European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
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Somatic and mental symptoms in 22 patients (16 women and 6 men) 22-73 months after a whiplash injury are described. The results of the present study are compared with the corresponding results of a previous study on the same patients. According to the Quebec Classification System, the whiplash injuries of 15 patients were classified as grade 2 and those of 7 patients as grade 3. ⋯ The Mood Adjective Check List was used as a measure of mental well-being. During the 2 years that had passed since the previous study, the patients had improved regarding pain intensity, pain tolerance level and mental well-being. The results show that patients with prolonged disability after a whiplash injury can improve even after a long time.
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Whilst neurologic injury following correction of scoliosis with CD-instrumentation is generally known to be an early complication, any late occurrence of cauda compression secondary to employment of a laminar hook-rod construct is exceptional. We report on such a rare case of late occurrence of cauda equina syndrome, when a laminar hook at level L2 became symptomatic causing compression of the cauda equina almost a decade after spine surgery. This case demonstrates that one should not only be aware of a potential neural injury at intraoperative placement of laminar hooks, but also one is reminded that a laminar hook poses the threat of late neurologic injury years after successful osseous spinal fusion. The surgeon treating patients with scoliosis must be aware of the possible complication described in our patient in addition to those that have already been well documented.
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Long-term exposure to whole-body vibration is known to increase the risk of low back problems. The chain of events leading from repeated loading of the lumbar spine to back complaints and the exact nature of the vibration-induced damage are, however, obscure. Fluid in- and outflow as well as viscoelastic deformation are important aspects of the physiological function of the lumbar disc. ⋯ Likewise, MRI examinations revealed no significant differences in the water content of the discs averaged over the lumbar spine. In addition, QCT examinations revealed no significant difference in the trabecular bone density of the third lumbar vertebra. The study thus revealed no significant difference between a cohort with long-term exposure and non-exposed controls with respect to viscoelastic properties of discs as determined by stadiometry, average water content of lumbar discs and trabecular bone density of L3.
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Tuberculosis of the spine is probably one of the earliest diseases to have affected the human race. Over the past few decades, the epidemiology, pathology, natural history and diagnostic methodology have been well studied. ⋯ Although it appears from this study that conservative treatment is as effective as surgical intervention for earlier and milder diseases, there are still reservations on the effect of such treatment at much longer follow-ups and for more severe diseases. Further developments in diagnosis using molecular genetic techniques, more effective antibiotics and more aggressive surgical protocols in the next millennium may help in solving the problems of late severe deformity and paraplegia in the debilitated immunocompromised patients.
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Low back pain (LBP) among children and adolescents has become the subject of an increasing amount of literature over the last 15 years. This topic, which was considered almost insignificant less than two decades ago, was the focus of a recent international meeting organised in Grenoble (France) in March 1999. This review paper is the result of an literature update search performed by members of three groups which have been active in this field for many years. Current epidemiological data on LBP is summarized as well as the role of the major risk factors according to studies published in the principal peer reviewed journals interested in the topic.