Correlation between Bone Mineral Density and Interverterbral Disc Degeneration

OBJECTIVE: To examine the correlation between bone mineral density and intervertebral disc degeneration through retrospective study. METHOD: Bone mineral density (BMD) and Magnetic resonance (MR) image of lumbar spine from 61 postmenopausal women were assessed to examine the correlation between bone mineral density and intervertebral disc degeneration. We determined BMD of lumbar spine using the dual energy X-ray absorptiometry (DEXA). And we evaluated signal intensity of intervertebral disc, disc height and disc herniation at each lumbar disc level using the MR image. The correlation between BMD (mean value of 2nd, 3rd and 4th lumbar spine BMD) and the sum of grading scores of intervertebral disc degeneration was assessed in all the patients. RESULTS: There was a positive correlation between BMD of lumbar spine and the sum of grading scores of intervertebral disc degeneration (r=0.415, p value=0.00087). CONCLUSION: Bone mineral density has an inverse correlation to intervertebral disc degeneration and which is important when considering degenerative spinal disease and osteoporosis.

Comparison of Lumbar Lordosis according to Heel Height in Normal Adults and Patients with Spondylolisthesis

OBJECTIVE: To evaluate how to influence static lumbar lordosis by different heel heights in normal adults and patients with spondylolisthesis. METHOD: The lumbolumbar angles, lumbosacral angles and slip angles were examined while standing on barefoot, on heel support with 5 cm heel, and with 10 cm heel in 14 normal adults and 10 patients with first grade of spondylolisthesis. Standing lumbar spine lateral view was performed by one half hour adaptation with corresponding shoe types. RESULT: The lumbolumbar angles (angles between upper margin of 2nd lumbar body and low margin of 5th lumbar body) and the lumbosacral angles (between upper margin of 2nd lumbar body and low margin of 1st sacral body) in normal are 36.8+/-6.5degrees, 50.1+/-9.5degrees on barefoot, 36.0+/-7.3degrees, 49.6+/-7.4degrees on heel support with 5 cm heel, and 36.1+/-7.6degrees, 49.7+/-8.3degrees with 10 cm heel. Lumbolumbar angles and lumbosacral angles in 10 patients with spondylolisthesis 38.8 8.3degrees on barefoot, 47.2+/-10.4degrees on heel support with 5 cm heel, 38.3+/-7.0degrees, 47.7+/-9.2degrees with 10 cm heel. The slip angles in 10 patients with spondylolisthesis are 29.8+/-1.2degrees on barefoot, 30.2+/-1.8degrees on heel support with 5 cm heel, and with 10 cm heel. CONCLUSION: The changes of heel height did not significantly influence the lumbar lordosis in normal adults and patients with spondylolisthesis. There were no significant differences in average slip angle according to heel height in patients with spondylolisthesis were found.

Comparison of Catecholamine Levels in Hemiplegic Patients with and without Reflex Sympathetic Dystrophy

OBJECTIVE: To determine whether the cause of sympathetic dysfunction is due to increased regional sympathetic outflow or receptor supersensitivity to circulating catecholamines in the pathogenesis of reflex sympathetic dystrophy in hemiplegia. METHOD: Ten hemiplegic patients with reflex sympathetic dystrophy were instructed to refrain from smoking or using caffeine and alcohol, and medications that influence catecholamine metabolism were witheld for 24 hours before blood sampling. Patients with cardiovascular disease, diabetes or abnormal liver and renal function tests were excluded from the study. Patients with a history of sympathectomy were also excluded. Ten hemiplegic patients without reflex sympathetic dystrophy served as the control group. Both groups of patients rested in supine position in a quiet room for 30 minutes. A needle with heparin cap was inserted into the dorsal venous arches of the affected hand and patients rested for another 20 minutes, after which blood was drawn through the heparin cap. The blood samples were assayed using high-performance liquid chromatography (HPLC) and norepinephrine and epinephrine were detected electrochemically. 24 hour urine was collected during rest and vanillylmandelic acid (VMA) and metanephrine were also detected using HPLC. RESULTS: The mean plasma norepinephrine levels were 1.05 0.24 ng/ml and 0.47 0.06 ng/ml in RSD affected and unaffected groups respectively, and the plasma norepinephrine level was significantly higher in the patient group with reflex sympathetic dystrophy (p<0.05). The plasma epinephrine and 24-hour urine VMA and metanephrine levels were not significantly different in two groups. CONCLUSION: These results may support a hypothesis of increased regional sympathetic outflow in the pathogenesis of reflex sympathetic dystrophy in hemiplegia.

Risk Factors of Low Back Pain in a General Population

OBJECTIVE: To examine the correlation between the prevalence and the risk factors of low back pain. METHOD: The number of subjects in this study was 575 men and 325 women who have visited the health center of the CHA hospital. The prevalence of low back pain was evaluated and the risk factors were assessed by history taking, physical examination and the questionnaires. Estimated factors influencing low back pain were age, sex, height, weight, body mass index, waist to hip ratio, range of motion, smoking, alcohol drinking, fitness and other disease. RESULTS: 1) Low back pain was correlated with age, sex, waist to hip ratio, flexibility, arthritis, nervous and depressive disorder and daily activities. 2) Chronic low back pain was correlated with age, right lateral bending, arthritis, cardiovascular disorder and daily activities. 3) Radicular symptom was correlated with age, left and right lateral bending, smoking, exercise, arthritis, nervous and depressive disorder, diabetes and daily activities. 4) Height, weight, body mass index and alcohol drinking had no correlation with low back pain. CONCLUSION: Understanding of the risk factors for low back pain will be helpful for providing objective standards for assessment of low back pain and preventing occurrence and recurrence of low back pain.