CJA Vol.22 Issue 2Editorial: Under the Bright Lights Lumbar Spine Lordosis in Low-back Pain: An Analysis of Radiographs Peter Bryner and Michael El Moussali Phillip EbrallTreatment of Chronic Low-Back Pain with Low Force Manipulation Hugh A. GemmellA Study of Patients and Patient Complaints at Chiropractic Teaching Clinics Max J. WalshABSTRACTS Lumbar Spine Lordosis in Low-Back Pain: An Analysis of Radiographs PETER BRYNER and MICHAEL EL MOUSSALI A retrospective survey of 124 erect lateral lumbar radiographs taken of both symptomatic and asymptomatic subjects in the lumbar region was carried out. The lumbar curve angle (L1-5), the lumbsacral disc angle, the sacral base angle and the intersection of the gravity line across the sacral base were measured using a standard protractor. The files of subjects were reviewed, and data regarding age, sex, number of births, and presence of symptoms were recorded. Across both groups, the mean lumbar curve angle was 47.6+2.3o (95% CI), mean sacral base angle was 40.6+1.5o (95% CI) and mean 15.3+1.0o (95% CI). There was a weak association between the lumbar curve angle and the presence of symptoms and between sexes. For males, the mean lumbar curve was 45.4o (S.D. 11.2), and for females it was 49.6o (S.D. 13.6)(F=3.41, p<0.10). The sacral base angle varied between multiparous women (41.4o) and nulliparous (37.5o) (F=1.10), p<0.05). When patients who reported a long duration of pain were isolated from those reporting recent onset of symptoms (less than 2 weeks), the mean sacral base angle was 37.4o compared with 41.4o (F=4.07, p<0.05). The lumbosacral disc angle did not vary with the presence of symptoms, with gender (F=0.30, NS) or with age (F=1.18 NS). No association was noted between the disc angle and the sacral base angle (F=1.27 NS). The angle of the L5 disc appears to be subject to less variation than other parameters measured here despite the close link between sacral base, L5 disc and the lumbar curve above. Many studies have concluded that measurements taken from radiographs are of little clinical value. There are confounding factors in most of these studies, which suggests that more careful investigation is warranted before this source of information for decision-making is rejected completely. INDEX TERMS: (MeSH) CHIROPRACTIC; LUMBAR VERTEBRAE; BACKACHE; LORDOSIS; (Non-MeSH) SACRAL BASE ANGLE Chiropractic J Aust 1992 Jun;22(2):42-6 PHILLIP S. EBRALL A retrospective study was made of all work-related mechanical low-back pain (MLBP) claimants within a twelve-month period in Victoria, Australia. Two matched samples were identified where management was solely by either a chiropractor or a medical practitioner. Comparisons of costs and outcomes were made between the two samples with the results being: (i) a significantly lower number of claimants requiring compensation days when chiropractic management was chosen, (ii) fewer compensation days taken by claimants who received chiropractic management, (iii) a greater number of patients progressed to chronic status when medical management was chosen, and (iv) a greater average payment per claim with medical management. A further result, namely, a higher average practitioner payment with chiropractic management, suggests a more intense level of practitioner/patient interaction by chiropractors. These results demonstrate a significant benefit to the community by chiropractic participation within the Victorian compensation scheme for work-related low-back pain. INDEX TERMS: MeSH: CHIROPRACTIC; BACKACHE; ACCIDENTS, OCCUPATIONAL; OCCUPATIONAL MEDICINE; WORKMEN'S COMPENSATION. OTHER: LOW BACK PAIN; INDUSTRIAL BACK SPRAIN. Chiropractic J Aust 1992 Jun;22(2):47-53 Treatment of Chronic Low-Back Pain with Low Force Manipulation HUGH A. GEMMELL A study was conducted using a replicated AB design with three subjects, having as its purpose the determination of the effectiveness of the Toftness method of spinal correction for treating chronic low-back pain. The subjects were randomly assigned to baselines of 5, 7 and 10 days. Sham Toftness adjustments were administered during baseline, and actual Toftness low force adjustments were delivered during treatment phases. The subjects rated their pain levels daily during the study, and it was determined that the Toftness method was an effective procedure for these subjects' chronic low back pain. INDEX TERMS: (MeSH) CHIROPRACTIC; MANIPULATION, ORTHOPEDIC; BACK ACHE. Chiropractic J Aust 1992 Jun;22(2):54-60 A Study of Patients and Patient Complaints at Chiropractic Teaching Clinics MAX J. WALSH A study was undertaken at three chiropractic teaching clinics for the purpose of comparing their new patient characteristics and presenting complaints. In terms of sex, age, and occupation, there was no significant difference between the three clinics. The chief presenting complaints were similar among all clinics, and the characteristics of these complaints, such as location, etiology, duration, and number of previous episodes, were also found to be similar across all clinics. The profile found was similar overall to that found in comparable studies of teaching clinics in the U.S.A. and Canada. INDEX TERMS: MeSH: CHIROPRACTIC, DEMOGRAPHY; OTHER: TEACHING CLINICS; PATIENT PROFILE. Chiropractic J Aust 1992 Jun;22(2):61-4 |
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