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WHICH LUMBOSACRAL STRUCTURES ARE MORE LIKELY INJURED AFTER MOTOR VEHICLE ACCIDENT, LIFTING INJURY, OR A FALL? A RETROSPECTIVE AUDIT.: GP 96.

DePalma, M J MD; Ketchum, J M PhD; Ruchala, M; Powell, D; Kouchouch, A; Trussell, B S MD

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Spine Journal Meeting Abstracts: October 2010 - Volume - Issue - p 238
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INTRODUCTION: Exploration of precipitating lifting versus non‐lifting events in LBP patients would provide a clinical correlate to biomechanical research findings. This study aimed to observe which spinal structure, disc (IDD), facet joint (FJA), or sacroiliac joint (SIJ), is more likely injured after a motor vehicle accident (MVA), lifting injury, or fall.

METHODS: Retrospective chart review of consecutive LBP patients. Patients either underwent provocation lumbar discography, dual diagnostic facet joint blocks with local comparative anesthetics, or intra‐articular diagnostic SIJ injections according to clinical impression until a diagnosis was achieved. Chi‐square analyses were used to identify differences in the percentages of precipitating MVA, lifting, or fall in each diagnostic category of LBP (IDD, FJA, SIJ).

RESULTS: 139 cases (34 % male) were included (mean age = 52.7 years, SD = 15.0). MVA was reported in 43 cases (13.2%), lifting in 26 cases (8.0%), and fall in 28 (8.6%). Subjects with a precipitating lifting injury had a significantly greater percentage of IDD (p‐value = 0.0019) and significantly lower percentages of FJA (p ‐value = 0.0393) but similar percentages of SIJ pain (p‐value = 0.5425) than those without precipitating lifting injury. Subjects with precipitating MVA did not have different percentages of IDD (p‐value = 0.5058), FJA (p‐value = 0.8509), or SIJ (p‐value = 0.6773) than those without precipitating MVA. Subjects reporting a precipitating fall did not have different percentages of IDD (p‐value = 0.3202), FJA (p‐value = 0.7069), or SIJ (p‐value = 0.3740) than those without precipitating fall.

DISCUSSION: The occurrence of IDD was observed more commonly for those with a lifting injury as compared to those without a lifting injury and the occurrence of painful FJA was observed less commonly for those without a lifting injury as compared to those with a lifting injury. Precipitating MVA and falls were not associated with any particular source of low back pain.

© 2010 Lippincott Williams & Wilkins, Inc.