Low back pain motor vehicle accidents

INTRODUCTION: Headaches are common after a motor vehicle accident (MVA). Post-traumatic headaches share many clinical symptoms including the clinical course of primary headaches. Secondary headaches (including those resulting from a subdural hematoma) are not as common, but should be considered in cases of post-traumatic events particularly if clinical symptoms progress. CLINICAL FEATURES: A case of a patient with a post-traumatic subdural hematoma demonstrates the importance of carefully examining, properly diagnosing and managing patients that experience headaches after MVAs...

Numerous patients ambulating independently arrive in the Emergency Department complaining of back pain after being involved in a motor vehicle crash (MVC). We examined the yield of routine screening radiographs of the lumbar and thoracic spine in these patients. A retrospective review was carried out of the records of 3173 patients who were involved in a MVC during a 1-year period and presented to a single medical center. Radiographs of the lumbar spine, thoracic spine, or both were obtained in all patients complaining of back pain...

OBJECTIVES: In low back pain, clinical studies suggest that kinesiophobia (fear of movement/(re)injury) is important in the etiology of chronic symptoms. In this prospective cohort study, the predictive role of kinesiophobia in the development of late whiplash syndrome was examined. METHODS: Victims of car collisions with neck symptoms who initiated compensation claim procedures with a Dutch insurance company were sent a questionnaire containing symptom-related questions and the Tampa Scale of Kinesiophobia (TSK-DV)...

UNLABELLED: In recent military conflicts the major source of soldier attrition has not been battle injuries but more mundane causes similar to those encountered in civilian life. In an effort to determine the pain conditions affecting soldiers during wartime, we conducted an observational study among 162 soldiers medically evacuated from Operation Iraqi Freedom who were referred to 2 large pain treatment centers located outside the theaters of combat. Fifty-three percent of soldiers presented with either radicular (n = 49) or axial (n = 37) low back pain, with lumbar herniated disk being the most frequently diagnosed condition (24%)...

The long-term orthopaedic, urologic, and psychiatric outcomes of patients treated non-operatively for unstable pelvic fractures were assessed. There were 55 males and 3 females with an average age of 7 (3-13). Eighty-one percent of the fractures were caused by motor vehicle accidents, and 68% by auto-pedestrian accidents. Thirty-four of the 58 fractures were type Tile type B and 24 were type C. Posterior urethral injury was determined in 41 patients, and head injury in 21. Three patients with type C injury died within the first 3 days...

OBJECT: Symptoms of cauda equina syndrome (CES) can include low-back pain, sciatica, lower-extremity weakness, sensory deficit, perineal hypesthesia or anesthesia, and loss of bowel or bladder function. Several causes of the syndrome are recognized, but its optimal treatment remains controversial and has been broadly based on data gathered from series involving herniated discs. Information on the treatment of CES caused by low lumbar traumatic injuries has not been well documented. METHODS: Between January 2000 and December 2003, 17 consecutive cases of CES caused by low lumbar traumatic injuries at L2-5 were identified...

OBJECTIVE: To determine the inciting events leading to the development of sacroiliac joint syndrome (SIJS). METHODS: This was a retrospective descriptive cohort series from an academic interdisciplinary spine center. Consecutive patients presenting with low back or buttock pain with or without leg symptoms who met specific inclusion and exclusion criteria for the diagnosis of SIJS were included in the study. Inciting events leading to the development of SIJS in these patients were categorized into traumatic, cumulative, and idiopathic events...

The bus drivers of a public bus company, working in a fast rotating 4 shift system from 05.00 to 24.30, were examined in 1993 (230 persons) and 1999 (266 persons). The comparison between the two years showed no significant differences for all the parameters evaluated by the Standard Shiftwork Index and medical examination. In both surveys work organisation was considered "efficient-fairly good" by most workers, who were mostly satisfied with their job. Work load was rated significantly higher for "afternoon" and "morning" shifts, during which most accidents at work and "in itinere" occurred...

OBJECTIVE: To prospectively document the satisfaction of a random sample of patients attending a specialized multidisciplinary spinal pain unit in the Australian public health care system and to collect associated data on patient characteristics, radiological findings, treatment modalities used, and any significant complications. Design and setting Spinal pain syndrome patients attended the specialized Multidisciplinary Spinal Pain Unit at Townsville General Hospital and the Kirwan Community Health Centre (Queensland, Australia) for diagnosis and management (ie, chiropractic spinal manipulation, medication, or needle acupuncture)...

STUDY DESIGN: Three cases of hysterical paralysis are reported and the literature is reviewed. OBJECTIVE: To report and discuss three cases of psychogenic paraplegia in order to increase the awareness and assist in the diagnosis and treatment of this uncommon disorder. SUMMARY OF BACKGROUND DATA: Hysterical paralysis, a form of conversion disorder, is an uncommon psychogenic, nonorganic loss of motor function precipitated by a traumatic event...

A prospective study was used to: (1) quantify potential risk factors for whiplash associated disorder following a rear-end motor vehicle collision; and (2) develop a simple clinical decision rule for the early identification of patients at risk for long-term whiplash associated disorder. Between 1 October 1995 and 31 March 1998, 446 adults involved in rear-end collisions presented to the only two emergency departments serving Kingston, Ontario. Eligible and consenting subjects (n = 353) were contacted by telephone soon after the collisions then at multiple occasions up to 2 years post-collision...

Different symptoms, together with neck pain, have been attributed to persons with persistent complaints after a previous motor vehicle crash (MVC) and are sometimes referred to as the "late whiplash syndrome." A cohort study was conducted to determine whether exposure to a rear-end collision, with or without whiplash injury, is associated with future health complaints. The results regarding future neck or shoulder pain have previously been described, and the objective of the present report was to focus on outcomes other than neck pain...

STUDY DESIGN: Population-based, cross-sectional mailed survey. OBJECTIVE: To identify factors associated with neck pain and its related disability in Saskatchewan adults. SUMMARY OF BACKGROUND INFORMATION: Little is known about the etiology of neck pain and its related disability. Previous cross-sectional population-based studies have suggested that neck pain may be associated with age, female gender, lower socioeconomic status, physically demanding work, and other comorbidities...

BACKGROUND: Previous studies of workers' compensation claims for low back pain (LBP) have revealed that the preponderance of disability is borne by a fraction of cases. However, less is known regarding the influence of occupational factors on these extreme conditions. METHODS: Workers' compensation claims (n=107,867) for LBP reported to a large, national insurer in 1992 were examined by antecedent event and industry class. In addition to summaries of the frequency and cost distribution, each factor was examined at two points on its cost distribution: one more representative of the typical case and one more representative of the case with long disability...

The objective of this study is to determine whether independent associations exist between a history of neck injury related to a motor vehicle collision and: (1) graded neck pain in the past 6 months; (2) headaches in the past 6 months and; (3) depressive symptomatology during the past week. We used data from the Saskatchewan Health and Back Pain Survey, a population-based cross-sectional survey mailed to a stratified random sample of 2184 Saskatchewan adults aged 20-69 years. Fifty-five percent of the eligible population participated...

OBJECTIVE: To discuss the chiropractic management of a patient who sustained a unilateral lamina fracture of the sixth cervical vertebra. CLINICAL FEATURES: The patient had suffered cervical trauma from a motor vehicle accident. Clinical evaluation revealed acute global neck pain with associated left arm radiculitis and approximately 75% loss of useful left-arm motor function. The patient also complained of headache and low back pain. Computerized tomography and radiographic findings indicated a left lamina fracture of the sixth cervical vertebra...

STUDY DESIGN: A survey of pain intensity and psychological symptoms in patients with chronic neck pain after whiplash injury. OBJECTIVES: To describe the pain and psychological profiles of patients with chronic whiplash. SUMMARY OF BACKGROUND DATA: Reports in the literature mention a constellation of symptoms associated with chronic whiplash injury but no systematic survey using objective patient report measures has been reported. METHODS: One hundred forty consecutive referred patients with chronic neck pain after a motor vehicle accident were studied using the SCL-90-R psychological profile and the McGill Pain Questionnaire...

Ninety subjects with complaints of low back pain sustained in a recent motor vehicle accident were studied for their incidence of abnormal findings on lumbar magnetic resonance imaging. The results were compared to other studies reporting a high incidence of abnormal findings on magnetic resonance imaging in asymptomatic subjects. Appropriateness of magnetic resonance imaging in some groups is questioned.

OBJECTIVE: This prospective study evaluated 39 consecutive patients with low back pain (LBP) or neck pain that resulted from a motor vehicle accident who had litigation pending. METHODS: Patients completed a McGill Pain Questionnaire (MPQ) to quantify pain and an Oswestry Low Back Disability Questionnaire (OSW) to quantify function and were interviewed regarding medications and work status at initial and final visits. RESULTS: Thirty-three patients completed an MPQ at initial and final visits...

STUDY DESIGN: A case report of a ganglion cyst rising from the anulus pulposus, causing lumbar nerve root compression. OBJECTIVES: A rare pathologic condition causing sciatica is described. The pathologic anatomy and the magnetic resonance image of the lesion is discussed. SUMMARY OF BACKGROUND DATA: A 35-year-old man was subjected to an abrupt twisting motion of the torso during a motor vehicle accident. The patient had a L5-S1 discectomy 1 year before the accident...