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1.
Asian Spine Journal ; : 574-585, 2018.
Article in English | WPRIM | ID: wpr-739256

ABSTRACT

The study aimed to review the etiology of failed back surgery syndrome (FBSS) and to propose a treatment algorithm based on a systematic review of the current literature and individual experience. FBSS is a term that groups the conditions with recurring low back pain after spine surgery with or without a radicular component. Since the information on FBSS incidence is limited, data needs to be retrieved from old studies. It is generally accepted that its incidence ranges between 10% and 40% after lumbar laminectomy with or without fusion. Although the etiology of FBSS is not completely understood, it is possibly multifactorial, and the causative factors may be categorized into preoperative, operative, and postoperative factors. The evaluation of patients with FBSS symptoms should ideally initiate with reviewing the patients' clinical history (observing “red flags”), followed by a detailed clinical examination and imaging (whole-body X-ray, magnetic resonance imaging, and computed tomography). FBSS is a complex and difficult pathology, and its accurate diagnosis is of utmost importance. Its management should be multidisciplinary, and special attention should be provided to cases of recurrent disc herniation and postoperative spinal imbalance.


Subject(s)
Humans , Diagnosis , Failed Back Surgery Syndrome , Incidence , Laminectomy , Low Back Pain , Magnetic Resonance Imaging , Pathology , Postural Balance , Spine
2.
LMJ-Lebanese Medical Journal. 2004; 52 (1): 19-24
in French | IMEMR | ID: emr-67270

ABSTRACT

Our aim was to find out which factors favor the occurrence of pain in adult patients with Scheuermann's disease -a juvenile manifestation of osteochondrosis of the spine, to study the clinical and radiological signs, the role of rehabilitation and the means to avoid the recurrence of pain. Patients and methods: Descriptive and retrospective study about 45 adults treated by rehabilitation. A data sheet listed the patient's occupation, current practice of sport, antecedents [violent sport, traumatism, pain], presence of a family form, motive of consultation, clinical and paraclinical examinations and immediate and long-term results of rehabilitation. Average age 35 years [18 to 65], male predominance [1.8: 1], occupational risk factors: 16%; only 24% practiced sports currently. Antecedents: sports 49%, spinal column traumatism 13%, dorsal and lumbar pain during adolescence 16%. Consultation motive: abnormal posture 4% and pain 96%.According to the examination: abnormal spinal column in 80% of cases. According to radiography, our patients were divided into 49% who were carriers of growth vertebral dystrophy and 51% who were carriers of the real Scheuermann's disease. The immediate results of rehabilitation were satisfactory, 75% of the results were very good and good. Between six months and four years, 70% of the results were very satisfactory. Exercises were observed in only 11% of the cases, and stopped after two months on average. Schcucrmann's disease in adults is a different entity from that of the teenager for the major manifestation is pain and not aesthetic quality. The patients occupation is rather sedentary; sport is beneficial. The functional rehabilitation is the basic treatment and recourse to surgery or dorso-lumbar braces is rare


Subject(s)
Humans , Male , Female , Pain , Osteochondritis , Spine , Retrospective Studies
3.
LMJ-Lebanese Medical Journal. 2003; 51 (4): 198-205
in French | IMEMR | ID: emr-63327

ABSTRACT

Rehabilitation plays a primordial role in the treatment of the patellofemoral syndrome. We wanted to seek in a sample of population suffering from this problem, the factors favoring the occurrence of this syndrome, the rehabilitation result and the continuation of exercises patients and methods: Prospective descriptive study on the rehabilitated patients in a questionnaire form divided in two parts. The first one seeks the information of the patients file demographical, social and professional data, risk factors, clinical assessment and imaging, medical treatment, immediate rehabilitation results. The second part seeks the long-term effect of rehabilitation, the perseverance to exercises and the resumption of professional and sports activities. 78 patients, feminine prevalence 59%; average age: 32.7 years [between 12 and 60 years]. Occurrence favoring factors found: intensive sports 47.4%, profession presenting a risk 14%, traumatism 24.5%, hypermobility 30,7%.Etiology: patellar instability 18/78, dysplasia 2, chondromalacia 14, femoropatellar osteoarthritis 4, non-marked 40. Previous treatment AINS: 45%, efficient in third of cases; previous physical therapy 9/78 [50% failure]. The evaluated results of short-term rehabilitation according to Ficat criteria, regardless of etiology, were satisfying [good or very good] in 77% of cases. Very good: 20.5%; good: 56.5%; acceptable: 19.2%] and bad 3.8%.At long term on 63 patients with an average recession of 18 months [6 months to 3 years] we had very good 22.2%, good: 55.5%, acceptable 20.6% and bad 1.7%. Average duration of carry on of exercises: 4 months. The functional rehabilitation has confirmed its efficiency in the treatment of young patients suffering from patellofemoral syndrome. The education, the life hygiene, the preparation to sports as well as carry on of exercises prevent recurrences


Subject(s)
Humans , Male , Female , Femur/pathology , Knee , Syndrome , Retrospective Studies , Rehabilitation
4.
LMJ-Lebanese Medical Journal. 2002; 50 (4): 168-74
in English | IMEMR | ID: emr-122255

ABSTRACT

Background data Magnetic resonance imaging [MRI] is widely used for the diagnosis of intraarticular anomalies of the knee. Its reliability is controversial mainly in the pediatric population, and its results may vary from one center to the other. The PURPOSE of this study was to assess the validity of MRI in detecting intraarticular abnormalities in patients who sustained an injury of their knee, by comparing its findings to those of arthroscopy. Material and methods: Two hundred and seventeen traumatic knees underwent MRI followed by arthroscopy. Findings of MRI and arthroscopy were statistically compared. Results: Accuracy of MRI was 95.39% and 99.08% for anterior and posterior cruciate ligament ruptures respectively, 85.25% and 90.78% for medial and lateral meniscal tears respectively, and 91.24% for injury of the articular cartilage. There was not a significant difference between the pediatric and the adult populations, except for a greater sensitivity to detect lateral meniscal tears and a better specificity and accuracy to identify chondral lesions in the first group. Variability between centers was significant for the diagnosis of chondral defects. Conclusion The good MRI reliability in detecting intraarticular abnormalities as demonstrated in this report, underlines its importance in the assessment of the injuried knee before arthroscopy


Subject(s)
Humans , Male , Female , Magnetic Resonance Imaging , Arthroscopy , Knee Injuries/diagnosis
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