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Virginia workers compensation conference 2017

Virginia workers compensation conference 2017. Dhruv b. pateder , md Orthopedic & neurosurgical spine surgery Town center orthopedic associates Reston/ centreville , va. 2015 Work injury statistics- Bureau of labor statistics. 2.9 million non-fatal work place injuries in US

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Virginia workers compensation conference 2017

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  1. Virginia workers compensation conference 2017 Dhruv b. pateder, md Orthopedic & neurosurgical spine surgery Town center orthopedic associates Reston/centreville, va

  2. 2015 Work injury statistics- Bureau of labor statistics • 2.9 million non-fatal work place injuries in US • 902,200 days away from work • 324,700 cases involving “sprains, strains & tears” • 155,740 cases involving injuries to the back • 4,836 fatal injuries • Cost up to $60 billion

  3. Outline • The injured worker: psychology • Common spinal injuries • Common treatment protocols • Efficacy of treatment • Psychology of treatment

  4. The injured worker • Patient Perspective • Fear • Pain • Frustration • Unfamiliarity with process • Suspicion? • Physician Perspective • “Common Injury” • Most injuries fall under standard protocols

  5. The injured worker- Provider’s job • Educate • Educate • Educate • Reassure • Reassure • Reassure

  6. Common spinal injuries- mechanisms • Lifting Injuries: strains/sprains • Twisting injuries • Falls • Repetitive activities (flexion/extension)

  7. Common spinal injuries- diagnosis • Lumbar & cervical strain • Disc herniation • Disc degeneration • Spinal stenosis

  8. Lumbar & cervical strain • Muscle/tendon injury • Benign • Self-limited • Generally improves with time • NSAIDs • Physical therapy

  9. Disc herniation • Extrusion vs Protrusion • Acute vs Chronic • Symptomatic vs Incidental • Treatment Options: • Time • Physical therapy • Injections • Surgery

  10. Disc degeneration • Very common with age • Symptomatic versus incidental finding • Mostly asymptomatic • Associated with back/neck pain in symptomatic patients • Aggravated with trauma

  11. Spinal stenosis • Acute disc herniation • Chronic degenerative stenosis • Spondylolisthesis • Scoliosis

  12. Common surgeries • Discectomy • Cervical & lumbar disc replacement • Cervical fusion • Lumbar fusion

  13. ANTERIOR CERVICAL DISCECTOMY AND FUSION

  14. ANTERIOR CERVICAL DISC REPLACEMENT

  15. lumbar CERVICAL DISC REPLACEMENT

  16. Lumbar DISC REPLACEMENT above fusion

  17. Lumbar fusion

  18. Efficacy of treatment • Physical Therapy • Injections • Surgery

  19. Physical therapy • Decrease pain/spasm/inflammation • Range of motion • Strengthening • Role of modalities • Role of dry needling

  20. Steroid injections • Selective nerve root block (“Epidural steroid injection”) • Facet blocks • SI joint injection

  21. surgery • Clinical concordance • Patient expectations

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