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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The authors studied the results of surgery for lombosacral spondylolisthesis with gross displacement. The technique of arthrodesis makes intersomatic fusion easy in displacement of grades II and III. This fusion, without reduction of the displacement, leads to good functional rsults climating low back pain, and most sciatic pain without which time would be necessary for posterior liberation at the olisthetic stage. The authors also believe that preliminary correction of displacement, although satisfying in orthopaedic terms but still difficult to achieve with current techniques, is at present rarely indicated.
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PMID:[Surgical treatment of lumbosacral spondylolisthesis with gross displacement]. 32 55

Ninety-six patients who had lumbar disk excision and primary posterior fusion were studied 10 or more years after their operations. Thirty-seven per cent complained of persistent graft donor site pain. A comparison of fused patients with and without donor site pain and 36 patients who underwent simple disk excision, revealed no differences in the flexion-extension mobility of the sacroiliac joints, or degenerative changes in the sacroiliac joints. Ectopic bone formation at graft donor sites, and cluneal nerve neuromata did not influence the result. Patients with graft donor site pain had significantly greater complaints of persistent low back pain, postoperative leg pain, and lost more time from work. If the graft was taken from the same side as that of preoperative leg pain, persistent complaints were more common. It is concluded that the sacroiliac joints are not adversely affected by lumbar spine fusion, and that persistent donor site pain is more likely part of a total pain complex referred from the lumbar spine. The sacroiliac joints appear to be relatively noncontributory to problems following lumbar disk surgery.
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PMID:The long-term effects of spinal fusion on the sacroiliac joints and ilium. 36 11

Fusion of the lumbosacral spine was carried out on 44 patients. A modification of the standing H-graft technique was used in 41 of the patients. The operative diagnosis was degeneration of the lumbosacral spine in nearly two-thirds of the cases and spondylolisthesis in about one-third. Operations for low back or sciatic pain had previously been performed on 17 patients. The duration of postoperative bed rest ranged from one to six weeks; a lumbosacral corset was used at least for six weeks postoperatively. The average stay in hospital was 52 days. Complications occurred in five cases. The operative results of 40 patients were evaluated on the basis of a follow-up examination performed on average 3.6 years after operation. Nearly half the patients with radiologically successful fusions had a good subjective improvement and about one-fourth had returned to their previous or corresponding occupations. The operative result was at least fair in about half the patients, assessed by a measure of the patients' subjective improvement and working capacity. In the non-fusion group (six cases) the operative results were exclusively poor. Age over 40 years, long-standing preoperative disability and previous back operations proved prognostic factors for poor results. Assessed from functional radiographs, 63% of two-segment fusions and 95% of one-segment fusions were successful. The operative technique appeared simple and suitable for fusions of one spinal segment, but the value of the lumbosacral fusion in the treatment of low back pain seemed doubtful because of the great proportion of poor clinical results even following technically successful fusions.
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PMID:Lumbosacral fusion by standing h-graft technique. 42 May 53

Radiological sacroiliac (SI) changes were found in 3 patients, 2 with primary hyperparathyroidism (1 also with associated chondrocalcinosis) and 1 with osteomalacia. Osteomalacia was due to celiac disease. None of the 3 patients, all females, had a history of psoriasis, urethritis, iritis or chronic colitis. There was no renal function impairment. Peripheral joints were affected in the patient with associated condrocalcinosis. HLA B 27 was negative in all cases. Low back pain and vertebral stiffness were present in the patient with osteomalacia. A dramatic improvement in pain and stiffness ensued after vitamin D injections. These SI lesions, which may simulate ankylosing spondylitis, were attributable to subchondral bone changes related to the metabolic bone diseases. In the case of osteomalacia the SI lesions were predominantly on the right side, where there was a Looser's zone on the ischial ramus suggesting that pseudofractures could be a cause of SI changes. Metabolic osseous diseases such as osteomalacia or primary hyperparathyroidism should be investigated in cases of HLA B 27 negative radiological "sacroiliitis".
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PMID:[Sacroiliac changes, HLA-B27 negative, in primary hyperparathyroidism and osteomalacia]. 46 71

After 43 years of investigating the intervertebral disk, the long term results of the management of patients from the standpoint of pain are not significantly different than they were prior to the identification of the herniated disk nor do they seem to be significantly different than no treatment at all. This should at least suggest that the phenomena of low back pain is far more complex than can be accounted for on the basis of a simple mechanical-pressure theory of disk derangement. There is a significant volume of literature that would point to the neural tissues themselves as the most logical structures for future research that attempts to interfere with the natural history of this disease from the standpoint of pain. It seems most appropriate to attack lumbar disk disease from this standpoint because except in uncommon cases, the pathological process is benign and self limiting. It also seems logical that major advancements in the management of "diskogenic" back pain will depend upon an appreciation of the importance of controlling neural inflammation in the early phases of the disease rather than developing new techniques of managing irreversible neural lesions and their iatrogenetic or psychiatric sequelae.
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PMID:Nerve roots and spinal nerves in degenerative disk disease. 60 96

Two hundred and ninety-five male Finnish concrete reinforcement workers, aged 19 to 64 years and engaged in heavy physical work including prolonged stooping, were radiologically examined by antero-posterior and lateral views of the lumbar spine while they were standing. The findings of lumbar disc degeneration were classified as none, slight, moderate or severe. The prevalence and degree of radiologically detectable lumbar disc degeneration depended strongly on age and increased especially rapidly from 40 to 44 years on. Lumbar disc degeneration showed an age-independent association to both a history of lumbago (chi2 = 10.5, p less than 0.01) and a history of sciatica (chi2 = 11.8, p less than 0.001). When disc degeneration was compared to reports of stiffness, fatigue, ache, and sharp pain in the back during an ordinary workday, no statistically significant associations were found, while disc degeneration was found to be slightly more common (chi2 = 4.6, p less than0.05) in the men reporting back symptoms as they bent down than in the men who did not report such symptoms. No association between length of exposure to static and dynamic back loads in reinforcement work and the prevalence of lumbar disc degeneration could be established, but definite conclusions on the possible effect of reinforcement work on the lumbar spine could not be drawn from the data.
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PMID:Radiologically detectable lumbar disc degeneration in concrete reinforcement workers. 66 71

Clinical features and laboratory findings of 300 inpatients with vibration disease before and after treatments were reviewed. Having been using chain saws or pneumatic hammers for a long period, the patients were afflicted with Raynaud's phenomenon, numbness, pain or stiffness of fingers, pain of elbows and neck, stiffness of shoulders and lumbago. They had high incidences of complaints due to the disorder of the central nervous system, especially of the higher center of the autonomic nervous system; i.e. headache (52.0%), palmar hyperhidrosis (70.0%), forgetfulness (78.2%), fatiguability (61.3%), tinnitus (41.8%), impotence (55.1%), etc. Laboratory findings of the autonomic nerve activity tests, electroencephalograms and audiograms also suggested the disorder of the central nervous system. Treatments during three months had improved significantly the subjective symptoms and the objective findings (p less than 0.05 to 0.001). Thus, vibration disease should be considered as a systemic disease, including disorders of the central nervous system, especially of the higher center of the autonomic nervous system, and disturbances of the peripheral functions.
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PMID:Clinical features and laboratory findings of vibration disease: a review of 300 cases. 91 75

The authors present percutaneous technic treatment of some pain syndrom by thermocoagulation of rachidian nerves with radiofrequency generator. This method had been employed on 60 patients in various indications (cervico-occipital neuralgias, low back pain, stage syndrom, painful scar etc...). After anatomic justification one literature analysis precede personal results of this therapeutic method. This one is easy to realise and seems to deserve a good place in the actual possibility of functional neurosurgery.
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PMID:[Percutaneous thermocoagulation of the spinal nerves for analgesia]. 101 20

The health condition of female cash register operators in relation to their working conditions was investigated. A questionnaire study revealed that cash register operators more frequently complained of general fatigue, headache, sleeplessness, and low back pain than female office machine operators or other female workers. Dullness and pain in the shoulder, arm, hand, and fingers especially on the right side were characteristic of cash register operators. Physical examinations in 1973 showed that 31.3% of 371 cash register operators suffered from muscle rigidity or tenderness; 13 were severely afficted and, 69 operators had to be either laid off, reassigned to other jobs, or given shorter working hours. Occupational cervicobrachial disorders were suggested to have been caused by repetitive upper limb motions combined with static load, an unfavorable working environment, and mental stress. Implementation of some improvements including shorter operation time, worker rotation, and adoption of electronic registers proved effective in reducing the number of sufferers of cervicobrachial disorders found during the 1975 physical examinations. But the improvements were not effective enough to alleviate fatigue of the neck, shoulder, and back due presumably to sustaining upper limbs while operating the keyboard.
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PMID:Health hazard among cash register operators and the effect of improved working conditions. 102 12

Peripheral nerve stimulating devices were implanted for pain control in 33 patients with a variety of disabling chronic pain conditions, which had persisted despite usual medical and surgical therapy. The implants were placed on major nerves innervating the area of the patient's pain. Records were obtained of each patient's stated relief from pain produced by nerve stimulation, along with assessments of narcotic withdrawal, ability to return to work, sleep pattern, and relief from depression. Based on these five criteria 17 patients were judged to be treatment failures, while eight patients had excellent results, and seven had intermediate results. Twelve of the failures were in patients with either low back pain with sciatica, or pain from metastatic disease. The most dramatic successes occurred in patients with peripheral nerve trauma. The incidence of complications has been low, and two patients have used the stimulator for 5 years without adverse effects. Techniques of peripheral stimulator implantation, possible mechanisms of action, and conclusions regarding peripheral nerve stimulation in the treatment of chronic pain are discussed.
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PMID:Peripheral nerve stimulation in the treatment of intractable pain. 108 48


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