VCA provided excellent correction of coronal and transverse planes with normalization of thoracic kyphosis in Lenke type 1 adolescent idiopathic scoliosis surgery.

Introduction: Musculoskeletal Diseases (MSDs) are among the most prevalent health problems encountered in the workforce in Europe. Multiple risk factors contribute to their onset. In the present study, different individual risk factors for chronic tendinous pathology affecting the shoulder were analysed in a sample of workers from the automotive manufacturing sector. Methods: An observational retrospective study was conducted with 73 cases of officially recognised and compensated occupational diseases and 94 aleatory cases of healthy workers from the same car assembly company. The experimental group comprised individuals with tendinous chronic pathology of the rotator cuff. Multiple variables that identified the risks present in the job were assessed along with participants clinical evaluation. Furthermore, two standardised guidelines for risk factors assessment were also used: the Spanish National Institute of Social Security (INSS) and the American Occupational Information Network (O*Net). Both descriptive statistical analysis and Odds ratios calculations considering the occupational disease as a dependent variable were performed. Results: Using univariate analysis, the use of hand tools, exposure to mechanical pressure in the upper limbs and awkward postures were the most prevalent risk factors. Pressure on the palm of the hand and the hand tool impacting the hand were also important risk factors. Some psychosocial factors such as lack of autonomy and mental workload were also associated shoulder tendinous diseases. In the logistic regression model, age, load handling, and awkward postures were the core risk factors responsible for most of the tendinous chronic injuries of the shoulder in this sample of car assembly workers.Conclusions: Both ergonomic and psychosocial factors were present and increased the risk of developing occupational chronic tendinopathies at the shoulder in this sample of workers. Aging, load handling, and awkward postures showed the strongest predictive values. Greater knowledge of how risk factors interact would facilitate the design of better preventive workplace strategies.

Background: Musculoskeletal Diseases (MSDs) are among the most prevalent health problems encountered in the workforce in Europe. Multiple risk factors contribute to their onset. In the present study, different individual risk factors for chronic tendinous pathology affecting the shoulder were analysed in a sample of workers from the automotive manufacturing sector. Methods: An observational retrospective study was conducted with 73 cases of officially recognised and compensated occupational diseases and 94 aleatory cases of healthy workers from the same car assembly company. The experimental group comprised individuals with tendinous chronic pathology of the rotator cuff. Multiple variables that identified the risks present in the job were assessed along with participants clinical evaluation. Furthermore, two standardised guidelines for risk factors assessment were also used: the Spanish National Institute of Social Security (INSS) and the American Occupational Information Network (O*Net). Both descriptive statistical analysis and Odds ratios calculations considering the occupational disease as a dependent variable were performed. Results: The use of hand tools, exposure to mechanical pressure in the upper limbs and awkward postures were the most prevalent risk factors. Pressure on the palm of the hand and the hand tool impacting the hand were also important risk factors. Some psychosocial factors such as lack of autonomy and mental workload were also associated shoulder tendinous diseases. The association of age, load handling, and awkward postures were the core risk factors responsible for most of the tendinous chronic injuries of the shoulder in this sample of car assembly workers.Conclusions: Both ergonomic and psychosocial factors were present and increased the risk of developing occupational chronic tendinopathies at the shoulder in this sample of workers. Aging, load handling, and awkward postures showed the strongest predictive values. Greater knowledge of how risk factors interact would facilitate the design of better preventive workplace strategies.

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OBJETIVO: Valorar una exploración neurofisiológica que identifique estos casos intraoperatoriamente y evite la mal posición de tornillos pediculares. MÉTODOS: En 293 pacientes intervenidos de escoliosis por vía posterior con tornillos pediculares y técnica "free hand", se implantaron 6.739 tornillos. De estos, ocho pacientes (2,7%), con edad promedio de 24 años, presentaron dolor radicular lumbar postoperatorio. En la TC postoperatoria se encontraron 10 tornillos lumbares (2L1-3L2-4L3-1L4) con prominencia mínima en la parte inferior del pedículo. Se evaluaron los umbrales de EMG del tornillo y del trayecto. RESULTADOS: En cirugía inicial no se detectaron anomalías en la palpación del trayecto, ni en el control radioscópico, ni alteraciones neurofisiológicas en la estimulación neurofisiológica con t-EMG. Todos presentaron dolor radicular en bipedestación y sedestación que remitía con reposo en cama. Los tornillos fueron retirados quirúrgicamente a los 37 días en promedio (R:4-182). En esta cirugía se repitió la monitorización neurofisiológica y volvió a mostrar valores normales (> 11mA). Tras la retirada de los tornillos, se realizó estimulación del trayecto que mostró en la parte media, umbrales por debajo de los valores normales (3,9-10,7mA). Tras un seguimiento promedio de 4,4 años (R:2,6-6.8), cinco pacientes referían tener molestias radiculares ocasionales y uno tenía déficit motor mínimo en la extremidad afectada. CONCLUSIONES: Se presenta un tipo de mal posicionamiento de tornillo pedicular lumbar que produce radiculalgia en bipedestación-sedestación y que no es detectado con monitorización convencional. La estimulación neurofisiológica del trayecto en la zona media, tras retirada del tornillo pedicular, produjo umbrales bajos de estimulación. Se recomienda estimulación sistemática del trayecto antes de la inserción del tornillo pedicular lumbar.