Heterogeneity of chronic pain.

By London Spine

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Heterogeneity of chronic pain.
Clin Drug Investig. 2012 Feb;32 Suppl 1:3-10
Authors: Vellucci R
Abstract
Chronic pain is a widespread public health issue that has many effects on physical, em…

0182 Predictors of Workers’ Compensation Claim Duration among Workers Disabled Due to Low Back Pain.

By London Spine
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0182 Predictors of Workers’ Compensation Claim Duration among Workers Disabled Due to Low Back Pain.

Occup Environ Med. 2014 Jun;71 Suppl 1:A22-3

Authors: Busse J, Steenstra I, Ebrahim S, Heels-Ansdell D, Walter S, Guyatt G

Abstract
OBJECTIVES: Low back pain (LBP) is a common complaint among workers receiving Workers’ Compensation wage replacement benefits. We used the administrative data from the Ontario Workplace Safety and Insurance Board (WSIB) to explore the association between baseline characteristics and commonly reimbursed therapies and time to claim closure among workers disabled due to LBP.
METHOD: Using the WSIB administrative database, we acquired a random sample of 6665 injured workers who reported an uncomplicated back injury (strain or sprain) with a date of injury between January 1, 2005 and June 30, 2005. We selected, a priori, 11 variables from the database that we judged may be associated with claim closure and predicted the direction of anticipated effects. We performed a time-to-event analysis using Cox proportional hazards regression to assess the association between time to claim closure and the independent variables. Receipt of WSIB-reimbursed chiropractic care or physiotherapy were treated as a time-dependent covariate to account for when treatment was initiated during the course of the disability claim.
RESULTS: Our adjusted regression analysis showed that older age and opioid prescription (adjusted hazard ratio [HR]=0.69; 99% CI=0.53, 0.89) in the first 4-weeks of claim reimbursed by the WSIB were associated with prolonged claim closure, whereas working for an employer that had a return-to-work program was associated with shorter claim duration (adjusted HR=1.73; 99% CI=1.42, 2.12). Neither reimbursement for chiropractic or physiotherapy were associated time to claim closure.
CONCLUSIONS: Our analysis suggests that commonly reimbursed treatment for Workers’ Compensation LBP claimants may be ineffective or even harmful.

PMID: 25018289 [PubMed – in process]

Classical and modern classifications of luxations and fractures of thoracolumbar spine. Biomechanical and clinical aspects. Review of literature.

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Classical and modern classifications of luxations and fractures of thoracolumbar spine. Biomechanical and clinical aspects. Review of literature.

Ortop Traumatol Rehabil. 2010 Sep-Oct;12(5):385-400

Authors: R?pa?a K, Walczak P, Truszczy?ska A

Abstract
The authors present the advantages and disadvantages of the Denis and AO classifications based on a review of classical and recent literature concerning the evolution of classification of thoracolumbar spine conditions. The newest classification of fractures proposed by Vaccaro (TLICS – Thoracolumbar Injury Classification Severity Score) is discussed in detail. Special attention is given to instability in these fractures. The principles of modern operative treatment are briefly discussed. Short transpedicular segmental stabilization and immobilization is a commonly accepted approach in unstable fractures with neurological deficits.

PMID: 21057146 [PubMed – indexed for MEDLINE]