Articles: low-back-pain.
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Z Orthop Ihre Grenzgeb · May 1993
Review[Long-term results following percutaneous facet coagulation].
93 patients with a mean follow up of 73 months (30-133 months) after lumbar percutaneous radiofrequency denervation (PRFD) were evaluated. Mean age of the patients at time of surgery was 47 years (18-76 years). 54 patients had no lumbar spine surgery prior to facet denervation, 32 patients had one or multiple disc surgery prior to denervation, and 7 patients had spinal fusions. 51 patients were in the process of early retirement or already retired at time of surgery. Out of all 93 patients only 50% had significant pain relief immediately after PRFD. 3 months after PRFD the success rate dropped down to 38%. 6 years after surgery only 25% of all patients had long lasting good results. Patients who were pain free after facet infiltration had significant better initial results, but were similar to the others after 6 years. 6 out of 7 patients after lumbar spinal fusions demonstrated bad results. The worst results had those patients who had applied for early retirement (workmens compensation cases). In this group the recurrence rate was 74% 6 years after surgery. We found no correlation between the surgeon and the outcome. ⋯ Without pain reduction after facet infiltration the success rate after PRFD is low. Spinal surgery prior to PRFD significantly reduces the success rate. The worst prognosis have workmans compensation cases. The recurrence rate is high within the first 6 months after PRDF.
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Baillieres Clin Rheumatol · Oct 1992
ReviewPrevention of low back pain: basic ergonomics in the workplace and the clinic.
Redesigning the job is a strategy for preventing low back injuries at work or for accommodating injured employees who return to work. An evaluation of the physical job demands is necessary in either strategy. Several job demands are associated with low back pain and injury--heavy physical work, static or postural effort, dynamic work-load and exposure to wholebody vibration. ⋯ A health care provider should be part of a task force that oversees these interventions. Future effort should be directed to finding a method that health care practitioners could be competent to carry out effectively in a clinical setting. Expert systems offer promising results in disseminating ergonomic knowledge in primary and secondary health care facilities.
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Low-back pain and back injuries are of such a complex nature that any one criterion cannot be applied by itself to give a valid assessment of the risk associated with manual materials-handling jobs. There is no question that low-back pain is an extremely significant cause of disability and has a major socioeconomic impact, but many different personal and job factors are associated with the incidence and prevalence of these complaints. There is a need for ongoing systematic investigations of the multiple risk factors that may be causally related to low-back pain and may possibly be amendable to preventive interventions. ⋯ If, however, such lifting is performed repetitively, the medical hazard extends beyond low-back problems to other musculoskeletal strain and sprain injuries and to fatigue-related injuries, particularly for weaker workers. In this latter regard, gender, age, anthropometry, and previous history of back pain are known to modify these risks for populations of workers. The inherent variability between workers and within any worker over time precludes the use of such factors to assign risk to any particular individual.