Difference between revisions of "Back Conditions"

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Donor
 
Donor
  
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==Guidance==
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==General Guidance==
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===Not acceptable (may be exacerbated by both G-CSF and bone marrow harvest)===
 
  
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Any donor with Inflammatory arthritis involving any part of the spinal column, sacro-iliac joints or hip joints, including rheumatoid arthritis, sacroiliitis and ankylosing spondylitis (but excluding osteoarthritis, spondylosis and spondylolisthesis);
+
In general, donors undergoing a bone marrow collection run the risk of exacerbating pre-existing mechanical back conditions due to the shearing forces applied to the lower back and pelvis during the procedure. However, many such donors may donate by PBSC.
  
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Any donor requiring regular steroid injections into the spine.
+
Donors with non-mechanical inflammatory back conditions, particularly those associated with autoimmune disease, such as ankylosing spondylitis, should not donate by either route.
  
−
Any donor with a back condition which may physically prohibit the donor transferring to an apheresis couch, or lying in an apheresis couch for at least four hours (venous access is not permitted in a wheelchair), or a back condition which might compromise the safety of the donor or staff during collection;
+
Any donor receiving regular steroid injection should be deferred regardless of current severity of condition  
  
−
Any donor having spinal surgery within the preceding six months;
+
Any donor with a back condition which may physically prohibit the donor transferring to an apheresis couch, or lying in an apheresis couch for at least four hours (venous access is not permitted in a wheelchair), or a back condition which might compromise the safety of the donor or staff during collection should be deferred
  
−
===Acceptable for PBSC only (assuming not excluded under 'Not acceptable')===
 
  
−
Any donor with a history of sciatica (or similar radiculopathy), disc prolapse/herniation, disc degeneration, spondylolisthesis, spondylosis or spinal stenosis, which does not require steroid injection;
+
==Individual Guidance==
  
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Any donor with a history of fracture, dislocation or instability of any axial bone or joint (including vertebra, sacrum, pelvis or proximal femur);
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Back complaints should be considered in the subgroups below
  
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Any donor with a history of spinal surgery at least six months ago;
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===Mild, occasional episodes related to exertion (incl sciatica). Minimal impact on activities of daily living and occasional use of medication===
  
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Any donor requiring either regular or frequent (at least monthly) painkillers or physiotherapy (the donor must be able to stop all non-steroidal (NSAID) medications whilst receiving G-CSF and during harvest: some donors may not be willing to do this);
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'''Recruitment'''  - Accept
 +
'''VT''' - Accept for PBSC only. Can consider BMH on case-by-case basis.
  
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Osteoporosis;
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===Severe chronic back pain. Impacts on activities of daily living===
  
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===Acceptable for both BM and PBSC===
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'''Recruitment''' - Defer
 +
'''VT''' - Defer
  
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Any back condition not excluded under 'Not acceptable' or 'PBSC only';
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===History of current or past herniated intevertebral disc===
  
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It is important that these cases are discussed with the medical officer
+
'''Recruitment''' - Accept for PBSC only
 +
'''VT''' - Accept for PBSC only
  
 +
===History of back surgery===
 +
 +
Defer if less than 6 months from date of surgery
 +
Must be fully recovered from [[surgery]]
 +
 +
'''Recruitment''' - Accept for PBSC only
 +
'''VT''' - Accept for PBSC Only
 +
 +
===Scoliosis===
 +
 +
'''Recruitment''' - Accept if no surgery and no impact on daily activities
 +
'''VT''' - Accept if no surgery and no impact on daily activities
 +
 +
 +
===History of fracture, dislocation or instability===
 +
 +
'''Recruitment''' - Accept for PBSC only provided does not meet criteria for severe chronic back pain
 +
'''VT''' - Accept for PBSC only provided does not meet criteria for severe chronic back pain
  
−
==Pseudonyms or Related Conditions==
 
  
 
 
 
==Version==
 
==Version==
−
Version 1, Edition 1
+
Version 2, Edition 1
  
 
====Date of Last Update====
 
====Date of Last Update====
−
15th June 2012
+
9 June 2016

Revision as of 16:49, 9 June 2016

Acceptability at Recruitment

QUALIFIED

Acceptability at CT / Work-Up

QUALIFIED

Individual at Risk

Donor

General Guidance

In general, donors undergoing a bone marrow collection run the risk of exacerbating pre-existing mechanical back conditions due to the shearing forces applied to the lower back and pelvis during the procedure. However, many such donors may donate by PBSC.

Donors with non-mechanical inflammatory back conditions, particularly those associated with autoimmune disease, such as ankylosing spondylitis, should not donate by either route.

Any donor receiving regular steroid injection should be deferred regardless of current severity of condition

Any donor with a back condition which may physically prohibit the donor transferring to an apheresis couch, or lying in an apheresis couch for at least four hours (venous access is not permitted in a wheelchair), or a back condition which might compromise the safety of the donor or staff during collection should be deferred


Individual Guidance

Back complaints should be considered in the subgroups below

Mild, occasional episodes related to exertion (incl sciatica). Minimal impact on activities of daily living and occasional use of medication

Recruitment - Accept VT - Accept for PBSC only. Can consider BMH on case-by-case basis.

Severe chronic back pain. Impacts on activities of daily living

Recruitment - Defer VT - Defer

History of current or past herniated intevertebral disc

Recruitment - Accept for PBSC only VT - Accept for PBSC only

History of back surgery

Defer if less than 6 months from date of surgery Must be fully recovered from surgery

Recruitment - Accept for PBSC only VT - Accept for PBSC Only

Scoliosis

Recruitment - Accept if no surgery and no impact on daily activities VT - Accept if no surgery and no impact on daily activities


History of fracture, dislocation or instability

Recruitment - Accept for PBSC only provided does not meet criteria for severe chronic back pain VT - Accept for PBSC only provided does not meet criteria for severe chronic back pain


Version

Version 2, Edition 1

Date of Last Update

9 June 2016

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