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[Spinal diseases in the health setting. Epidemiologic findings at a hospital in eastern Sicily].

The importance of spinal column disorders has long been known, both for their frequency in working environments and the social consequences they provoke, i.e. absence from work and social insurance costs. Our study focussed on 800 health care workers: nursing personnel who provide direct patient care, and 150 office workers of Sicily Hospital. We estimated column pathologies by using Colombini, Occhipinti, Grieco method. On the basis of our results we may affirm that the column disorders are more frequent in hospital assistants: S.A.P. II degree 22% S.A.P. III degree 10%, in office workers S.A.P. II degree 6% S.A.P. III degree 3%.

Humans↗
PubMed1986

Occult respiratory and autonomic dysfunction in craniovertebral anomalies and upper cervical spinal disease.

Sudden unexplained death may be seen with treatment of craniovertebral anomalies and surgery of the upper cervical spine. Death is due to sleep-induced apnea, premonitored by periods of confusion, lethargy, and asthenia. There may be associated hypotension, bradycardia, hyponatremia, hypothermia, inappropriate antidiuretic hormone secretion, and difficulty in micturition. The potential for respiratory failure may be predicted if a CO2 response test demonstrates an attenuated or abnormal response. Apnea during sleep may be reversed by arousal or may require ventilatory support for a period of time. The condition is self-limiting, but remains the major life-threatening complication. Both apnea and autonomic dysfunction are treatable and curable with appropriate diagnosis and management.

Asthenia↗
PubMed1996

Primary bone tumors of the pelvis presenting as spinal disease.

Low back pain and sciatica are usually attributed to localized structural pathology; however, tumors of the pelvis may also cause these symptoms. Pelvic bone neoplasms are seldom immediately diagnosed and, therefore, may result in significant morbidity and mortality. Fourteen cases of malignant primary bone tumors of the pelvis that caused spinal symptoms were referred to our Musculoskeletal Tumor Service. Several recurring characteristics of these cases that may alert the clinician to the possibility of underlying pelvic bone malignancy in a patient with low back pain were identified: 1) age > or = 45 years; 2) insidious onset of symptoms without antecedent trauma; 3) prolonged symptoms for more than 1 month; 4) progressive pain that fails conservative therapy; and 5) presence of anorexia, malaise, or night pain. We suggest that in diagnosis of a patient presenting with these characteristics, the clinician instruct that the pelvis be included in initial radiographs. If plain radiograph is non-diagnostic and symptoms remain unresponsive, we recommend obtaining a bone scan, and then, if necessary, computerized tomography or magnetic resonance imaging.

Adult↗