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1.
J Med Life ; 15(6): 871-875, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35928356

RESUMO

The purpose of this case report was to describe chiropractic management of acute lumbar disc herniation in a patient with a large abdominal aortic aneurysm. A 72-year-old male patient presented with low back pain and right lower leg numbness for 12 months. A review of full-spine X-ray and lumbar MRI revealed moderate spondylosis at L2-5, moderate lumbar scoliosis, and a 7.15 cm abdominal aortic aneurysm (AAA). Given the minimum 2-weeks of referral waiting time to receive treatment for AAA, the patient received chiropractic treatment with a hybrid rehabilitation to address the disc herniation causing severe physical disability. Through the treatments, the patient's pain was significantly alleviated with careful consideration of potential risk factors associated with AAA. In addition, the acute disc herniation was successfully managed by a series of chiropractic treatments before and after the operation for AAA. This case supports that low back pain in patients with AAA can be managed by manual therapy, in contrast to a widespread belief that manual therapy is contraindicated in AAA. More case reports of AAA patients with low back pain are warranted to assess the effectiveness and safety of manual therapy along with surgical treatment for AAA.


Assuntos
Aneurisma da Aorta Abdominal , Deslocamento do Disco Intervertebral , Dor Lombar , Idoso , Aneurisma da Aorta Abdominal/complicações , Aneurisma da Aorta Abdominal/diagnóstico por imagem , Aneurisma da Aorta Abdominal/cirurgia , Humanos , Deslocamento do Disco Intervertebral/complicações , Deslocamento do Disco Intervertebral/diagnóstico por imagem , Deslocamento do Disco Intervertebral/cirurgia , Perna (Membro) , Dor Lombar/etiologia , Vértebras Lombares/diagnóstico por imagem , Vértebras Lombares/cirurgia , Imageamento por Ressonância Magnética , Masculino
2.
BMC Med Imaging ; 22(1): 138, 2022 08 05.
Artigo em Inglês | MEDLINE | ID: mdl-35931973

RESUMO

BACKGROUND: Low back pain (LBP) is one of the most serious public health problem globally with substantial socioeconomic implications. Degenerative disc disease is an important cause of LBP in the elderly. Magnetic resonance imaging (MRI) is routinely ordered by physicians in evaluation of patients with suspected degenerative disc disease in the lumbar spine. However there is no unanimous agreement in the literatures when it comes to the association of degree of disability to that of severity of lumbar MRI findings. OBJECTIVE: The aim of this study is to assess the association between degree of disability measured using Oswestry Disability Index (ODI) and findings on lumbar spine MRI in patients with degenerative disc disease at University of Gondar comprehensive Specialized Hospital, North West Ethiopia, 2020. METHODS AND MATERIALS: A prospective cross-sectional study was conducted on 72 consecutively enrolled patients with degenerative disc disease who underwent lumbar MRI scan. Degree of disability was measured using ODI questionnaire translated to local language. Association between lumbar spine MRI parameters and ODI score and category was tested using Spearman's rank correlation coefficient and Chi square tests. RESULTS: The mean age of the study subjects was 43.81 ± 1.88 years (range 22-83 years). Forty-three (59.7%) of the study population were female. In terms of ODI category, most fell under minimal 33 (45.8%) or moderate 25 (34.7%) disability. Disc bulge (81.9%) and foraminal stenosis were the most frequent MRI abnormalities detected. ODI score showed weak correlation with grade of spinal canal stenosis. Grade of foraminal stenosis showed no correlation with ODI score. CONCLUSION: The clinical relevance of MRI findings in predicting degree of disability in patients with degenerative disc disease is limited and MRI study should be sparingly ordered in evaluation of these patients particularly in resource constrained settings.


Assuntos
Degeneração do Disco Intervertebral , Dor Lombar , Adulto , Idoso , Idoso de 80 Anos ou mais , Constrição Patológica/complicações , Estudos Transversais , Etiópia , Feminino , Hospitais , Humanos , Degeneração do Disco Intervertebral/diagnóstico por imagem , Dor Lombar/diagnóstico por imagem , Dor Lombar/etiologia , Vértebras Lombares/diagnóstico por imagem , Imageamento por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Adulto Jovem
3.
BMC Public Health ; 22(1): 1493, 2022 08 05.
Artigo em Inglês | MEDLINE | ID: mdl-35931976

RESUMO

BACKGROUND: With the acceleration of industrialization and population aging, low back pain (LBP) has become the leading cause of life loss years caused by disability. Thus, it places a huge economic burden on society and is a global public health problem that needs urgent solution. This study aimed to conduct an epidemiological investigation and research on a large sample of workers in key industries in different regions of China, determine the incidence and distribution characteristics of LBP, explore the epidemic law, and provide a reference basis for alleviating global public health problems caused by LBP. METHODS: We adopted a modified epidemiological cross-sectional survey method and a stratified cluster sampling method. All on-duty workers who fulfill the inclusion criteria are taken as the research participants from the representative enterprises in key industries across seven regions: north, east, central, south, southwest, northwest, and northeast China. The Chinese version of the musculoskeletal disease questionnaire, modified by a standardized Nordic questionnaire, was used to collect information, and 57,501 valid questionnaires were received. Descriptive statistics were used, and multivariate logistic regression analysis (p < 0.05) was performed to explore the association between musculoskeletal disorders and potential risk factors. RESULTS: LBP annual incidence among workers in China's key industries is 16.4%. There was a significant difference in LBP incidence among occupational groups across different industries (p < 0.05). The multivariate regression model showed the following as risk factors for LBP: frequent repetitive movements with the trunk, working in the same positions at a high pace, trunk position, frequently turning around with your trunk, often working overtime, lifting heavy loads (i.e., more than 20 kg), education level, staff shortage, working age (years), cigarette smoking, use of vibration tools at work, body mass index, lifting heavy loads (i.e., more than 5 kg), and age (years). Physical exercise, often standing at work, and absolute resting time were protective factors. CONCLUSION: LBP incidence among key industries and workers in China is high. Thus, it is urgent to take relevant measures according to the individual, occupational, and psychosocial factors of LBP to reduce the adverse impact of LBP on workers' health.


Assuntos
Dor Lombar , Doenças Profissionais , China/epidemiologia , Estudos Transversais , Humanos , Dor Lombar/epidemiologia , Dor Lombar/etiologia , Doenças Profissionais/etiologia , Prevalência , Fatores de Risco , Inquéritos e Questionários
4.
N Engl J Med ; 387(5): 478-479, 2022 08 04.
Artigo em Inglês | MEDLINE | ID: mdl-35921469
6.
N Engl J Med ; 387(5): 479-480, 2022 08 04.
Artigo em Inglês | MEDLINE | ID: mdl-35921471
7.
Neurosci Lett ; 786: 136806, 2022 08 24.
Artigo em Inglês | MEDLINE | ID: mdl-35850319

RESUMO

BACKGROUND: For people above 65 years old, low-back pain (LBP) is associated with balance problems and falls. Down-weighting of proprioception due to ageing and LBP may cause such balance problems. While lumbar proprioceptive deficits have been shown in LBP and indications for more generalized deficits have been found, ankle proprioception, which is crucial for balance control, has not been studied in people with LBP. RESEARCH QUESTION: Is there any difference in ankle proprioceptive acuity between community-dwelling older adults with and without LBP? We hypothesized that ankle proprioception was impaired in community-dwelling older adults with LBP compared to those without LBP. METHODS: Thirty participants over 65 years old volunteered. Fifteen had LBP (M/F = 2/13, age = 72.0 (4.6) years), fifteen were healthy controls without back pain (control group) (M/F = 2/13, age = 72.1 (4.8) years). Ankle proprioception was measured in normal weight-bearing conditions, using the Active Movement Extent Discrimination Apparatus (AMEDA). Accuracy on the ankle proprioceptive test was expressed as absolute error (AE), constant error (CE) and variable error (VE). RESULTS: AE was significantly larger (P = 0.029, 95 % CI = [0.00, 0.90]) in the LBP group, CE was also significantly larger (P = 0.046, 95 % CI = [-0.91, -0.01]), indicating an underestimation of ankle inversion in participants with LBP compared to controls. VE was not different between the two groups (P = 0.520, 95 % CI = [-0.20, 0.59]). No significant correlation was found between pain intensity and AE, CE or VE (P > 0.05). CONCLUSION: Ankle proprioception decreased in older people with LBP compared to healthy peers, suggesting impaired central proprioceptive processing. Older people with LBP underestimate the extent of ankle inversion, which may increase fall risk. Thus, evaluation and training of ankle proprioception may be useful in older people with LBP.


Assuntos
Dor Lombar , Idoso , Tornozelo , Articulação do Tornozelo , Humanos , Vida Independente , Dor Lombar/etiologia , Propriocepção
8.
Spinal Cord Ser Cases ; 8(1): 70, 2022 07 26.
Artigo em Inglês | MEDLINE | ID: mdl-35882852

RESUMO

INTRODUCTION: Cysticercosis, caused by Cysticercus cellulosae, is one of the common parasitic diseases that can affect the central nervous system (neurocysticercosis, NCC). Isolated involvement of cysticercosis of the spine, without the involvement of the brain, has been very rarely reported. CASE PRESENTATION: This report presented a case, who was presenting with low back pain with radiation and cauda equina syndrome (CES). On MRI, the patient was found to have a subarachnoid cystic lesion at the level of lumbosacral vertebrae. Under neurosurgery, the patient underwent L5/S1 laminectomy, decompression, and excision of the cyst. On histopathological examination, the patient was diagnosed of having Cysticercosis. Immediately after surgery, the patient had neurological deterioration. However, at the end of 1 year, the patient had significant improvement both neurologically and functionally. DISCUSSION: Spinal NCC should be considered in the differential diagnosis for a patient, who presents with a cystic lesion in the spinal subarachnoid space. Surgical exploration and excision of the cysts should be conducted not only to establish the diagnosis but also to decompress the cord and peripheral nerves.


Assuntos
Síndrome da Cauda Equina , Cisticercose , Dor Lombar , Neurocisticercose , Síndrome da Cauda Equina/diagnóstico , Síndrome da Cauda Equina/etiologia , Síndrome da Cauda Equina/cirurgia , Cisticercose/diagnóstico , Humanos , Dor Lombar/etiologia , Neurocisticercose/diagnóstico , Neurocisticercose/diagnóstico por imagem , Coluna Vertebral/patologia
9.
Artigo em Inglês | MEDLINE | ID: mdl-35886392

RESUMO

Musculoskeletal disorders (MSDs) represent a significant occupational burden for dentists and dentistry students. This study aimed to assess the five-year development of most common musculoskeletal complaints among dentistry students during the whole length of their studies and to analyze the impact of some potentially associated risk factors. A longitudinal questionnaire survey regarding the occurrence of MSDs was conducted among a total of 73 dentistry students between 2014 and 2021. The same students enrolled in three consecutive years were monitored throughout their entire studies. Statistical analysis was performed using methods of descriptive statistics, Chi-square test, Fisher's exact test, McNemar test, and univariate and multivariate logistic regression analyses. The most frequent areas of complaints were neck (61.6%) and lower back (49.3%). The increase in self-reported complaints between the first and the fifth year was statistically significant for neck pain (increase by 15%, p = 0.043) but not for lower back pain (by 6.8%, p = 0.44). According to our data, age, performing top-level sport, and participating in regular sporting activities had a statistically significant influence on neck and/or back pain. The results of this longitudinal prospective study showed that neck, as well as lower back pain, are significant problems for dentistry students.


Assuntos
Dor Lombar , Doenças Musculoesqueléticas , Doenças Profissionais , Odontologia , Humanos , Dor Lombar/epidemiologia , Dor Lombar/etiologia , Doenças Musculoesqueléticas/epidemiologia , Cervicalgia/epidemiologia , Doenças Profissionais/epidemiologia , Prevalência , Estudos Prospectivos , Fatores de Risco , Estudantes , Inquéritos e Questionários
10.
Rev Med Suisse ; 18(790-2): 1460-1463, 2022 Jul 20.
Artigo em Francês | MEDLINE | ID: mdl-35856514

RESUMO

Low back pain is a common symptom in athletes, hindering their activity. The etiology is tightly linked to the type of sport, often a consequence of repetitive movements, high pressures and strain being applied to the spine and adjacent muscular and ligamentous structures and a high degree of activity. The diagnosis is the key and causes are usually not severe. However, some red flags may indicate a more serious origin. Treatment is mostly conservative and based on functional therapies with the goal of a rapid and secure return to sports. As such, sedentary lifestyle should be avoided.


La lombalgie est un symptôme courant chez les athlètes pouvant entraver leur pratique sportive. L'étiologie est intimement liée au type d'activité pratiquée, souvent secondaire aux mouvements répétitifs, aux forces appliquées sur les structures musculosquelettiques et au degré d'activité. Le diagnostic clinique reste essentiel pour la prise en charge et les causes sont le plus souvent peu sévères. Des drapeaux rouges peuvent néanmoins alerter la présence d'une atteinte grave nécessitant une prise en charge urgente. L'imagerie immédiate étant indiquée uniquement en leur présence. Le traitement est dans la majeure partie des cas conservateur et basé sur les thérapies fonctionnelles dans l'objectif d'un retour sécuritaire au sport de prédilection dès que possible. La sédentarité, quant à elle, est à proscrire.


Assuntos
Traumatismos em Atletas , Dor Lombar , Esportes , Atletas , Traumatismos em Atletas/complicações , Traumatismos em Atletas/diagnóstico , Traumatismos em Atletas/terapia , Dor nas Costas/etiologia , Humanos , Ligamentos , Dor Lombar/diagnóstico , Dor Lombar/etiologia , Dor Lombar/terapia
11.
Am J Case Rep ; 23: e936600, 2022 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-35776690

RESUMO

BACKGROUND Ankylosing spondylitis (AS) is an immune-mediated chronic inflammatory condition grouped under spondyloarthritis (SpA), which is an umbrella term for a group of interrelated inflammatory rheumatic conditions with characteristic radiographic findings such as erosions and ankylosis of the sacroiliac joint. Unfortunately, there is an average delay of 8-9 years between the onset of the symptoms and diagnosis due to infrequent consideration of this disease in the differential diagnosis of patients with low back pain and unusual or incomplete presenting clinical symptoms. CASE REPORT We describe the case of a 37-year-old male patient with no significant past medical history and surgical history of bilateral hip arthroplasty secondary to idiopathic aseptic necrosis of the bilateral femoral head and bilateral rotator cuff repaired surgery due to multiple motor vehicle accidents (MVA) with a chief concern of chronic low back pain. In this case of ankylosing spondylitis presenting with low back pain and radicular symptoms, his symptoms were resistant to multiple opioid medications, trigger point injections, and epidural steroid injections. Initiation of adalimumab subsequently relieved the patient's symptoms and restored his ability to perform daily activities. CONCLUSIONS This is an unusual presentation of AS with radiographic evidence of bilateral sacroiliitis. The neurological manifestations in AS are not uncommon, and they can occur during the quiescent stage of the disease. It should be emphasized that early diagnosis is essential to prevent progression of the disease and avoid unnecessary treatment for the patient.


Assuntos
Dor Lombar , Radiculopatia , Espondilite Anquilosante , Acidentes de Trânsito , Adalimumab/uso terapêutico , Adulto , Humanos , Dor Lombar/tratamento farmacológico , Dor Lombar/etiologia , Masculino , Radiculopatia/tratamento farmacológico , Radiculopatia/etiologia , Espondilite Anquilosante/complicações , Espondilite Anquilosante/tratamento farmacológico
12.
Pain Physician ; 25(5): 409-418, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35901482

RESUMO

BACKGROUND: There are patients with limiting low back pain (LBP) with or without radicular pain in whom conventional supine magnetic resonance imaging (MRI) show no causative pathology. Despite the limitations of dynamic axially loaded MRI examinations, these imaging studies have shown a striking ability to diagnose pathology unrecognized by conventional MRI. The difference in findings between supine and prone MRI with patient symptom correlation has not been studied. METHODS: Nineteen patients suffering from chronic moderate-to-severe LBP and/or radicular pain nonresponsive to conventional therapy or interventional treatment, were included in this study. Both supine and prone MRIs were performed and analyzed by a neuroradiologist. Specific supine and prone measurements were registered, including spinal canal area, lateral recess diameter, foraminal area, and ligamentum flavum thickness. Three-dimensional  MRI reconstructions of varying pathology patterns were created. RESULTS: The mean patient age was 48.7 years (range [R]: 30-69), 63% of patients were women. The mean numeric pain score  was 6.5 (R: 4-8). In 52.6% of cases, disc pathology/increased disc pathology was seen only on prone imaging. We observed significant buckling and increased thickness of the ligamentum flavum in 52.6 % of cases in the prone position that was absent from the supine MRIs. We also documented varying grades of spondylolisthesis and facet joint subluxation resulting in significant foraminal stenosis in 26.3% of prone cases not seen from supine MRIs. CONCLUSIONS: Four patterns of pathological findings have been identified by MRI performed in the prone position. These findings were not observed in the supine position. Prone MRI can be a significant and useful tool in the diagnosis and treatment of patients with back pain refractory to treatment whose conventional supine MRIs appeared unremarkable.


Assuntos
Dor Lombar , Radiculopatia , Estenose Espinal , Adulto , Idoso , Feminino , Humanos , Dor Lombar/etiologia , Vértebras Lombares/diagnóstico por imagem , Vértebras Lombares/patologia , Imageamento por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Decúbito Ventral , Radiculopatia/diagnóstico por imagem , Radiculopatia/etiologia , Estenose Espinal/complicações
13.
Pain Physician ; 25(4): E657-E667, 2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-35793190

RESUMO

BACKGROUND: Ultrasound (US) has been widely used for the diagnosis and guided interventions of peripheral nerve disorders. Although superior cluneal nerve (SCN) entrapment is an important cause of lower back pain, a relevant review as to how US can be used for imaging and guided intervention for cases of SCN entrapment is still lacking. OBJECTIVES: This review aims to revisit the anatomy and pertinent clinical issues of SCN entrapment, as well as the role of US regarding the diagnosis and subsequent management of relevant clinical scenarios. STUDY DESIGN: A narrative review. METHODS: Although the present article is a narrative review, we used a systematic approach to search the relevant literature. The combinations of key words, including SCN, ultrasound, and sonography, were used to search PubMed and Medline without restriction of languages or article types. The search period was from the earliest record through November 2021. RESULTS: Our included studies showed that high-resolution US and knowledge of sonoanatomy facilitated the visualization of individual branches of the SCN after emerging from the erector spinae muscles. However, the diagnostic block was needed for confirmation of SCN entrapment. Perineural US-guided injection was helpful in relieving the complaints of SCN entrapment; whereas, hydrodissection underneath the thoracolumbar fascia over the iliac crest seems to be a feasible approach for postsurgical analgesia. LIMITATIONS: There was no clinical trial comparing the efficacy of different injection techniques and regimens. CONCLUSIONS: US imaging is helpful for guiding injections of SCN entrapment and related clinical conditions. The evidence of US imaging in diagnosing SCN disorders remains insufficient, which requires more prospective studies to validate.


Assuntos
Dor Lombar , Síndromes de Compressão Nervosa , Humanos , Dor Lombar/diagnóstico por imagem , Dor Lombar/etiologia , Dor Lombar/terapia , Síndromes de Compressão Nervosa/complicações , Estudos Prospectivos , Nervos Espinhais , Ultrassonografia
14.
RMD Open ; 8(2)2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35738804

RESUMO

OBJECTIVE: In patients with rheumatoid arthritis (RA) with low 28-joint tender and swollen joint counts but who assessed their disease as active, to evaluate whether activity reflected RA symptoms. METHODS: We carried out a cross-sectional study of patients in BRASS, a cohort of patients with established RA who had 28-joint counts assessed, scored their disease activity, identified their painful joints, and answered questions about other sites of pain and fatigue. Patients and their rheumatologists were asked about the presence of fibromyalgia. We examined whether patients reported pain in joints excluded from the 28-joint joint count (feet, ankles, hips, neck) and pain or symptoms probably unrelated to RA including low back pain, headache and fibromyalgia. Fatigue was not classified. Analyses were descriptive. RESULTS: Of 272 patients, 49 had tender and swollen joint counts <1 and a patient global assessment score of ≥3/10. 48/49 (95%) reported pain in joints excluded from the 28-joint count. Of these 49, 24 (45%) also had other symptoms especially low back pain. Fatigue was present in all patients. No patient had fibromyalgia. CONCLUSION: If joint counts <=1 are scored in 28 joints, patient global assessments of ≥3/10 often occur when there is pain in uncounted joints, joints that may respond to RA treatment.


Assuntos
Artrite Reumatoide , Fibromialgia , Dor Lombar , Artrite Reumatoide/complicações , Artrite Reumatoide/diagnóstico , Artrite Reumatoide/epidemiologia , Estudos Transversais , Fadiga/diagnóstico , Fadiga/etiologia , Fibromialgia/diagnóstico , Fibromialgia/epidemiologia , Humanos , Dor Lombar/diagnóstico , Dor Lombar/etiologia , Índice de Gravidade de Doença
15.
BMC Med Imaging ; 22(1): 108, 2022 06 04.
Artigo em Inglês | MEDLINE | ID: mdl-35659200

RESUMO

BACKGROUND: Studies on MRI findings among patients with LBP have been conducted; especially among adolescents and young adult population in developed countries. However, MRI lumbar spine evaluation findings in young adult patients with low back pain in Uganda is not known. The purpose of this study was to determine the MRI findings and their correlation to clinical features in young adult patients with low back pain in Nsambya hospital. METHODS: This was a descriptive cross sectional study. One hundred and fifty-seven patients with low back pain in the 18-39 year age group underwent MRI lumbar spine evaluation. The MRI changes in the lumbar spine and correlation to clinical features were determined. Correlation was assessed by Pearson chi square tests (Fisher's exact test) and p values reported at 0.05 level of significance. RESULTS: Of the 157 patients 129 (82.2%) had severe pain, whereas ninety (57.3%) had pain that had lasted more than 10 weeks. Sixty-five (41.4%) patients were found to have MRI evidence of disc desiccation, majority (61%) of whom had multiple level disease, mostly involving the lowest 2 disc levels. Facet joint arthropathy (47.8%), marginal osteophyte (31.8%) and disc contour irregularity [disc bulge] (31.2%) were other common MRI features seen. There was an association between duration of pain and limb weakness, and development of marginal osteophytes. There was also association between clinical presentation and disc bulge. CONCLUSIONS: The MRI finding of disc degeneration among young adult patients with LBP is higher than reported. Age and pain distribution are predictors of developing disc desiccation.


Assuntos
Degeneração do Disco Intervertebral , Dor Lombar , Adolescente , Estudos Transversais , Hospitais , Humanos , Degeneração do Disco Intervertebral/diagnóstico por imagem , Degeneração do Disco Intervertebral/patologia , Dor Lombar/diagnóstico por imagem , Dor Lombar/epidemiologia , Dor Lombar/etiologia , Vértebras Lombares/diagnóstico por imagem , Imageamento por Ressonância Magnética/métodos , Adulto Jovem
16.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi ; 36(6): 672-680, 2022 Jun 15.
Artigo em Chinês | MEDLINE | ID: mdl-35712923

RESUMO

Objective: To investigate the effectiveness of microscope assisted anterior lumbar discectomy and fusion (ALDF) and mobile microendoscopic discectomy assisted lumbar interbody fusion (MMED-LIF) for lumbar degenerative diseases. Methods: A clinical data of 163 patients with lumbar degenerative diseases who met the criteria between January 2018 and December 2020 was retrospectively analyzed. Fifty-three cases were treated with microscope assisted ALDF (ALDF group) and 110 cases with MMED-LIF (MMED-LIF group). There was no significant difference between the two groups in terms of gender, age, disease type, surgical segments, preoperative visual analogue scale (VAS) scores of low back pain and leg pain, Oswestry disability index (ODI), intervertebral space height, lordosis angle, and spondylolisthesis rate of the patients with lumbar spondylolisthesis ( P>0.05). The operation time, intraoperative blood loss, and hospital stay of the two groups were recorded. The effectiveness was evaluated by VAS scores of low back pain and leg pain and ODI. Postoperative lumbar X-ray films were taken to observe the position of Cage and measure the intervertebral space height, lordosis angle, and spondylolisthesis rate of the patients with lumbar spondylolisthesis. Results: The operations were successfully completed in both groups. The operation time, intraoperative blood loss, and hospital stay in ALDF group were less than those in MMED-LIF group ( P<0.05). The patients in both groups were followed up 12-36 months, with an average of 24 months. The VAS scores of low back pain and leg pain and ODI after operation were lower than those before operation in the two groups, and showed a continuous downward trend, with significant differences between different time points ( P<0.05). There were significant differences between two groups in VAS score of low back pain and ODI ( P<0.05) and no significant difference in VAS score of leg pain ( P>0.05) at each time point. The improvement rates of VAS score of low back pain and ODI in ALDF group were significantly higher than those in MMED-LIF group ( t=7.187, P=0.000; t=2.716, P=0.007), but there was no significant difference in the improvement rate of VAS score of leg pain ( t=0.556, P=0.579). The postoperative lumbar X-ray films showed the significant recovery of the intervertebral space height, lordosis angle, and spondylolisthesis rate at 2 days after operation when compared with preoperation ( P<0.05), and the improvements were maintained until last follow-up ( P>0.05). The improvement rates of intervertebral space height and lordosis angle in ALDF group were significantly higher than those in MMED-LIF group ( P<0.05). There was no significant difference in the reduction rate of spondylolisthesis between the two groups ( t=1.396, P=0.167). During follow-up, there was no loosening or breakage of the implant and no displacement or sinking of the Cage. Conclusion: Under appropriate indications, microscope assisted ALDF and MMED-LIF both can achieve good results for lumbar degenerative diseases. Microscope assisted ALDF was superior to MMED-LIF in the improvement of low back pain and function and the recovery of intervertebral space height and lordosis angle.


Assuntos
Lordose , Dor Lombar , Fusão Vertebral , Espondilolistese , Perda Sanguínea Cirúrgica , Discotomia , Humanos , Lordose/cirurgia , Dor Lombar/etiologia , Dor Lombar/cirurgia , Vértebras Lombares/cirurgia , Procedimentos Cirúrgicos Minimamente Invasivos , Estudos Retrospectivos , Fusão Vertebral/métodos , Espondilolistese/cirurgia , Resultado do Tratamento
17.
BMC Musculoskelet Disord ; 23(1): 552, 2022 Jun 08.
Artigo em Inglês | MEDLINE | ID: mdl-35676704

RESUMO

BACKGROUND: Low back pain (LBP) is a major symptom of symptomatic lumbar spinal stenosis (SLSS). It is important to assess LBP in patients with SLSS to develop better treatment. This study aimed to analyse the factors associated with LBP in patients with SLSS. METHODS: This cross-sectional study included consecutive patients with SLSS aged between 51 and 79 years who had symptoms in one or both the legs, with and without LBP. The participants were classified into two groups: the high group (LBP visual analogue scale [VAS] score ≥ 30 mm) and the low group (LBP VAS score < 30 mm). We performed multiple logistic regression analysis with the high and low groups as dependent variables, and a receiver operating characteristic (ROC) analysis. RESULTS: A total of 80 patients with LSS were included (35 men and 45 women; mean age 64.5 years), with 47 and 30 patients in the high and low groups, respectively. Multivariate logistic regression analysis revealed that the sagittal vertical axis (SVA; + 10 mm; odds ratio, 1.331; 95% confidence interval, 1.051 - 1.660) and pelvic incidence-lumbar lordosis (PI-LL; + 1°; odds ratio, 1.065; 95% confidence interval, 1.019-1.168) were significantly associated with LBP. A receiver operating characteristic analysis revealed cut-off values of 47.0 mm of SVA and 30.5° of PI-LL, respectively. CONCLUSION: Our results indicated that SVA and PI-LL were significant predictors for LBP in SLSS. It is suggested that these parameters should be taken into consideration when assessing LBP in patients with SLSS.


Assuntos
Dor Lombar , Fusão Vertebral , Estenose Espinal , Idoso , Estudos Transversais , Avaliação da Deficiência , Feminino , Humanos , Dor Lombar/diagnóstico , Dor Lombar/epidemiologia , Dor Lombar/etiologia , Vértebras Lombares/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fusão Vertebral/métodos , Estenose Espinal/complicações , Estenose Espinal/diagnóstico , Estenose Espinal/epidemiologia , Resultado do Tratamento
18.
Am J Case Rep ; 23: e936058, 2022 Jun 22.
Artigo em Inglês | MEDLINE | ID: mdl-35729859

RESUMO

BACKGROUND Vertebral osteomyelitis is a rare form of bone infection that requires prompt diagnosis and treatment; however, this is challenging because of the lack of specific symptoms and low sensitivity of diagnostic tests, especially in the early stages. Our case demonstrates the challenges in diagnosing vertebral osteomyelitis and provides relevant information for other physicians dealing with possible cases of vertebral osteomyelitis. CASE REPORT An 83-year-old man presented to the Emergency Department with severe low back pain of 2 weeks' duration. He had experienced occasional pain for several years, which was diagnosed as a compression fracture by an orthopedic surgeon at a local clinic. On arrival, he had a high-grade fever (40.2°C). The initial diagnosis was urinary tract infection, based on urinalysis results. However, after admission, vertebral osteomyelitis was diagnosed based on the results of magnetic resonance imaging of the spine and blood and urine cultures (both yielded methicillin-sensitive Staphylococcus aureus). He was immediately treated with the appropriate antibiotics and discharged on the 92nd day of admission without complications. CONCLUSIONS Our report highlights the difficulties in clinical diagnosis of vertebral osteomyelitis and identifies factors that can affect the diagnosis, including clinician bias, search satisficing, premature closure, anchoring bias, and diagnostic momentum. All patients with low back pain should be considered potential candidates for vertebral osteomyelitis.


Assuntos
Dor Lombar , Osteomielite , Infecções Estafilocócicas , Idoso de 80 Anos ou mais , Antibacterianos/uso terapêutico , Dor nas Costas , Viés , Cognição , Humanos , Dor Lombar/tratamento farmacológico , Dor Lombar/etiologia , Masculino , Osteomielite/diagnóstico , Osteomielite/tratamento farmacológico , Infecções Estafilocócicas/tratamento farmacológico
19.
Int J Mol Sci ; 23(12)2022 Jun 09.
Artigo em Inglês | MEDLINE | ID: mdl-35742903

RESUMO

Low back pain (LBP) represents a frequent and debilitating condition affecting a large part of the global population and posing a worldwide health and economic burden. The major cause of LBP is intervertebral disc degeneration (IDD), a complex disease that can further aggravate and give rise to severe spine problems. As most of the current treatments for IDD either only alleviate the associated symptoms or expose patients to the risk of intraoperative and postoperative complications, there is a pressing need to develop better therapeutic strategies. In this respect, the present paper first describes the pathogenesis and etiology of IDD to set the framework for what has to be combated to restore the normal state of intervertebral discs (IVDs), then further elaborates on the recent advances in managing IDD. Specifically, there are reviewed bioactive compounds and growth factors that have shown promising potential against underlying factors of IDD, cell-based therapies for IVD regeneration, biomimetic artificial IVDs, and several other emerging IDD therapeutic options (e.g., exosomes, RNA approaches, and artificial intelligence).


Assuntos
Degeneração do Disco Intervertebral , Disco Intervertebral , Dor Lombar , Inteligência Artificial , Humanos , Peptídeos e Proteínas de Sinalização Intercelular , Disco Intervertebral/patologia , Degeneração do Disco Intervertebral/etiologia , Degeneração do Disco Intervertebral/patologia , Degeneração do Disco Intervertebral/terapia , Dor Lombar/etiologia , Dor Lombar/terapia
20.
PLoS One ; 17(6): e0270046, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35767547

RESUMO

This study was conducted to investigate the incidence of lumbar degeneration findings and low back pain (LBP) in children and adolescent weightlifters using magnetic resonance imaging (MRI) and medical questionnaires over a 5-year period. Moreover, we aimed to reveal the temporal changes in the lumbar vertebrae caused by long-term weightlifting training during the growth period. Twelve children and adolescent weightlifters who participated in weightlifting for >2 years (six boys, six girls, 11.4±2.0 years) were enrolled. Participants underwent annual medical questionnaire surveys, including data on practice frequency, competition history, presence of LBP, and lumbar examinations using MRI during the 5-year follow-up. Lumbar disc degeneration was detected in all the participants after 4 years, and lumbar disc herniation findings were detected in 33% of participants after 5 years; one underwent herniotomy during the follow-up period. Lumbar spondylolysis was detected in 58% of patients at 5 years. Although there were three participants who had LBP in the final year, none had LBP that prevented them from returning to weightlifting. This 5-year cohort study of 12 children and adolescent weightlifters detected lumbar degeneration in all participants. High frequency weightlifting training over a long period during the growth period may increase the risk of developing current and future LBP.


Assuntos
Degeneração do Disco Intervertebral , Deslocamento do Disco Intervertebral , Dor Lombar , Adolescente , Criança , Estudos de Coortes , Feminino , Humanos , Incidência , Degeneração do Disco Intervertebral/complicações , Degeneração do Disco Intervertebral/diagnóstico por imagem , Degeneração do Disco Intervertebral/epidemiologia , Deslocamento do Disco Intervertebral/patologia , Dor Lombar/epidemiologia , Dor Lombar/etiologia , Dor Lombar/patologia , Vértebras Lombares/diagnóstico por imagem , Vértebras Lombares/patologia , Imageamento por Ressonância Magnética/efeitos adversos , Masculino , Estudos Prospectivos
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