摘要:

ObjectiveThis prospective study evaluated 39 consecutive patients with low back pain (LBP) or neck pain that resulted from a motor vehicle accident who had litigation pending.MethodsPatients completed a McGill Pain Questionnaire (MPQ) to quantify pain and an Oswestry Low Back Disability Questionnaire (OSW) to quantify function and were interviewed regarding medications and work status at initial and final visits.ResultsThirty-three patients completed and MPQ at initial and final visits. Pain decreased in 29 (88%) and increased in four (12%). Thirty-eight patients completed and OSW at initial and final visits. Function improved in 34 and worsened in four. The authors observed statistically significant improvements in pain, function, and medication use.ConclusionPatients with low back pain or neck pain resulting from a motor vehicle accident showed a statistically significant improvement with treatment despite ongoing litigation.

ISSN:0362-2436    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Study DesignThis study critically reviewed current conceptualizations of occupational disability resulting from low back pain (LBP). It proposes a new classification system for back pain built on a phase-model of disability.ObjectivesThe goal was to develop a classification system that overcomes the shortcomings of existing classification schemes and is useful for interdisciplinary research, prevention, treatment, and rehabilitation.Summary of Background DataAttempts to study and prevent disability resulting from LBP have been hampered by the use of inadequate classifications of LBP.MethodsCurrent classifications of LBP were critically reviewed, and criteria for a useful classification system are described. The disabling process is organized in eight consecutive phases determined by the presence and duration of work disability.ResultsThe proposed eight-phase classification is based primarily on the presence and duration of work-disability rather than on clinical categories. It takes into account the developmental and social character of disability. The simplicity, reliability, and expandability of the model allow for its interdisciplinary use in research and intervention.ConclusionThe prevention of disabling back pain requires an interdisciplinary approach. For this purpose, other than purely biomedical classifications of LBP are needed. The authors propose an eight-phase classification system primarily based on the duration of work disability and that takes into account other biomedical, developmental, and social characteristics of work-disability resulting from LBP.

ISSN:0362-2436    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

ObjectiveThis study investigated the ability to predict maximal functional lifting capacity from peak isometric lumbar extension torque and submaximal lifting mechanics.MethodsPeak isometric lumbar extension torques were measured on 26 healthy men and women, ages 18 to 39 years. In addition, their lifting mechanics were evaluated while they lifted a submaximal load. Each subject's maximal lifting capacity (kg) then was predicted from the peak torque and submaximal kinetic analysis using a linear regression model.ResultsMean values for the predicted and actual maximum weight the subjects lifted were not significantly different (50.3 ± 15.6 kg and 48.5 ± 17.0 kg, respectively, P ≥ 0.05). The correlation between predicted and criterion values was high (r=0.96), and the total error of the prediction was 5.1 kg, Which represented 10.5% of the actual maximum value.ConclusionsThis multi-faceted functional assessment model involving biomechanical analysis of a submaximal lift and maximal isometric lumbar extension strength accurately predicted a subject's maximum functional lifting capacity.

ISSN:0362-2436    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Study DesignThirty-six patients with congenital scoliosis underwent full clinical and radiologic evaluation of their deformity and their full pulmonary functions.ObjectivesThis study observed pulmonary functions in congenital scoliosis in detail, evaluated pulmonary functions in nonsurgically treated patients, and established whether, in surgically treated patients, there are any differences between those with multipla thoracic anomalies and those with lumbar or one or two thoracic anornalies.Summary of Background DataEighty-six of our patients in both groups (surgically and nonsurgically treated) showed abnormal increases in residual volumes, indicating restrictive pattern of lung function. The results of their pulmonary functions were analyzed using predicted values to eliminate age affect.MethodsPulmonary functions were assessed using the Gould 5000IV Computerized Pulmonary Function System.ResultsOverall, mean total lung capacity was 89% of predicted value, and mean vital capacity and forced vital capacity were 74% of predicted value. The mean residual volume was significantly increased, being 154% of predicted value. Nonsurgically treated patients showed normal total lung capacity (mean 99.8% of predicted value); this mean value was 82% of predicted value in surgically treated patients.ConclusionVital capacity was found to be significantly reduced in surgically treated patients (68% of predicted value), especially in those patients who had multiple thoracic anomalies. We believe that children with congenital scoliosis due to multiple anomalies should be operated on at an early age before deformity is too severe.

ISSN:0362-2436    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Study DesignThe effect of spinal instrumentation in Idiopathic scoliosis was studied in 21 patients who had Harrington instrumentation and 15 who had Wisconsin Drummond instrumentation.ObjectiveRadiographs were analyzed to determine if the frontal and transverse plane shape of the scoliosis curve was changed by surgery, with and without segmental fixation.Summary of Background DataPrevious reports were based on frontal plane measurements of the curve (Cobb angle). The study reports correction in the frontal plans (Cobb angle) and transverse plane (apical vertebral rotation), as well as the regional distribution of the correction.MethodsRadiographs before surgery, soon after, and between 5 and 48 months after surgery were marked and digitized to measure the regional distribution of the frontal plane shape and transverse plane vertebral rotation.ResultsDespite improvement in the magnitude of the deformity, the scoliosis curbe shape remained almost constant postoperatively. There was minimal correction of the apical vertabra axial rotation in either group.ConclusionThis study documents that although the Harrington and Wisconsin-Drummond instrumentation systems decrease the Cobb angle, they do not change the shape of the curve or correct apical vertebra axial rotation. Newer instrumentation designs need to look beyond the Cobb angle as the only measure of outcome.

ISSN:0362-2436    

出版商:OVID    

年代:1994

数据来源: OVID

ISSN:0362-2436    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Study DesignThe authors employed a new mode of treatment for spinal tuberculosis consisting of single stage posterior instrumentation and fusion without anterior debridment. Ten patients were operated upon in this manner. Chemotherapy was instituted 2 weeks preoperatively and continued for a mean period of 11 months. Cotrel-Dubousset or a comparable system was used for fixation.ObjectivesPatients were followed for 3 monthly intervals with serial anteroposterior and lateral x-rays, erythrocyte sedimentation rate, physical examination, and patients' self reports. The mean follow up period was 24.2 months (range, 17–36 months).MethodsMeasurement of kyphosis angle in the lateral x-ray view was used to evaluate treatment.ResultsOnly a 3.4°; mean loss of correction was observed over the follow-up period. All patients were satisfied.ConclusionOur results show that posterior rigid fixation and chemotherapy provide satisfactory stabilization, reduce surgical morbidity, and prevent development of late kyphosis in selected patients with Pott's disease of the thoracolumbar spine.

ISSN:0362-2436    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Study DesignThis retrospective study revlewed 100 children with clinically and electrodiagnostically proven Charcot-Marie-Tooth disease (CMTD)ObjectiveTo determine the incidence of spinal deformity in children with CMTD.Summary of Background of DataA 10% incidence of hyphoscoliois has been reported.MethodsAll charts and electrodiagnostic studies were reviewed to confirm that CMTD diagnostic criteria were met. Existing radiographs on 89 children were available. Cobb angles were measured and deformity was defined as scoliosis ≥ 10° and kyphosis >40°.ResultsThirty-seven of 89 CMTD children had spinal deformity. There was scoliosis in 20, kyphoscoliosis in 14, and kyphosis in 3. In children with radiographs taken at maturity, 50% had deformity. The most common scolotic pattern was a thoracic curve with convexity in either direction. Spinal deformity is more likely in fermale and Type 1 patients.ConclusionThis study found an incidence of 37%-50% spiral deformity in children with CMTD, with female and Type 1 patients at greatest risk. However, the deformity rarely required treatment.

ISSN:0362-2436    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Study DesignThe Low Back Pain Symptom Check List identifies psychological disturbance in patients with low back pain. This reports traces the development of a translation for Hispanic populations.ObjectivesThe study explores the reliability and assesses the equivalence of the translation in providing pain and psychological information.Summary of Background DataA number of psychometric metric measures appear suitable for routinely assessing psychological disturbance among back injured patients. Unfortunately, there are few measures with language translations that can be applied to Hispanic populartions.MethodsIn study 1. the English form was translated by two bilingual physicians. In study 2, reliability was examined using Cronbach's measure of internal consistency. In study 3, the equivalence of the Hispanic and English forma in predicting treatment outcome was examined.ResultsConfficient alphas and mean pain scores were similar for the English and Hispanic forms. Overall agreement between the two forms in tracking psychological disturbance was 91%. The Hispanic form was equally acaurate in predicting treatment outcome.ConclusionsThe Hispanic form is reliable and provides pain and psychological information much like the English form.

ISSN:0362-2436    

出版商:OVID    

年代:1994

数据来源: OVID

ISSN:0362-2436    

出版商:OVID    

年代:1994

数据来源: OVID