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Chance Fracture
Published in Kelechi Eseonu, Nicolas Beresford-Cleary, Spine Surgery Vivas for the FRCS (Tr & Orth), 2022
Kelechi Eseonu, Nicolas Beresford-Cleary
Surgical management should be reserved for bony fractures with neurological deficits and ligamentous chance fractures, which have a poor rate of healing. Decompression should only be considered where MRI scanning reveals neural compression. Surgical management should be followed by a rehabilitation programme consisting of extension exercises to strengthen back muscles and reduce backache.
A builder with back pain
Published in Tim French, Terry Wardle, The Problem-Based Learning Workbook, 2022
In the absence of screening (see later in this question), a common problem of prostate cancer is late presentation with metastatic bone disease. Often this involves the lumbosacral spine. Patients’ first symptoms of the disease may include backache. The ‘red flags’ to assess in patients aged over 55 years old with back pain are that the pain is: constantprogressivenon-mechanicallocalised: worse at night or pain ‘wakes from sleep’severe, with a sudden onset, e.g. following cough – pathological fractureassociated with significant weight lossassociated with past medical history of carcinoma.
When I Control the Pain, I Control My Life: Opioids and Opioid-Containing Analgesic Medication in the Management of Chronic Intractable Pain
Published in Michael S. Margoles, Richard Weiner, Chronic PAIN, 2019
I have tried, over the past years, physical therapy of various types, antidepressant medications, exercises prescribed by several therapists as well as those available in the popular press for “backache,” the TENS unit, I have the best mattress that money can buy, all the special pillows that are supposed to help back pain, and I have a supportive family who do what they can to help me. Nothing relieves my pain except narcotic pain medications. I want to continue working, and I want to be able to love my husband and raise my child to be a strong, productive member of our world, and I do not think I can do these things when I am in constant, unmitigated pain that robs me of my sleep, prevents me from concentrating on life around me, and makes me feel sick and unhappy to be alive and sentient. With the medications I am presently taking, and only with them, I can reduce my pain to a livable level that allows me to function and participate in my family and the society to which I would like to contribute and to which I feel I am making daily contribution.
Management and diagnosis of recurrent anterior uveitis due to underlying HLA–B27 positive, seronegative spondyloarthropathy
Published in Clinical and Experimental Optometry, 2021
Simon Backhouse, James A Armitage
Uveitis in patients with SpA has a characteristic appearance, with over 80 per cent of SpA patients presenting with acute, unilateral, anterior uveitis.6 If the patient is also HLA‐B27 positive there is a significantly increased risk of developing a hypopion or a significant fibrinous reaction in the anterior chamber.7 However, the risk of severe vision loss from SpA‐associated uveitis is low.8 Patients with underlying SpA are highly prone to frequent recurrences of their uveitis. Around 50 per cent of SpA patients present with at least one recurrence of their uveitis.6 These recurrences can occur in either eye, often showing an alternating pattern between eyes, with average observed recurrence rates of between 0.6 to 3.3 recurrences per year.8 Recurrence of acute, unilateral, anterior uveitis, particularly when the recurrence occurs in the fellow eye, should therefore trigger strong suspicion of an underlying SpA. Even in the absence of recurrent uveitis, the possibility of an underlying SpA should still be investigated given the high rate of undiagnosed SpA seen in patients initially diagnosed with idiopathic uveitis. Undertaking a thorough patient history around chronic lower back pain is useful in elucidating the presence of inflammatory backache that may be associated with an underlying diagnosis of SpA.5
Three-step Reduction Therapy of Integrated Chinese and Western Medicine for Thoracolumbar Burst Fracture
Published in Journal of Investigative Surgery, 2019
Wang Decheng, Shi Hao, Wang Zhongwei, Li Jiaming, Yang Bin, Hai Yong
Osteology and traumatology of traditional Chinese medicine has a long history and lots of work. Currently, reduction with bolster and reduction of hyperextension are commonly applied in clinic. With the development of medicine, only depending on manual reduction was not sufficient to achieve a completely restore, like the height of injured centrum and malformation of spine. Furthermore, the biomechanical structure of spine cannot restore completely and even manifest lumbago and backache and delayed neuropathy in later period.11 In modern period, people are inclined to choose internal fixation of fracture reduction with the theory of Arbeitsgemeinschaft Osteosynthesesfragen (AO) being spread. However, complications, like operation injury, neural or vascular injury, insufficient reduction, continuous lumbago and backache, and postoperative infection should be considered. According to the therapeutic principles of Chinese medicine like “same importance of muscle and bone” and “association of activity and inertia”, and modern Chinese medicine principles like “touch with hand and understand tacitly”, “pull and stretch to traction”, “angulation and fold the top” and “bend and stretch, adduction and abduction” were combined to modern clinical therapy. Then we put forward the theory of three-step reduction of thoracolumbar fracture.
The effects of chair intervention on lower back pain, discomfort and trunk muscle activation in office workers: a systematic review
Published in International Journal of Occupational Safety and Ergonomics, 2022
Sirinant Channak, Thaniya Klinsophon, Prawit Janwantanakul
The following medical electronic databases were searched from 1980 to May 2020: PubMed, ScienceDirect, Web of Science, Scopus and Cochrane Library. Two reviewers (S.C. and T.K.) independently searched these databases using an agreed range of keywords. These groups of keywords related to either (a) chair intervention, (b) LBP, (c) muscle activation or (d) discomfort. The specific keywords for each group were: (a) ‘chair OR seat OR sitting OR ball’; (b) ‘back pain OR low back pain OR LBP OR backache’; (c) ‘trunk muscle activation OR trunk muscle activity’; (d) ‘comfort OR discomfort’. The groups of keywords were then combined using ‘AND’. After the inclusion of articles based on the selection criteria, references were searched for additional articles.