Risk Factors of Postoperative Low Back Pain for Low-Grade Degenerative Spondylolisthesis: An At Least 2-Year Follow-Up Retrospective Study

Objective To investigate the risk factors of postoperative low back pain (LBP) following posterior lumbar interbody fusion (PLIF) surgery for low-grade isthmic spondylolisthesis (IS). Methods This retrospective study enrolled patients with IS that underwent PLIF between January 2011 and January 2016. Demographic, clinical, surgical and radiological characteristics were analysed to determine associations between these characteristics and LBP as measured using a visual analogue scale (VAS) pain score. Results A total of 192 patients were enrolled in the study. The mean VAS pain score of LBP decreased significantly after surgery. The mean preoperative VAS pain score was significantly greater in patients with symptoms of ≤3 years duration compared with those with symptoms lasting >3 years. The postoperative VAS pain score was significantly lower in patients with grade 1 slippage compared with those with grade 2 slippage. There was a significant correlation between preoperative to postoperative change of VAS pain score and postoperative disc height ( r = 0.99). Conclusion PLIF significantly improved LBP in patients with low-grade IS, although patients still reported some postoperative LBP. The grade of slippage was a risk factor for postoperative LBP. Restoring the disc height appeared to improve LBP.

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Surgical treatment of adult degenerative spondylolisthesis by instrumented transforaminal lumbar interbody fusion in the Han nationality

Journal of Neurosurgery Spine ◽

10.3171/2009.2.spine08623 ◽

2009 ◽

Vol 10 (5) ◽

pp. 496-499 ◽

Cited By ~ 20

Author(s):

Hao Xu ◽

Hao Tang ◽

Zhonghai Li

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Interbody Fusion ◽

Degenerative Spondylolisthesis ◽

Transforaminal Lumbar Interbody Fusion ◽

Low Back ◽

Lumbar Interbody Fusion ◽

Peek Cage ◽

Han Nationality

Object The transforaminal lumbar interbody fusion (TLIF) procedure was developed to provide the surgeon with a fusion procedure that may reduce many of the risks and limitations associated with posterior lumbar interbody fusion, yet produce similar stability in the spine. There are few large series with long-term follow-up data regarding instrumented TLIF and placement of 1 diagonal polyetheretherketone (PEEK) cage. The authors performed a prospective study to evaluate the outcome and safety of instrumented TLIF with 1 diagonal PEEK cage for degenerative spondylolisthesis in the Han nationality in China. Methods Between May 2001 and April 2006, 60 patients (35 men and 25 women; mean age 55.5 years, range 45–70 years) with symptomatic degenerative spondylolisthesis underwent the TLIF procedure with 1 diagonal PEEK cage and additional pedicle screw internal fixation at the authors' institution. The inclusion criteria involved degenerative spondylolisthesis (Grades I and II) in patients with chronic low-back pain with or without leg pain. Results One patient had a postoperative temporary motor and sensory deficit of the adjacent nerve root. Reoperation was required in 1 patient because of pedicle screw migration. One patient developed a pseudarthrosis and had increasing complaints of low-back pain 1 year postoperatively and underwent a subsequent revision surgery. Two patients had nerve root symptomatic compression resulting from cage migration and insufficient decompression after surgery, and they underwent revision. Two patients had a dural tear that required fibrin glue application during surgery. No implant fracture or subsidence occurred in any patient. Clinically, the pain index and Oswestry Disability Index (ODI) score improved significantly from before surgery to the 2-year follow-up. In the TLIF group, the pain index improved from 69 to 25 (p < 0.001). The postoperative ODI showed a significant postoperative reduction of disability during the whole period of follow-up (p < 0.001). The preoperative mean ODI score was 32.3 (16–80), and postoperative 13.1 (0–28). Disc space height and foraminal height were restored by the surgery and maintained at the latest follow-up time. Conclusions In the authors' experience, instrumented TLIF with 1 diagonal PEEK cage can be a surgical option for treatment of degenerative spondylolisthesis in the Han nationality in China.

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Nonsurgically managed patients with degenerative spondylolisthesis: a 10- to 18-year follow-up study

Journal of Neurosurgery Spine ◽

10.3171/spi.2000.93.2.0194 ◽

2000 ◽

Vol 93 (2) ◽

pp. 194-198 ◽

Cited By ~ 20

Author(s):

Shunji Matsunaga ◽

Kosei Ijiri ◽

Kyoji Hayashi

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Clinical Symptoms ◽

Degenerative Spondylolisthesis ◽

Low Back ◽

Indications For Surgery ◽

Initial Examination ◽

Content Type ◽

Fine Print

Object. Controversy exists concerning the indications for surgery and choice of surgical procedure for patients with degenerative spondylolisthesis. The goals of this study were to determine the clinical course of nonsurgically managed patients with degenerative spondylolisthesis as well as the indications for surgery. Methods. A total of 145 nonsurgically managed patients with degenerative spondylolisthesis were examined annually for a minimum of 10 years follow-up evaluation. Radiographic changes, changes in clinical symptoms, and functional prognosis were surveyed. Progressive spondylolisthesis was observed in 49 patients (34%). There was no correlation between changes in clinical symptoms and progression of spondylolisthesis. The intervertebral spaces of the slipped segments were decreased significantly in size during follow-up examination in patients in whom no progression was found. Low-back pain improved following a decrease in the total intervertebral space size. A total of 84 (76%) of 110 patients who had no neurological deficits at initial examination remained without neurological deficit after 10 years of follow up. Twenty-nine (83%) of the 35 patients who had neurological symptoms, such as intermittent claudication or vesicorectal disorder, at initial examination and refused surgery experienced neurological deterioration. The final prognosis for these patients was very poor. Conclusions. Low-back pain was improved by restabilization. Conservative treatment is useful for patients who have low-back pain with or without pain in the lower extremities. Surgical intervention is indicated for patients with neurological symptoms including intermittent claudication or vesicorectal disorder, provided that a good functional outcome can be achieved.

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Manual treatment for kidney mobility and symptoms in women with nonspecific low back pain and urinary infections

Journal of Osteopathic Medicine ◽

10.1515/jom-2020-0288 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Francesca Lo Basso ◽

Alessandra Pilzer ◽

Giulio Ferrero ◽

Francesco Fiz ◽

Emanuele Fabbro ◽

...

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Retrospective Study ◽

Lumbar Spine ◽

Low Back ◽

Manual Treatment ◽

Group A ◽

Group B ◽

Movement Group

Abstract Context Recent studies have suggested a connection between low back pain (LBP) and urinary tract infections (UTI). These disturbances could be triggered via visceral-somatic pathways, and there is evidence that kidney mobility is reduced in patients suffering from nonspecific LBP. Manual treatment of the perinephric fascia could improve both kidney mobility and LBP related symptoms. Objectives To assess whether manual treatment relieves UTI and reduces pain in patients with nonspecific LBP through improvement in kidney mobility. Methods Records from all patients treated at a single physical therapy center in 2019 were retrospectively reviewed. Patients were included if they were 18 years of age or older, had nonspecific LBP, and experienced at least one UTI episode in the 3 months before presentation. Patients were excluded if they had undergone manipulative treatment in the 6 months before presentation, if they had one of several medical conditions, if they had a history of chronic pain medication use, and more. Patient records were divided into two groups for analysis: those who were treated with manipulative techniques of the fascia with thrust movement (Group A) vs those who were treated without thrust movement (Group B). Kidney Mobility Scores (KMS) were analyzed using high resolution ultrasound. Symptoms as reported at patients’ 1 month follow up visits were also used to assess outcomes; these included UTI relapse, lumbar spine mobility assessed with a modified Schober test, and lumbar spine pain. Results Of 126 available records, 20 patients were included in this retrospective study (10 in Group A and 10 in Group B), all of whom who completed treatment and attended their 1 month follow up visit. Treatments took place in a single session for all patients and all underwent ultrasound of the right kidney before and after treatment. The mean (± standard deviation) KMS (1.9 ± 1.1), mobility when bending (22.7 ± 1.2), and LBP scores (1.2 ± 2.6) of the patients in Group A improved significantly in comparison with the patients in Group B (mean KMS, 1.1 ± 0.8; mobility when bending, 21.9 ± 1.1; and LBP, 3.9 ± 2.7) KMS, p<0.001; mobility when bending, p=0.003; and LBP, p=0.007). At the 1 month follow up visit, no significant statistical changes were observed in UTI recurrence (secondary outcome) in Group A (−16.5 ± 4.3) compared with Group B (−20.4 ± 7) (p=0.152). Conclusions Manual treatments for nonspecific LBP associated with UTI resulted in improved mobility and symptoms for patients in this retrospective study, including a significant increase in kidney mobility.

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Psychosocial and physical risk factors associated with low back pain: a 24 year follow up among women and men in a broad range of occupations

Occupational and Environmental Medicine ◽

10.1136/oem.55.2.84 ◽

1998 ◽

Vol 55 (2) ◽

pp. 84-90 ◽

Cited By ~ 48

Author(s):

C. O. Thorbjornsson ◽

L. Alfredsson ◽

K. Fredriksson ◽

M. Koster ◽

H. Michelsen ◽

...

Keyword(s):

Risk Factors ◽

Low Back Pain ◽

Back Pain ◽

Low Back ◽

Factors Associated ◽

Physical Risk ◽

Physical Risk Factors

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Cardiovascular risk factors and low back pain in a long-term follow-up of industrial employees

Scandinavian Journal of Work Environment & Health ◽

10.5271/sjweh.971 ◽

2006 ◽

Vol 32 (1) ◽

pp. 12-19 ◽

Cited By ~ 65

Author(s):

Päivi Leino-Arjas ◽

Svetlana Solovieva ◽

Juhani Kirjonen ◽

Antti Reunanen ◽

Hilkka Riihimäki

Keyword(s):

Risk Factors ◽

Low Back Pain ◽

Back Pain ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Low Back ◽

Long Term Follow Up

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Low back pain caused by Iliopsoas tendinopathy treated with ultrasound-guided local injection of anesthetic and steroid: a retrospective study

10.21203/rs.2.16345/v1 ◽

2019 ◽

Author(s):

Zhaochen Zhu ◽

Jieyuan Zhang ◽

Jiagen Sheng ◽

Changqing Zhang ◽

Zongping Xie

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Retrospective Study ◽

Groin Pain ◽

Local Injection ◽

Harris Hip Score ◽

Low Back ◽

Ultrasound Guided ◽

Iliopsoas Tendon

Abstract Background Low back pain is a prevalent symptom that occur in all age of people, whereas the pathogenesis is unknown. Iliopsoas tendinopathy is an increasingly recognized hip disorder that may contribute to low back pain. Our purpose is to reveal the relationship of iliopsoas tendinopathy with low back pain and to evaluate the effect of ultrasound-guided local injection of anesthetic and steroid into iliopsoas tendon in treating low back pain. Methods This retrospective study reviewed 45 patients diagnosed with iliopsoas tendinopathy treated by B-ultrasound guided injection of lidocaine and triamcinolone into the iliopsoas tendon from March 2016 to June 2016. Medical records were collected to analyze the clinical presentation. Visual Analogue scale (VAS) and Harris Hip score (HHS) were administered to determine patient outcomes. Telephone follow-up was conducted, and the mean follow-up was 11 months. Results We observed that most patients with iliopsoas tendinopathy also complain chronic low back pain except for groin pain. After injection of anesthetic and corticosteroid into the iliopsoas tendon, the VAS fell from 7.82±1.35 to 2.73±1.24 immediately after the injection, and 0.8±0.75 at follow-up. The HHS improved from 41.09±17.67 to 97.89±2.79 at follow-up. Statistically significant difference (P<0.001) was observed. All patients returned to their original level of function and only seven patients (15%) presented with mild pain at the follow-up. Conclusions Low back pain is a prevalent presentation for iliopsoas tendinopathy. Diagnosis of iliopsoas tendinopathy should be considered in patients with low back pain with tenderness over the iliopsoas tendon. Ultrasound-guided local injection of anesthetic and steroid lead to satisfactory effect in relieving low back and groin pain and improving joint function.

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Analysis of Influencing Factors of Residual Low Back Pain After PVP

10.21203/rs.3.rs-103705/v1 ◽

2020 ◽

Author(s):

Fengwei Qin ◽

Shuai Wang ◽

Wencai Zhang ◽

Wen Chen ◽

Yonghui Feng ◽

...

Keyword(s):

Risk Factors ◽

Low Back Pain ◽

Back Pain ◽

Retrospective Study ◽

Bone Cement ◽

Low Back ◽

Resonance Imaging ◽

Factors Associated ◽

Surgical Data ◽

Magnetic Resonance Imaging Mri

Abstract Study design: Retrospective studyObjective: The purpose of this paper is to explore the possible risk factors for residual low back pain after PVP and to analyze their correlation.Method: A retrospective study was conducted on 1120 patients hospitalized for OVCF and treated with PVP between from July 2015 to June 2019 at our Hospital. Baseline, clinical and surgical data were collected to analyze the factors associated with residual low back pain after PVP.Results: 61 patients complained of residual low back pain, and the prevalence was 5.4%. Among the observed indexes included, there were significant differences in preoperative Thoracolumbar fascia injury (TFI), a liquefaction signal on magnetic resonance imaging (MRI) of the affected vertebrae, the number of responsible vertebrae and the distribution of bone cement between the two groups (P<0.05). Multivariate analysis revealed that preoperative TFI (OR=5.378, 95% CI: 1.713~16.888, P=0.004), a liquefaction signal on MRI of the affected vertebrae (OR=6.111, 95% CI：1.898~19.673, P=0.002), the number of responsible vertebrae (OR=0.098, 95% CI: 0.039~0.249, P=0.004), and the distribution of bone cement (OR=0.253, 95% CI: 0.079~0.810, P=0.021) were risk factors for residual low back pain after PVP.Conclusion: TFI, a liquefaction signal on MRI of the affected vertebrae, the number of responsible vertebrae and the distribution pattern of bone cement may be risk factors for residual low back pain after PVP.

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Intradiscal Pulsed Radiofrequency Application Duration Effect on Lumbar Discogenic Low Back Pain

January 2018 - Pain Physician ◽

10.36076/ppj.2020/23/e535 ◽

2020 ◽

Vol 5;23 (9;5) ◽

pp. E535-E540

Author(s):

Chan Hong Park

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Retrospective Study ◽

Pain Score ◽

Small Sample ◽

Low Back ◽

Pulsed Radiofrequency ◽

Discogenic Pain ◽

Discogenic Low Back Pain

Background: Discogenic pain is recognized as the most important and most common cause of low back pain (LBP). Intradiscal pulsed radiofrequency (ID-PRF) is used for the treatment of chronic discogenic pain. Objectives: We investigated the effects of the duration of percutaneous monopolar ID-PRF application on chronic discogenic LBP. Study Design: Retrospective study. Setting: Department of Anesthesiology and Pain Medicine, Neurosurgery at Wooridul Spine Hospital. Methods: Forty-five patients were included in this retrospective study. The patients were assigned into 2 groups according to the duration of the PRF procedure they underwent (7-minute group = 17 patients vs. 15-minute group = 28 patients). The main outcome measures tested were pain score, as determined by the Numeric Rating Scale (NRS-11) and the Oswestry Disability Index (ODI), at baseline, at 2-week, and 6-month follow-up visits. Success was defined as a reduction in NRS11 of 50% or more or an ODI reduction of 40% or more. Results: The mean posttreatment pain scores at 2 weeks and 6 months were significantly lower (P < 0.05) in both groups, but the differences between the groups were not significant. ODI scores were also significantly lower compared with the baseline, but the differences between the groups were not significant. At the 6-month follow-up, 12 patients (70.6%) in the 7-minute group and 20 patients (71.4%) in the 15-minute group reported more than 50% reduction in the pain score (P = 0.16), and there was no significant difference between the 2 groups in the number of patients with more than 40% reduction in ODI score (P = 0.23). Limitations: This study was performed with a small sample size and there was no control group. Additional well-designed and well-controlled studies that include parameters such as the stimulation duration, mode, and intensity of PRF are needed to fully assess the efficiency of ID-PRF. Conclusions: ID-PRF was shown to be effective for the treatment of discogenic LBP regardless of duration of ID-PRF application (7 vs. 15 minutes). Key words: Discogenic pain, pulsed, radio frequency, duration, pain, reduction

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Retrospective Study of the Analgesic Effect of Sacroiliac Joint Radiofrequency Denervation

January 2018 - Pain Physician ◽

10.36076/ppj.2021.24.e625 ◽

2021 ◽

pp. E625-E629

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Retrospective Study ◽

Pain Relief ◽

Pain Intensity ◽

Sacroiliac Joint ◽

Analgesic Effect ◽

Low Back ◽

Pulsed Rf

BACKGROUND: Interventional radiofrequency (RF) ablation techniques are indicated when an adequate effect is not obtained with conservative measures. OBJECTIVES: The primary objective of this study was to evaluate pain relief after RF denervation of the sacroiliac joint. The secondary objective was to evaluate pain intensity and relief duration. STUDY DESIGN: The study was retrospective. SETTING: The study was conducted at Vera Cruz Hospital, Campinas, Brazil. METHODS: Data were collected from the medical records of patients undergoing RF denervation for low back pain originating in the sacroiliac joint, from January 2015 to December 2017. There were 78 patients studied, between 18 and 65 years old, of both genders, ASA I or II, who underwent knee arthroscopic meniscectomy. The patients were submitted to denervation of sacroiliac joint by 3 types of RF (conventional, pulsed, and cooled). The following parameters were evaluated, number of patients who obtained ? 50% pain relief; pain intensity, measured using the visual analog scale (before the procedure and 15, 30, 90 and 180 days after, performed by the same evaluator); and the use of complementary analgesic for 2 weeks. RESULTS: Of the 78 included patients, 56 (71.8%) underwent conventional RF, 9 (11.5%) underwent pulsed RF, and 13 (16.7%) underwent cooled RF. There were losses to follow-up including 40 patients who underwent conventional RF, 5 who underwent pulsed RF, and 12 who underwent cooled RF, who were retained for 6 months. There was significant pain relief with the three types of RF for up to 6 months of follow-up, with no difference among the types. After 6 months, 90.2% of patients who underwent conventional RF, 100% who underwent pulsed RF, and 91.7% who underwent cooled RF maintained ? 50% pain relief. Complementary analgesics were used by 95% of the patients who underwent conventional RF, 80% who underwent pulsed RF, and 91% who underwent cooled RF 2 weeks after the procedure. There were mild adverse effects, such as edema, hematoma, and local pain, without complications. LIMITATIONS: As for limitations, the number of pulsed and cooled RF is low and in a retrospective study some data may be missing, especially from follow-up. CONCLUSIONS: RF denervation of the sacroiliac joint is effective and promotes a long-lasting analgesic effect. KEY WORDS: Analgesia, denervation, low back pain, radiofrequency, sacroiliac joint

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