The utility and tolerability of ultrasound guided muscle biopsy in the investigation of myopathy: a follow-up study.

INTRODUCTION: Open surgical muscle biopsy has traditionally been required for the histological diagnosis of myopathy but requires neurosurgical expertise with a variable diagnostic yield. Ultrasound guided percutaneous approaches are less resource intensive and invasive. This follow-up study aims to assess the diagnostic yield and tolerability of this approach to assess its utility as an adjunct to the traditional open surgical technique. METHODOLOGY: Between March of 2020 and June of 2021, 24 patients underwent a muscle biopsy following discussion at our regional neuromuscular multi-disciplinary team meeting. A consultant musculoskeletal radiologist used a modified Bergstrom needle to obtain a minimum of 2 samples under 500 mmHg of suction and ultrasound guidance. These were followed up to assess the diagnostic yield. A survey was also sent to the patients to assess the tolerability of the procedure. RESULTS: 21 out of the 24 biopsies performed provided diagnostic information. Of these 3 non diagnostic samples were obtained, two were insufficient in size and one consisted of fatty tissue. Of the 21 patients who responded to the survey, 18 rated the procedure as good or excellent with 3 patients rated it as average or poor citing administrative or communication issues rather than procedural. All 5 patients who had previously undergone surgical biopsy expressed a preference for the ultrasound guided percutaneous approach. No patients experienced any complications. CONCLUSION: This follow-up study reinforces the conclusion of its predecessor by highlighting that ultrasound guided percutaneous muscle biopsy is a useful and tolerable adjunct to the traditional surgical technique in investigating muscle disorders.

Wearable technology for spine movement assessment: A systematic review.

Continuous monitoring of spine movement function could enhance our understanding of low back pain development. Wearable technologies have gained popularity as promising alternative to laboratory systems in allowing ambulatory movement analysis. This paper aims to review the state of art of current use of wearable technology to assess spine kinematics and kinetics. Four electronic databases and reference lists of relevant articles were searched to find studies employing wearable technologies to assess the spine in adults performing dynamic movements. Two reviewers independently identified relevant papers. Customised data extraction and quality appraisal form were developed to extrapolate key details and identify risk of biases of each study. Twenty-two articles were retrieved that met the inclusion criteria: 12 were deemed of medium quality (score 33.4-66.7%), and 10 of high quality (score >66.8%). The majority of articles (19/22) reported validation type studies. Only 6 reported data collection in real-life environments. Multiple sensors type were used: electrogoniometers (3/22), strain gauges based sensors (3/22), textile piezoresistive sensor (1/22) and accelerometers often used with gyroscopes and magnetometers (15/22). Two sensors units were mainly used and placing was commonly reported on the spine lumbar and sacral regions. The sensors were often wired to data transmitter/logger resulting in cumbersome systems. Outcomes were mostly reported relative to the lumbar segment and in the sagittal plane, including angles, range of motion, angular velocity, joint moments and forces. This review demonstrates the applicability of wearable technology to assess the spine, although this technique is still at an early stage of development.