Quantitative Correlations of Trunk Muscles in Young and Middle-aged Men with Chronic Low Back Pain by Magnetic Resonance Imaging

OBJECTIVE: To evaluate the correlation of the cross-sectional areas (CSA) of paraspinal (multifidus and erector spinae) and psoas muscles and chronic low back pain by MRI (magnetic resonance image) in young and middle-aged patients. METHOD: Medical records of eighty subjects (50 young-aged and 30 middle-aged men) with low back pain were retrospectively reviewed. Their MR images were scanned and analysed by means of pixel to find the lumbar paraspinal and psoas muscle CSA and evaluated the correlation of the types of disc and age. RESULTS: There were significant increases of body mass index (BMI) in middle-aged patients compared with young- aged, and no difference in the disc types. Paraspinal muscle atrophy was increased in young patients with HIVD (herniated intervertebral disc), but not in middle-aged patients although they had HIVD. CONCLUSION: The paraspinal and psoas muscle atrophy could be assessed by MRI of lumbar spine in young patient with chronic low back pain. It may helpful for further evaluation and planning the treatment of low back pain.

Comparison between the Effect of Local Steroid Injection and Prolotherapy on Iliac Crest Pain Syndrome

OBJECTIVE: To evaluate the therapeutic effect of local steroid injection and prolotherapy on the iliac crest pain syndrome (ICPS) in patients with nonspecific low back pain. METHOD: 44 patients with ICPS were chosen randomly. The treatment groups were divided into two. The first group received a mixture of triamcinolone and lidocaine. The second received with a mixture of dextrose and lidocaine. The patients in each group were injected once a week over 4 weeks. The effectiveness of treatment was evaluated by a visual analogue scale (VAS), a pressure threshold and patient's life activities with modified Oswestry questionnaire before injection, 30 minutes, 1 week, 4 weeks and 3 months later after injection respectively. RESULTS: VAS, pressure threshold and patient's life activities of two groups were all improved at 30 minutes, 1 week, 1 month and 3 months after injection compared with those of pre-injection, and there was no significant difference between groups. CONCLUSION: The low back pain on ICPS can be significantly improved by local steroid injection and prolotherapy equally. Therefore, patients with risk of steroid injection could be treated by prolotherapy.

Brachial Plexopathy Caused by Pancoast Tumor: A case report

Pancoast tumor is a specific lung carcinoma that has symptoms according to the location. It often involves the extrathoracic structure more than parenchyme of lung, that cause shoulder pain. A 61-years old man had been complaining of shoulder pain and limitation of range of motions of shoulder joint. Conservative management of the shoulder pain was not effective with physical therapy and injection therapy and the symptom of right upper extremity radiating pain had been aggravated. We had examination of the eletro-diagnostic test in 17 months after shoulder pain was developed. The findngs of the electrodiagnostic test was suspected as the injury of lower trunk of brachial plexus, so we had checked MRI on brachial view. The pancoast tumor was found in the extrathoracic region that invaded the lower trunk of the brachial plexus. The shoulder pain related with tumor was rare and could cause brachial plexopathy.