PubMed Health⌕ Search

Biomedical subjects

S J Bigos

Publications and source records attributed to S J Bigos.

At least 19 recordsLinked to original sources
PubMed1992

Dermatomal somatosensory evoked potentials in the diagnosis of lumbosacral spinal stenosis: comparison with imaging studies.

Dermatomal somatosensory evoked potentials (DSEPs) and computerized tomography/magnetic resonance (CT and/or MR) images were retrospectively analyzed to evaluate their relationship in the diagnosis of lumbosacral spinal stenosis (SS). Of 155 patients referred for DSEPs with a clinical suspicion of lumbosacral SS, 58 met the inclusion criteria. DSEP abnormality was defined as: (1) N1 latency absent or greater than 2.5 SD; (2) side-to-side latency difference greater than 2 SD; (3) amplitudes greater than 2 SD below the mean; or (4) amplitude ratio greater than 2 SD. Involvement of two or more DSEP levels by any of the above criteria was labeled multiple root disease (MRD). Involvement of one level was labeled single root disease (SRD). Images were reviewed independently by a neuroradiologist. Results revealed 54 subjects with SS by imaging; 42 had MRD and 8 had SRD by DSEPs. Sensitivity for MRD and SS was 78%, and for MRD plus SRD and SS was 93%.

Electromyography↗
PubMed1992

MMPI scale 3 as a predictor of back injury report: what does it tell us?

Items and selected subscales of Scale 3 (Hysteria) of the MMPI were examined to pinpoint personality or emotional factors predictive of back injury reports in an industrial setting. Data were derived from a previous prospective-design study of back pain in volunteer hourly wage employees of an aircraft manufacturing company. After physical examination and completion of questionnaires pertaining to demographic, psychosocial (including the MMPI), and workplace factors, workers were followed for an average of 3 years. Those who subsequently reported back injury were compared with those who did not. In that study three variables predicted report of back injury, one of which was Scale 3 of the MMPI. Individual items, Ornduff et al. subscales of Psychological Denial and Body Concern, and the five Harris-Lingoes (1955) subscales of Scale 3 were analyzed. Three Harris-Lingoes subscales showed significant relationships to the criterion. Hy-3: Lassitude/Malaise; Hy-1: Denial of Social Anxiety; and, marginally, Hy-2: Need for Affection, significantly contributed to prediction effectiveness. Results and implications for the understanding of factors predicting back injury reports and for the medical evaluation of pain and the concept of pain are discussed.

Back Injuries↗
PubMed1992

A prospective evaluation of preemployment screening methods for acute industrial back pain.

Preemployment screening methods have been ineffective in predicting those at risk, and in curbing the impact of back problems in industry. Such methods have centered on individual physical factors (capacities and clinical examination). This study evaluates commonly used physical examination measures and simple historical data for its ability to predict individuals at risk for future back injury reporting in the aircraft industry. In this study, once simple historical information about previous pain treatment was known, information gained from physical factors added no significant predictive value.

Adult↗
PubMed1992

The value of preemployment roentgenographs for predicting acute back injury claims and chronic back pain disability.

Preemployment roentgenographs have long been used in industry to screen job applicants. Roentgenographs have had little effect, however, in curbing the cost of back problems in industry. This study evaluates the capabilities of preemployment roentgenographs for predicting acute back injury claims within the longshoring industry and for predicting back problems that lead to back disability of more than six months. The data indicate that lumbosacral roentgenographs are not helpful in predicting who is more likely to make a back injury claim, or those few who make up the vast majority of the costs for industrial back pain by becoming disabled for more than six months. Lumbosacral roentgenographs have little link to back disorders and may be viewed as discriminatory. The radiation exposure is not justified by their predictive value as a preemployment screening tool.

Acute Disease↗
PubMed1992

A longitudinal, prospective study of industrial back injury reporting.

The authors prospectively evaluated 3020 volunteers of the Boeing-Everett plant to assess risk factors that predispose workers to file industrial back injury claims. During four years of follow-up observation, more than 279 subjects reported acute back problems. The effect of the only predictive physical variable was explainable by a history of medical treatment. The most predictive individual factors were (1) job task dissatisfaction and (2) distress as reported on Scale 3 of the Minnesota Multiphasic Personality Inventory (MMPI). This data perhaps explains why the focus on purely physical and injury-related factors has met with little success in dealing with what has become the most expensive orthopedic problem. Clinically, nonphysical factors that significantly impact the reporting of back injuries may also affect patients' responses to medical treatment.

Accidents, Occupational↗
PubMed1992

Morbidity and mortality in association with operations on the lumbar spine. The influence of age, diagnosis, and procedure.

We examined the rates of postoperative complications and mortality, as recorded in a hospital discharge registry for the State of Washington for the years 1986 through 1988, for patients who had had an operation on the lumbar spine. When patients who had had a malignant lesion, infection, or fracture are excluded, there were 18,122 hospitalizations for procedures on the lumbar spine, 84 per cent of which involved a herniated disc or spinal stenosis. The rates of morbidity and mortality during hospitalization, as well as the hospital charges, increased with the ages of the patients. The rate of complications was 18 per cent for patients who were seventy-five years or older. Nearly 7 per cent of patients who were seventy-five years old or more were discharged to nursing homes. Complications were most frequent among patients who had spinal stenosis, but multivariate analysis suggested that the complications associated with procedures for this condition were primarily related to the patient's age and the type of procedure. Complications, length of hospitalization, and charges were higher for patients who had had a spinal arthrodesis than for those who had not. Over-all, operations for conditions other than a herniated disc were associated with more complications and greater use of resources, particularly when arthrodesis was performed, than were operations for removal of a herniated disc. No data on symptoms or functional results were available.

Adolescent↗
PubMed1991

A prospective study of work perceptions and psychosocial factors affecting the report of back injury.

A longitudinal, prospective study was conducted on 3,020 aircraft employees to identify risk factors for reporting acute back pain at work. The premorbid data included individual physical, psychosocial, and workplace factors. During slightly more than 4 years of follow-up, 279 subjects reported back problems. Other than a history of current or recent back problems, the factors found to be most predictive of subsequent reports in a multivariate model were work perceptions and certain psychosocial responses identified on the Minnesota Multiphasic Personality Inventory (MMPI). Subjects who stated that they "hardly ever" enjoyed their job tasks were 2.5 times more likely to report a back injury (P = 0.0001) than subjects who "almost always" enjoyed their job tasks. The quintile of subjects scoring highest on Scale-3 (Hy) of the MMPI were 2.0 times more likely to report a back injury (P = 0.0001) than subjects with the lowest scores. The multivariate model, including job task enjoyment, MMPI Scale-3, and history of back treatment, revealed that subjects in the highest risk group had 3.3 times the number of reports in the lowest risk group. These findings emphasize the importance of adopting a broader approach to the multifaceted problem of back complaints in industry and help explain why past prevention efforts focusing on purely physical factors have been unsuccessful.

Adult↗
PubMed1991

Practitioner's guide to industrial back problems.

If return to work is part of the expected outcome, more and more data indicate that medical care alone does not hold the key to providing success. Our modern physical treatments may seem a humane alternative to no treatment, but they have not been proven to significantly alter the natural course of back problems. Even the results of strongly indicated surgical treatment differ little from doing nothing at all after a 4-year period. From the physical standpoint, activation has the best track record for recovery and can be simply provided in a manner that can be used lifelong. The real key to return to work goes beyond the physical treatment by addressing the predicament of what the patient will do until age 65. This humane approach to care has evolved from common frustrations of dealing with patients with back problems, observations in the third world, and information gained from scientific studies. Medical pain, and physical models alone are unsuccessful. To be humane and successful, we can no longer ignore the nonphysical factors that can, and do, influence patients' responses to physical treatment, especially when return to work is part of the expected outcome.

Back Pain↗
PubMed1991

The treatment of lumbar disc herniation: simple fragment excision versus disc space curettage.

The purpose of this study was to determine whether there was any difference in the clinical outcome between groups of patients treated with lumbar discectomy and vertebral endplate curettage as compared with disc fragment excision without endplate curettage. Eighty-three patients requiring lumbar disc excision for herniated nucleus pulposus were evaluated retrospectively at minimum 2-year follow-up. Forty-three patients had undergone fragment excision and disc space curettage at one center, whereas 40 patients underwent fragment excision without curettage at two other centers. There was no increased rate of reherniation or reoperation in the excision-only group. Vertebral endplate curettage carries a risk of annular penetration and damage to the great vessels. This study shows that this potentially dangerous step of the operation is unwarranted. In addition, patients who underwent endplate curettage had a higher incidence of low-back pain on follow-up.

Adult↗
PubMed1991

Industrial back pain complaints. A broader perspective.

Industry has looked to medicine for assistance in developing screening and prevention programs to reduce the problem of industrial back injuries. Unfortunately, little is known about the pathology underlying most back symptoms, and few risk factors for industrial back pain complaints have been clearly and consistently identified. These limitations in knowledge have placed obvious constraints on the design of effective intervention programs. Recent information on the importance of perceptions of the nonphysical work environment and other psychosocial factors provide a broader perspective of the industrial back pain problems that may lead to more enlightened and effective approaches.

Back Pain↗
PubMed1990

Herniated lumbar intervertebral disk.

Low back pain is common, but a herniated intervertebral disk is the cause in only a small percentage of cases. Most symptomatic disk herniations result in clinical manifestations (pain, reflex loss, muscle weakness) that resolve with conservative therapy, and only 5% to 10% of patients require surgery. Sciatica is usually the first clue to disk herniation, but sciatica may be mimicked by other disorders that cause radiating pain. Because more than 95% of lumbar disk herniations occur at the L4-5 or L5-S1 levels, the physical examination should focus on abnormalities of the L5 and S1 nerve roots. Plain radiography is not useful in diagnosing disk herniation, but more sophisticated imaging (myelography, computed tomography, or magnetic resonance imaging) should generally be delayed until a patient is clearly a surgical candidate. Conservative therapy includes nonsteroidal anti-inflammatory drugs, brief bed rest (often for less than 1 week), early progressive ambulation, and reassurance about a favorable prognosis. Muscle relaxants and narcotic analgesics have a limited role, and their use should be strictly time-limited. Conventional traction and corsets are probably ineffective. Except for patients with the cauda equina syndrome, surgery is generally appropriate only when there is a combination of definite disk herniation shown by imaging, a corresponding syndrome of sciatic pain, a corresponding neurologic deficit, and a failure to respond to 6 weeks of conservative therapy.

Back Pain↗
PubMed1990

The role of spinal flexibility in back pain complaints within industry. A prospective study.

Commonly used clinical measurements of spinal flexibility in the sagittal and frontal planes were examined as predictors of future back pain reports within industry. The study sample consisted of 3,020 aircraft manufacturing employees who were examined and tracked for more than 4 years for reports of back pain. Modified Schober, sit-and-reach, and lateral bending measurements were not significantly associated with risk of future back pain reporting, nor were any trends present. There was a statistically significant relationship between decreased flexibility and reports of current or previous back problems. However, the differences in flexibility between subjects with and without a history of back problems were too small to be of practical significance.

Adult↗
PubMed1990

Anthropometric and clinical measures as predictors of back pain complaints in industry: a prospective study.

A prospective, longitudinal investigation was conducted to investigate anthropometric and clinical examination measures as predictors of future back pain reports in industry. Associations between these measures and a history of back problems were examined as well. Participants in the study included 3,020 aircraft manufacturing employees who underwent an examination and then were tracked for greater than 4 years for subsequent back pain reports. Back symptoms elicited on straight leg raising (SLR) was the measure most significantly associated with subsequent back pain reporting among both men and women (p less than 0.0001). The only variables to add predictive value in addition to back pain on SLR were age and weight in women, and history of back problems and age in men.

Adult↗
PubMed1989

A prospective study of the role of cardiovascular risk factors and fitness in industrial back pain complaints.

The authors conducted a prospective study of risk factors for industrial back pain complaints among 3,020 aircraft manufacturing employees. The study subjects completed a cardiovascular risk questionnaire, and were asked about their smoking status and past medical history, including previous back problems. Premorbid submaximal treadmill testing to predict maximum oxygen uptake (Vo2max) was completed in 2,434 subjects who were not excluded from testing due to cardiovascular risk screening. During several years of subsequent follow-up, 279 subjects reported back problems. Those who reported smoking at the time of the premorbid examination were significantly more likely to report a subsequent back problem than nonsmokers (P = 0.002). When controlling for sex and age, cardiovascular fitness, as measured through VO2max, was not predictive of future back injury reports (P = 0.26).

Adult↗
PubMed1989

Isometric lifting strength as a predictor of industrial back pain reports.

The objective of our investigation was to study isometric lifting strength in a population of industrial workers who perform a great variety of manual tasks, and to determine whether isometric strength is predictive of future back problems in such a population. Of 3,020 study subjects, 2,178 (72%) underwent strength testing in three standard lifting positions. During a 4-year follow-up period, 172 subjects tested reported back problems. When examining each isometric lift separately as a predictor of industrial back pain reports, those with greater isometric strength were at significantly greater risk than were weaker workers. However, after controlling for the effects of age, only a slight trend remained. For the blue collar workers in this study, isometric lifting strength testing was ineffective in identifying individuals at risk for industrial back problems.

Adult↗