2011, Number 4
Anales de Radiología México 2011; 10 (4)
Radiological criteria for exclusion, by simple study of lumbar spine, of employment candidates to perform work involving physical effort
García HGD, Guerrero AG
Full text
Language: Spanish
References: 15
Page: 319-327
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ABSTRACT
Introduction. One of the leading causes of missed work days in patients whose work requires continuous physical effort are lumbar spine injuries, which can cause disabilities of between 4 and 12 weeks’ duration; such injuries can become chronic and prevent the worker from returning to his or her employment. This in turn lowers productivity and causes increasingly burdensome healthcare expenses for companies that are obliged to conduct screening and exclusion studies for “asymptomatic” potential employment candidates, in order to detect preexisting injuries that could eventually present complications and lead to permanent injury.Material and methods. Conventional lumbar spine studies were performed, with anteroposterior (AP) and lateral (LAT) projections, on 5,664 patients (men and women) between 18 and 45 years of age. The patients were positioned in standing position, barefoot; measurements were taken to rule out scoliosis with Cobb’s method, hyperlordosis, and unstable spine. Ferguson’s angle and pelvic tilt were measured and patients were checked for alterations such as reduction of intervertebral spaces, spondylolisthesis, marginal osteophytes, and ligamentous calcifications, as well as congenital alterations: hemivertebrae, vertebral fusion, sacralization of transverse apophysis of L5, transverse megaapophysis, lack of closure of spinal apophysis, and occult spina bifida.
Discussion. The type of alterations found in each individual was variable, from an alteration that excludes a person as a candidate for work with physical effort, such as listhesis in any degree, or a combination of alterations such as scoliosis plus hyperlordosis or scoliosis, sacralization of transverse apophysis, and pelvic tilt, among many other possible combinations.
Conclusion. Based on the results, we can affirm that conventional study of the lumbar spine is a useful tool to rule out preexisting injuries in asymptomatic patients. Analysis can help reduce disabilities and work absenteeism due to future injuries and lower healthcare costs, in addition to serving as a prophylactic procedure for the benefit of employment candidates.
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