Virtually all patients operated within the first year showed a subsequent improvement of symptoms. Only 25 % of patients operated at a later stage achieved some measure of improvement. Time is a relevant factor for success.
For decision making, we should take mechanical fracture analysis and dynamic processes within traumatized tissue a part of whose is the blood supply and oxygenation into surgical consideration. We recommend anterior rather than posterior stabilization for the cases with damaged vessel canal, and the vertebroplasty could pose an alternative in the elderly.
PURPOSE OF THE STUDYThere s a known relation between the chronical back-pain-syndrome and psychical problems. We suppose a direct causality between acute stress and onset of the backpain syndrome.
MATERIAL AND METHODSA prospective cohort-study (IV/2014 -VIII/2014) of patients who came to our emergency department with acute backpain-syndrome, with no relevant previous history -such as operations or chronic pain. We questioned together 39 patients (19 female and 20 male). The patients filled in two charts: FW7, and also a modified HADS-D. In the later one the patients were questioned in two extra points regarding contingent excessive emotional or existential problems in their brief history. The Pain-Severity-Score was assessed as well.
RESULTSCombined together, relevant score-results and / or anamnesis of excessive emotional or existential problem was found in 79.5% (SD 0.4%) of the whole cohort.
CONCLUSIONSThis could have implications for guidelines, introducing the psychotherapy-first into the concepts.
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