Spine
-
The possibility of a relationship between discographic pain responses and Minnesota Multiphasic Personality inventory scores was investigated. ⋯ Discographic pain reports are not only related to anatomic abnormalities, but are influenced by personality as assessed by the Minnesota Multiphasic Personality Inventory. Patients with elevated scores on the hypochondriasis, hysteria, and depression scales may tend to overreport pain during discographic injection. Among such patients, even those with a concordant computed tomography/discographic image, selection of therapeutic modalities should be made with caution.
-
Case Reports
Amyloidosis-related cauda equina compression in long-term hemodialysis patients. Three case reports.
These case reports illustrate the neurologic manifestations due to beta 2 microglobulin amyloid deposition at the lumbar spine level in long-term hemodialysis patients. ⋯ In long-term hemodialysis patients, cauda equina compression may develop as the consequence of beta 2 microglobulin amyloid deposition in lumbar intervertebral discs, facet joints, and ligaments. Magnetic resonance imaging is well suited to show the extent of the compression and supports the argument for the amyloid origin of extradural soft tissue.
-
Comparative Study
The effect of litigation status on adjustment to whiplash injury.
This retrospective study examined the effect of civil litigation on reports of pain and disability in chronic pain patients who sustained whiplash injuries after a motor vehicle accident. ⋯ That litigation status did not predict employment status suggests that secondary gain does not figure prominently in influencing the functionality of these patients. The rather robust effect of litigation status on pain reports is discussed with respect to the potential mediational role of the stress of litigation.
-
This study analyzed two groups of subjects during forward bending. Group 1 (n = 20) contained subjects with a history of low back pain and Group 2 (n = 21) included subjects without a history of low back pain. ⋯ The results provide quantitative data to guide clinical assessment of forward bending motion. Results also suggest that although people with a history of low back pain have amounts of lumbar spine and hip motion during forward bending similar to those of healthy subjects, the pattern of motion is different. It may be desirable to teach patients with a history of low back pain to use more hip motion during early forward bending, and hamstring stretching may be helpful for encouraging earlier hip motion.
-
Retrospective review and prospective follow-up of 88 patients who had decompressive laminectomy with or without fusion from 1983 to 1986. ⋯ Seven to 10 years after decompressive surgery for spinal stenosis, 23% of patients had undergone reoperation and 33% of respondents had severe back pain. Despite a high prevalence of nonspinal problems in this elderly cohort, spinal symptoms were the most important correlate of reduced functional status.