Imaging Evaluation of Low Back Pain: Important Imaging Features Associated With Clinical Symptoms

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.

Download Full-text

A COMPARATIVE STUDY ON EFFICACY AND SAFETY OF TOLPERISONE VERSUS TIZANIDINE IN PATIENTS SUFFERING FROM ACUTE LOW BACK PAIN WITH MUSCLE SPASM

Asian Journal of Pharmaceutical and Clinical Research ◽

10.22159/ajpcr.2021.v14i12.43295 ◽

2021 ◽

pp. 153-157

Author(s):

ABDUL FAHEEM KHAN ◽

KHANETA PARVEEN

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Comparative Study ◽

Clinical Symptoms ◽

Mean Value ◽

Muscle Spasm ◽

Low Back ◽

Efficacy And Safety ◽

Acute Low Back Pain ◽

Significant Difference

OBJECTIVES: The objectives of this study were to compare the efficacy and safety of Tolperisone tablets 50 mg three times daily versus Tizanidine 2 mg tablets thrice daily for the treatment of acute low back pain with muscle spasm. METHODS: The comparative study was carried out in 50 patients from orthopedics Dr. Pinnamaneni Siddhartha Institute of Medical Sciences and Research Foundation, Vijayawada. Only those patients fulfilling the inclusion/exclusion criteria were enrolled into the study. Participants suffering from acute low back pain with muscle spasm were divided into two groups. The participants were followed up on Day-14 as final analysis. RESULTS: Subjects receiving Tolperisone showed a mean value of 16.43±1.16 in the Roland Morris low back pain and disability questionnaire both groups on day 1 and was reduced to 7.82±1.15 (51.94%) on day 7 and 2.56±1.53 (84.46%) on day 14. Similarly, the patients in the tizanidine group had mean value of 15.93±1.61 on day 1, which was reduced to 6.77±1.68 (57.64%) on day 7, and 2.88±1.92 (81.95%) on day 14, as comparable to the Tolperisone group. There was no statistically significant difference between the two groups, (p>0.05) for pain at rest, pain at night, restrictions of movement, changes in stiffness, changes in numbness, and changes in tenderness. There was a statistically significant difference between the two groups, (p<0.05) for pain on movement and kinesalgia. CONCLUSIONS: Tolperisone was found comparable in efficacy to Tizanidine in improving the clinical symptoms of changes in pain Self-assessment by the patient on different applied parameters.

Download Full-text

DIAGNOSTIC RADIOLOGY METHODS OF DEGENERATIVE CHANGES IN LUMBAR INTERVERTEBRAL DISCS IN YOUNG PEOPLE

International Medical Journal ◽

10.37436/2308-5274-2019-3-18 ◽

2020 ◽

pp. 93-96

Author(s):

Ilhar Halyb ohly Mammadov

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Clinical Symptoms ◽

Intervertebral Discs ◽

Information Value ◽

Diagnostic Radiology ◽

Degenerative Changes ◽

Low Back ◽

Disc Disease ◽

Disc Protrusion

In recent years, the number of scientific studies investigating the prevalence of low back pain among schoolchildren has been significantly increased. Degenerative disease of the discs is often accompanied by a low back pain with irradiation into the legs in representatives of different age groups, in particular, in older children. The main factors of its development are genetic predisposition, trauma, obesity, lack of exercise. Most of the components of the vertebral motor segment have the nerve endings and reflex influences, accompanied by inflammation, microcirculatory disorders, and their combination contributes to an appearance of back pain. Diagnosis of degenerative disc disease includes the study of the patient's medical history, analysis of clinical symptoms, use of functional tests and various types of imaging to clarify the degree of macrostructural changes in disks, among which the main place is taken by the magnetic resonance imaging. The development of degenerative changes in intervertebral discs as early as childhood, which requires a further study using non−invasive, accessible and informative methods, especially ultrasound ones. The results of ultrasonography of lumbar intervertebral discs were analyzed in 36 adolescents aged 16−18 years, diagnosed for the protrusion when the MRI was applied. Paramedian protrusion was found to be significantly more frequent than posterolateral, median, and circular ones. Due to its non−invasiveness, low price and information value, the ultrasound can be the most popular method not only as a screening one but also for the expert evaluation of lumbar intervertebral disc protrusion in schoolchildren. Key words: diagnostic radiology, lumbar intervertebral discs, adolescents.

Download Full-text

Three-dimensional reconstruction of intervertebral disc based on magnetic resonance imaging in patients with acute low back pain

Studies in Health Technology and Informatics - Research into Spinal Deformities 9 ◽

10.3233/shti210436 ◽

2021 ◽

Author(s):

T Kotwicki ◽

S Rubczak ◽

P Glowka

Keyword(s):

Magnetic Resonance Imaging ◽

Low Back Pain ◽

Back Pain ◽

Magnetic Resonance ◽

Intervertebral Disc ◽

Clinical Symptoms ◽

Low Back ◽

Resonance Imaging ◽

Acute Low Back Pain ◽

Dimensional Reconstruction

The aim of the study is to evaluate the morphology of the intervertebral discs visible in the magnetic resonance image in patients with sudden severe low back pain (with or without radiation of pain to the lower limb). The second goal of the study is to perform a digital three-plane reconstruction of the intervertebral disc and to compare this technique with a standard magnetic resonance imaging test. Twenty-five patients, mean age 35.5 years, all with acute low back pain, were examined. We compared the 3D MR models with standard MRI scans by measuring seven MRI parameters. In patients with sudden, severe low back pain, with clinical symptoms suggesting an etiology within the intervertebral disc, changes in a standard MRI are found consisting of the presence of a hernia / protrusion of the intervertebral disc and lowering the height of the intervertebral disc – with lowering the disc height occurs to a greater extent in the rear section. The 3D reconstruction is a reliable 3D representation of the intervertebral disc and adjacent vertebral bodies.

Download Full-text

Parameters of dermatomal somatosensory evoked potentials in normal conditions and patients with clinical symptoms of low back pain

Journal of Medical Science ◽

10.20883/jms.2016.4 ◽

2016 ◽

Vol 85 (1) ◽

pp. 30-38

Author(s):

Magdalena Wojtysiak ◽

Małgorzata Wilk ◽

Adrian Dudek ◽

Aleksandra Kulczyk ◽

Martyna Borowczyk ◽

...

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Evoked Potentials ◽

Somatosensory Evoked Potentials ◽

Clinical Symptoms ◽

Low Back

Download Full-text

Magnetic resonance imaging for low back pain: indications and limitations

Annals of the Rheumatic Diseases ◽

10.1136/ard.2009.110973 ◽

2009 ◽

Vol 69 (01) ◽

pp. 7-11 ◽

Cited By ~ 27

Author(s):

N J Sheehan

Keyword(s):

Magnetic Resonance Imaging ◽

Low Back Pain ◽

Back Pain ◽

Magnetic Resonance ◽

Clinical Symptoms ◽

Neurological Deficits ◽

Spinal Diseases ◽

Low Back ◽

Resonance Imaging ◽

National Guidelines

Magnetic resonance imaging (MRI) is the preferred investigation for most spinal diseases and is increasingly requested for people with low back pain (LBP). However, determining the cause of back pain is complicated as it is often multifactorial and anatomical abnormalities are common in the spine and may not necessarily translate into clinical symptoms. Thus, national guidelines discourage the use of MRI in non-specific LBP and recommend reserving it for the investigation of severe or progressive neurological deficits or for those cases in which serious underlying pathology is suspected. It also has an acknowledged role in planning surgical management in cases of radiculopathy and spinal stenosis. This review summarises the indications for MRI in LBP and calls for improved education of patients and health professionals in the limitations of this investigation.

Download Full-text

Abnormal medial prefrontal cortex functional connectivity and its association with clinical symptoms in chronic low back pain

Pain ◽

10.1097/j.pain.0000000000001507 ◽

2019 ◽

Vol 160 (6) ◽

pp. 1308-1318 ◽

Cited By ~ 17

Author(s):

Yiheng Tu ◽

Minyoung Jung ◽

Randy L. Gollub ◽

Vitaly Napadow ◽

Jessica Gerber ◽

...

Keyword(s):

Low Back Pain ◽

Prefrontal Cortex ◽

Back Pain ◽

Functional Connectivity ◽

Medial Prefrontal Cortex ◽

Chronic Low Back Pain ◽

Clinical Symptoms ◽

Low Back

Download Full-text

Management of Chronic Low Back Pain: Review of Fluoroscopy-Guided Epidural Steroid Injection

Neurographics ◽

10.3174/ng.2000032 ◽

2021 ◽

Vol 11 (1) ◽

pp. 1-11

Author(s):

A. Chacko Achanaril ◽

M.D. Jhaveri ◽

S. Gaddikeri

Keyword(s):

Health Care ◽

Low Back Pain ◽

Back Pain ◽

Minimally Invasive ◽

Health Care Providers ◽

Chronic Low Back Pain ◽

The United States ◽

Imaging Features ◽

Low Back ◽

Care Providers

Chronic low back pain point prevalence in US adults ages 20‐69 years is approximately 13.1%. It is estimated that approximately 12%‐15% of visits to health care providers in the United States are related to low back pain and is considered as an economic burden, not only due to the loss of work productivity but also due to direct health care costs, with an estimated median treatment cost of approximately $13,015 per quality-adjusted life year. Even with well-selected patients, the surgical outcome in patients with low back pain may vary. Conservative management by using physical therapy and rehabilitation is considered an equally good alternative option for patients with chronic low back pain. Percutaneous minimally invasive pain-alleviating spinal procedures are helpful for patients who do not have a compelling indication for surgical intervention, who are not good surgical candidates due to their associated comorbidities, and who cannot tolerate the oral pain medications in the required doses. Percutaneous minimally invasive pain-alleviating spinal procedures are increasingly popular due to increasing patient awareness of alternative treatment options and also the skepticism about the cost-effective role of spinal surgery for pain. In this article, we provide a basic review of relevant anatomy, preprocedure assessment, and techniques for most commonly used percutaneous image-guided spinal epidural procedures and briefly discuss the potential complications.Learning Objectives: To describe relevant spinal anatomy; to provide a brief illustration of basic techniques and approaches for spinal pain control procedures and regional anesthesia; and to discuss predisposing factors, pathophysiology, and imaging features of associated complications.

Download Full-text

SURVEY THE FREQUENCY OF CLINICAL SYMPTOMS ACCORDING TO TRADITIONAL MEDICINE IN PATIENTS WITH LOW BACK PAIN

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2020.6.9 ◽

2020 ◽

pp. 65-72

Author(s):

Nhung Phan Thi Hong ◽

Tan Nguyen Thi ◽

Hung Nguyen Van

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Traditional Medicine ◽

Clinical Symptoms ◽

Pulse Frequency ◽

High Rate ◽

Common Disease ◽

Low Back ◽

Cross Sectional ◽

Pain Symptoms

Background: Low back pain is a very common disease in daily life and clinical, which affects much to the health. Traditional medical symptoms of low back pain are very diverse and clinically difficult to diagnose. So we conduct this study to contribute to the standardization of symptoms according to traditional medicine and initially contributed to the improvement of diagnosis and treatment of diseases. Objectives: to survey the frequency of clinical symptoms according to traditional medicine in patients with low back pain and find out some factors related to the frequency of clinical types of the disease. Subjects and Methods: Including 92 patients were diagnosed with low back pain and treatment at the Traditional Medicine department of Hue Central Hospital and Thua Thien Hue Traditional Medicine Hospital. Research methodology is descriptive cross-sectional. Results: The symptoms of the tongue: 65.2% pale red tongue, 6.5% bluish purple tongue, 37.0% enlarged tongue, 8.7% thin tongue. About the tongue fur: 68.5% white fur and 31.5% yellow fur, 42.4% moist fur, 4.3% sticky slimy fur, 58.7% thin fur and 41.3% thick fur. The symptoms of the pulse: 17.4% floating pulse, 69.6% sunken pulse, nmoderate pulse 43.5%, powerful pulse 84.8%, weak pulse 15.2%. Among the patients have 33.7% constipation, 45.7% nocturia, 34.8% inability to sleep, 17.4% night sweating 12.0% spontaneous sweating. Conclusion: Symptoms: pale red tongue, white fur, moist fur, thin fur, constipation, nocturia, inability to sleep, sunken pulse, moderate pulse, powerful pulse have high rate; Symptoms have low rate such as bluish purple, the thin tongue, sticky slimy fur. There were significant relationships between clinical types and age, tongue color, tongue fur color, pain properties and pulse frequency (p < 0.05). Key words: Low back pain, symptoms, traditional medicine.

Download Full-text