Artificial Intelligence Algorithm-Based Lumbar and Spinal MRI for Evaluation of Efficacy of Chinkuei Shin Chewan Decoction on Lumbar Spinal Stenosis

The study aimed to explore the application value of lumbar Magnetic Resonance Imaging (MRI) images processed by artificial intelligence algorithms in evaluating the efficacy of chinkuei shin chewan decoction (a traditional Chinese medicine to nourish the kidney) in the treatment of lumbar spinal stenosis (LSS). Specifically, 110 LSS patients admitted to the hospital were selected as the research subjects. They were randomly divided into the control group (n = 55) and experimental group (n = 55) according to different treatment methods. The control group was treated with traditional medicine, and the experimental group additionally took chinkuei shin chewan decoction on its basis. Based on the traditional U-net algorithm, a U-net registration algorithm based on artificial intelligence was designed by introducing the information entropy theory, and the algorithm was applied to the lumbar MRI image evaluation of LSS patients. Compared with the traditional U-net algorithm, the artificial intelligence-based U-net registration algorithm had a decreased noise level P < 0.05 , the Jaccard (J) value (0.84) and the Dice value (0.93) increased significantly versus the traditional algorithm (J = 0.63, Dice = 0.81), and the characteristics of the image were more accurate. Before treatment, the Oswestry Disability Index (ODI) scores of the experimental group and the control group were 44.32 ± 6.45 and 43.32 ± 5.45, respectively. After treatment, the ODI scores of the two groups were 10.21 ± 5.05 and 17.09 ± 5.23, respectively. Both showed significant improvement, while the improvement of the experimental group was more obvious than that of the control group P < 0.05 . The overall effective rates of the two groups of patients were 96.44% and 82.47%, respectively, and the experimental group was significantly higher than the control group P < 0.05 . Under the U-net registration algorithm based on artificial intelligence, the diagnostic accuracy of lumbar MRI in the experimental group was 94.45%, significantly higher than 67.5% before the introduction of the algorithm P < 0.05 . In conclusion, chinkuei shin chewan decoction are effective for the treatment of LSS, and lumbar MRI based on the artificial intelligence U-net registration algorithm can evaluate the efficacy of LSS well and is worthy of promotion.

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Efficacy and safety of percutaneous transforaminal endoscopic discectomy in the treatment of lumbar spinal stenosis combined with osteoporosis

Revista da Associação Médica Brasileira ◽

10.1590/1806-9282.65.6.779 ◽

2019 ◽

Vol 65 (6) ◽

pp. 779-785

Author(s):

Xiaobin Gu ◽

Wenhui Zhu ◽

Haiyi He ◽

Zili Wang ◽

Shaolong Ding ◽

...

Keyword(s):

Spinal Stenosis ◽

Lumbar Spinal Stenosis ◽

Adverse Reactions ◽

Leg Pain ◽

Control Group ◽

Efficacy And Safety ◽

Significant Difference ◽

Endoscopic Discectomy ◽

Percutaneous Transforaminal Endoscopic Discectomy ◽

Lumbar Spinal

SUMMARY OBJECTIVE: To investigate the efficacy and safety of percutaneous transforaminal endoscopic discectomy (PTED) in the treatment of lumbar spinal stenosis (LSS) combined with osteoporosis. METHODS: Eighty patients with LSS combined with osteoporosis were divided into a control and PTED group, which received conventional transforaminal lumbar interbody fusion and PTED, respectively. The surgical indications, incision visual analogue scale (VAS), lumbar and leg pain VAS, lumbar Japanese Orthopaedic Association (JOA) and Oswestry disability index (ODI) scores, bone mineral density (BMD), and adverse reactions were observed. RESULTS: Compared with the control group, in the PTED group, the operation time, bleeding loss and hospitalization duration, incision VAS scores at postoperative 12, 24 and 48 h and lumbar and leg pain VAS and lumbar ODI scores on postoperative 6 months were significantly decreased (P < 0.01), and the lumbar JOA score on postoperative 6 months was significantly increased (P < 0.05). There was no significant difference in BMD between two groups (P > 0.05). Compared with the control group, in the PTED group, the total effective rate was significantly higher (P < 0.05), and the incidence of adverse reactions was significantly lower (P < 0.05). CONCLUSIONS: PTED is safe and effective in the treatment of LSS combined with osteoporosis.

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Treatment for Lumbar Spinal Stenosis Secondary to Ligamentum Flavum Hypertrophy Using Percutaneous Endoscopy through Interlaminar Approach: A Retrospective Study

10.21203/rs.3.rs-25682/v1 ◽

2020 ◽

Author(s):

Yi Liu ◽

Yingjie Qi ◽

Diarra Mohamed Diaty ◽

Guanglei Zheng ◽

Xiaoqiang Shen ◽

...

Keyword(s):

Elderly Patients ◽

Spinal Stenosis ◽

Lumbar Spinal Stenosis ◽

Disease Duration ◽

Ligamentum Flavum ◽

Leg Pain ◽

Control Group ◽

Interlaminar Approach ◽

Lumbar Spinal ◽

Percutaneous Endoscopy

Abstract Background This paper is to first describe percutaneous endoscopy in the treatment of lumbar spinal stenosis secondary to ligamentum flavum hypertrophy targetedly. To investigate the efficacy and safety of percutaneous endoscopy in the treatment of this kind of lumbar spinal stenosis in elderly patients. Method: A retrospective analysis of 40 elderly patients with lumbar spinal stenosis secondary to ligamentum flavum hypertrophy admitted between January 2016 and January 2018 was performed. According to different surgical methods, they were divided into two groups: the control group and the endoscopy group (interlaminar approach), 20 people per group. There were 9 males and 11 females in the control group; the age of patients was 65.65 ± 4.44years, and the average disease duration was 4.55 ± 1.85 years. Besides, There were 10 males and 10 females in the endoscopy group; the age of patients was 67.30 ± 4.23years, and the average disease duration was 4.95 ± 2.04 years. Collect and count surgical-related indicators, preoperative and postoperative radiologic findings, incision visual analogue scale (VAS), lumbar and leg pain VAS, lumbar Japanese Orthopaedic Association (JOA) and Oswestry disability index (ODI) scores of all patients. Result A series of surgical indicators (including the operation time, the quantity of bleeding and postoperative hospital stay) in the endoscopy group was significantly lower than that in the control group (p < 0.05). The incision VAS score in the endoscopy group was also significantly lower than that in the control group at each time after surgery (p < 0.05). Besides, compared with the control group, in the endoscopy group, the leg pain VAS score and lumbar ODI score after surgery were significantly decreased (p < 0.05). Compared with the control group, in the endoscopy group, the lumbar JOA score was significantly higher (p < 0.05). Conclusion Percutaneous endoscopic technique is a small trauma, quick recovery, safe and effective minimally invasive surgery for patients with lumbar spinal stenosis secondary to ligamentum flavum hypertrophy.

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Lumbar Neurogenic Claudication

10.1093/med/9780190626761.003.0010 ◽

2018 ◽

Author(s):

Raj J. Gala ◽

James Yue

Keyword(s):

Spinal Stenosis ◽

Lumbar Spinal Stenosis ◽

The Elderly ◽

Clinical Syndrome ◽

Neurogenic Claudication ◽

Epidural Steroid Injections ◽

Magnetic Resonance Imaging Mri ◽

Asymptomatic Individuals ◽

Lumbar Spinal ◽

Epidural Steroid

Lumbar neurogenic claudication, sometimes referred to as pseudoclaudication, is the clinical syndrome of back pain radiating down one or both legs during ambulation. Classically, the symptoms abate with forward flexion of the lumbar spine and worsen with extension. The condition arises from lumbar spinal stenosis, which is common in the elderly population. Many asymptomatic individuals have lumbar spinal stenosis seen on magnetic resonance imaging (MRI), so this syndrome is a clinical diagnosis. The majority of patients have favorable responses with conservative treatment, which includes physical therapy, bracing, medications, and epidural steroid injections. Patients who do not improve may go on to have surgery. Spinal stenosis has become one of the most common reasons to undergo lumbar spinal surgery in patients older than 65 years of age.

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Predictability of the effects of epidural injection in lumbar spinal stenosis by assessment of lumbar MRI scans

Journal of Back and Musculoskeletal Rehabilitation ◽

10.3233/bmr-181249 ◽

2019 ◽

pp. 1-9

Author(s):

Ulf Krister Hofmann ◽

Ramona Luise Keller ◽

Maximilian von Bernstorff ◽

Christian Walter ◽

Falk Mittag

Keyword(s):

Spinal Stenosis ◽

Lumbar Spinal Stenosis ◽

Epidural Injection ◽

Lumbar Mri ◽

Mri Scans ◽

Lumbar Spinal

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Facet Tropism and Orientation: Risk Factors for Degenerative Lumbar Spinal Stenosis

BioMed Research International ◽

10.1155/2020/2453503 ◽

2020 ◽

Vol 2020 ◽

pp. 1-6

Author(s):

Janan Abbas ◽

Natan Peled ◽

Israel Hershkovitz ◽

Kamal Hamoud

Keyword(s):

Risk Factors ◽

Lumbar Spine ◽

Spinal Stenosis ◽

Lumbar Spinal Stenosis ◽

Control Group ◽

Degenerative Lumbar Spinal Stenosis ◽

Lower Lumbar Spine ◽

Lumbar Spinal ◽

Lower Lumbar ◽

Facet Tropism

The aim of this study is to establish whether facet tropism (FT) and orientation (FO) are associated with degenerative lumbar spinal stenosis (DLSS). A retrospective computerized tomography (CT) study including 274 individuals was divided into two groups: control (82 males and 81 females) and stenosis (59 males and 52 females). All participants have undergone high-resolution CT scan of the lumbar spine in the same position. FT and FO were measured at L1-2 to L5-S1. Significant sagittal FO was noted in the stenosis males (L2-3 to L4-5) and females (L2-3 to L5-S1) compared to the controls. The prevalence of FT was remarkably greater in the stenosis males (L4-5, L5-S1) and females (L3-4, L5-S1) compared to their counterparts in the control group. Our results also showed that FT (L3-4 to L5-S1) increases approximately 2.9 times the likelihood for DLSS development. This study indicates that FO and FT in the lower lumbar spine are significantly associated with DLSS.

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Surgical treatment for lumbar spinal stenosis: a single-blinded randomized controlled trial

Advances in Rheumatology ◽

10.1186/s42358-021-00184-6 ◽

2021 ◽

Vol 61 (1) ◽

Author(s):

Luiz Claudio Lacerda Rodrigues ◽

Jamil Natour

Keyword(s):

Surgical Treatment ◽

Spinal Stenosis ◽

Lumbar Spinal Stenosis ◽

Likert Scale ◽

Control Group ◽

Walk Test ◽

Medium Term ◽

Sf 36 ◽

Significant Difference ◽

Lumbar Spinal

Abstract Objective To evaluate the effectiveness of surgery for the management of patients with symptomatic lumbar spinal stenosis. Methods Sixty-three patients with lumbar canal stenosis were randomized into two groups: the intervention group (IG) and control group (CG). IG patients underwent surgery and both groups participated in the same physical therapy program twice a week for a period of 12 weeks and were followed up at 1 year. The primary endpoint was visual analogue scale for pain, and the secondary endpoints were function (6-min walk test, Roland Morris and Oswestry questionnaires), quality of life (SF-36 questionnaire) and satisfaction with treatment (Likert scale). Results No significant difference between groups was observed for pain over time (p = 0.145). Significant differences between groups, in favor of the IG, were observed for the Oswestry score (p = 0.006) and vitality domain score of the SF-36 (p = 0.047). Function in the Roland Morris and 6-min walk test and the role of the physical domain of SF-36 also showed significant differences between the groups; however, these differences occurred due to a worsening of the IG in the short term, and the medium-term. The Likert scale demonstrated greater satisfaction with the IG treatment compared to control group. Conclusions Lumbar stenosis surgery did not improve pain in short and medium terms. Function and vitality were better in the group that underwent surgery in the medium term, and patients were more satisfied with the surgical treatment. Trial registration Clinicaltrials.gov (NCT02879461).

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Acupuncture for Patients with Lumbar Spinal Stenosis: A Randomised Pilot Trial

Acupuncture in Medicine ◽

10.1136/acupmed-2015-010962 ◽

2016 ◽

Vol 34 (4) ◽

pp. 267-274 ◽

Cited By ~ 10

Author(s):

Kun Hyung Kim ◽

Yu Ri Kim ◽

Seung Kug Baik ◽

Seung Hee Noh ◽

Dae Hun Kim ◽

...

Keyword(s):

Usual Care ◽

Spinal Stenosis ◽

Lumbar Spinal Stenosis ◽

Pilot Trial ◽

Acupuncture Group ◽

Self Management ◽

Control Group ◽

Registration Number ◽

Secondary Outcomes ◽

Lumbar Spinal

Objective To assess the safety and feasibility of acupuncture for participants with symptomatic lumbar spinal stenosis (LSS) in a pilot study. Methods 50 participants with a clinical and radiological diagnosis of LSS were randomised to receive acupuncture combined with usual care (acupuncture group), or usual care alone (control group). Participants in the acupuncture group were offered 12–16 sessions of manual acupuncture±electroacupuncture over 6 weeks and maintained their usual self-management. The control group was provided with physical therapy as required and maintained their usual self-management. The primary outcome was the change in back-specific functional status, as measured by the Oswestry disability index (ODI) at the 3-month follow-up. Secondary outcomes included symptoms and other relevant domains. Outcome assessors were not blinded. Results 39 participants (78%) completed the trial with 524 treatment visits. There were no significant differences between the two groups in back-specific function (ODI: mean difference −2.5, 95% CI −8.9 to 3.8). Pain in the back and/or leg showed small improvements at 3 months, while there were no significant differences in other secondary outcomes. The total number of adverse events was 61 (12% of 524 treatment visits). All but one were minor and transient. The one severe adverse event was deemed to be unrelated to acupuncture. Conclusions The study was feasible. Acupuncture combined with usual care did not confer significant functional improvements over usual care alone. Further randomised trials with adequate sample sizes and outcome assessor blinding are warranted to evaluate the role of acupuncture for LSS. Trial Registration Number NCT01987622.

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Pedicle Morphometry Variations in Individuals with Degenerative Lumbar Spinal Stenosis

BioMed Research International ◽

10.1155/2020/7125914 ◽

2020 ◽

Vol 2020 ◽

pp. 1-6

Author(s):

Janan Abbas ◽

Natan Peled ◽

Israel Hershkovitz ◽

Kamal Hamoud

Keyword(s):

General Population ◽

Sex Ratio ◽

Spinal Stenosis ◽

Lumbar Spinal Stenosis ◽

Lumbar Vertebrae ◽

Control Group ◽

Degenerative Lumbar Spinal Stenosis ◽

Males And Females ◽

Lumbar Spinal ◽

Age Range

The aim of this study was to compare pedicle dimensions in degenerative lumbar spinal stenosis (DLSS) with those in the general population. A retrospective computerized tomography (CT) study for lumbar vertebrae (L1 to L5) from two sample populations was used. The first included 165 participants with symptomatic DLSS (age range: 40-88 years, sex ratio: 80 M/85 F), and the second had 180 individuals from the general population (age range: 40-99 years, sex ratio: 90 M/90 F). Both males and females in the stenosis group manifested significantly greater pedicle width than the control group at all lumbar levels (P<0.05). In addition, pedicle heights for stenosis females were remarkably smaller on L4 and L5 levels compared to their counterparts in the control group (P<0.001). Males have larger pedicles than females for all lumbar levels (P<0.001). Age and BMI did not demonstrate significant association with pedicle dimensions. Our outcomes indicate that individuals with DLSS have larger pedicle widths than the control group. More so, pedicle dimensions are gender-dependent but independent of age and BMI.

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Is Lumbosacral Transitional Vertebra Associated with Degenerative Lumbar Spinal Stenosis?

BioMed Research International ◽

10.1155/2019/3871819 ◽

2019 ◽

Vol 2019 ◽

pp. 1-7

Author(s):

Janan Abbas ◽

Natan Peled ◽

Israel Hershkovitz ◽

Kamal Hamoud

Keyword(s):

Sex Ratio ◽

Spinal Stenosis ◽

Lumbar Spinal Stenosis ◽

Control Group ◽

Lumbar Region ◽

Degenerative Lumbar Spinal Stenosis ◽

Transitional Vertebra ◽

Lumbosacral Transitional Vertebra ◽

Lumbar Spinal ◽

Age Range

The aim of this study was to shed light on the association between lumbosacral transitional vertebra (LSTV) and degenerative lumbar spinal stenosis (DLSS). A cross-sectional retrospective study was performed on 165 individuals that were diagnosed with clinical picture of DLSS (age range: 40-88 years; sex ratio: 80M/85F) and 180 individuals without DLSS related symptoms (age range: 40-99 years; sex ratio: 90M/90F). All participants had undergone high-resolution CT scan for the lumbar region in the same position. We also used the volume rendering method to obtain three-dimensional CT images of the lumbosacral area. Both males and females in the stenosis group manifest greater prevalence of LSTV than their counterparts in the control group (P<0.001). Furthermore, the presence of LSTV increases the likelihood of degenerative spinal stenosis (odds ratio= 3.741, P<0.001). In the control group, LSTV was more common in males, and sacral slope angle of males was significantly greater in LSTV group compared to non-LSTV. This study indicates that LSTV was significantly associated with symptomatic DLSS.

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Effects of Nasal Calcitonin vs. Oral Gabapentin on Pain and Symptoms of Lumbar Spinal Stenosis: A Clinical Trial Study

Clinical Medicine Insights Arthritis and Musculoskeletal Disorders ◽

10.4137/cmamd.s39938 ◽

2016 ◽

Vol 9 ◽

pp. CMAMD.S39938 ◽

Cited By ~ 2

Author(s):

Kaveh Haddadi ◽

Leila Asadian ◽

Ahdie Isazade

Keyword(s):

Clinical Trial ◽

Spinal Stenosis ◽

Lumbar Spinal Stenosis ◽

Salmon Calcitonin ◽

Control Group ◽

Neurogenic Claudication ◽

Nasal Calcitonin ◽

Significant Difference ◽

Nasal Salmon Calcitonin ◽

Lumbar Spinal

Lumbar spinal stenosis (LSS) is a chronic and prevalent disease that occurs in 10.8% of the general population, mostly in old age. We designed the first clinical trial study to compare the effects of administering the nasal salmon calcitonin spray and gabapentin in patients with LSS. In this clinical trial, 90 patients with symptoms of neurogenic claudication and magnetic resonance imaging-proven LSS were randomly assigned to nasal salmon calcitonin, gabapentin, or placebo treatments for eight weeks (30 participants in each group). This was followed by a washout period of four weeks. After three months of study and after four weeks off the prescription, mean values of Oswestry Disability Index in the calcitonin, gabapentin, and control groups were 23 ± 12.05, 32 ± 16.08, and 38 ± 22.09, respectively ( P ≤ 0.05, calcitonin group vs. gabapentin group, and P ≤ 0. 001, calcitonin group vs. control group with respect to pretreatment scores). Thus, three months after the treatment, although most of the patients in the control group had a satisfactory period of improvement, the improvement in the calcitonin group was more than the other two groups with a significant difference ( P ≤ 0.05 when compared to gabapentin group and P ≤ 0.01 when compared to placebo group). We revealed that the 200 International Unit (IU) and nasal calcitonin spray daily are more effective compared to 300 mg gabapentin three times per day and the placebo effect for eight weeks of treatment of symptoms of patients with LSS.

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