens Ivar & Ekeberg, Ole Marius (2019). The reliability, validity, interpretability, and responsiveness of the Norwegian version of the Anterior Knee Pain Scale in patellofemoral pain. Disability and Rehabilitation. ISSN 0963-8288. doi: 10.1080/09638288.2019.1671499.
• Bråten, Lars Christian Haugli; Rolfsen, Mads Peder; Espeland, Ansgar; Wigemyr, Monica; Assmus, Jörg & Froholdt, Anne [Show all 28 contributors for this article] (2019). Efficacy of antibiotic treatment in patients with chronic low back pain and Modic changes (the AIM study): double blind, randomised, placebo controlled, multicentre trial. The BMJ. ISSN 1756-1833. 367. doi: 10.1136/bmj.l5654. Full text in Research Archive Show summary

  Objective To assess the efficacy of three months of antibiotic treatment compared with placebo in patients with chronic low back pain, previous disc herniation, and vertebral endplate changes (Modic changes). Design Double blind, parallel group, placebo controlled, multicentre trial. Setting Hospital outpatient clinics at six hospitals in Norway. Participants 180 patients with chronic low back pain, previous disc herniation, and type 1 (n=118) or type 2 (n=62) Modic changes enrolled from June 2015 to September 2017. Interventions Patients were randomised to three months of oral treatment with either 750 mg amoxicillin or placebo three times daily. The allocation sequence was concealed by using a computer generated number on the prescription. Main outcome measures The primary outcome was the Roland-Morris Disability Questionnaire (RMDQ) score (range 0-24) at one year follow-up in the intention to treat population. The minimal clinically important between group difference in mean RMDQ score was predefined as 4. Results In the primary analysis of the total cohort at one year, the difference in the mean RMDQ score between the amoxicillin group and the placebo group was −1.6 (95% confidence interval −3.1 to 0.0, P=0.04). In the secondary analysis, the difference in the mean RMDQ score between the groups was −2.3 (−4.2 to−0.4, P=0.02) for patients with type 1 Modic changes and −0.1 (−2.7 to 2.6, P=0.95) for patients with type 2 Modic changes. Fifty patients (56%) in the amoxicillin group experienced at least one drug related adverse event compared with 31 (34%) in the placebo group. Conclusions In this study on patients with chronic low back pain and Modic changes at the level of a previous disc herniation, three months of treatment with amoxicillin did not provide a clinically important benefit compared with placebo. Secondary analyses and sensitivity analyses supported this finding. Therefore, our results do not support the use of antibiotic treatment for chronic low back pain and Modic changes.

• Enger, Martine Merete; Skjaker, Stein Arve; Nordsletten, Lars; Pripp, Are Hugo; Melhuus, Knut & Moosmeyer, Stefan [Show all 7 contributors for this article] (2019). Sports-related acute shoulder injuries in an urban population. BMJ Open sport & exercise medicine. ISSN 2055-7647. 5(1), p. 1–9. doi: 10.1136/bmjsem-2019-000551. Full text in Research Archive
• Hott, Alexandra Christine; Brox, Jens Ivar; Pripp, Are Hugo; Juel, Niels Gunnar; Paulsen, Gøran & Liavaag, Sigurd (2019). Effectiveness of Isolated Hip Exercise, Knee Exercise, or Free Physical Activity for Patellofemoral Pain: A Randomized Controlled Trial. American Journal of Sports Medicine. ISSN 0363-5465. 47(6), p. 1312–1322. doi: 10.1177/0363546519830644.
• Vandvik, Per Olav; Lähdeoja, Tuomas; Ardern, Clare; Buchbinder, Rachelle; Moro, Jaydeep & Brox, Jens Ivar [Show all 20 contributors for this article] (2019). Subacromial decompression surgery for adults with shoulder pain: A clinical practice guideline. The BMJ. ISSN 1756-1833. 364:I294, p. 1–8. doi: 10.1136/bmj.l294.
• Austevoll, Ivar Magne; Gjestad, Rolf; Grotle, Margreth; Solberg, Tore; Brox, Jens Ivar & Hermansen, Erland [Show all 10 contributors for this article] (2019). Follow-up score, change score or percentage change score for determining clinical important outcome following surgery? An observational study from the Norwegian registry for Spine surgery evaluating patient reported outcome measures in lumbar spinal stenosis and lumbar degenerative spondylolisthesis. BMC Musculoskeletal Disorders. ISSN 1471-2474. 20:31, p. 1–15. doi: 10.1186/s12891-018-2386-y. Full text in Research Archive
• Søberg, Helene L.; Engebretsen, Kaia Beck; Juel, Niels Gunnar; Røe, Yngve & Brox, Jens Ivar (2019). Associations between shoulder pain and functioning on the ICF Checklist and the Disabilities of the Arm, Shoulder and Hand scale – a cross-sectional study. Disability and Rehabilitation. ISSN 0963-8288. p. 1–8. doi: 10.1080/09638288.2019.1584252.
• Hermansen, Erland; Myklebust, Tor Åge; Austevoll, Ivar Magne; Rekeland, Frode; Solberg, Tore & Storheim, Kjersti [Show all 11 contributors for this article] (2019). Clinical outcome after surgery for lumbar spinal stenosis in patients with insignificant lower extremity pain. A prospective cohort study from the Norwegian registry for spine surgery . BMC Musculoskeletal Disorders. ISSN 1471-2474. 20:36, p. 1–8. doi: 10.1186/s12891-019-2407-5. Full text in Research Archive
• Austevoll, Ivar Magne; Hermansen, Erland; Fagerland, Morten; Rekeland, Frode; Solberg, Tore & Storheim, Kjersti [Show all 12 contributors for this article] (2019). Decompression alone versus decompression with instrumental fusion the NORDSTEN degenerative spondylolisthesis trial (NORDSTEN-DS); study protocol for a randomized controlled trial. BMC Musculoskeletal Disorders. ISSN 1471-2474. 20:7, p. 1–10. doi: 10.1186/s12891-018-2384-0. Full text in Research Archive
• Aulie, Vibeke Smith; Halvorsen, Vera Baasland & Brox, Jens Ivar (2018). Motor abilities in 182 children treated for idiopathic clubfoot: a comparison between the traditional and the Ponseti method and controls. Journal of Children's Orthopaedics. ISSN 1863-2521. 12(4), p. 383–389. doi: 10.1302/1863-2548.12.170195.
• Molland, Ragnhild Susanne; Diep, Lien My; Brox, Jens Ivar; Stuge, Britt; Holm, Inger & Kibsgård, Thomas (2018). Reliability and Construct Validity of the Adapted Norwegian Version of the Early-Onset Scoliosis 24-item Questionnaire. JAAOS: Global Research & Reviews. ISSN 2474-7661. 2(7). doi: 10.5435/JAAOSGlobal-D-17-00066. Full text in Research Archive
• Holtedahl, Robin; Brox, Jens Ivar; Aune, Arne Kristian; Nguyen, Daniel; Risberg, May Arna & Tjomsland, Ole (2018). Changes in the rate of publicly financed knee arthroscopies: An analysis of data from the Norwegian patient registry from 2012 to 2016. BMJ Open. ISSN 2044-6055. 8(6), p. 1–6. doi: 10.1136/bmjopen-2017-021199. Full text in Research Archive Show summary

  Objective: To examine rates of publicly financed knee arthroscopic surgery in Norway between 2012 and 2016. Design: Analysis of anonymised data from the National Patient Registry. Interventions: Beginning in 2012, South-Eastern Norway Regional Health Authority implemented administrative measures to bring down rates of knee arthroscopy. Similar measures were not introduced in the other three Regional Health Authorities. Main outcome measures: We analysed annual national rates of publicly financed knee arthroscopies in 2012 and 2016. We compared the rates in South-Eastern Norway Regional Health Authority with corresponding rates in the rest of the country. Variations by county, public hospital versus publicly reimbursed private hospital, gender and age were also assessed. Results: The overall annual rate of arthroscopic procedures declined by 33% from 2012 to 2016, from 310 to 207 per 100 000 inhabitants, respectively. Hospitals in South-Eastern Norway Regional Health Authority reported a 48% reduction, compared with mean 13% in the other three Regional Health Authorities. In public hospitals, rates decreased nationally by 42%, while rates in publicly reimbursed private hospitals increased by 12%. Rates in publicly reimbursed private hospitals decreased by 30% in South-Eastern Norway Regional Health Authority but increased by 63% in the other Regional Health Authorities. The proportion of patients ≥50 years (excluding meniscal repairs) in Norway was 54% in 2012 and fell to 46% in 2016. Average rates per county varied by a factor of 3:1. Conclusion: We report a marked overall reduction of knee arthroscopic procedures from 2012 to 2016 in publicly funded hospitals. The largest decrease was reported in South-Eastern Norway Regional Health Authority, and this coincides in time with implemented administrative measures. The results suggest that the trend of increasing rates of knee arthroscopies can be reversed through purposeful professional and administrative interventions.

• Juel, Niels Gunnar; Brox, Jens Ivar; Hellund, Johan Castberg; Merckoll, Else; Holte, Kristine Bech & Berg, Tore Julsrud (2018). Radiological glenohumeral osteoarthritis in long-term type 1 diabetes. Prevalence and reliability of three classification systems. The Dialong shoulder study. Skeletal Radiology. ISSN 0364-2348. 47(9), p. 1245–1251. doi: 10.1007/s00256-018-2923-7.
• Kvalvaag, Elisabeth Myrset; Røe, Cecilie; Engebretsen, Kaia Beck; Søberg, Helene L.; Juel, Niels Gunnar & Bautz-Holter, Erik [Show all 8 contributors for this article] (2018). One year results of a randomized controlled trial on radial Extracorporeal Shock Wave Treatment, with predictors of pain, disability and return to work in patients with subacromial pain syndrome. European Journal of Physical and Rehabilitation Medicine. ISSN 1973-9087. 54(3), p. 341–350. doi: 10.23736/S1973-9087.17.04748-7.
• Furunes, Håvard; Hellum, Christian; Espeland, Ansgar; Brox, Jens Ivar; Småstuen, Milada C & Berg, Linda [Show all 7 contributors for this article] (2018). Adjacent disc degeneration after lumbar total disc replacement or non-operative Treatment: A randomized study with eight-year follow-up. Spine. ISSN 0362-2436. 43(24), p. 1695–1703. doi: 10.1097/BRS.0000000000002712. Full text in Research Archive
• Enger, Martine; Skjaker, Stein Arve; Melhuus, Knut; Nordsletten, Lars; Pripp, Are Hugo & Moosmeyer, Stefan [Show all 7 contributors for this article] (2018). Shoulder injuries from birth to old age A 1-year prospective study of 3031 shoulder injuries in an urban population. Injury. ISSN 0020-1383. 49(7), p. 1324–1329. doi: 10.1016/j.injury.2018.05.013.
• Juel, Niels Gunnar; Brox, Jens Ivar; Hellund, Johan Castberg; Holte, Kristine Bech & Berg, Tore Julsrud (2017). The prevalence of radiological glenohumeral osteoarthritis in long-term type 1 diabetes: the Dialong shoulder study. Scandinavian Journal of Rheumatology. ISSN 0300-9742. 47(4), p. 325–330. doi: 10.1080/03009742.2017.1397189.
• Storheim, Kjersti; Espeland, Ansgar; Grøvle, Lars; Skouen, Jan Sture; Assmus, Jörg & Anke, Audny [Show all 20 contributors for this article] (2017). Antibiotic treatment In patients with chronic low back pain and Modic changes (the AIM study): study protocol for a randomised controlled trial. Trials. ISSN 1745-6215. 15(18), p. 596–607. doi: 10.1186/s13063-017-2306-8. Full text in Research Archive
• Kvalvaag, Elisabeth Myrset; Anvar, Masoud D; Karlberg, Anna Cecilia; Brox, Jens Ivar; Engebretsen, Kaia Beck & Søberg, Helene L. [Show all 10 contributors for this article] (2017). Shoulder MRI features with clinical correlations in subacromial pain syndrome: A cross-sectional and prognostic study. BMC Musculoskeletal Disorders. ISSN 1471-2474. 18(469), p. 1–10. doi: 10.1186/s12891-017-1827-3.
• Kvalvaag, Elisabeth Myrset; Brox, Jens Ivar; Engebretsen, Kaia Beck; Søberg, Helene L.; Juel, Niels Gunnar & Bautz-Holter, Erik [Show all 8 contributors for this article] (2017). Effectiveness of radial extracorporeal shock wave therapy (rESWT) when combined with supervised exercises in patients with subacromial shoulder pain: a double-masked, randomized, sham-controlled trial. American Journal of Sports Medicine. ISSN 0363-5465. 45(11), p. 2547–2554. doi: 10.1177/0363546517707505.
• Furunes, Håvard; Hellum, Christian; Brox, Jens Ivar; Rossvoll, Ivar; Espeland, Ansgar & Berg, Linda [Show all 9 contributors for this article] (2017). Lumbar total disc replacement: predictors for long-term outcome. European spine journal. ISSN 0940-6719. 27(3), p. 709–718. doi: 10.1007/s00586-017-5375-1. Full text in Research Archive
• Holte, Kristine Bech; Juel, Niels Gunnar; Brox, Jens Ivar; Hanssen, Kristian Folkvord; Fosmark, Dag Sigurd & Sell, David R. [Show all 8 contributors for this article] (2017). Hand, shoulder and back stiffness in long-term type 1 diabetes; cross-sectional association with skin collagen advanced glycation end-products. The Dialong study. Journal of Diabetes and its Complications (JDC). ISSN 1056-8727. 31(9), p. 1408–1414. doi: 10.1016/j.jdiacomp.2017.06.007.
• Furunes, Håvard; Storheim, Kjersti; Brox, Jens Ivar; Johnsen, Lars Gunnar; Skouen, Jan Sture & Franssen, Eric [Show all 9 contributors for this article] (2017). Total disc replacement versus multidisciplinary rehabilitation in patients with chronic low back pain and degenerative discs: 8-year follow-up of a randomized controlled multicenter trial. The spine journal. ISSN 1529-9430. 17(10), p. 1480–1488. doi: 10.1016/j.spinee.2017.05.011. Full text in Research Archive
• Magnusson, Karin; Holte, Kristine Bech; Juel, Niels Gunnar; Brox, Jens Ivar; Hagen, Kåre Birger & Haugen, Ida Kristin [Show all 7 contributors for this article] (2017). Long term type 1 diabetes is associated with hand pain, disability and stiffness but not with structural hand osteoarthritis features - The Dialong hand study. PLOS ONE. ISSN 1932-6203. 12:e0177118(5), p. 1–13. doi: 10.1371/journal.pone.0177118. Full text in Research Archive
• Juel, Niels Gunnar; Brox, Jens Ivar; Brunborg, Cathrine; Holte, Kristine Bech & Berg, Tore Julsrud (2017). Very high prevalence of frozen shoulder in patients with type 1 diabetes of ≥45 years' duration: The Dialong Shoulder Study. Archives of Physical Medicine and Rehabilitation. ISSN 0003-9993. 98(8), p. 1551–1559. doi: 10.1016/j.apmr.2017.01.020.
• Schrøder, Cecilie Piene; Skare, Øystein; Reikerås, Olav; Mowinckel, Petter & Brox, Jens Ivar (2017). Sham surgery versus labral repair or biceps tenodesis for type II SLAP lesions of the shoulder: a three-armed randomised clinical trial. British Journal of Sports Medicine. ISSN 0306-3674. 51(24), p. 1759–1766. doi: 10.1136/bjsports-2016-097098. Full text in Research Archive
• Habiba, Samer; Nygaard, Øystein Petter; Brox, Jens Ivar; Hellum, Christian; Austevoll, Ivar Magne & Solberg, Tore (2017). Risk factors for surgical site infections among 1,772 patients operated on for lumbar disc herniation: a multicentre observational registry-based study. Acta Neurochirurgica. ISSN 0001-6268. 159(6), p. 1113–1118. doi: 10.1007/s00701-017-3184-2. Full text in Research Archive
• Hermansen, Erland; Austevoll, Ivar Magne; Romild, Ulla Kristina; Rekeland, Frode; Solberg, Tore & Storheim, Kjersti [Show all 11 contributors for this article] (2017). Study-protocol for a randomized controlled trial comparing clinical and radiological results after three different posterior decompression techniques for lumbar spinal stenosis: the Spinal Stenosis Trial (SST) (part of the NORDSTEN Study). BMC Musculoskeletal Disorders. ISSN 1471-2474. 18:121, p. 1–7. doi: 10.1186/s12891-017-1491-7. Full text in Research Archive
• Moosmeyer, Stefan; Ekeberg, Ole Marius; Hallgren, Hanna Bjørnsson; Heier, Ingar; Kvalheim, Synnøve Kristin & Blomquist, Jesper [Show all 11 contributors for this article] (2017). KALK study: ultrasound guided needling and lavage (barbotage) with steroid injection versus sham barbotage with and without steroid injection - protocol for a randomized, double-blinded, controlled, multicenter study. BMC Musculoskeletal Disorders. ISSN 1471-2474. 18:138, p. 1–9. doi: 10.1186/s12891-017-1501-9. Full text in Research Archive
• Olsen, Unni Solveig Johansen; Brox, Jens Ivar & Bjørk, Ida Torunn (2016). Preoperative bowel preparation versus no preparation before spinal surgery: A randomised clinical trial. International Journal of Orthopaedic and Trauma Nursing. ISSN 1878-1241.
• Hermansen, Erland; Romild, Ulla Kristina; Austevoll, Ivar Magne; Solberg, Tore; Storheim, Kjersti & Brox, Jens Ivar [Show all 8 contributors for this article] (2016). Does surgical technique influence clinical outcome after lumbar spinal stenosis decompression? A comparative effectiveness study from the Norwegian Registry for Spine Surgery. European spine journal. ISSN 0940-6719. 26(2), p. 420–427. doi: 10.1007/s00586-016-4643-9.
• Haugen, Anne Julsrud; Grøvle, Lars; Brox, Jens Ivar; Natvig, Bård & Grotle, Margreth (2016). Pain-related fear and functional recovery in sciatica: results from a 2-year observational study. Journal of Pain Research. ISSN 1178-7090. 9, p. 925–931. doi: 10.2147/JPR.S115003.
• Reme, Silje; Tveito, Torill Helene; Harris, Anette; Lie, Stein Atle; Grasdal, Astrid & Indahl, Aage [Show all 15 contributors for this article] (2016). Cognitive Interventions and Nutritional Supplements (The CINS Trial): A Randomized Controlled, Multicenter Trial Comparing a Brief Intervention with Additional Cognitive Behavioral Therapy, Seal Oil, and Soy Oil for Sick-Listed Low Back Pain Patients. Spine. ISSN 0362-2436. 41(20), p. 1557–1564. doi: 10.1097/BRS.0000000000001596. Full text in Research Archive Show summary

  STUDY DESIGN: A randomized controlled trial. OBJECTIVE: The aim of this study was to evaluate whether a tailored and manualized cognitive behavior therapy (CBT) or nutritional supplements of seal oil and soy oil had any additional benefits over a brief cognitive intervention (BI) on return to work (RTW). SUMMARY OF BACKGROUND DATA: Brief intervention programs are clinically beneficial and cost-effective for patients with low back pain (LBP). CBT is recommended for LBP, but evidence on RTW is lacking. Seal oil has previously been shown to have a possible effect on muscle pain, but no randomized controlled trials have so far been carried out in LBP patients. METHODS: Four hundred thirteen adults aged 18 to 60 years were included. Participants were sick-listed 2 to 10 months due to LBP. Main outcome was objectively ascertained work participation at 12-month follow-up. Participants were randomly assigned to BI (n = 100), BI and CBT (n = 103), BI and seal oil (n = 105), or BI and soy oil (n = 105). BI is a two-session cognitive, clinical examination program followed by two booster sessions, while the CBT program is a tailored, individual, seven-session manual-based treatment. RESULTS: At 12-month follow-up, 60% of the participants in the BI group, 50% in the BI and CBT group, 51% in the BI and seal oil group, and 53% in the BI and soy oil group showed reduced sick leave from baseline, and had either partly or fully RTW. The differences between the groups were not statistically significant (χ = 2.54, P = 0.47). There were no significant differences between the treatment groups at any of the other follow-up assessments either, except for a significantly lower sick leave rate in the BI group than the other groups during the first 3 months of follow-up (χ = 9.50, P = 0.02). CONCLUSION: CBT and seal oil had no additional benefits over a brief cognitive intervention on sick leave. The brief cognitive intervention alone was superior in facilitating a fast RTW.

• Austevoll, Ivar Magne; Gjestad, Rolf; Brox, Jens Ivar; Solberg, Tore; Storheim, Kjersti & Rekeland, Frode [Show all 9 contributors for this article] (2016). The effectiveness of decompression alone compared with additional fusion for lumbar spinal stenosis with degenerative spondylolisthesis: a pragmatic comparative non-inferiority observational study from the Norwegian Registry for Spine Surgery. European spine journal. ISSN 0940-6719. 26(2), p. 404–413. doi: 10.1007/s00586-016-4683-1. Show summary

  Purpose To evaluate the effect of adding fusion to decompression in patients operated for lumbar spinal stenosis with a concomitant lumbar degenerative spondylolisthesis. Methods After propensity score matching, 260 patients operated with decompression and fusion and 260 patients operated with decompression alone were compared. Primary outcome measures were leg and back pain [Numeric Rating Scale (NRS), 0–10] and Oswestry Disability Index (ODI, 0–100) at 12 months. Results At 12-month follow-up, the fusion group rated their pain significantly lower than the decompression alone group [leg pain 3.0 and 3.6, respectively, mean difference −0.6, 95 % confidence interval (CI) −1.2 to −0.05, p = 0.03 and back pain 3.3 and 3.9, respectively, mean difference −0.6, 95 % CI −1.1 to −0.1, p = 0.02]. ODI was not significantly different between the groups (21.0 versus 23.3, mean difference −2.3, 95 % CI −5.8 to 1.1, p = 0.18). Seventy-four percent of the fusion group and 63 % of the decompression alone group achieved a clinically important improvement in back pain (difference in proportion of responders = 11 %, 95 % CI 2–20 %, p = 0.01), corresponding to a number needed to treat of 9 patients (95 % CI 5–50). There was no significant difference in responder rate for leg pain (74 and 67 %, respectively, difference 7 %, 95 % CI −1 to 16 %, p = 0.09) or for ODI (67 and 59 %, respectively, difference 8 %, 95 % CI 0–18 %, p = 0.06). The duration of surgery and hospital stay was longer for the fusion group (mean difference 68 min, 95 % CI 58–78, p < 0.01 and mean difference 4.2 days, 95 % CI 3.5–4.8, p < 0.01). Conclusion In the present non-inferiority study, we cannot conclude that decompression alone is as good as decompression with additional fusion. However, the small differences in the groups’ effect sizes suggest that a considerable number of patients can be treated with decompression alone. A challenge in future studies will be to find the best treatment option for each patient.

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• Taso, Mirad & Brox, Jens Ivar (2024). Letter to the editor regarding “Patient expectations impact patient-reported outcomes and satisfaction after lumbar fusion” by Zhang et al. The spine journal. ISSN 1529-9430. 24(7). doi: 10.1016/j.spinee.2024.02.025.
• Werner, Erik Lønnmark & Brox, Jens Ivar (2024). Smertebehandling av ryggpasienter. Tidsskrift for Den norske legeforening. ISSN 0029-2001. 144(2), p. 1–3. doi: 10.4045/tidsskr.24.0031.
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• Fors, Egil Andreas; Brox, Jens Ivar; Simula, Anna-Sofia & Andersen, Tor Inge (2022). LOW BACK PAIN: HOW TO MANAGE IN PRIMARY CARE?
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• Brox, Jens Ivar (2020). En legeroman. Klassekampen. ISSN 0805-3839.
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• Molland, Ragnhild Susanne; Diep, Lien My; Brox, Jens Ivar; Stuge, Britt; Holm, Inger & Kibsgård, Thomas (2017). Discriminative characteristics of the Early Onset Scoliosis-24-item Questionnaire (EOSQ-24) and its usefulness in follow-up examinations.
• Brox, Jens Ivar (2017). Specific symptoms and signs of unstable back segments and curative surgery? Scandinavian Journal of Pain. ISSN 1877-8860. 16, p. 211–222. doi: 10.1136/bjsports-2017-098251.
• Brox, Jens Ivar; Schrøder, Cecilie Piene; Skare, Øystein; Mowinckel, Petter & Reikerås, Olav (2017). Author response - Sham surgery versus labral repair or biceps tenodesis for type II SLAP lesions of the shoulder: A three-armed randomised clinical trial. British Journal of Sports Medicine. ISSN 0306-3674. 51(24), p. 1778–1779. doi: 10.1136/bjsports-2017-098251.
• Mannion, Anne F.; Brox, Jens Ivar & Fairbank, Jeremy C. (2016). Consensus at last! Long-term results of all randomized controlled trials show that fusion is no better than non-operative care in improving pain and disability in chronic low back pain. The spine journal. ISSN 1529-9430. 16(5), p. 588–590. doi: 10.1016/j.spinee.2015.12.001.
• Adobor, Raphael Dziwornu; Joranger, Pål; Steen, Harald; Navrud, Ståle & Brox, Jens Ivar (2016). Re: To screen or not to screen for adolescent idiopathic scoliosis? A review of the literature. Public Health. ISSN 0033-3506. 133, p. 124–125. doi: 10.1016/j.puhe.2015.12.010.
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