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PubMed · 11056917

A proactive approach.

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A Smith, H Kaplan. 2000. A proactive approach.. https://pubmed.ncbi.nlm.nih.gov/11056917/

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Upper thoracic spinal cord injury without vertebral bony lesion: a report of two cases.

STUDY DESIGN: Case report. OBJECTIVES: To describe a rarely reported type of upper thoracic spinal cord injury without vertebral bony lesion in two cases with multiple trauma. SUMMARY OF BACKGROUND DATA: Because it is supported by the stiffness of the rib cage, the upper thoracic spine has greater stability than the cervical and lumbar regions, and thus its fracture or fracture dislocation is less frequent. Nevertheless, when fracture or fracture dislocation of upper thoracic spine occurs, spinal cord involvement and severe concomitant injuries are frequently associated. METHODS: Two cases who were suspected to have thoracic spinal cord injuries were referred to our emergency center: a 19-year-old girl presented with paraparesis after her motorcycle collided with a truck, and a 63-year-old male involved in an industrial accident presented with paraplegia. RESULTS: Radiograph and computed tomography scan showed no abnormality or dislocation in the vertebral bodies in these two cases, although the upper thoracic spinal cord injuries were suspected by clinical features. Magnetic resonance images detected abnormal signals, suggesting spinal cord injuries, and these signals each emanated from levels that coincided with the observed clinical features. CONCLUSIONS: Transient subluxation or displacement might have caused the upper thoracic spinal cord injuries after the support of the rib cages was temporarily lost on application of excessive force, although such findings could not be confirmed by imaging procedures.

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Prevalence of musculoskeletal symptoms in single and multiple body regions and effects of perceived risk of injury among manual handling workers.

STUDY DESIGN: A cross-sectional study was conducted to investigate 217 male workers from the Hong Kong with varied levels of manual lifting experience. OBJECTIVES: To determine whether musculoskeletal symptoms are prevalent in different and multiple body regions among manual handling workers, and to determine whether a simple index (i.e., perceived risk of lifting injury) evaluated by the worker is significantly associated with musculoskeletal outcomes in single and multiple body regions. SUMMARY OF BACKGROUND DATA: Little research has been conducted to investigate the effect of manual lifting tasks on musculoskeletal symptoms in different and multiple body regions. METHODS: A structured interview that followed a set of standardized questionnaires was administered to each worker by the same investigator. The workers were asked to detail their demographic characteristics, physical fitness level, years of experience in manual lifting, current working condition, and musculoskeletal symptom survey. RESULTS: Lower back symptoms were the most frequent among manual handling workers, followed by the shoulders, then the upper back, hips-upper legs, and neck. Finger symptoms had the lowest prevalence values. Musculoskeletal symptoms for multiple body parts (two or more) were more prevalent (64% of all workers) than those for single body regions (19%). Approximately 85% of lower back symptoms were associated with disorders in other body regions. Multivariate analyses indicated that the effects of perceived risk were significant for eight body regions, and that age was significant for three of them. Perceived risk of lifting injury also was significant for multiple body regions. CONCLUSIONS: Musculoskeletal symptoms are prevalent in single and multiple body regions among manual handling workers. The perceived risk of injury is significantly associated with musculoskeletal symptoms in eight body regions.

Accidents, Occupational↗