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

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.

scholarly journals Fluoroscopically-Guided Injections to Treat “Kissing Spine” Disease

2008 ◽  
Vol 4;11 (8;4) ◽  
pp. 549-554 ◽  
Author(s):  
Tim Lamer
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Lumbar Spine ◽  
Soft Tissues ◽  
Nerve Fibers ◽  
Low Back ◽  
Mri Findings ◽  
Mri Features ◽  
Spinous Processes ◽  
Spine Disease

Background: Any spine structure that is innervated by afferent nociceptive nerve fibers is a potential pain generator. In the lumbar spine, the most studied pain generators include: sacroiliac joints, the zygapophysial joints, the intervertebral discs, myofascial structures. Anomalous lumbosacral articulations, the spinous processes, and lumbar spine osteophytes are less commonly reported. Objective: To describe the diagnostic and therapeutic features of “kissing spine” disease or Baastrup’s Sign with particular attention to MRI findings and fluoroscopicallyguided injection therapy. Design: A series of 3 patients with axial low back pain presented with exam findings and MRI changes suggestive of pain emanating from adjacent spinous processes that appeared to be in direct contact or very closely opposed. This has been described in the literature as “kissing spine” disease or Baastrup’s sign. Fluoroscopically-guided injections were performed and the responses were studied. Results: The 3 patients had MRI findings consisting of inflammation and/or edema in the spinous processes and surrounding soft tissues. Fluoroscopically-guided injections provided pain relief in all 3 patients. One patient with recurrent pain eventually underwent successful surgical resection of the involved spinous processes. Conclusion: Painful adjacent and closely opposed spinous processes can be a source of axial low back pain. We have described MRI features and the responses to fluoroscopically-guided injections in 3 patients with this condition. Key words: Baastrup’s, kissing spine, spine injection

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

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

Degenerative Changes in the Lumbar Spine Correlate with Spino-Pelvic Alignment in Patients with Low Back Pain

2013 ◽  
Vol 13 (9) ◽  
pp. S153-S154
Author(s):  
Dominique A. Rothenfluh ◽  
Julia Lebschi ◽  
Esin Rothenfluh
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Lumbar Spine ◽  
Degenerative Changes ◽  
Low Back

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

2020 ◽  
Vol 29 (1) ◽  
pp. 28-36 ◽  
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.

scholarly journals Magnetic Resonance Imaging Findings Among Young Adults with Low Back Pain at Nsambya Hospital

2021 ◽  
Author(s):  
Komakech Richard Lukecha ◽  
Erem Geoffrey ◽  
Mubuuke A. Gonzaga ◽  
Bugeza Sam
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Lumbar Spine ◽  
Young Adult ◽  
Clinical Features ◽  
Adult Patients ◽  
Low Back ◽  
Mri Findings ◽  
Mri Features ◽  
Disc Bulge

Abstract Back ground: Studies on MRI findings among patients with LBP have been conducted; especially among adolescents and young adult population in developed countries. However, MRI lumber 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 hospitalMethods: This was a descriptive cross sectional study. One hundred and fifty-seven patients with low back pain in the 18 - 39year 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.

scholarly journals Jogging Kinematics After Lumbar Paraspinal Muscle Fatigue

2009 ◽  
Vol 44 (5) ◽  
pp. 475-481 ◽  
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 &lt; .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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