Administration of methylprednisolone-bupivacaine provided a favorable effect immediately after posterior lumbosacral spine surgery for discectomy, decompression, and/or spinal fusion without complication.

Prevalence of musculoskeletal symptoms among garment workers in Kandal province, Cambodia: Leap Van, et al. Department of Community Medicine, Faculty of Medicine, Khon Kaen University, Thailand Objective The main objectives of this cross‐sectional descriptive study were to identify the prevalence of musculoskeletal symptoms and workstation biomechanical risk levels for garment workers in Kandal Province, Cambodia. Methods This cross‐sectional descriptive study used multistage sampling techniques to select 714 workers from three garment factories among 22 medium‐size factories (250−1,000 workers). Face‐to‐face interviews and direct observation using the rapid upper limb assessment scale (RULA) were used to collect data. Results The response rate was 98.3% (702/714), and the majority (89.3%) of the respondents were female. Ninety‐two percent (95% CI=90.0−94.0) of the workers reported musculoskeletal symptoms in at least one body region in the previous 12 months and 89.0% (95% CI=86.7−91.3) of the workers reported such symptoms in the past seven‐day period. The neck, shoulder, and lower back were the most affected body regions. In addition, the RULA data showed that 81.2% of the workers’ postures were rated as action level 3, indicating that investigation and change were required soon, and that 7.5% their postures were rated as action level 4, indicating that investigation and change were required immediately. Conclusions Cambodian garment workers reported a high prevalence of musculoskeletal symptoms in upper body regions, and their workplaces were rated as high risk ergonomically.

Study DesignAgreement study.PurposeTo validate the interrater reliability of the histopathological classification of the post-laminectomy epidural fibrosis in an animal model.Overview of LiteratureEpidural fibrosis is a common cause of failed back surgery syndrome. Many animal experiments have been developed to investigate the prevention of epidural fibrosis. One of the common outcome measurements is the epidural fibrous adherence grading, but the classification has not yet been validated.MethodsFive identical sets of histopathological digital files of L5-L6 laminectomized adult Sprague-Dawley rats, representing various degrees of postoperative epidural fibrous adherence were randomized and evaluated by five independent assessors masked to the study processes. Epidural fibrosis was rated as grade 0 (no fibrosis), grade 1 (thin fibrous band), grade 2 (continuous fibrous adherence for less than two-thirds of the laminectomy area), or grade 3 (large fibrotic tissue for more than two-thirds of the laminectomy area). A statistical analysis was performed.ResultsFour hundred slides were independently evaluated by each assessor. The percent agreement and intraclass correlation coefficient (ICC) between each pair of assessors varied from 73.5% to 81.3% and from 0.81 to 0.86, respectively. The overall ICC was 0.83 (95% confidence interval, 0.81-0.86).ConclusionsThe postoperative epidural fibrosis classification showed almost perfect agreement among the assessors. This classification can be used in research involving the histopathology of postoperative epidural fibrosis; for example, for the development of preventions of postoperative epidural fibrosis or treatment in an animal model.

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