Lumbar spine angles in subjects with a history of flexion-related back pain when performing a typing task

Abstract Background: Osteopetrosis is a group of rare inherited skeletal dysplasias, with each variant sharing the hallmark of increased bone mineral density (BMD). Abnormal osteoclast activity produces overly dense bone predisposing to fracture and skeletal deformities. Whilst no cure for these disorders exists, endocrinologists play an important role in surveillance and management of complications. Clinical Cases: A 43-year-old female had findings suggestive of increased BMD on radiographic imaging performed to investigate shoulder and back pain. X-ray of lumbar spine demonstrated a ‘rugger jersey’ spine appearance, while shoulder X-ray revealed mixed lucency and sclerosis of the humeral head. DXA scan showed T-scores of +11 at the hip and +12.5 at the lumbar spine. MRI of head displayed bilateral narrowing and elongation of the internal acoustic meatus and narrowing of the orbital foramina. Genetic assessment confirmed autosomal dominant osteopetrosis with a CLCN7 variant. Oral colecalciferol supplementation was commenced and multi-disciplinary management instigated with referral to ophthalmology and ENT teams. A 25-year-old male presented with a seven-year history of low back pain and prominent bony swelling around the tibial tuberosities and nape of neck. Past medical history included repeated left scaphoid fracture in 2008 and 2018. Recovery from his scaphoid fracture was complicated by non-union requiring bone grafting with open reduction and fixation. Plain X-rays of the spine again demonstrated ‘rugger jersey’ spine. DXA scan was notable for elevated T scores; +2.9 at hip and +5.8 lumbar spine. MRI spine showed vertebral endplate cortical thickening and sclerosis at multiple levels. The patient declined genetic testing and is under clinical review. A 62-year-old male was referred to the bone metabolism service following a DXA scan showing T scores of +11. 7 at the hip and +13 at the lumbar spine. His primary complaint was of neck pain and on MRI there was multi-level nerve root impingement secondary to facet joint hypertrophy. Past medical history was significant for a long history of widespread joint pains; previous X-ray reports described generalized bony sclerosis up to 11 years previously. Clinical and radiological monitoring continues. Conclusion: Individuals with osteopetrosis require a multidisciplinary approach to management. There is no curative treatment and mainstay of therapy is supportive with active surveillance for complications.

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Spinal Kinematics of Adolescent Male Rowers with Back Pain in Comparison with Matched Controls During Ergometer Rowing

Journal of Applied Biomechanics ◽

10.1123/jab.2015-0012 ◽

2015 ◽

Vol 31 (6) ◽

pp. 459-468 ◽

Cited By ~ 9

Author(s):

Leo Ng ◽

Amity Campbell ◽

Angus Burnett ◽

Anne Smith ◽

Peter O’Sullivan

Keyword(s):

Back Pain ◽

Lumbar Spine ◽

Tracking System ◽

Adolescent Male ◽

Lower Lumbar Spine ◽

Spinal Kinematics ◽

Ergometer Rowing ◽

History Of ◽

Lumbar Spinal ◽

Lower Lumbar

There is a high prevalence of low back pain (LBP) in adolescent male rowers. In this study, regional lumbar spinal kinematics and self-reported LBP intensity were compared between 10 adolescent rowers with moderate levels of LBP relating to rowing with 10 reporting no history of LBP during a 15-minute ergometer trial using an electromagnetic tracking system. Adolescent male rowers with LBP reported increasing pain intensity during ergometer rowing. No significant differences were detected in mean upper or lower lumbar angles between rowers with and without LBP. However, compared with rowers without pain, rowers with pain: (1) had relatively less excursion of the upper lumbar spine into extension over the drive phase, (2) had relatively less excursion of the lower lumbar spine into extension over time, (3) had greater variability in upper and lower lumbar angles over the 15-minute ergometer trial, (4) positioned their upper lumbar spine closer to end range flexion for a greater proportion of the drive phase, and (5) showed increased time in sustained flexion loading in the upper lumbar spine. Differences in regional lumbar kinematics exist between adolescent male rowers with and without LBP, which may have injury implication and intervention strategies.

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Atraumatic Bilateral Lumbar Pedicle Fractures in a Patient with Back Pain and History of Long- Term Bisphosphonate Therapy: A Case Report

Pain Management Case Reports ◽

10.36076/pmcr.2020/4/97 ◽

2020 ◽

pp. 97-102

Author(s):

Alec L. Meleger

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Case Report ◽

Lumbar Spine ◽

Conservative Management ◽

Chronic Low Back Pain ◽

Bisphosphonate Therapy ◽

Low Back ◽

History Of ◽

Lumbar Pedicle

of atypical femoral fractures is a known complication of chronic bisphosphonate therapy; however, the finding of atraumatic lumbar pedicle fractures without a prior history of spinal surgery or contralateral spondylolysis is rare. While a few cases of osteoporotic pedicle fractures associated with adjacent vertebral compression fractures have been reported, only a single case of isolated atraumatic bilateral pedicle fractures has been published in a patient who had been on chronic risedronate therapy of 10-year duration. Case Report: The present case report illustrates a 63-year-old man who developed isolated atraumatic bilateral lumbar pedicle fractures after 3 years and 5 months on alendronate treatment. The patient’s past medical history had been significant for osteoporosis with a lumbar spine T-score of -2.7. At the time of initial diagnosis, a comprehensive work-up for secondary causes of osteoporosis proved to be negative; this was followed by initiation of bisphosphonate treatment with 70 mg of alendronate once per week. Ten months after starting bisphosphonate therapy, he underwent magnetic resonance imaging (MRI) of the lumbar spine for low back pain that had not responded to conservative management, with imaging not revealing any evidence of pedicle fractures or pedicle stress reaction. He was again seen in the spine clinic, for atraumatic exacerbation of his chronic low back pain with concurrent right lower extremity radiation, 6 months after stopping bisphosphonate therapy. Since the patient failed to respond to conservative management over the ensuing 6 months, a repeat MRI was obtained, which showed new acute/subacute bilateral L5 pedicle fractures. Conclusion: An isolated atraumatic lumbar pedicle fracture may be an additional type of atypical fracture associated with chronic bisphosphonate therapy in an osteoporotic patient. Key words: Chronic low back pain, bisphosphonate, alendronate, pedicle fracture Pain Medicine

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Spinal Epidural Haemangioma Associated with Extensive Gastrointestinal Haemangiomas

Interventional Neuroradiology ◽

10.1177/159101990501100207 ◽

2005 ◽

Vol 11 (2) ◽

pp. 161-166 ◽

Cited By ~ 3

Author(s):

L. T. E. Cheng ◽

W. E. H. Lim

Keyword(s):

Back Pain ◽

Lumbar Spine ◽

Chronic Lower Back Pain ◽

Cavernous Haemangioma ◽

Open Biopsy ◽

Lower Back ◽

Paravertebral Muscles ◽

History Of ◽

Spinal Epidural ◽

Spine Mri

A case of spinal epidural cavernous haemangioma associated with gastrointestinal haemangiomas is discussed. The patient was a young Chinese female presenting with chronic lower back pain. She had a history of extensive gastric and small bowel haemangiomas. Lumbar spine MRI showed a heterogeneously enhancing epidural mass infiltrating the paravertebral muscles. Open biopsy confirmed an epidural cavernous haemangioma. To our knowledge, an association between spinal epidural cavernous haemangiomas and gastrointestinal haemangiomas has not been reported.

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Effect of increased relative stiffness of the lumbar spine on hamstring muscle stretching in individuals with a history of low back pain suspected to have a clinical lumbar instability: A randomized crossover design

Clinical Biomechanics ◽

10.1016/j.clinbiomech.2020.104996 ◽

2020 ◽

Vol 75 ◽

pp. 104996

Author(s):

Peemongkon Wattananon ◽

Wallika Prasertkul ◽

Prasert Sakulsriprasert ◽

James J. Laskin

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Lumbar Spine ◽

Crossover Design ◽

Low Back ◽

Hamstring Muscle ◽

Lumbar Instability ◽

Relative Stiffness ◽

Muscle Stretching ◽

History Of

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Landing Stiffness Between Individuals With and Without a History of Low Back Pain

Journal of Sport Rehabilitation ◽

10.1123/jsr.2017-0081 ◽

2020 ◽

Vol 29 (1) ◽

pp. 28-36 ◽

Cited By ~ 1

Author(s):

Mark A. Sutherlin ◽

L. Colby Mangum ◽

Shawn Russell ◽

Susan Saliba ◽

Jay Hertel ◽

...

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Lumbar Spine ◽

Lower Extremity ◽

Previous History ◽

Joint Stiffness ◽

Low Back ◽

Vertical Stiffness ◽

Landing Mechanics ◽

History Of

Context: Reduced spinal stabilization, delayed onset of muscle activation, and increased knee joint stiffness have been reported in individuals with a history of low back pain (LBP). Biomechanical adaptations resulting from LBP may increase the risk for future injury due to suboptimal loading of the lower-extremity or lumbar spine. Assessing landing mechanics in these individuals could help identify which structures might be susceptible to future injury. Objective: To compare vertical and joint stiffness of the lower-extremity and lumbar spine between individuals with and without a previous history of LBP. Design: Cross-sectional study. Setting: Research laboratory. Participants: There were 45 participants (24 without a previous history of LBP—age 23 [8] y, height 169.0 [8.5] cm, mass 69.8 [13.8] kg; 21 with a previous history of LBP—age 25[9] y, height 170.0 [8.0] cm, mass 70.2 [11.8] kg). Interventions: Single-limb landing trials on the dominant and nondominant limb from a 30-cm box. Main Outcome Measures: Vertical stiffness and joint stiffness of the ankle, knee, hip, and lumbar spine. Results: Individuals with a previous history of LBP had lower vertical stiffness (P = .04), but not joint stiffness measures compared with those without a previous history of LBP (P > .05). Overall females had lower vertical (P = .01), ankle (P = .02), and hip stiffness (P = .04) compared with males among all participants. Males with a previous history of LBP had lower vertical stiffness compared with males without a previous history LBP (P = .01). Among all individuals without a previous history of LBP, females had lower vertical (P < .01) and ankle stiffness measures (P = .04) compared with males. Conclusions: Landing stiffness may differ among males and females and a previous history of LBP. Comparisons between individuals with and without previous LBP should be considered when assessing landing strategies, and future research should focus on how LBP impacts landing mechanics.

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Frequent Benign, Nontraumatic, Noninflammatory Causes of Low Back Pain in Adolescents: MRI Findings

Radiology Research and Practice ◽

10.1155/2018/7638505 ◽

2018 ◽

Vol 2018 ◽

pp. 1-5

Author(s):

Aikaterini Solomou ◽

Pantelis Kraniotis ◽

Aspasia Rigopoulou ◽

Theodore Petsas

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Lumbar Spine ◽

Degenerative Changes ◽

Low Back ◽

Mri Findings ◽

Scheuermann’S Disease ◽

Scheuermann's Disease ◽

Endplate Changes ◽

History Of

Introduction. Low back pain (LBP) is common in children and adolescents. There are many factors that cause LBP, including structural disorders, degenerative changes, Scheuermann’s disease, fractures, inflammation, and tumors. Magnetic Resonance Imaging is the gold standard for diagnosing spinal abnormalities and is mandatory when neurological symptoms exist. The study focuses on common MRI findings in adolescents with persistent LBP, without history of acute trauma or evidence of either inflammatory or rheumatic disease. Materials and Methods. Eleven adolescents were submitted to thoracic and/or lumbar spine MRI due to persistent LBP. The protocol consisted of T1 WI, T2 WI, and T2 WI with FS, in the axial, sagittal, and coronal plane. Results. MRI revealed structural abnormalities (scoliosis and kyphosis) in 4/11 (36.36%); disc abnormalities and endplate changes were found on 11/11 (100%). Typical Scheuermann’s disease was found in 3/11 (27.27%). Endplate changes were severe in Scheuermann’s patients and mild to moderate in the remaining 8/11 (72.72%). Kyphosis was in all cases secondary to Scheuermann’s disease. Disk bulges and hernias were found in 8/11 (72.72%), all located in the lumbar spine. Conclusion. In adolescents with LBP, structural spinal disorders, degenerative changes, and Scheuermann’s disease are commonly found on MRI; however, degenerative changes prevail.

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Jogging Kinematics After Lumbar Paraspinal Muscle Fatigue

Journal of Athletic Training ◽

10.4085/1062-6050-44.5.475 ◽

2009 ◽

Vol 44 (5) ◽

pp. 475-481 ◽

Cited By ~ 22

Author(s):

Joseph M. Hart ◽

D. Casey Kerrigan ◽

Julie M. Fritz ◽

Christopher D. Ingersoll

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Lumbar Spine ◽

Lower Extremity ◽

Healthy Controls ◽

Low Back ◽

Trunk Flexion ◽

History Of ◽

Lumbar Extension ◽

Recurrent Low Back Pain

Abstract Context: Isolated lumbar paraspinal muscle fatigue causes lower extremity and postural control deficits. Objective: To describe the change in body position during gait after fatiguing lumbar extension exercises in persons with recurrent episodes of low back pain compared with healthy controls. Design: Case-control study. Setting: Motion analysis laboratory. Patients or Other Participants: Twenty-five recreationally active participants with a history of recurrent episodes of low back pain, matched by sex, height, and mass with 25 healthy controls. Intervention(s): We measured 3-dimensional lower extremity and trunk kinematics before and after fatiguing isometric lumbar paraspinal exercise. Main Outcome Measure(s): Measurements were taken while participants jogged on a custom-built treadmill surrounded by a 10-camera motion analysis system. Results: Group-by-time interactions were observed for lumbar lordosis and trunk angles (P < .05). A reduced lumbar spine extension angle was noted, reflecting a loss of lordosis and an increase in trunk flexion angle, indicating increased forward trunk lean, in healthy controls after fatiguing lumbar extension exercise. In contrast, persons with a history of recurrent low back pain exhibited a slight increase in spine extension, indicating a slightly more lordotic position of the lumbar spine, and a decrease in trunk flexion angles after fatiguing exercise. Regardless of group, participants experienced, on average, greater peak hip extension after lumbar paraspinal fatigue. Conclusions: Small differences in response may represent a necessary adaptation used by persons with recurrent low back pain to preserve gait function by stabilizing the spine and preventing inappropriate trunk and lumbar spine positioning.

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Comparison of Lumbar Kinematics with a History of Low Back Pain During Baseball Hitting

International Journal of Sports Medicine ◽

10.1055/a-1014-3041 ◽

2020 ◽

Vol 41 (02) ◽

pp. 119-127

Author(s):

Tomoki Oshikawa ◽

Koji Kaneoka ◽

Yasuhiro Morimoto ◽

Hiroshi Akuzawa

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Lumbar Spine ◽

Three Dimensional ◽

Flexion Angle ◽

Control Group ◽

Low Back ◽

Lumbar Flexion ◽

Spine Pain ◽

History Of

AbstractThe purpose of this study was to examine the influence of a history of low back pain (LBP) on pelvic and lumbar kinematics during baseball hitting. Twenty collegiate male baseball players (age, 21±1 years; height, 172.8±4.7 cm; weight, 72.7±6.2 kg; baseball experience, 13±1 years) performed 5 bat swings. Participants were categorized into the LBP group (n=10) or control group (n=10) based on having experienced lumbar spine pain due to bat swing that lasted more than 24 h within the last 12 months. Three-dimensional kinematic data of the pelvis and lumbar spine during bat swing were measured. Two-way ANOVAs were used to compare pelvic and lumbar kinematics throughout the bat swing between groups, and independent t-tests were used to compare the other outcomes between groups. There was a significant main effect between groups in lumbar flexion angle throughout the bat swing (p=0.047). The mean lumbar flexion angle of the LBP group throughout the bat swing was less than that of the control group. Additionally, the peak angular velocity of lumbar flexion of the LBP group was significantly faster than that of control group (p=0.047). These results can be helpful for longitudinal studies that identify the risk factors of LBP due to bat swing.

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