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The Bone & Joint Journal
Vol. 103-B, Issue 9 | Pages 1464 - 1471
1 Sep 2021
Barker TP Steele N Swamy G Cook A Rai A Crawford R Lutchman L

Aims

Cauda equina syndrome (CES) can be associated with chronic severe lower back pain and long-term autonomic dysfunction. This study assesses the recently defined core outcome set for CES in a cohort of patients using validated questionnaires.

Methods

Between January 2005 and December 2019, 82 patients underwent surgical decompression for acute CES secondary to massive lumbar disc prolapse at our hospital. After review of their records, patients were included if they presented with the clinical and radiological features of CES, then classified as CES incomplete (CESI) or with painless urinary retention (CESR) in accordance with guidelines published by the British Association of Spinal Surgeons. Patients provided written consent and completed a series of questionnaires.


Orthopaedic Proceedings
Vol. 98-B, Issue SUPP_6 | Pages 7 - 7
1 Feb 2016
Critchley J Prempeh M Jia W Daniell H Crawford R
Full Access

Purpose:

To produce objective evidence that lifting is more comfortable in lumbar flexion than lumbar extension.

Traditionally, lifting is taught in lumbar extension (“straight back”) but in our experience is more comfortable and stronger in flexion with backward lumbar tilt.

Method and results:

58 subjects performed maximal comfortable static lifts:

‘Natural’ lifting position - hip flexion, knee extension, lumbar extension

Traditionally taught position - hip flexion, knee flexion, lumbar extension

Backward pelvic tilt - hip flexion, knee flexion, lumbar flexion

The order of these lifting methods varied to allow for variation due to fatigue/recruitment. All lifts were measured with a computerised dynamometer.

The mean force for natural lifting was 13.4 kgs, for traditionally taught lifting 15.1 kgs and for backward pelvic tilt lifting 22.2 kgs

This represented a 13% greater load for traditionally taught lift compared with natural lift, 66% greater for backward pelvic tilt compared with natural lift and 48% greater for backward pelvic tilt compared with traditionally taught lift.


Orthopaedic Proceedings
Vol. 96-B, Issue SUPP_6 | Pages 30 - 30
1 Apr 2014
Durst A Bhagat S Mahendran K Grover H Blake J Lutchman L Rai A Crawford R
Full Access

Aim:

An analysis of significant neuromonitoring changes (NMCs) and evaluation of the efficacy of multimodality neuromonitoring in spinal deformity surgery.

Method:

A retrospective review of prospectively collected data in 320 consecutive paediatric and adult spinal deformity operations. Patients were sub-grouped according to demographics (age, gender), diagnosis, radiographic findings (Cobb angles, MR abnormalities) and operative features (surgical approach, duration, levels of fixation). Post-operative neurological deficit was documented and defined as either spinal cord or nerve root deficit.