Faculty Bibliography

Phantom limb pain has been well described in the literature. However, new-onset lumbar radicular pain superimposed on baseline lower extremity phantom pain is a clinical scenario that can be challenging to recognize. Furthermore, literature on recognition and treatment of phantom radiculopathy is all but lacking. We present a patient who experienced new-onset lumbar radiculopathy superimposed on her phantom pain that was successfully treated with fluoroscopic interlaminar and transforaminal epidural steroid injections

OBJECTIVE: To study the incidence and types of injuries sustained by professional roller hockey players in practices and games, and to compare these statistics with those from ice hockey. DESIGN: This injury survey used a strict definition of injury, standardized reporting strategies, and diagnosis by a team physician as standards by which to analyze the characteristics of roller hockey injuries. SETTING: The injuries were recorded after the players had been examined by a team physician at the game or practice site or in the physician's office. PARTICIPANTS: During three seasons for one roller hockey team and one season for another team, an average of 22 players per team participated in the study. Due to personnel changes, the team rosters were modified between seasons. Each player injury was included in the study. An injury was defined as any physical impairment caused during a practice or game that eliminated the player from that practice or game or the next day's practice session or contest, or any physical ailment that necessitated a physical examination by the team physicians. MAIN OUTCOME MEASURE: Injury data were categorized and injury rates were calculated. RESULTS: 122 injuries were recorded during four professional roller hockey seasons, resulting in an overall participation injury rate of 14.4 per 1,000 player hours. The game injury rate was 304.9 per 1,000 player hours. The players were 105.1 times more likely to be injured during a game than during practice. Preseason practices produced 4.5 times more injuries than regular season practices. In comparison, sample data from the only other published study of roller hockey injuries and from several studies of ice hockey have indicated game injury rates of 139.0 (roller hockey), 119.0, 96.1, 78.4, 78.8, and 66.0 per 1,000 player hours, respectively. CONCLUSION: Results of this study demonstrate that roller hockey produces a higher rate of both contact and noncontact injuries than ice hockey; this contradicts the findings of the only other published research study on injuries in roller versus ice hockey. This increased incidence of injury may be due in part to the differences in surfaces, and can prove hazardous to even the recreational roller hockey player or in-line skater

The parents of sixty-three patients who were less than twenty-one years old and who had operatively confirmed herniation of a lumbar disc were interviewed regarding a history of sever back pain, sciatica, and herniated disc, to determine whether aggregation of herniation of a lumbar disc occurs in families of patients in this young age-group. The parents of sixty-three additional patients who had a non-spinal orthopaedic diagnosis (control group) were matched for age and sex with the study group and were given the same interview. Of the patients who had herniation of a lumbar disc and were less than twenty-one years old, 32 per cent had a positive family history for that lesion compared with 7 per cent of the control group. The relative risk of development of herniation of a lumbar disc before the age of twenty-one years is estimated to be approximately five times greater in patients who have a positive family history. The results indicate a familial basis for herniation of a lumbar disc in patients who are less than twenty-one years old