Author/Editor		Kosta, Eva
Title		Obravnava bolnika z radikulopatijo na invalidski komisiji
Translated title		Assessment of work disability in patients with radiculopathy
Type		članek
Source		Zdrav Vars
Vol. and No.		Letnik 39, št. 7-8
Publication year		2000
Volume		str. 168-70 in
Language		slo
Abstract		The first part of the article, the procedure and the privciples of work of the Disability Assessment Commission are described with regard to disability as defined by the law. The second part shows percentages of cases of work disability by categories in musculoskeletal diseases, in radiculopathies, and in related conditions of back pain. Disability Assessment Commission consists of two physicians and an occupational safety engineer. The expert opinion on work capacity of the presenting patients- benefits climants is given on the basis of the general practitioner's report, on the findings of the physical examination at the session, and on the claimant's own work as defined by the law. Radiculopathy occurs most frequently as a nerve root disorder of cervical and especially lumbosacral region, accompanied by nerve deficits of the limbs, thus affecting the musculoskeletal system. Usually it is a self-limiting condition with the patient fully recovering in a matter of weeks or months. Claimants presenting with resulting persisting nerve deficits and functional restrictions are assessed as invalids of the third category (defined as capable for full time work with diminished capacity for certain activities, thus requiring restrictions in working conditions). In case of radiculopathy this means lighter work with restriction of tasks including activities or movements causing further exposure of affected nerve roots. Of 21055 benefits claimants assessed for work disability in Slovenia in 1999, 14% had radiculopathy as the first diagnosis. 10% were assessed as invalids, among these 7% as third category. Finding claimants with radiculopathy in categories for more severily disabled, as well as finding cases of disability with diagnoses of just pain conditions and no objective clinical findings, can be explained as the result of using only one, main diagnosis in the data analysis. (Abstract truncated at 2000 characters).
Summary		Prvi del članka opisuje potek in načela ocenjevanja delazmožnosti na invalidski komisiji (IK), ki daje mnenja o invalidnosti, kot jo opredeljuje zakon. V drugem delu je prikazana pogostnost ocen invalidnosti, po kategorijah pri boleznih mišičnoskeletnega sistema, radikulopatijah in pri sorodnih bolečinskih in obrabnih stanjih hrbta. V IK navadno sodelujeta dva zdravnika in strokovnjak za področje dela. Kot izvedenci podajo mnenje o delazmožnosti bolnikov - zavarovancev na podlagi poročila izbranega zdravnika in specialističnih izvidov, osebnega pregleda in opisa dela zavarovanca. Odločilno je ugotovljeno funkcionalno stanje zavarovanca glede na pogoje, v katerih dela. Radikulopatija se največkrat pojavlja kot prizadetost vratnih in še posebej ledvenih živčnih korenin z nevrološkimi izpadi na okončinah in tako prizadene gibalni aparat. Večinoma se pozdravi brez pomembnih posledic. Pri redkih težjih primerih je zaradi zaostalih funkcionalnih motenj pri obolelih strokovno utemeljena ocena invalidnosti. Praviloma so kot invalidi tretje kategorije prerazporejeni na lažje delo z omejitvami položajev in aktivnosti, ki povzročajo draženje poškodovanih živčnih korenin. Analiza vseh zaradi ocene delazmožnosti obravnavanih zavarovancev v Sloveniji v letu 1999 na IK prve stopnje je pokazala, da je bila radikulopatija prva diagnoza pri 14% predstavljenih zavarovancev. Pri 10% izmed teh je bila ugotovljena invalidnost, in sicer pri 7% invalidnosti tretje kategorije. Med invalidsko upokojenimi zavarovanci jih je bilo tudi nekaj z zgolj bolečinsko simptomatiko v hrbtu. Pojavljanje radikulopatij tudi v prvi in drugi kategoriji in primeri zavarovancev le z bolečinskimi stanji med invalidi si lahko razlagamo kot posledico upoštevanja ene same, tj. glavne diagnoze pri analizi, napak v šifriranju in upoštevanja ne zgolj medicinskih meril pri ocenjevanju. (Izvleček prekinjen pri 2000 znakih).
Descriptors		RADICULITIS DISABILITY EVALUATION DISABLED BACK PAIN