OBJECTIVES: People who have chronic diseases, as well as gait imbalance or psychiatric drug use, may be susceptible to injuries from falls and slips. The purpose of this study was to evaluate the effect of musculoskeletal diseases on incidental fall-related injuries among adults in Korea. METHODS: We analyzed data from the 4th Korea National Health and Nutrition Examination Survey (2007-2009), which are national data obtained by a rolling survey sampling method. The 1-year incidence of fall-related injuries was defined by health service utilization within the last year due to injury occurring after a slip and fall, and musculoskeletal diseases included osteoarthritis, rheumatoid arthritis, osteoporosis, and back pain. To evaluate the effects of preexisting musculoskeletal diseases, adults diagnosed before the last year were considered the exposed group, and adults who had never been diagnosed were the unexposed group. RESULTS: The weighted lifetime prevalence of musculoskeletal disease was 32 540 per 100 000 persons. Musculoskeletal diseases were associated with a higher risk of fall-related injury after adjustment for sex, age, residence, household income, education, occupation, visual disturbance, paralysis due to stroke, and medication for depression (odds ratio [OR], 1.41; 95% confidence interval [CI], 1.03 to 1.93). As the number of comorbid musculoskeletal diseases increased, the risk of fall-induced injuries increased (p-value for trend <0.001). In particular, patients who had any musculoskeletal condition were at much higher risk of recurrent fall-related injuries (OR, 6.20; 95% CI, 1.06 to 36.08). CONCLUSIONS: One must take into account the risk of fall-related injuries and provide prevention strategies among adults who have musculoskeletal diseases.
Accidental Falls/*statistics & numerical data ; Adolescent ; Adult ; Age Factors ; Aged ; Arthritis, Rheumatoid/complications/epidemiology ; Back Pain/complications/epidemiology ; Female ; Health Surveys ; Humans ; Incidence ; Male ; Middle Aged ; Musculoskeletal Diseases/*complications ; Osteoarthritis/complications/epidemiology ; Osteoporosis/complications/epidemiology ; Republic of Korea/epidemiology ; Risk Factors ; Sex Factors ; Socioeconomic Factors ; Young Adult

PURPOSE: To examine the effects of conservative and surgical treatments for nocturnal leg cramps in patients with lumbar spinal stenosis (LSS). Nocturnal leg cramps is frequently observed in patients with peripheral neuropathy. However, there have been few reports on the relationship between nocturnal leg cramps and LSS, and it remains unknown whether conservative or surgical intervention has an impact on leg cramps in patients with LSS. MATERIALS AND METHODS: The subjects were 130 LSS patients with low back and leg pain. Conservative treatment such as exercise, medication, and epidural block was used in 66 patients and surgical treatment such as decompression or decompression and fusion was performed in 64 patients. Pain scores and frequency of nocturnal leg cramps were evaluated based on self-reported questionnaires completed before and 3 months after treatment. RESULTS: The severity of low back and leg pain was higher and the incidence of nocturnal leg cramps was significantly higher before treatment in the surgically treated group compared with the conservatively treated group. Pain scores improved in both groups after the intervention. The incidence of nocturnal leg cramps was significantly improved by surgical treatment (p=0.027), but not by conservative treatment (p=0.122). CONCLUSION: The findings of this prospective study indicate that the prevalence of nocturnal leg cramps is associated with LSS and severity of symptoms. Pain symptoms were improved by conservative or surgical treatment, but only surgery improved nocturnal leg cramps in patients with LSS. Thus, these results indicate that the prevalence of nocturnal leg cramps is associated with spinal nerve compression by LSS.
Adult ; Aged ; Aged, 80 and over ; Decompression, Surgical ; Female ; Humans ; Leg/*pathology ; Low Back Pain/epidemiology/etiology ; Male ; Middle Aged ; Pain/*epidemiology/*etiology ; Prospective Studies ; Questionnaires ; Spinal Stenosis/*complications/*physiopathology/surgery

BACKGROUND: To determine the prevalence of spondylolysis in a selected population and evaluate the association of spondylolysis with low back pain (LBP). Spondylolysis is widespread in the general population but the prevalence of spondylolysis and its relationship with LBP in the Korean population is controversial. METHODS: A sample of 855 participants (age, 20 to 86 years) from our medical center who underwent multidetector computed tomography (CT) imaging to assess abdominal and urological lesions were enrolled in this study. The occurrence of LBP requiring medication in the preceding 12 months was evaluated using a self-report questionnaire (a modified Nordic Low Back Pain Questionnaire). The presence of spondylolysis was characterized by CT imaging. Multiple logistic regression models were used to examine the association between spondylolysis and LBP, while adjusting for gender and age. RESULTS: Seventy-eight study subjects (9%) demonstrated spondylolysis on CT imaging. There was no significant difference between the age groups (p = 0.177). The p-value of gender was 0.033 but this was not significant due to the selected population bias. Three hundred eleven study subjects (36%) had back pain. There was a significant difference between gender (p = 0.001). No significant association was identified between spondylolysis and the occurrence of LBP. CONCLUSIONS: The prevalence of LBP was 36.37% and the prevalence of lumbar spondylolysis in a selected population, who visited hospital for abdominal or urological lesions except LBP, was 9.12% based on CT imaging. Males demonstrated a similar presence of LBP to females but a significantly higher incidence of spondylolysis (p = 0.033). The prevalence of spondylolysis was not associated with the presence of LBP and age in adulthood.
Adult ; Age Factors ; Aged ; Aged, 80 and over ; Cross-Sectional Studies ; Female ; Humans ; Korea/epidemiology ; Logistic Models ; Low Back Pain/*etiology ; Male ; Middle Aged ; Prevalence ; Self Report ; Sex Factors ; Spondylolysis/*complications/*epidemiology/radiography ; Tomography, X-Ray Computed ; Young Adult

To evaluate the efficacy and safety of modified pedicle subtraction osteotomy for treatment of thoracolumbar old fracture with kyphosis.
 Methods: From January 2003 to January 2013, 58 patients of thoracolumbar kyphosis, who underwent modified pedicle subtraction osteotomy, were reviewed. Among them, 45 cases underwent initial operation and 13 cases underwent revision surgery. Preoperative and postoperative kyphotic Cobb's angle, score of back pain, as well as the incidence of complication were accessed by using visual analogue scale (VAS) and Oswestry disability index (ODI).
 Results: Mean follow-up duration was 42 months (range, 24-60 months). Average operative time was 258 min (range, 190-430 min), while average bleeding was 950 mL (range, 600-1 600 mL). All the patients were significantly improved in function and self-image, and achieved kyphosis correction with 17.9°± 4.3°. VAS of low back pain was decreased by 3.1±0.6; ODI was dropped by 25.3%±5.5%. 3 patients (5.2%) suffered anterior thigh numbness and got recovery after 3 months of follow-up. Complications happened in 19 patients, including 12 with cerebrospinal fluid leak, 4 with superficial wound infection, and 3 with urinary tract infection. All these complications were managed properly and none of them underwent reoperation.
 Conclusion: Modified pedicle subtraction osteotomy is a safe and effective technique for the treatment of old fracture with kyphosis.
Back Pain ; surgery ; Blood Loss, Surgical ; statistics & numerical data ; Cerebrospinal Fluid Leak ; epidemiology ; Female ; Follow-Up Studies ; Fractures, Bone ; complications ; surgery ; Humans ; Hypesthesia ; etiology ; Kyphosis ; etiology ; surgery ; Lumbar Vertebrae ; injuries ; surgery ; Male ; Operative Time ; Osteotomy ; adverse effects ; methods ; Postoperative Complications ; epidemiology ; Reoperation ; statistics & numerical data ; Retrospective Studies ; Surgical Wound Infection ; epidemiology ; Thoracic Vertebrae ; injuries ; surgery ; Treatment Outcome ; Urinary Tract Infections ; epidemiology

PURPOSE: To determine the prevalence and characteristics of neuropathic pain (NP) in patients with lumbar spinal stenosis (LSS) according to subgroup analysis of symptoms. MATERIALS AND METHODS: We prospectively enrolled subjects with LSS (n=86) who were scheduled to undergo spinal surgery. The patients were divided into two groups according to a chief complaint of radicular pain or neurogenic claudication. We measured patient's pain score using the visual analog scale (VAS), Oswestry Disability Index (ODI) and Leads Assessment of Neuropathic Symptoms and Signs (LANSS). According to LANSS value, the prevalence of NP component pain in patients with LSS was assessed. Statistical analysis was performed to find the relationship between LANSS scores and the other scores. RESULTS: From our sample of 86 patients, 31 (36.0%) had a NP component, with 24 (63.4%) in the radicular pain group having NP. However, only seven patients (15.6%) in the neurogenic claudication group had NP. The LANSS pain score was not significantly correlated with VAS scores for back pain, but did correlate with VAS scores for leg pain (R=0.73, p<0.001) and with ODI back pain scores (R=0.54, p<0.01). CONCLUSION: One-third of the patients with LSS had a NP component. The presence of radicular pain correlated strongly with NP. The severity of leg pain and ODI score were also closely related to a NP component. This data may prove useful to understanding the pain characteristics of LSS and in better designing clinical trials for NP treatment in patients with LSS.
Adult ; Aged ; Back Pain ; Decompression, Surgical ; Disability Evaluation ; Female ; Humans ; *Lumbar Vertebrae/surgery ; Male ; Middle Aged ; Neuralgia/*complications/epidemiology ; Outcome Assessment (Health Care) ; Pain Measurement/*methods ; Prevalence ; Prospective Studies ; Republic of Korea/epidemiology ; Severity of Illness Index ; Spinal Stenosis/epidemiology/*surgery ; Surveys and Questionnaires ; Treatment Outcome