Patient handling with and without slings: an analysis of the risk of injury to the lumbar spine

Nursing is among the most physically challenging occupations and involves intensive lifting activities often including twisting of torso while performing tasks such as patient handling. Frequent and repetitive twisting of the body is known to induce large demands on the musculature, which may lead to MSD with direct and indirect costs to the hospital governance. One solution proposed through this article includes an exoskeleton specifically designed to assist in twisting movements of the trunk. This involves a double-actuator fully passive system that assists in rotation of the torso with the help of mechanical springs and cable modules. Our study provides a conceptual design of the mechanism, and a preliminary analysis using the concepts of kinematics, dynamics, usability, wearability, and freedom of movement. Results show that the mechanism could offer freedom of rotation for the wearer’s torso up to 52, 25 and 22 degrees (with stationary hip joint) along the transverse, sagittal and coronal planes, respectively. Moreover, similar force generation (up to 80N) was obtained in both actuators for same rotation on transverse plane in both directions for a combination of spring stiffness (0.5 – 1 N/mm) and damping (0.1 - 0.5 N-sec/mm) parameters. Our proposed design could also be integrated to the current exoskeletons in the form of a module and could be beneficial in more general work settings.

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CORRELATION: IMPEDANCE AND TOMOGRAPHY IN IMPLANTS INSERTION IN LUMBAR ARTHRODESIS

Coluna/Columna ◽

10.1590/s1808-185120161504162728 ◽

2016 ◽

Vol 15 (4) ◽

pp. 283-286

Author(s):

ÉRIKO GONÇALVES FILGUEIRA ◽

LUCIANO DE ALMEIDA FERRER ◽

ITAMAR ALVES BARBOSA NETO ◽

LEONARDO MORAIS PAIVA ◽

RICARDO SUGAI ◽

...

Keyword(s):

Lumbar Spine ◽

Quantitative Method ◽

Pedicle Screws ◽

Perioperative Period ◽

Nerve Roots ◽

Safe Method ◽

Risk Of Injury ◽

Post Operative Period ◽

Lumbar Arthrodesis ◽

Retrospective Multicenter Study

ABSTRACT Objective: To define whether the electroneurophysiological stimulation would be a safe method for reducing injuries in nerve roots during surgery of lumbar spine arthrodesis, as well as verify whether there is a direct correlation between the intraoperative impedance values and the distance from the medial cortical pedicle screw. Methods: Randomized retrospective multicenter study of 10 patients who underwent arthrodesis of lumbar spine after conservative treatment failure, with a total of 50 pedicle screws instrumented. Reliable and safe impedance values were measured in order to reduce the risk of injury to nerve roots in the perioperative period, and these values were compared with the distance between the screw and the medial cortical of the pedicle by CT scan, measured in the immediate post-operative period. Results: There is no direct correlation between the intraoperative impedance values and the distance from the screw to the medial cortical of the pedicle. Conclusion: The electroneurostimulation proved to be a reliable quantitative method to reduce the risk of injury to nerve roots during surgery of lumbar spine arthrodesis when the measured values are greater than 10mA.

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Intervertebral Disc Disease of the Lumbar Spine in Health Personnel with Occupational Exposure to Patient Handling—A Systematic Literature Review and Meta-Analysis

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17134832 ◽

2020 ◽

Vol 17 (13) ◽

pp. 4832

Author(s):

Christofer Schröder ◽

Albert Nienhaus

Keyword(s):

Lumbar Spine ◽

Occupational Exposure ◽

Health Personnel ◽

Meta Analysis ◽

Patient Handling ◽

Disc Disease ◽

Work Related ◽

Exposed Workers ◽

Heavy Loads ◽

Geriatric Nurses

Lifting or carrying loads or working while the trunk is in a bent position are well established risk factors for the development of disc disease of the lumbar spine (LDD). Patient handling is associated with certain hazardous activities, which can result in exposure to heavy loads and high pressure for the discs of the lumbar spine of the nurses performing these tasks. The purpose of this review was to examine the occurrence of work-related LDD among health personnel (HP) with occupational exposure to patient handling activities in comparison to un-exposed workers. A systematic literature search was conducted using the following databases: PubMed, CINAHL, Scopus, and Web of Science. A meta-analysis of odds ratios (OR) was conducted by stratifying for various factors. Five studies reported a higher prevalence for LDD among nurses and geriatric nurses (11.3–96.3%) compared to all controls (3.78–76.47%). Results of the meta-analysis showed a significantly increased OR for LDD among HP compared to all controls (OR 2.45; 95% confidence interval (CI) 1.41, 4.26). In particular, the results of this review suggest that nurses have a higher probability of developing disc herniation than office workers.

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Risk of injury in lumbar spine during explosion of low-mass charge under vehicle

10.1063/1.5092081 ◽

2019 ◽

Author(s):

Tomasz Klekiel ◽

Grzegorz Sławiński ◽

Marek Świerczewski ◽

Paweł Bogusz ◽

Romuald Będziński

Keyword(s):

Lumbar Spine ◽

Risk Of Injury ◽

Low Mass

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Impairment Tutorial: Recurrent Radioculpathy: Recurrent Radioculpathy and Apportionment

Guides Newsletter ◽

10.1001/amaguidesnewsletters.2002.julaug03 ◽

2002 ◽

Vol 7 (4) ◽

pp. 8-10

Author(s):

Christopher R. Brigham ◽

Leon H. Ensalada

Keyword(s):

Lumbar Spine ◽

Range Of Motion ◽

Disk Herniation ◽

Fourth Edition ◽

Recurrent Injury ◽

Injury Model ◽

Whole Person ◽

Spinal Region

Abstract Recurrent radiculopathy is evaluated by a different approach in the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fifth Edition, compared to that in the Fourth Edition. The AMA Guides, Fifth Edition, specifies several occasions on which the range-of-motion (ROM), not the Diagnosis-related estimates (DRE) method, is used to rate spinal impairments. For example, the AMA Guides, Fifth Edition, clarifies that ROM is used only for radiculopathy caused by a recurrent injury, including when there is new (recurrent) disk herniation or a recurrent injury in the same spinal region. In the AMA Guides, Fourth Edition, radiculopathy was rated using the Injury Model, which is termed the DRE method in the Fifth Edition. Also, in the Fourth Edition, for the lumbar spine all radiculopathies resulted in the same impairment (10% whole person permanent impairment), based on that edition's philosophy that radiculopathy is not quantifiable and, once present, is permanent. A rating of recurrent radiculopathy suggests the presence of a previous impairment rating and may require apportionment, which is the process of allocating causation among two or more factors that caused or significantly contributed to an injury and resulting impairment. A case example shows the divergent results following evaluation using the Injury Model (Fourth Edition) and the ROM Method (Fifth Edition) and concludes that revisions to the latter for rating permanent impairments of the spine often will lead to different results compared to using the Fourth Edition.

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