scholarly journals The effect of posterior lumbar dynamic fixation and intervertebral fusion on paraspinal muscles

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Geng-Xiong Lin ◽  
Yan-Ming Ma ◽  
Yong-Chun Xiao ◽  
Dian Xiang ◽  
Jian-Xian Luo ◽  
...  

Abstract Background The aim of this study was to analyze the effect of unilateral K-rod dynamic internal fixation on paraspinal muscles for lumbar degenerative diseases. Methods This study retrospectively collected 52 patients who underwent lumbar surgery with the K-rod group or PLIF. The operation time, intraoperative blood loss, postoperative drainage volume, postoperative exercise time were compared in the two groups. The visual analog scale (VAS) score and the oswestry dysfunction index (ODI) were employed to evaluate the clinical outcomes. The functional cross-sectional area (FCSA) of the paraspinal muscles and paraspinal muscles fat infiltration were measured to assess on the paraspinal muscles. Results As compared with the PLIF group, the operation time, the postoperative time in the field, and the average postoperative hospital stay in the K-rod internal fixation group were significantly shortened. At the last follow-up, both the groups showed significant improvement in the VAS score and ODI. The FCSA atrophy of the upper and lower adjacent segments (UAS and LAS) of the K-rod internal group was significantly less than that of the PLIF group. The extent of increase in the fatty infiltration of the paraspinal muscles in the K-rod group was significantly lesser than that in the PLIF group. The postoperative low back pain of the two groups of patients was significantly positively correlated with the FCSA atrophy. Conclusions As compared to PLIF, the posterior lumbar unilateral K-rod dynamic internal fixation showed significantly lesser paraspinal muscle atrophy and fatty infiltration, which were significantly positively correlated with postoperative low back pain.

2021 ◽  
Author(s):  
Geng-Xiong Lin ◽  
Yan-Ming Ma ◽  
Rong-Sheng Wang ◽  
Dian Xiang ◽  
Jian-xian Luo ◽  
...  

Abstract Background: The aim of this study was to analyze the effect of unilateral K-rod dynamic internal fixation on paraspinal muscles for lumbar degenerative diseases. Methods: This study retrospectively collected 52 patients who underwent lumbar surgery with the K-rod group or PLIF. The operation time, intraoperative blood loss, postoperative drainage volume, postoperative exercise time were compared in the two groups. The visual analog scale (VAS) score and the oswestry dysfunction index (ODI) were employed to evaluate the clinical outcomes. The functional cross-sectional area (FCSA) of the paraspinal muscles and paraspinal muscles fat infiltration were measured to assess on the paraspinal muscles. Results: As compared with the PLIF group, the operation time, the postoperative time in the field, and the average postoperative hospital stay in the K-rod internal fixation group were significantly shortened. At the last follow-up, both the groups showed significant improvement in the VAS score and ODI. The FCSA atrophy of the upper and lower adjacent segments (UAS and LAS) of the K-rod internal group was significantly less than that of the PLIF group. The extent of increase in the fatty infiltration of the paraspinal muscles in the K-rod group was significantly lesser than that in the PLIF group. The postoperative low back pain of the two groups of patients was significantly positively correlated with the FCSA atrophy.Conclusions: As compared to PLIF, the posterior lumbar unilateral K-rod dynamic internal fixation showed significantly lesser paraspinal muscle atrophy and fatty infiltration, which were significantly positively correlated with postoperative low back pain.


2017 ◽  
Vol 2017 ◽  
pp. 1-14 ◽  
Author(s):  
Leonid Kalichman ◽  
Eli Carmeli ◽  
Ella Been

This narrative review investigated imaging parameters of the paraspinal muscles and their association with spinal degenerative features and low back pain (LBP) found in the literature. Three principal signs of muscle degeneration were detected on imaging: decreased muscle size, decreased radiographic density, and increased fat deposits. Men have a higher density of paraspinal muscles than women, younger individuals have a higher density than older ones, and lean individuals have a higher density than those with an increased body mass index. Fatty infiltration appears to be a late stage of muscular degeneration and can be measured noninvasively by an MRI scan. Fatty infiltration in the lumbar multifidus is common in adults and is strongly associated with LBP, especially in women, independent of body composition. Fatty infiltration develops in areas where most degenerative changes are found. MR spectroscopy studies have corroborated that the lumbar multifidus in LBP subjects has a significantly higher fat content than asymptomatic controls. There is a strong need for establishing uniform methods of evaluating normal parameters and degenerative changes of the paraspinal muscles. Additional imaging studies are needed to improve the understanding of the association and causal relationships between LBP, spinal degeneration, and changes in the paraspinal muscles.


2020 ◽  
Vol 14 (4) ◽  
pp. 430-437
Author(s):  
Izaya Ogon ◽  
Hiroyuki Takashima ◽  
Tomonori Morita ◽  
Tsutomu Oshigiri ◽  
Yoshinori Terashima ◽  
...  

Study Design: Cross-sectional observational study.Purpose: This study aimed to analyze any potential associations of extramyocellular lipid (EMCL) and intramyocellular lipid (IMCL) contents with (1) the intensity of low back pain (LBP); (2) age, cross-sectional area (CSA), and fatty infiltration (FI) of the psoas major; and (3) spinopelvic parameters.Overview of Literature: The psoas major has clinically relevant function; however, the association of this muscle with chronic LBP is controversial. Magnetic resonance spectroscopy enables a detailed analysis of the composition of muscular fat tissues such as its EMCL and IMCL contents.Methods: The study population comprised 40 patients (19 males, 21 females; mean age, 61.7±2.4 years). Possible correlations of LBP Visual Analog Scale (VAS) scores, age, CSA, FI, and spinopelvic parameters with EMCL and IMCL contents of the psoas major were assessed.Results: No association was identified between the EMCL and IMCL contents and LBP VAS scores (<i>r</i>=0.05, <i>p</i>=0.79 and <i>r</i>=0.06, <i>p</i>=0.75, respectively). The EMCL content correlated with age (<i>r</i>=0.47, <i>p</i><0.01), body mass index (BMI) (<i>r</i>=0.44, <i>p</i><0.01), CSA (<i>r</i>=−0.59, <i>p</i>< 0.01), and FI (<i>r</i>=0.49, <i>p</i><0.01). EMCL content showed a significant negative correlation with sacral slope (SS) (<i>r</i>=−0.43, <i>p</i><0.05) and positive correlation with pelvic tilt (PT) (<i>r</i>=0.56, <i>p</i><0.01).Conclusions: EMCL content correlated with age, BMI, CSA, and FI of the psoas major, while IMCL content had no correlation. This study found correlations between SS and PT and EMCL content of the psoas major, but no correlations were found between spinopelvic parameters and IMCL content of the psoas major.


Author(s):  
S. Quinones ◽  
M. Konschake ◽  
L. L. Aguilar ◽  
C. Simon ◽  
P. Aragones ◽  
...  

Abstract Purpose Lumbar discogenic diffuse pain is still not understood. Authors describe the sinuvertebral nerve (SVN) as one possible cause. Body-donor studies are rare and controversial. Therefore, the aim was to revisit the origin, course and distribution in a body-donor study. Methods Six lumbar blocks (3 female, 3 male) aged between 59 and 94 years were dissected. After removal of the back muscles, lamina, dura mater and cauda equina, the anterior vertebral venous plexus, spinal artery and SVN were exposed and evaluated. Results 43 nerves out of 48 levels could be evaluated. The origin of the SVN was constituted by two roots: a somatic and a sympathetic branch arising from the rami communicantes. In 4/48 intervertebral canals studied (8.3%), we found two SVN at the same level. In 35/48 cases, one SVN was found. In 9/48 cases, no SVN was found. The SVN had a recurrent course below the inferior vertebral notch; in the vertebral canal it showed different patterns: ascending branch (31/43, 72.1%), common branch diverging into two branches (10/43, 23.3%), double ascending branch (1/43, 2.3%) finalizing two levels above and a descending branch (1/43, 2.3%). In 12/43 cases (27.9%) the SVN had ipsilateral connections with another SVN. The distribution ended in the middle of the vertebral body supplying adjacent structures. Conclusion A thorough understanding of the anatomy of the SVN might lead to significant benefits in therapy of discogenic low back pain. We suggest blocking the SVN at the level of the inferior vertebral notch of two adjacent segments. Level of evidence I Diagnostic: individual cross-sectional studies with consistently applied reference standard and blinding


2017 ◽  
Vol 11 (1) ◽  
pp. 75
Author(s):  
Kursiah Warti Ningsih

<p><em>Low back pain </em>adalah rasa nyeri yang dirasakan pada punggung bawah yang sumbernya tulang belakang daerah spinal, otot, saraf, atau struktur lainnya disekitar daerah tersebut. Dari 10 perawat 6 perawat mengalami keluhan <em>low back pain</em>. Tujuan dari penelitian ini adalah untuk mengetahui faktor Keluhan <em>Low back pain</em>.</p><p>Jenis penelitian kuantitatif dengan desain <em>cross sectional</em>, pada 25 juni- 3 juli  di Rumah Sakit Umum Daerah Selasih Pangkalan Kerinci. Penelitian dilakukan pada 30 perawat dengan kuesioner. Analisa data yang digunakan secara univariat,</p><p>Hasil penelitian: 13 orang (43,3%) mengalami keluhan <em>low back pain</em>. Hasil uji bivariat terdapat hubungan antara sikap kerja, dan kebiasaan olahraga terhadap kejadian <em>low back pain</em>. Hasil analisis multivariate menunjukkan variable sikap kerja merupakan variable yang paling mempengaruhi kejadian low back pain deng nilai OR 43 kali. Dimana variable IMT merupakan <em>counfounding</em> terhadap variable sikap kerja dan kebiasaan olah raga dan variable kebiasaan olahraga merupakan <em>counfounding</em> terhadap variable IMT.</p><p>Peneliti mengharapkan pihak Rumah Sakit Umum Daerah Selasih Pangkalan Kerinci mengadakan seminar tentang sikap kerja yang baik, menjaga IMT karyawan &lt;25 dan  mengadakan kegiatan olah raga secara teratur di lingkungan Rumah Sakit Umum Daerah Selasih Pangkalan Kerinci.</p><p> </p><p><em>Low back pain is pain that felt in the lower back that is the source of the spine area of spinal, muscles, nerves, or other structures surrounding areas.</em><em> of the 10 nurses 6 nurses complain of low back</em><em> </em><em>pain. </em><em>the purpose of this study was to determine the factors complaint low backpain.</em></p><p><em>T</em><em>ype quantitative research cross-sectionaldesign,</em><em> </em><em>on 25 June-3 July at the General Hospital of </em><em>Selasih</em><em> Pangkalan Kerinci. The study was conducted on 30 nurses by questionnaires. Data analysis used univariate, </em><em>bivariate and multivariate.</em><em></em></p><p><em>E</em><em>esults of the study: 13 patients (43.3%) had complaints of low backpain.The result of bivariate correlation between working attitude and exercise habits on the incidence of low backpain.Results of multivariate analysis showed variable working attitude is the variable that most influences the incidence of low back pain deng OR value 43 times. Where the variable BMI is counfounding to variable working attitude and exercise habits and variable exercise habits is counfounding to variable IMT.</em></p><p><em>Researchers expect the Regional General Hospital Basil Pangkalan Kerinci hold a seminar on good working attitude, keep IMT employees &lt;25 and hold sports activities regular exercise in the District General Hospital Basil Pangkalan Kerinci.</em></p>


Pain Medicine ◽  
2021 ◽  
Author(s):  
Beth B Hogans ◽  
Bernadette C Siaton ◽  
Michelle N Taylor ◽  
Leslie I Katzel ◽  
John D Sorkin

Abstract Objective Low back pain (LBP) is a leading cause of pain and disability. Substance use complicates the management of LBP, and potential risks increase with aging. Despite implications for an aging, diverse U.S. population, substance use and LBP comorbidity remain poorly defined. The objective of this study was to characterize LBP and substance use diagnoses in older U.S. adults by age, gender, and race. Design Cross-sectional study of a random national sample. Subjects Older adults including 1,477,594 U.S. Medicare Part B beneficiaries. Methods Bayesian analysis of 37,634,210 claims, with 10,775,869 administrative and 92,903,649 diagnostic code assignments. Results LBP was diagnosed in 14.8±0.06% of those more than 65 years of age, more in females than in males (15.8±0.08% vs. 13.4±0.09%), and slightly less in those more than 85 years of age (13.3±0.2%). Substance use diagnosis varied by substance: nicotine, 9.6±0.02%; opioid, 2.8±0.01%; and alcohol, 1.3±0.01%. Substance use diagnosis declined with advancing age cohort. Opioid use diagnosis was markedly higher for those in whom LBP was diagnosed (10.5%) than for those not diagnosed with LBP (1.5%). Most older adults (54.9%) with an opioid diagnosis were diagnosed with LBP. Gender differences were modest. Relative rates of substance use diagnoses in LBP were modest for nicotine and alcohol. Conclusions Older adults with LBP have high relative rates of opioid diagnoses, irrespective of gender or age. Most older adults with opioid-related diagnoses have LBP, compared with a minority of those not opioid diagnosed. In caring for older adults with LBP or opioid-related diagnoses, health systems must anticipate complexity and support clinicians, patients, and caregivers in managing pain comorbidities. Older adults may benefit from proactive incorporation of non-opioid pain treatments. Further study is needed.


2020 ◽  
Vol 25 (1) ◽  
Author(s):  
Mina Magdy Wahba ◽  
Dina Othman Shokri Morsi Galal ◽  
Aliaa Rehan Youssef

Abstract Background Smartphone use has been associated with pain in the upper quadrant; however, the relationship between usage duration and low back pain is still unclear. This study investigated the association between continuous smartphone use up to 30-min and back pain severity and proprioception acuity in patients with chronic low back pain. Fifty-eight patients with chronic mechanical LBP played a game for 10- and 30-min. In each session, pain and back repositioning errors were measured at baseline and immediately after task completion. Results Pain significantly but slightly increased following smartphone use, regardless to the duration (after 10 min: mean increase = 0.75 ± 1.17, P value < 0.001, 95% CI 0.44–1.06; after 30 min: mean increase = 0.96 ± 1.93, P value < 0.001, 95% CI 0.44–1.46). However, changes in perceived pain scores were not significantly different between the two tested durations (P value = 0.42). Proprioception repositioning error was not significantly different within the same testing session (mean change = 0.08 ± 1.83, 0.13 ± 1.77, P value = 0.73, 0.58, 95% CI − 0.40–0.56, − 0.60–0.33, for the 10 and 30 min, respectively). The changes in proprioception were not significant between the two-tested durations (P value = 0.56). Further, smartphone addiction did not significantly affect changes in pain and proprioception after game playing, regardless of the duration (P > 0.05). Conclusions These findings show that smartphone use slightly increases back pain immediately after continuous use; with no effect on back proprioception within the duration tested in this study. Changes in pain and proprioception were not influenced by smartphone addiction.


Sign in / Sign up

Export Citation Format

Share Document