Purpose of study: Pain mechanisms underlying the majority of low back and leg pain remain to be elucidated. A recently developed neuropathic pain questionnaire (PainDETECT) was used to assess for the presence of probable neuropathic pain in a group of patients with low back ± leg pain and the effect this has on them.

Method: Patients with low back ± leg pain referred to an Extended Scope Practitioner Physiotherapy clinic who consented to take part completed the PainDETECT questionnaire, and the Roland Morris Disability Questionnaire, and the Fear Avoidance Beliefs Questionnaire. Patients were then grouped by the PainDETECT score into probable neuropathic pain, unlikely neuropathic pain or pain of uncertain underlying mechanism. In patients imaged subsequent to assessment in the clinic (MRI) the PainDETECT scores were compared to evidence of compression of nerve roots.

Results: 17% of patients had probable neuropathic pain, in 47% neuropathic pain unlikely and 36% uncertain. Those with probable neuropathic pain when compared to unlikely neuropathic pain were more disabled (p> .001), scored higher on a visual analogue scale (p=0.013), but were no different on the Fear avoidance scale (p=0.08). Those with neuropathic components to their pain always reported leg pain (93% below knee), whereas 63% of unlikely neuropathic pain patients had leg pain (38% below knee). The relationship between nerve root compression and neuropathic pain score was uncertain.

Conclusion: Patients with a neuropathic component to their back pain report higher levels of pain, more leg pain and are more disabled by their problem.

Introduction: Surgery in patients with neuromuscular scoliosis is aimed at improving truncal balance, facilitating sitting, prevention of progression of the curve and preservation of respiratory function.

Patients and Methods: This was a retrospective study of surgical results in a group of 24 patients with minimum follow up of 2 years an average post-operative follow up of 5 years (2–9 years) with neuromuscular scoliosis due to varying aetiologies. The aetiologies included SMA (7), CP (6), Duchenne (5), Congenital Myopathies (3), Spina Bifida (2) and Paraspinal Neuroblastoma (1).

Results: The average age at surgery was 10.6 years, the average duration was 4hrs 25mins with an average blood loss pf 1.1 liters. An average ICU stay was 1–2 days and stay in hospital is 11 days. The curves ranged from 25–103° (average 75.6°) pre-operative and we were able to obtain a correction of 56%. In all but 2 of our patients we were successful in preventing deterioration of respiratory function and all our patients could at least sit without support post-operatively. Our complications included only one deep infection (necessitating implant removal), 1 rod breakage and 2 patients with UTI. There were no significant respiratory complications in post-operation.

Conclusion: Spinal surgery in patients with neuromuscular scoliosis is safe and prevents deterioration of respiratory and improve truncal balance and hence quality of life.