320 The Initial Impact Of COVID-19 On Paediatric Spinal Services Across Scotland

Background The COVID-19 pandemic has meant a significant decline in the activities of the paediatric spinal services in Scotland. Method All referrals to the Scottish paediatrics spinal service from 1st January 2020 to 30th June 2020 were analysed. Comparison was made to the same period in 2019. All orthotist initial consultations and all paediatrics spinal theatre activity in Scotland from 1st March 2020 to 30th June 2020 was analysed and compared to the previous year. Results There was a 64.3% decline in referrals during the first wave of the pandemic in Scotland to the paediatric spinal service. The mean wait time to be seen in 1st clinic for a new referral was 6.56 weeks in 2020 compared to 10.94 in 2019. There were however 60 patients still waiting to be seen. The number of paediatric spinal operations declined by 34% during March to June 2020 when compared to the same months in 2019 There was a reduction of 50% of new paediatric patients seen by orthotists from March – June 2020 when compared to 2019 Conclusions COVID-19 has had a significant effect on paediatric spinal services in Scotland. This is likely due to a combination of service delivery factors and patient factors. This is likely to result in delays to children getting the care they require for their spinal condition. There will also be a back-log of patients requiring to be seen when services start to re-establish themselves. There are several options available to department to optimise efficiency, such as video consultants and streamlining referral systems.

TREATMENT OF BACK PAIN AFTER HIP ARTHROPLASTY, USING DEEP OSCILLATION

Objective: Deep Oscillation® is an electromechanical procedure with deep therapy that allow to create a pulsed electrostatic field between the hand applicator and the processing better tissue nutrition, enhanced cellular metabolism, faster healing. The purpose of this work is to assessment of the outcome of the treatment of spinal pain after hip arthroplasty using Deep osсillation Methods: The study included 85 patients between the ages of 40 and 75 who were referred to the Arena 2 Rehabilitation Center for post hip joint arthroplasty spine pain, including 57 women and 28 men. Patients physical modalities: complex rehabilitation programme including deep oscillation (DO - fibromyalgia programme) and kinesitherapy - active analytic exercises (including isometric exercises) and soft tissue techniques (post-isometric relaxation, stretching of the lumbar fascia, manual massage). Spinal condition was assessed before treatment after treatment using the Modified Oswestry Disability Index (ODI). Results: Mean value of points before treatment - 3.35+1.1, after treatment - 1.36+0.79. p<0.001 Oswestry Disability Index –67% and 27.2% respectively. Conclusion: After total endoprosthesis, there is a change in biomechanics and a shift in the center of gravity, which causes a change in the position of the spine and pain, so we definitely consider the spine examination and adequate rehabilitation and treatment in the post hip joint arthroplasty period. Involvement in the deep spine's treatment method reduces pain and improves the patient's quality of life, improve function and return-to-work status. Keywords: deep oscillation, hip arthroplasty, back pain.

CERVICAL SPONDYLOTIC MYELOPATHY: CLINICAL CASES AND PHYSIOTHERAPY

ABSTRACT The aims of this article are to present cervical spondylotic myelopathy, a spinal condition caused by bony, ligament and disc alterations that results in spinal cord compression leading to progressive degeneration of the spinal cord, and to describe the possible physiotherapeutic interventions. The pathology has different forms of progression and affected areas, which contributes to the diversity of clinical presentations. This work presents two evaluations of three patients diagnosed with this disease, at different times, to compare the severity, the affected regions, and the evolution of each one. Subsequently, it describes the most appropriate physiotherapeutic treatment for this illness, demonstrating its wide variability according to the signs and symptoms presented. Level of Evidence: IV. Case series.

Lumbosacral transitional vertebrae in cats and its relationship to lumbosacral vertebral canal stenosis

Objectives Although a clear relationship has been demonstrated between the presence of lumbosacral transitional vertebrae and the development of lumbosacral stenosis in dogs, this relationship has not been evaluated in cats. The aim of this study was to investigate the relationship between the presence of lumbosacral transitional vertebrae and lumbosacral stenosis in cats. Methods The medical records and diagnostic imaging studies of 13 cats diagnosed with lumbosacral stenosis were retrospectively reviewed for lumbosacral abnormalities and compared with findings of 405 cats that underwent CT for reasons unrelated to spinal disease. Results Clinical signs associated with lumbosacral stenosis included lumbosacral pain, low tail carriage, difficulty jumping, and urinary or faecal incontinence. Neurological signs included proprioceptive deficits, ambulatory paraparesis, pelvic limb ataxia, reduced spinal reflexes and reduced perianal reflex. Duration of clinical signs ranged from 1 day to 10 months (mean 3 months). Of the 13 cats with lumbosacral stenosis, seven (53.8%) were diagnosed with lumbosacral transitional vertebrae. In the control population of 405 cats, 24 (5.9%) were diagnosed with lumbosacral transitional vertebrae. Results indicated that lumbosacral transitional vertebrae were significantly ( P <0.0001) more prevalent in cats with lumbosacral stenosis compared with the control feline population (odds ratio 18.52, 95% confidence interval 6.1–62.1). Development of clinical signs of lumbosacral stenosis in cats with lumbosacral transitional vertebrae (mean 10.8 years) was not significantly different from that of cats without lumbosacral transitional vertebrae (mean 12.7 years). Likewise, there was no significant influence of breed ( P >0.99) or sex ( P = 0.29) on the occurrence of lumbosacral transitional vertebrae. Conclusions and relevance Despite lumbosacral stenosis being a rare spinal condition in cats, lumbosacral transitional vertebrae can be considered a risk factor for its development.

Comparative study of non-ionic contrast agents Optiray 350 and Ultravist 370 in myelography in dogs

Introduction: An essential quality of non-ionic contrast agents is that of containing in their chemical composition, elements with high atomic weight, which determine an increasing absorption of the X-ray beam and this will cause intense radiopacity. The possibilities for radiological exploration with non-ionic contrast agents are very wide. Currently the radiological examination with contrast agent no longer constitutes a risky step in medical diagnosis. Aims: To highlight the importance of using the non-ionic contrast agents Optiray 350 and Ultravist 370 in dog’s myelography and to compare the changes induced in cerebrospinal fluid and blood biochemical constituents by the administration of those non-ionic contrast substances. Materials and Methods: To determine the influence of non-ionic preparations Optiray 350 and Ultravist 370 on cerebrospinal fluid and on some haematological parameters were included in the study a total of 10 dogs. Results: Myelographies with Optiray 350 and Ultravist 370 in dogs with severe spinal condition negatively influence biochemical and haematological blood status, being necessary to take preventive measures. Optiray 350 and Ultravist 370 administration cause a slight sensitization of liver with blood biochemical parameters return to normal within 24-48 hours. Conclusion: Non-ionic contrast agents Optiray 350 and Ultravist 370 offer a very good opacification of the subarachnoidian space, but because it causes liver sensitization, we recommend using them with caution and only after a prior check of liver function.