S288 S290
Objective:
To evaluate parental satisfaction in patients who were
treated with a pharmaceutical grade of tetra-hydro cannabinol (THC):
Marinol (Dronabinol), for neuro-irritability and agitation not respond-
ing to traditional medications.
Design:
Convenience cohort study using structured phone interviews
to assess parental perceptions of benefit in their child’s agitation,
sleep duration, muscle tone, muscle spasticity, attention span, and
displays of physical violence. A standardized agitation scale was also
used in a small subset.
Setting:
Tertiary Children’s hospital in Rocky Mountain Region.
Participants:
15 subjects mean age of 13.9 years (range 7-40) with a
secondary diagnosis of agitation. Primary diagnoses were cerebral
palsy (n
¼
9), developmental delays (n
¼
3), brain injury (n
¼
2), and
Angelmen Syndrome (n
¼
1). Majority of the population were white
(86.7%) non-Hispanics (80.0%).
Interventions:
Not applicable.
Main Outcome Measures:
Qualitative and quantitative assessment of
agitation and other symptoms.
Results:
Overall 73.3% of parents felt that Marinol was effective in
treating their child’s agitation. 13% of families reported that taking
Marinol helped their child sleep more. 20% of families felt there was a
positive change in muscle tone and muscle spasticity and attention
span. 20% of families felt their child displayed less physical violence
while being treated. 73.3% of families decided to stay on Marinol and
in total 86.7% of families continued medical TCH treatment.
Conclusions:
Marinol may be a promising option for treatment of
agitation as well as other secondary sequelae of pediatric brain
damage from various causes. These preliminary results suggest that
further work is warranted on the use of Marinol in treating symptoms
resistant to other treatment paradigms.
Level of Evidence:
Level III
CATEGORY: PAIN & SPINE MEDICINE
Poster 487:
A Minimum of 5-Year Follow-Up after Lumbar Transforaminal
Epidural Steroid Injections in Patients with
Lumbar Radicular Pain due to Intervertebral Disc Herniation
David J. Kennedy, MD (Stanford University, Redwood City, CA, United
States), Patricia Z. Zheng, MD, Matthew Smuck, MD,
Zachary McCormick, MD, Lisa Huynh, MD, Byron J. Schneider, MD
Disclosures:
David Kennedy: I Have No Relevant Financial Relation-
ships To Disclose
Objective:
To determine the long-term outcomes for patients with
acute unilateral lumbar radicular pain after lumbar epidural steroid
injection at 5 years.
Design:
Prospective cohort study.
Setting:
2 academic institutions.
Participants:
18 years old with single leg radicular pain rating 4/10
for less than 6 months duration, with radiographic congruent single
level herniated nucleus pulposus.
Interventions:
All patients initially underwent a single level lumbar
TFESIs due to failure of conservative care, but could elect to pursue
surgical intervention or repeat injections.
Main Outcome Measures:
Pain and functional markers as determined
by independent phone interview at least 5 years after initial
enrollment.
Results:
At 5 years, 39 (50%) of the original 78 subjects were reach-
able for independent phone follow-up. Of these, 30 [76.9%, 95% CI
(61.7-87.4%)] had a history of recurrent pain since the initial TFESI.
However, only 9 [23.1%, 95% CI (12.7-38.3%)] had current pain, while 3
[7.7%, 95% CI (2.7-20.3%)] were currently taking opioid medications. 9
[23.1%, 95% CI (12.7-38.3%)] had received additional TFESIs, and 19
[48.7%, 95% CI (33.9-63.8%)] had received surgery. Only 3 [7.7%, 95% CI
(2.7-20.3%)] were unemployed due to related pain at time of follow-
up. When comparing the group that had surgery vs those that did not,
there were no differences in the rates of recurrent pain (16, 84.2% vs
14 (70.0%, P
¼
.81), current pain (6, 31.6% vs 3, 15.0%, P
¼
.47), opioid
use (2, 10.5% vs 1, 5.0%; P
¼
1.00), rate of additional injections (6,
31.6% vs 3, 15.0%, P
¼
.47), or unemployment status (2, 10.5% vs 1,
5.0%; P
¼
1.00).
Conclusions:
Despite a high success rate at 6 months, the majority
of subjects experienced a recurrence of symptoms at some time
during the subsequent 5 years. Lumbar disc herniation is a disease
that can be effectively treated in the short-term by TFESI or surgery,
but long-term recurrence rates are high regardless of treatment
received.
Level of Evidence:
Level III
CATEGORY: MSK & SPORTS MEDICINE
Poster 488:
The Prevalence of Musculoskeletal Complaints and Pain
Intensity in Furniture Industry Workers in Brazil
Vinicius Tieppo Francio, MD/PhD(c) (USAT College of Medicine,
Oklahoma City, OK, United States), Luana Tasca, MS, Chris Towery,
PA-C, NP, Saeid Davani, MD/PhD Candidate, USAT
Disclosures:
Vinicius Tieppo Francio: I Have No Relevant Financial
Relationships To Disclose
Objective:
To determine the prevalence of musculoskeletal com-
plaints and the mean greatest intensity of pain in Brazilian workers of
the furniture industry, including administrative, shipping, machinery
and packaging sectors.
Design:
Prevalence study.
Setting:
Industrial.
Participants:
200 furniture industry workers.
Interventions:
The adapted Corlett and Bishop form was utilized to
collect the mean pain intensity and most common areas of complaint.
Main Outcome Measures:
N/A.
Results:
The lumbar spine region was the most common area of
complaint reported by 114 individuals (57%), followed by the upper
thoracic with 95 individuals (47.5%), and the cervical spine with 90
individuals (45%). Specifically, machinery, packaging and shipping
sector workers reported the lumbar spine most commonly, in contrast
to the upper thoracic and cervical spine, by administrative workers.
The greatest mean pain intensity was a 7-10 (lumbar spine) and 6-10
(left knee) by workers of the shipping sector, followed by 5-10 (cer-
vical spine) and 3-10 (right shoulder, upper thoracic spine), by workers
of the administrative sectors. Interestingly, shipping workers reported
the least number of complaints (lumbar spine and left knee), but the
greatest mean pain intensity (7-10 and 6-10, respectively). The ma-
chinery sector reported the lowest mean pain intensity (3-10), but the
greatest number of complaints (lumbar, cervical, upper thoracic spine,
right wrist, and right shoulder).
Conclusions:
At least one musculoskeletal complaint was reported by
all individuals, with 7-10 to 3-10 mean pain levels. These findings could
potentially be associated to repetitive movements related to specific
sectors, such as the shipping sector that requires more lower body
mechanics, in contrast to the machinery sector, which requires more
upper body mechanics. This data emphasizes the importance muscu-
loskeletal injury screening, treatment and prevention to potentialize
work-performance, cost-effectiveness and prevent miss days at work.
Level of Evidence:
Level IV
S288
Abstracts / PM R 9 (2017) S131-S290