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Explore the source record for details and available documents.
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In order to study the effect of posterolateral spinal fusion on pain and returning to work of patients with chronic lower back pain, a retrospective study was carried out at the University Hospital, Maastricht. Fifty-nine patients with spondylolisthesis I or II, spondylolysis, hemisacralisation, disc degeneration and pseudoarthrosis after spinal fusion were treated by posterolateral spinal fusion. A questionnaire and visual analogue scale were used to assess the pain. The mean preoperative pain level was 8.6; the postoperative pain level was 4.5; 13 patients were without pain. Before operation 41 patients had a job; after operation 34 returned to work. Sex, age, period of complaints, indication or level of operation did not significantly affect the pain score. In particular cases, posterolateral spinal fusion diminishes pain in patients with spondylolisthesis I or II, spondylolysis or hemisacralisation in whom pain does not improve after non-operative therapy. After the operation most patients return to their work.
The professional outcome in 65 patients with chronic low back pain who stayed in the Invalidity Insurance Medical Observation Center from 1982 to 1987 was studied retrospectively. The group studied was composed of 51 males and 14 females aged 28 to 61 years. Thirty-one out of 65 patients (48%) returned to work, 4 to full time employment (active group), whereas 34 did not return to work (inactive group). Data established during our initial observation served to compare the 2 groups by means of a logistic regression. No significant difference was found between the 2 groups of height, weight, age, family situation, severity of the X-ray findings and the existence of an associated psychiatric diagnosis were compared. On the other hand, the absence of professional training, female gender and the presence of a radicular syndrome significantly decreased the proportion of patients returning to work. If these 3 risk factors were absent, the chance of resuming work was 72%; if one was present it was 50%, and if there were 2 or 3 risk factors it was 28%.
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The incidence of 14 different vegetative and functional symptoms in patients with generalized tendomyopathy (fibromyalgia), chronic low back pain syndrome, and healthy controls was compared. The presence of these symptoms was a common finding in patients with generalized tendomyopathy. Although not so frequent, a number of these symptoms was also found in patients with chronic low back pain syndrome. Our findings suggest that presence of 7 or more symptoms is typical for generalized tendomyopathy and could be used as an additional criterium for diagnosis and classification of this disease. Further prospective studies are needed for confirming the hypothesis that chronic low back pain syndrome could lead to generalized tendomyopathy.
36 patients with rheumatoid arthritis and 44 patients with chronic low back pain were psychologically tested by the MMPI-201, Self-concept of Invalidism Scale, Impact of Pain on the Patients' Lives Scale, and "Pain Games" Scale. Patients with rheumatoid arthritis show significantly higher values at the depression and hypomania scale, while those with chronic low back pain manifest significantly higher values at the hysteria scale of the MMPI-201. This latter group also manifests significantly higher values at the Self-concept of Invalidism Scale and at the "Pain-Game" Scale.
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Spinal cord compression is a true medical emergency. This article outlines clues in the history and physical examination that may lead to the diagnosis of spinal cord compression. The evaluation and emergent management of the compression are discussed. The advantages and disadvantages of magnetic resonance imaging in the evaluation are detailed. Treatment options, including surgery, are presented.