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academies
Journal of Neurology and Neurorehabilitation Research | Volume 3
November 26-27, 2018 | Dubai, UAE
Spine and Spine Disorders
Addiction Research and Therapy
3rd International Conference on
International Conference on
Joint Event
&
Mysteries of Spinal pain and pain distribution
Raman V Kalyan
1
, A Hamilton
2
, P Nolan
2
, E Cooke
2
, N Eames
2
, M Crone
2
and
D Marsh
1
1
Royal National Orthopaedic Hospital, UK
2
Royal Victoria Hospital, UK
Objectives:
To analyze the pain distribution in the acute and
chronic phase following Thoraco-lumbar fractures.
Study design: Prospective observational study
Subjects:
39 patients with fractures between T11 and L2, with
no neurological deficit, were treated conservatively. Strict
inclusion and exclusion criteria were applied. All had X-rays and
MR imaging (whole spine) at post-injury and one-year follow-
up.
Outcome measures & Methods: The patients documented
their pain distribution using pain drawing, along with 10 other
domains of pain and functional outcomes for a period over 12
months. The pain distribution was analyzed. The association
of distal pain distribution to other associated injury, resultant
kyphosis, pre-existing or increase in disc degeneration at the
lower non-injured disc levels – were analyzed and reviewed
Results:
The most common site of the pain distribution in both
the acute (90%) and chronic phase (97%) was distal to the
fracture (regions - iliac crest, lumbosacral junction and buttock).
Factors mentioned above that could be related to distal pain
distribution did not show any significant correlation (P>0.5)
with different domains of pain outcome.
Conclusions:
Some of the commonly believed reasons for distal
pain distribution like resultant Kyphosis and associated disc/
facet pathologies were not supported by our study findings.
The distal pain distribution corresponds to the scelerotomal
referred pain mapping, which could be the probable
explanation. Thoraco-lumbar pathologies could be the source
of pain in patients complaining of low back symptoms. Distal
pain distribution of spine pathologies should not be attributed
as functional.
Speaker Biography
Raman V Kalyan is a Consultant Spine Surgeon from UK working in North East England.
His busy practice covers a wide spectrum of both Adult and Paediatric Spine Pathologies.
He is an Honorary Consultant in James Cook University Hospital, UK. From 1992 to
2000, he has gained extensive experience from working in numerous renowned spinal
centres in UK, Europe and India. He started his training in Spinal Surgery in the famous
institution Christian Medical College Hospital in India in 1992. In Europe, he got specialized
training in Spinal Surgery by attaining the prestigious fellowship in France (under Prof J
Dubousset, 1998) and Germany (Prof. J. Harms, 1997). In UK, he undertook further
spinal training and fellowships under eminent surgeons in Edinburgh (Mr M Mc Master),
Belfast and London (Stanmore Hospital). He obtained his dual accreditation (clinical
and academic) in Trauma and Orthopaedics, by undertaking the Northern Ireland and
Stanmore rotations. In 1996, he was elected for the TNOA travelling fellowship to visit
few distinguished spinal surgeons. He was awarded the MD degree in Belfast for his
research work in Spinal fractures and has won prizes for his research work. As a Clinical
lecturer in UCL University London (2008 - 2009), he gained experience in conducting
courses and teaching programmes. His research interests focus on Spinal Pain, Less
invasive management of Spinal Pathologies, Spinal fractures and Spinal deformity.
e
:
vkalyanv@hotmail.com