Document o9qBZ6ZDe37OQw2DNQrXkwZDg

JUL-28-2003 02:30P FROM: IU- ItUAAJV i w . . with these when timers may be an occupational aspact apart from a direct accident* Since tack conditions are so varied and result from bo many different Causes, moat of which are entirely unrelated to the job, it la difficult to classify them properly or to treat them adequately. Because the subject is so all Inclusive, 1 shall not attempt to do any- thlHg'more' than discuss briefly our policy with regard to the value of x-rays In these ailments. t We have been asked on numerous occasions why we do not take x-rays, of the spine on all preplacement applicants to rule out potential back cases* We have not advocated this 'procedure ;for the following reasons. 1.' Taking x-rays of the spine is an expensive, timeconsuming procedure, requiring specialised equip ment and expert technicians* 2V interpretation of suoh films la not particularly satisfactory even In the hands of highly competent orthopedic surgeons* 3. The experienoe of other .Industries who have tried it has not been such that it la a justifiable venture. , j, ( : 4# Even where the Company is large and has an "ln plant" medical hospital completely equipped and staffed with a large x--ray department, the value of such a policy is very dubious, 5, in Brake Shoe with Its many soattered locations and varied population, the Idea is just not feasible or, in my opinion, justifiable. This does not mean that x-ray of the spine in certain salaoted oases should not be made. They flhould. be taken hub eaoh must be decided * on an Individual basis rather the a Company wide program. We believe that the "teaoh them to lift properly1* idea is the simplest and most effeotlve procedure If adequately explained and insisted upon. Herniated Diaos. Most of you are faoed with this situation at some time or other and a 'word about our polloy in this oase might be timely. nRemlatd Die oh" have become very popular in the last ten years and while not minimizing their significance, I believe that the value of surgloal removal has been over-emphasized or perhaps not properly applied to suitable ca^es. If the disc material (nucleus pulposus) has herniated or ruptured through the oartiloginous oapsule of the Intervertebral disc and a fragment is lying out in the foramen of the spinal canal against a nerve root, the patient will almost oertainly be a victim of intract able sciatica. He cannot be expected to "Improve on conservative therapy "!,2f8t*supports, etc. Simple surgical removal of the disc in this ipyob. y oo^pibtely restore his employability. But every such syndrome is not cured by removal of the disc. Stabilization of associated 80 I a t 4 SPNY 000150