scholarly journals Short-Term Effect of Lumbar Traction on Intervertebral Discs in Patients with Low Back Pain: Correlation between the T2 Value and ODI/VAS Score

Cartilage ◽  
2021 ◽  
pp. 194760352199679
Author(s):  
Zhen-zhen Liu ◽  
Hui-quan Wen ◽  
Ye-qing Zhu ◽  
Bin-liang Zhao ◽  
Qing-cong Kong ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
T2 Mapping ◽  
Low Back ◽  
Vas Score ◽  
Grade Ii ◽  
Lumbar Traction ◽  
Vas Scores ◽  
The Mean ◽  
Pfirrmann Grade

Objective The effect of lumbar traction on low back pain (LBP) patients is controversial. Our study aims to assess changes in the intervertebral disc water content after lumbar traction using T2 mapping and explore the correlation between changes in the T2 value and Oswestry Disability Index (ODI)/visual analogue scale (VAS) score. Design Lumbar spine magnetic resonance imaging was performed, and the ODI/VAS scores were recorded in all 48 patients. Midsagittal T2-weighted imaging and T2 mapping were performed to determine the Pfirrmann grade and T2 value. Then, the T2 values were compared between pre- and posttraction, and the correlation between changes in the T2 value and ODI/VAS scores were examined. Results In the traction group, the changes in the nucleus pulposus (NP) T2 values for Pfirrmann grades II-IV and the annulus fibrosus (AF) T2 values for Pfirrmann grade II were statistically significant after traction ( P < 0.05). Changes in the mean NP T2 value of 5 discs in each patient and in the ODI/VAS score showed a strong correlation ( r = 0.822, r = 0.793). Conclusion T2 mapping can be used to evaluate changes in the intervertebral disc water content. Ten sessions of traction resulted in a significant increase in quantitative T2 measurements of the NP in discs for Pfirrmann grade II-IV degeneration and remission of the patients’ clinical symptoms in the following 6 months. Changes in the mean NP T2 value of 5 discs in each patient were strongly correlated with changes in the ODI/VAS score.

scholarly journals Transforaminal Epiduroscopic Basivertebral Nerve Laser Ablation for Chronic Low Back Pain Associated with Modic Changes: A Preliminary Open-Label Study

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Hyeun Sung Kim ◽  
Nitin Adsul ◽  
Farid Yudoyono ◽  
Byapak Paudel ◽  
Ki Joon Kim ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Laser Ablation ◽  
Chronic Low Back Pain ◽  
Modic Changes ◽  
Type I ◽  
Low Back ◽  
Vas Score ◽  
The Mean

Background. Chronic low back pain (CLBP) arising from degenerative disc disease continues to be a challenging clinical and diagnostic problem whether treated with nonsurgical, pain intervention, or motion-preserving stabilization and arthrodesis. Methods. Fourteen patients with CLBP, greater than 6 months, unresponsive to at least 4 months of conservative care were enrolled. All patients were treated successfully following screening using MRI findings of Modic type I or II changes and positive confirmatory provocative discography to determine the affected levels. All patients underwent ablation of the basivertebral nerve (BVN) using 1414 nm Nd:YAG laser-assisted energy guided in a transforaminal epiduroscopic approach. Macnab’s criteria and visual analog scale (VAS) score were collected retrospectively at each follow-up interval. Results. The mean age was 46 ± 9.95 years. The mean symptoms duration was 21.21 ± 21.87 months. The mean follow-up was 15.3 ± 2.67 months. The preoperative VAS score of 7.79 ± 0.97 changed to 1.92 ± 1.38, postoperatively (P<0.01). As per Macnab’s criteria, seven patients (50%) had excellent, six patients (42.85%) had good, and one patient (7.14%) had fair outcomes. Conclusion. The transforaminal epiduroscopic basivertebral nerve laser ablation (TEBLA) appears to be a promising option in carefully selected patients with CLBP associated with the Modic changes.

Urinary Excretion of Hydroxyproline after Fractures

1970 ◽  
Vol 16 (10) ◽  
pp. 853-855
Author(s):  
Mala Herzberg ◽  
Z Oberman ◽  
O Khermosh ◽  
S L Weissman
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Urinary Excretion ◽  
Collagen Metabolism ◽  
Bone Collagen ◽  
Control Group ◽  
Low Back ◽  
Multiple Fractures ◽  
Daily Excretion ◽  
The Mean

Abstract Urinary excretion of hydroxyproline was measured in 12 cases of multiple fractures as an index of bone collagen metabolism. Measurements were made for 10 consecutive days after injury; 10 patients with low back pain served as the control group. With three exceptions, the mean daily excretion of hydroxyproline and the day-to-day variations were within the same range in the group with multiple fractures as in the control group.

scholarly journals POS1290 CYTOKINE BIOMARKERS IN COMMON LOW BACK PAIN

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 926.3-926
Author(s):  
R. Dhahri ◽  
A. Dghaies ◽  
M. Slouma ◽  
L. Metoui ◽  
I. Gharsallah ◽  
...  
Keyword(s):  
Neuropathic Pain ◽  
Low Back Pain ◽  
Back Pain ◽  
Inflammatory Cytokines ◽  
Enzyme Linked Immunosorbent Assay ◽  
Healthy Controls ◽  
Low Back ◽  
Tnf Α ◽  
Functional Scores ◽  
The Mean

Background:Common low back pain (LBP) is a common health problem affecting 50 to 80% of working age adults. It is one of the common and costly health problems in Tunisia. Actually, the role of the immune response and inflammatory cytokines in the pathogenesis of chronic pain has been of growing interest.Objectives:The aim of this study was to assess whether pro and anti-inflammatory cytokines could be detected in serum in patients with LBP compared with healthy subjects and whether they could be related to pain severity and to clinical findings.Methods:It was a an analytical cross-sectional study including 50 patients with at least three months of LBP, in the department of rheumatology, orthopedics and immunology at the Military Hospital of Tunis between January 1st and March 31, 2020. All patients had a standardized clinical assessment.Levels of serum cytokines IL-6, IL-8, IL-1β and TNF- α, were measured using the chimiluminescence technique. Serum concentration of IL-10 was assayed by the enzyme-linked immunosorbent assay technique (ELISA). The normal levels of cytokines were determined in 50 healthy controls.Results:The mean age of the patients was 41.9 ± 8.4 years and the sex ratio was 4.5. LBP duration was 66.4 months. The mean lumbar visual analog scale (VAS) was 4.5 ± 1.9, and the root VAS was 2.6 ± 2.5. Neuropathic pain was found in 26% of patients. The average BMI was 27 ± 3.7 kg/m2. Only serum level of IL-8 was significantly higher in subjects with LBP compared to healthy controls (p <10-3). IL-1β was indetectable in both patients and controls. Positive correlations were found between IL-8 levels and anxiety/functional scores (r = 0.3; p = 0.02/ r = 0.3; p = 0.04). IL-6 was positively correlated with BMI, and negatively correlated with the Schober test. No correlations were found between serum levels of IL-6, IL-8, IL-10, TNF-α and pain intensity (VAS), neuropathic pain (DN4), fibromyalgia (FIRST), depression (HAD) and various radiological data.Conclusion:Interleukin-8 is a biomarker of common low back pain and correlate with anxiety and functional disability. These results suggest that IL-8 may be a therapeutic target to reduce chronic back pain and reduce the social and profession impact.Disclosure of Interests:None declared

Thoracolumbar Fascia Enthesopathy as a Cause of Low Back Pain: A Retrospective and Follow-up Study

2021 ◽  
Author(s):  
Ouidade A. Tabesh ◽  
Roba Ghossan ◽  
Soha H Zebouni ◽  
Rafic Faddoul ◽  
Michel Revel ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Iliac Crest ◽  
Pain Syndrome ◽  
Clinical Findings ◽  
Complete Relief ◽  
Low Back ◽  
Thoracolumbar Fascia ◽  
The Mean

Abstract Aim. To evaluate ultrasonography findings of Thoracolumbar Fascia (TLF) enthesis in patients with low back pain (LBP) due to iliac crest pain syndrome (ICPS). Method. The ultrasonographic and clinical findings of 60 patients with LBP due to ICPS were compared to those of 30 healthy volunteers with no LBP. Thickness of the TLF was measured with ultrasound (US) at its insertion on the iliac crest. Results. Forty-eight women and 12 men with a mean age of 42.1±11.3 years were diagnosed with ICPS. In patients, the mean thickness of the TLF was 2.51±0.70mm in affected sides compared to 1.81±0.44mm in the contralateral unaffected sides. The mean thickness difference of 0.82mm between the affected and non-affected sides was statistically significant (95%CI, 0.64-0.99, P<0.0001). In volunteers, the mean thickness of the TLF was 1.6±0.2mm. The mean thickness difference of 0.89mm between the affected sides of patients and volunteers was statistically significant (95%CI, 0.73-1.06, P<0.0001). Forty-two patients who didn’t improve with conservative therapy, received injections of methylprednisolone acetate and 1% lidocaine around the TLF enthesis. All patients reported complete relief of their LBP within 20 minutes of the injections thanks to the lidocaine anesthetic effect. Fifty-six (93.3%) patients were reached by phone for a long-term follow-up. Among them, 33 (58.9%) patients experienced a sustained complete pain relief after a mean follow-up of 45±19.3 months (range, 3-74 months). Conclusion. our findings suggest that TLF enthesopathy is a potential cause of nonspecific LBP that can be diagnosed using US.

scholarly journals Motor Control Exercise for Chronic Low Back Pain: A Randomized Placebo-Controlled Trial

2009 ◽  
Vol 89 (12) ◽  
pp. 1275-1286 ◽  
Author(s):  
Leonardo O.P. Costa ◽  
Christopher G. Maher ◽  
Jane Latimer ◽  
Paul W. Hodges ◽  
Robert D. Herbert ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Motor Control ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Exercise Intervention ◽  
Patient Specific ◽  
Low Back ◽  
Functional Scale ◽  
The Mean ◽  
Control Exercise

BackgroundThe evidence that exercise intervention is effective for treatment of chronic low back pain comes from trials that are not placebo-controlled.ObjectiveThe purpose of this study was to investigate the efficacy of motor control exercise for people with chronic low back pain.DesignThis was a randomized, placebo-controlled trial.SettingThe study was conducted in an outpatient physical therapy department in Australia.PatientsThe participants were 154 patients with chronic low back pain of more than 12 weeks’ duration.InterventionTwelve sessions of motor control exercise (ie, exercises designed to improve function of specific muscles of the low back region and the control of posture and movement) or placebo (ie, detuned ultrasound therapy and detuned short-wave therapy) were conducted over 8 weeks.MeasurementsPrimary outcomes were pain intensity, activity (measured by the Patient-Specific Functional Scale), and patient's global impression of recovery measured at 2 months. Secondary outcomes were pain; activity (measured by the Patient-Specific Functional Scale); patient's global impression of recovery measured at 6 and 12 months; activity limitation (measured by the Roland-Morris Disability Questionnaire) at 2, 6, and 12 months; and risk of persistent or recurrent pain at 12 months.ResultsThe exercise intervention improved activity and patient's global impression of recovery but did not clearly reduce pain at 2 months. The mean effect of exercise on activity (measured by the Patient-Specific Functional Scale) was 1.1 points (95% confidence interval [CI]=0.3 to 1.8), the mean effect on global impression of recovery was 1.5 points (95% CI=0.4 to 2.5), and the mean effect on pain was 0.9 points (95% CI=−0.01 to 1.8), all measured on 11-point scales. Secondary outcomes also favored motor control exercise.LimitationClinicians could not be blinded to the intervention they provided.ConclusionsMotor control exercise produced short-term improvements in global impression of recovery and activity, but not pain, for people with chronic low back pain. Most of the effects observed in the short term were maintained at the 6- and 12-month follow-ups.

Clinical Results of Instrumentation Reduction and Posterolateral Fusion After Decompression of Symptomatic Lumbar Spondylolisthesis

1998 ◽  
Vol 02 (02) ◽  
pp. 109-122
Author(s):  
Kam Kong Chan
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Clinical Results ◽  
Fusion Rate ◽  
Radicular Pain ◽  
Posterolateral Fusion ◽  
Low Back ◽  
Loss Of Reduction ◽  
Grade Ii ◽  
Lumbar Spondylolisthesis

From July 1990 to June 1993, 35 patients suffering lumbar spondylolisthesis (21 degenerative; 14 isthmic) were operated on and reviewed. They all had single-level involvement either L4-5 or L5-S1 and only this level was confined for operation. The operative procedures included decompression, posterolateral fusion and pedicle screw instrumentation for fixation and reduction of the vertebral slip. The age ranged from 42 to 65 years old, with an average of 55 years. There were 21 patients with grade 1 slip; 13 with grade II; and 1 with grade III. The follow-up periods ranged from 30 to 55 months with an average of 42 months. The clinical results were evaluated according to the improvement of low back pain, radicular pain, claudication and the incidence of fusion. Twenty-four patients (74%) were rated good to excellent and the fusion rate was 88%. However, there were 16 patients who still suffered from significant low back pain and who had reportd that such pain adversely affected the rating of clinical result. Loss of reduction were found in 16 patients, but there was no difference in clinical outcome between patients with or without reduction loss after the operation. The purpose of this paper is to report the clinical outcomes of the treatment of symptomatic spondylolisthesis with decompression, posterolateral fusion and instrumental reduction of the slip. The incidence of reduction loss and the prevalence of remaining low back pain are two important factors to consider in doing such reduction procedure. We inferred that slip reduction may not be a worthwile procedure in the treatment of adult spondylolisthesis if ordinary posterolateral fusion with short segment instrumentation is contemplated.

TEST-RETEST RELIABILITY OF POSTURAL STABILITY MEASURES DURING QUIET STANDING IN PATIENTS WITH A HISTORY OF NONSPECIFIC LOW BACK PAIN

2010 ◽  
Vol 22 (03) ◽  
pp. 255-262
Author(s):  
Masood Mazaheri ◽  
Mahyar Salavati ◽  
Hossein Negahban ◽  
Mohamad Parnianpour
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Standard Deviation ◽  
Low Back ◽  
Rigid Surface ◽  
Eyes Closed ◽  
History Of ◽  
The Mean ◽  
Test Retest Reliability ◽  
Total Velocity

As balance is the foundation for all voluntary motor skills, considerable research has been conducted to evaluate postural control in patients with low back pain (LBP). Although reliability is a population-specific property, to the authors' knowledge, there has been no study to determine the test-retest reliability of the center of pressure (COP) measures in the general population of LBP patients. As many as 11 patients with a history of nonspecific LBP randomly completed postural measurements with three levels of difficulty (rigid surface-eyes open, rigid surface-eyes closed, and foam surface-eyes closed) in two sessions. The COP data were used to calculate standard deviation of amplitude, phase plane portrait, standard deviation of velocity, mean total velocity, and area (95% confidence ellipse). Relative reliability of these measures was assessed using intraclass correlation coefficient (ICC) and absolute reliability using standard error of measurement (SEM), and coefficient of variation (CV). Among different COP parameters, the mean total velocity in all conditions of postural difficulty showed the highest reliability, with the ICC range of 0.73–0.80, SEM range of 0.09–0.32 cm/s, and CV range of 5.7–8.2%. Therefore, the mean total velocity may be an optimal COP parameter to be used for quantification and assessment of balance performance in LBP patients.

scholarly journals Prediction based on preoperative opioid use of clinical outcomes after transforaminal lumbar interbody fusions

2017 ◽  
Vol 26 (2) ◽  
pp. 144-149 ◽  
Author(s):  
Alan T. Villavicencio ◽  
E. Lee Nelson ◽  
Vinod Kantha ◽  
Sigita Burneikiene
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Clinical Outcomes ◽  
Low Back ◽  
Opioid Use ◽  
Pain Disability ◽  
Vas Scores ◽  
Opioid Medications

OBJECTIVE Opioid analgesics have become some of the most prescribed drugs in the world, despite the lack of long-term studies evaluating the benefits of opioid medications versus their risks associated with chronic use. In addition, long-term opioid use may be associated with worse long-term clinical outcomes. The primary objective of this study was to evaluate whether preoperative opioid use predicted inferior clinical outcomes among patients undergoing transforaminal lumbar interbody fusion (TLIF) for symptomatic lumbar degenerative disc disease. METHODS The authors of this observational study prospectively enrolled 93 patients who underwent 1-level to 2-level TLIFs in 2011–2014; the patient cohort was divided into 2 groups according to preoperative opioid use or no such use. Visual analog scale (VAS) scores for low-back pain and leg pain, Oswestry Disability Index scores, and the scores of the mental component summary (MCS) and physical component summary (PCS) on the 36-Item Short Form Health Survey were used to assess pain, disability, and health-related quality of life outcomes, respectively. The clinical scores for the 2 groups were determined preoperatively and at a 12-month follow-up examination. RESULTS In total, 60 (64.5%) patients took prescribed opioid medications preoperatively. Compared with those not taking opioids preoperatively, these patients had significantly higher VAS scores for low-back pain (p = 0.016), greater disability (p = 0.013), and lower PCS scores (p = 0.03) at the 12-month follow-up. The postoperative MCS scores were also significantly lower (p = 0.035) in the opioid-use group, but these lower scores were due to significantly lower baseline MCS scores in this group. A linear regression analysis did not detect opioid dose–related effects on leg and back pain, disability, and MCS and PCS scores, suggesting that poorer outcomes are not significantly correlated with higher opioid doses taken by the patients. CONCLUSIONS The use of opioid medications to control pain before patients underwent lumbar fusion for degenerative lumbar conditions was associated with less favorable clinical outcomes postoperatively. This is the first study that has demonstrated this association in a homogeneous cohort of patients undergoing TLIF; this association should be studied further to evaluate the conclusions of the present study. Clinical trial registration no.: NCT01406405 (clinicaltrials.gov)

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