Degenerativne bolesti cervikalne i lumbosakralne kralješnice u sklopu opće invalidnosti

From a sample of workers declared as disabled during 1981, 111 males and 36 females were selected in whom a rheumatic umatic disease was one of the first two diagnoses on the basis of which the respective commissions declared them as disabled. The average age of the workers was 52 ± 6.17 years, and length of active work 25.9 ± 7.18 years. Of the 147 examiness 29% were unskilled workers, 40% were skilled, and 14% highly skiled workers, while 17% of the disabled in the sample were employees. Rheumatic complaints were the main cause of disability in 31.3% of the examined persons. Pain in the cervical part of the spine was registered in 48.9%, and in the lumbo-sacral part in 88.5% of the examinees. Compressive radicular syndrome of the cervical spine of a moderate or serious degree was diagnosed in 23.2%, and the syndrome of the lumbo-sacral spine in 67.7% of the examinees. A positive Lazarevic-Laseque sign was registered in 24.5% of the disabled - in 8.2% of them on both sides. As regards the capacity of work of these disabled persons, 58.5% of them were found to be totally unfit for work; 21.8% were found to be able to do some other work; and 19.7% were found to have been pensioned off prematurely because of a rheumatic complaint. The possibilities are discussed of the prevention and treatment of myelo-radicular compressive syndromes as very frequent causes both of temporary and of permanent disability.U uzorku ispitanika koji su tijekom 1981. god. proglašeni invalidima rada odabrano je 111 muškaraca i 36 žena u kojih su reumatske bolesti bile jedna od prve dvije dijagnoze zbog kojih su komisije bolesnike proglasile invalidima. Prosječna životna dob ispitanika bila je 52 ± 6,2 god. a radni staž 25,9 ± 7,2 god. Od 147 ispitanika 29% su bili NKV, 40% KV, 14% VKV radnici, a 17% invalida u uzorku bili su službenici. Reumatske bolesti bile su glavni uzrok invalidnosti u 31,3% invalida. Tijekom pregleda i obrade u Centru za ocjenu radne sposobnosti Instituta za medicinska istraživanja i medicinu rada u Zagrebu, bolnost u vratnom dijelu kralješnice registrirana je u 48,9%, a u slabinskom dijelu u 88,5% ispitanika. Kompresivni radikularni sindrom vratne kralješnice umjerenog ili težeg stupnja dijagnosticiran je u 23,2 % a sindrom slabinske kralješnice utvrđen je u 67,7% bolesnika. Pozitivan Lazarević-Lasegueov znak zabilježen je u 24,5% ispitanika, i to u 8,2% obostrano. S obzirom na radnu sposobnost ovih invalida, ocijenjene je da 58,5% ispitanika uopće nije bilo sposobno za posao, 21,8% bi moglo obavljati neki drugi posao, a 19,7% je zbog reumatskih bolesti prerano umirovljeno. Raspravlja se o mogućnostima prevencije i terapije mijeloradikularnih kompresivnih sindroma, kao vrlo čestih uzroka privremene i trajne radne nesposobnosti. Čini se da bi dugotrajnom konzervativnom liječenju tih tegoba trebalo dati prednost pred kirurškim tretmanom. Pravilnoj i pravovremenoj upotrebi ortopedskih pomagala trebalo bi posvetiti više pažnje