Low back pain- Algorithm of diagnosis and management

Introduction: Low back pain is a frequent condition, associated as a symptom with a multitude of organic or non-organic pathologies, resulting in the appearance of disability generating negative economic and soc-professional consequences. Being a relatively common symptom among patients, we created this paper with the aim to high-light the importance of the clinical examination along with the correct direction of the patient to a profile depart-ment, the review of differential diagnoses, as well as the establishment of a particular recovery plan adapted to each case. Materials and Methods: We analyzed a series of recent articles using the PubMed and the Cochrane Library data-bases ,using the keywords words “low back pain” and “rehabilitation”, to obtain data on the clinical and paraclinical examination, positive and differential diagnosis of chronic low back pain, as well as on rehabilitation management. Results: Low back pain may appear due to vertebral conditions (inflammatory, infectious, traumatic, neoplastic, degenerative, metabolic), or due to extravertebral causes. Along with the anamnesis, clinical examination and im-agistic investigations, we establish the positive diag-nosis and create an individualised rehabilitation plan. The reha-bilitation protocol is divided into stages , the final goal is to minimize the ischemia-pain-contracture chain. Conclusion: The pathology of the lumbosacral spine can be characterized by the word "diversi-ty", being one of the causes of early disability of the population in the field of work. Our work highlights the importance of the clinical and paraclinical examination in outlining the differen-tial diagnosis of chronic lumbar pain, as well as the role of the multidisciplinary team in com-plex individualized rehabilitation treatment

Analysis of cognitive status during rehabilitation after hip arthroplasty associated with pre-existing knee arthroplasty on the same leg: Case Presentation

Introduction: Hip arthroplasty conducted through either cemented or cementless prostheses must alleviate pain and restore joint mobility and muscle strength. The main goal is to restore mobility, stability and to maintain ADL (Activities of Daily Living) within normal parameters. Current surgical techniques allow for state-of-the-art surgeries to be performed. Yet, the postop-erative course is strongly influenced by both pre-and postoperative psychological factors, as well as by associated diseases. Materials and Methods: We present the case of a 79-year-old female patient from Iasi, a retired yet still physically active gym teacher who was admitted an emergency to the Orthopedics Clin-ic of the ”Sf. Spiridon” Emergency Hospital with a displaced left femoral neck fracture resulting from same-level fall. The patient had for 6 years a Scorpio-Stryker cemented knee prosthesis on the same leg. Through surgical intervention, a cementless bipolar Lépine prosthesis was inserted into the left hip. Then, the patient presented to the Department of Physical Medicine and Reha-bilitation of the Iasi Clinical Railroad Hospital to receive an adequate post-operative rehabili-tation program. Results: The psychosocial factors have been analyzed with the help of various recent and spe-cialized psychological scales. The obtained results confirm the fact that these factors significantly influence the rehabilitation of prosthesis-wearing patients. Conclusion: Our study emphasizes the psychological impact on standing and walking rehabili-tation in a patient with two prostheses on the same motor axi