Various studies have highlighted issues regarding the prevalence of back pain due to lead apron use. The health and safety executive guidelines on personal protection equipment state that an employee should be able to carry the weight of a lead apron without injury (HSE, 2017). It has been suggested that wearing a 15 pound lead apron can place pressures of up to 300 pounds per square inch of the intervertebral discs (Khalil, 1993), ‘interventionalist's disc disease’ has been identified as a confirmed entity (Ross et al. 1997). To evaluate the prevalence of back pain amongst theatre staff and correlate this to lead apron use.Background
Aim
Spondylodiscitis and vertebral osteomyelitis can lead to long-term sequelae if not diagnosed and treated promptly and appropriately. The Royal National Orthopaedic Hospital (RNOH) has devised a new spinal infection referral system within the UK that allows cases to be discussed in a specialist multi-disciplinary (MDT) forum. National guidelines were devised in 2013 to help guide treatment, which recommends both tissue biopsies from the affected region and a MRI of the entire spine. The aims of this study were to assess the current treatment and referral practices and compare them with the set guidelines. It is hypothesised that a high percentage of patients are started on antibiotics without a biopsy or a positive set of blood cultures, a low percentage of patients are referred without undergoing a MRI of the full spine and that there is a long delay in referral to the MDT. A retrospective case study analysis was carried out on all spinal infection referrals received by the Royal National Orthopaedic Hospital over a 2-year period (2014–16), using the standards set by the current national guidelines. Clinical features, haematology results, imaging, biopsy results, treatment and outcome were all reviewed. Three key areas were addressed; whether antibiotics were commenced before positive cultures or biopsy, whether a MRI of the entire spine was performed and the time taken for referral from the onset of symptoms.Aim
Method
