日本財団 図書館


F-1-02-05

SPINAL CORD STIMULATION FOR SPINAL CORD AND BRACHIAL PLEXUS INJU RED PATIENTS

H. Kawai, K. Fujiwara, K. Yamamoto, T. Tsuda, M. Asano, S. Yata

(Hoshigaoka Koseinenkin Hospital, Hirakata-shi, Japan)

 

For intractable and severe pain by spinal cord injury and brachial plexus injury, spinal cord stimulation is a method of choice for pain relief in a selected group of patients. Seventeen patients were treated by spinal cord stimulation with epidural electrode(Medtronic, Pisces-Quad Model 3487A or Resume II Model 3587A) in Hoshigaoka Koseinenkin Hospital. The age ranged from 30 to 67 years of age, averaging 51 years of age. Spinal cord injuries were 15 cases (cervical 4; lower thoracic and upper lumbar 7; cervical myelopathy due to CP 1; spinal infarction 1; spinal tumor 1; multiply operated back 1) and brachial plexus root avulsion were 2 cases. Spinal cord stimulation was performed for mainly intractable pain in 14 cases and for severe spasticity in 3 cases. The follow-up period was 36 months on the average, ranging from 14 to 69 months after injury. The pain grade by visual analogue scale after spinal cord stimulation was rated as good in 2, fair in 10 and poor in 5 cases. Spasticity was remarkably relieved after spinal cord stimulation in 3 severe spastic cases. There were no major complications.

 

F-1-02-06

OUTCOME IN REHABILIATION A RETROSPECTIVE EVALUATION OF 525 RANDOMLY SELECTED

PATIENTS IN OREBRO COUNTY Patrik Ugge: Carl-Erik Fallstrom (Orebro Medical Centre Hospital, Sweden)

 

Material and methods: A random selection was made from forsakringskassans register. This resulted in 744 cases. 98 of these where excluded since their absence from work where less than 60 days. Relevant data was subsequently transferred to standardized protocols. Sex, age, social status, medical diagnosis, rehabilitation both medical and occuptional and the duration of the period was noted in the protocols.

 

Results: Diseases of the muscoloskeletal apparatus was the most common diagnosis. Together with injuries, neurological and psychiatric disease they contain 70% of the cases. Social problems are frequent, usually related to work (22% unemployed, 21% workrelated problems). 59% of the cases are back in work partially or full-time within a year. 87% of patients unable to work due to injury are back in work within a year. There exists a correlation between a precise diagnosis and return to work p <0.01 and a negative correlation between social problems and return to work p<0.01.

 

Conclusions: Pain is the most cartoon cause of being unable to work. In the material 69% of the cases describes pain to be a major symtom which prevents work. A precise diagnosis enhances the possibility of a successful rehabilitation back to work. Coexisting social problems decreases the possibility of successful rehabilitation back to work.

 

 

 

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