shahnam baboli

Chronic low back pain is one of the most common debilitating occupational diseases. It seems that the frequency of this type of back pain is increasing, especially among young military staff. The aim of this study was to evaluate the causes of chronic low back pain according to interpretation of MRI reports in military personnel of army land forces of the Islamic Republic of Iran.

In this descriptive cross-sectional study, the data of military personnel with chronic low back pain, referring to the Neurosurgery Council of Khanevadeh Hospital, Tehran in 2016 were extracted. The information included demographic and occupational characteristics of the patients, clinical findings, and MRI reports. We used chi-square and Fischer exact tests for data analysis at the significance level of 95%.

326 male military personnel with chronic low back pain were evaluated. The mean age of the subjects was 37.3 ± 0.6 years. The most common MRI finding was disc herniation which was detected in 174 cases (53.3%). low back pain was most frequent in the combat branch, which included 114 cases (34.9%). There was no statistically significant correlation between MRI findings and types of military branches (P=0.071). The highest frequency of disc herniation belonged to the patients between 20 and 29 years of age (p=0.002) and the highest frequency of degenerative changes was seen in the patients over 50 years of age (p=0.005).

The most important finding of this study was the low mean age of the patients with chronic low back pain who were in their active working years. We suggest revision of the trend of periodic examinations of military personnel, ergonomics of the work environment and military training.

Brain hydatid cyst constitutes one of the leading causes of cranial mass in the endemic region, especially among the children. Symptoms of the disease are associated with rising of intracranial pressure and focal neurological deficit. Surgical excision of the cyst is essential to treatment. Here we present a 19 yr-old male livings in Ardabil, northwest of Iran, referred to Neurosurgery Clinic in Khanevadeh University Hospital, Tehran, Iran with a large brain hydatid cyst and atypical symptoms. He was treated by surgical excision of the cyst without any complication. There were not any clinical or radiological signs of recurrence after one-year follow-up.

Disease and nonbattle injuries are common among deployed military forces and musculoskeletal disease is a leading burden of disease in military population. Consequently, military employees and veterans frequency need medical and surgical management for lumbar disc herniation. Because of considerable complications and long post operation rehabilitation period, minimal invasive procedures have substituted old techniques in many modern military hospitals.. In this study, the preliminary results of 30 operated cases with the full endoscopic lumbar disc herniectomy technique in a military hospital were presented for feasibility, complications and follow-up outcomes. Disc herniation was more frequent in left side, particularly in L5-S1 level. Three patients from the first 10 cases were converted to open surgery. No important complication was observed and all patients were pain free, had no complication after 1 and 2 months follow-up and returned to their work.. We observed that the procedure is feasible and accompanied with an acceptable success rate, short hospital stay and very few perioperative and postoperative complications. It is an appropriate choice of treatment, even in combat region and moving hospitals and can reduce the morbidity of the disease..

Paraplegia can be caused by different factors like rupture or repair of the aortic aneurysm or aortic thrombosis, aortic dissection, anterior spinal cord artery emboli, coagulation disorders and lupus disease, all of which cause impaired spinal cord blood flow and spinal cord ischemia. In addition, hypotension may be the cause of spinal cord infarction but Medline researches have reported a few cases of spinal cord infarction in patients laparotomized for the reasons other than aortic lesions. In this paper we report one case of paraplegia who had experienced spinal infarction and paraplegia after internal bleeding and two times laparatomies due to long lasting hypotension. In this case regarding the patient ’ s age, occupation and physical health, the possibility of cardiovascular lesions and consequent thromboembolism seems very unlikely. Furthermore, considering the two operations performed and the temporal space between them, the only factor that could have led to ischemia and infarction of the spinal cord in this patient is long-standing hypotension.