PubMed · 10994866
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M Werneke. 2000. Models coexisting.. https://doi.org/10.2519/jospt.2000.30.9.557
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STUDY DESIGN: The Boeing prospective study was reviewed. The Boeing prospective study, comprising two articles, was a large field study that explored why workers would or would not report occupational back pain problems. OBJECTIVES: The most immediate objective was to determine the extent to which conclusions drawn from the Boeing prospective study withstand critical examination. The ultimate purpose of this review was to develop guidelines for field studies of back pain in industry. SUMMARY OF BACKGROUND DATA: For more than a century, researchers have noted great variability among individuals in the reporting of back pain, but the explanations posed for this variability have been inconsistent. Because findings gain credibility roughly to the extent that they bear on the world outside the laboratory, field studies in particular hold great potential for clarifying the underlying explanation for individual variability in back pain reporting. The Boeing prospective study was a large and ambitious field study that examined this issue. METHODS: The Boeing prospective study was examined through the lens of research conducted since it was published. The review used both the methodological and substantive literature. RESULTS: The Boeing prospective study, based on a minority of workers originally solicited to participate in it (33-41%), accounted for 7% of the variation in why workers would or would not report a back pain problem. A number of issues that may have biased its results toward the null are examined. CONCLUSIONS: The highlighting of the Boeing prospective study's limitations may be instructive not so much to criticize this one particular study but, rather, to anticipate problems that in general may be encountered in field studies of back pain in industry. Looking beyond the Boeing prospective study, the following guidelines for the conduct of such studies may be proposed: 1) Study designs should be based on explanations from which testable hypotheses may be derived; 2) Subgroups within the more general category of "back pain" should be delineated; 3) Both occupational exposures and psychosocial factors should be entered into the analysis; 4) Factors not apparent at the workplace should be considered; 5. Abstracts of articles should be carefully crafted.
PURPOSE: The aim of this study was to identify substantial psychosocial events--'psychosocial markers' (PMs) in the clients files and to correlate the PMs to the outcome of the rehabilitation, in order to find out whether this information had any impact on the outcome of vocational rehabilitation (VR). METHOD: Three-hundred and seventy-two individuals were included, being an object of a VR measure during 1993-1994. All were impaired by either disc hernia back pain syndrome or other diseases of the loco-motor system. The PM was defined as any psychosocial loaded information of the person's life situation, not immediately related to the original set of medical problems. RESULTS: Twenty-seven PMs were identified among men and 36 for women. Alcohol related problems dominated for men and private life related problems for women. Only approximately 25% of the PM concerned work related matters. After 3 years the OR (odds ratio) for full disability pension was 2.6 (n.s.) for men with the PM and 4.3 (p < 0.05) for women. The outcome was independent of background factors such as unemployment, blue-collar work and low education. CONCLUSIONS: The PM was found to be an important and independent factor to impact the outcome of rehabilitation in women.
STUDY DESIGN: Case report and literature review. OBJECTIVES: Clinicians use methylmethacrylate vertebroplasty to treat vertebral hemangiomas, metastases, and osteoporotic fractures. Cement may leak out of the vertebral body and compress the adjacent spinal cord and nerve roots. We review a case of nerve-root and cord compression from methylmethacrylate extrusion during vertebroplasty. SUMMARY OF BACKGROUND DATA: A 50-year-old female presented with disabling thoracic back pain. A metastasis to T1 was discovered, with collapse of the vertebral body but without cord compression. Methylmethacrylate vertebroplasty was performed. After injection, portable computed tomography (CT) showed a leakage of methylmethacrylate into the C8 and T1 foramina and spinal canal. Radiculopathy and myelopathy developed. Surgical decompression using the anterior approach was necessary. METHODS: Case report. RESULTS: Early surgical intervention decompressed the neural elements and relieved the neurological deficits. CONCLUSIONS: Neurologic complications of methylmethacrylate vertebroplasty necessitate active involvement of spine surgeons in patient evaluation and management.