Spine
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A retrospective case series of primary care patients receiving Workers' Compensation (WC) for back pain. ⋯ Many individuals with a WC claim do not have a stable PCP relationship around the onset of their WRLBP episode. Those with PCP relationships uncommonly involve the PCP in their WRLBP, and if they do, it is usually later in the course because of persistent or recurrent symptoms. Disability outcomes appear to be similar regardless of whether a PCP was involved. However, PCP involvement is associated with greater medical costs, which may reflect confounding based on duration of symptoms rather than the nature of the care provided. Additional research is needed to understand how different patterns of care for patients with a WRLBP claim relate to outcomes and how these patients compare with individuals without such a claim, as well as the factors that lead patients to involve their PCP or not.
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We compared the prevalence of chronic back pain (CBP) at two points 4 years apart and examined socio-demographic, health, and pain-related factors associated with its onset and persistence. ⋯ CBP is a common and lasting problem, whose persistence and onset are predicted by clinical (especially pain) and help-seeking behavior factors, rather than socio-demographic. Prevention should focus on these factors.
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Post-traumatic inflammatory response was studied in 11 human cases of acute spinal cord contusion injury. ⋯ Endogenous cells (neurons and microglia) in the human spinal cord, not the blood-borne leukocytes, contribute to the early production of interleukin-1beta, interleukin-6, and tumor necrosis factor-alpha in the post-traumatic inflammatory response, and microglia are involved the early response to traumatic axonal injury.
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Comparative Study
Morphologic characteristics of atlantoaxial complex in rheumatoid arthritis and surgical consideration among Chinese.
A morphometric study of lateral mass from C1 to C2 and involving 42 patients with rheumatoid arthritis (RA). ⋯ The work provides detailed bony data on the rheumatoid C2 isthmus and C1 structure. Anatomic variation in either side or both sides of the C2 isthmus is severe during erosion in patients with RA. Unilateral C1-C2 transarticular screw, modification of screw diameter, or alternative techniques for C1-C2 arthrodesis should be considered in most Chinese rheumatoid cases.
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Postal survey. OBJECTIVES.: To determine whether Australian primary-care clinicians think that nonspecific low back pain (NSLBP) is one condition or a number of conditions (subgroups), and whether this belief influences their management of NSLBP. ⋯ Although assigning NSLBP patients to subgroups has not been validated, it is common in primary-care settings and influences case management. If subgroups exist within the NSLBP population, there are implications for research into the effects of treatment. Further research into the validity of subgroups is warranted.