scholarly journals The effectiveness of preoperative assessment using a patient-specific three-dimensional pseudoarticulation model for minimally invasive posterior resection in a patient with Bertolotti’s syndrome: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Kensuke Shinonara ◽  
Michiya Kaneko ◽  
Ryo Ugawa ◽  
Shinya Arataki ◽  
Kazuhiro Takeuchi
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Surgical Planning ◽  
Three Dimensional ◽  
Young Patients ◽  
Patient Specific ◽  
Low Back ◽  
3D Navigation ◽  
Plaster Model ◽  
Lumbosacral Transitional Vertebrae

Abstract Background Bertolotti’s syndrome is widely known to cause low back pain in young patients and must be considered as a differential diagnosis. Its treatment such as conservative therapy or surgery remains controversial. Surgical procedure is recommended for intractable low back pain. The three-dimensional (3D) lumbosacral transitional vertebrae anatomy should be completely understood for a successful surgery. Using an intraoperative 3D navigation and preoperative preliminary surgical planning with a patient-specific 3D plaster model contribute for safe surgery and good outcome. Case presentation A case of a 22-year-old Japanese male patient with intractable left low back pain due to lumbosacral transitional vertebrae with Bertolotti’s syndrome. The symptom resisted the conservative treatment, and anesthetic injection at pseudoarticulation only provided a short-term pain relief. Posterior resection using intraoperative three-dimensional (3D) navigation has been performed through microendoscopic view. Pseudoarticulation was totally and successfully resected in a safe manner. Conclusions Preoperative surgical planning and rehearsal using a patient-specific 3D plaster model was greatly useful and effective for surgeons in performing accurate and safe pseudoarticulation resection.

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.

A Patient-specific Approach for Measuring Functional Status in Low Back Pain

Physiotherapy ◽  
1996 ◽  
Vol 82 (8) ◽  
pp. 467 ◽  
Author(s):  
AJHM Beurskens ◽  
HCW de Vet ◽  
AJA Köke
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Functional Status ◽  
Patient Specific ◽  
Low Back ◽  
Specific Approach

scholarly journals Effect of age on outcomes after allogeneic disc tissue supplementation in patients with chronic discogenic low back pain in the VAST trial

2021 ◽  
Author(s):  
Corey W Hunter ◽  
Richard Guyer ◽  
Mark Froimson ◽  
Michael J DePalma
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Controlled Trial ◽  
Young Patients ◽  
Functional Improvement ◽  
Low Back ◽  
Disc Tissue ◽  
Discogenic Low Back Pain ◽  
Post Hoc ◽  
Significant Functional Improvement

Aim: To explore the effects of viable allogeneic disc tissue supplementation in younger patients with discogenic chronic low back pain (CLBP). Patients & methods: VAST was a randomized placebo-controlled trial of disc allograft supplementation in 218 patients with discogenic CLBP. We conducted a post hoc analysis of change from baseline to 12 months in Oswestry Disability Index (ODI) and visual analog scale for pain intensity scores stratified by patient age. Results: Patients aged <42 years receiving allograft experienced greater improvement in ODI (p = 0.042) and a higher ODI response rate (≥10-, ≥15- and ≥20-point reductions in ODI) than those receiving saline (p = 0.001, p = 0.002 and p = 0.021, respectively). Conclusion: Young patients with discogenic CLBP may have significant functional improvement following nonsurgical disc allograft supplementation.

Three-Dimensional Torso Motion in Tethered Front Crawl Stroke and its Implications on Low Back Pain

2016 ◽  
Vol 32 (1) ◽  
pp. 50-58 ◽  
Author(s):  
Tanghuizi Du ◽  
Ikumi Narita ◽  
Toshimasa Yanai
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Range Of Motion ◽  
Twist Angle ◽  
Three Dimensional ◽  
Low Back ◽  
Front Crawl ◽  
Active Range Of Motion ◽  
High Incidence ◽  
Competitive Swimmers

Low back pain is a common problem among competitive swimmers, and repeated torso hyperextension is claimed to be an etiological factor. The purpose of this study was to describe the three-dimensional torso configurations in the front crawl stroke and to test the hypothesis that swimmers experience torso hyperextension consistently across the stroke cycles. Nineteen collegiate swimmers underwent 2 measurements: a measurement of the active range of motion in 3 dimensions and a measurement of tethered front crawl stroke at their maximal effort. Torso extension beyond the active range of torso motion was defined as torso hyperextension. The largest torso extension angle exhibited during the stroke cycles was 9 ± 11° and it was recorded at or around 0.02 ± 0.08 s, the instant at which the torso attained the largest twist angle. No participant hyperextended the torso consistently across the stroke cycles and subjects exhibited torso extension angles during tethered front crawl swimming that were much less than their active range of motion. Therefore, our hypothesis was rejected, and the data suggest that repeated torso hyperextension during front crawl strokes should not be claimed to be the major cause of the high incidence of low back pain in swimmers.

Automated detection of sacroiliitis on plain radiograph using EfficientDet algorithm in young patients with back pain: a pilot study

2021 ◽  
Author(s):  
Sung Hyun Noh ◽  
Chansik An ◽  
Dain Kim ◽  
Seung Hyun Lee ◽  
Min-Yung Chang ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Deep Learning ◽  
Back Pain ◽  
Object Detection ◽  
Sacroiliac Joint ◽  
Plain Radiograph ◽  
Young Patients ◽  
Training Dataset ◽  
Detection Accuracy ◽  
Low Back

Abstract Background A computer algorithm that automatically detects sacroiliac joint abnormalities on plain radiograph would help radiologists avoid missing sacroiliitis. This study aimed to develop and validate a deep learning model to detect and diagnose sacroiliitis on plain radiograph in young patients with low back pain. Methods This Institutional Review Board-approved retrospective study included 478 and 468 plain radiographs from 241 and 433 young (< 40 years) patients who complained of low back pain with and without ankylosing spondylitis, respectively. They were randomly split into training and test datasets with a ratio of 8:2. Radiologists reviewed the images and labeled the coordinates of a bounding box and determined the presence or absence of sacroiliitis for each sacroiliac joint. We fine-tined and optimized the EfficientDet-D4 object detection model pre-trained on the COCO 2107 dataset on the training dataset and validated the final model on the test dataset. Results The mean average precision, an evaluation metric for object detection accuracy, was 0.918 at 0.5 intersection over union. In the diagnosis of sacroiliitis, the area under the curve, sensitivity, specificity, accuracy, and F1-score were 0.932 (95% confidence interval, 0.903–0.961), 96.9% (92.9–99.0), 86.8% (81.5–90.9), 91.1% (87.7–93.7), and 90.2% (85.0–93.9), respectively. Conclusions The EfficientDet, a deep learning-based object detection algorithm, could be used to automatically diagnose sacroiliitis on plain radiograph.

Hybrid imaging (SPECT/computed tomography) with three-dimensional reconstruction: a new diagnostic tool for the study of low back pain after spinal fusion surgery

2015 ◽  
Vol 15 (2) ◽  
pp. 377-378 ◽  
Author(s):  
Estefania López Rodriguez ◽  
Rosario Garcia Jimenez ◽  
Marta Sanchez Aguilar ◽  
Julio Valencia Anguita ◽  
Javier Luis Simon
Keyword(s):  
Computed Tomography ◽  
Low Back Pain ◽  
Back Pain ◽  
Diagnostic Tool ◽  
Hybrid Imaging ◽  
Three Dimensional ◽  
Low Back ◽  
Fusion Surgery ◽  
Spinal Fusion Surgery ◽  
Dimensional Reconstruction

In Vivo Three-Dimensional Morphometric Analysis of the Lumbar Spinal Bony Canal in Healthy and Low Back Pain Patients

2011 ◽  
Author(s):  
J. S. An ◽  
A. A. Espinoza Orías ◽  
H. S. An ◽  
G. B. J. Andersson ◽  
N. Inoue
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Imaging Technique ◽  
Three Dimensional ◽  
Low Back ◽  
Bony Canal ◽  
Three Dimensional Models ◽  
Lumbar Spinal ◽  
Pain Patients

To accurately quantify the anatomic parameters of the lumbar spinal bony canal using a novel three-dimensional imaging technique based on in vivo CT three-dimensional models.

scholarly journals Are stabilisation exercises different to other treatments in improving physical activity or reducing disability for people with persistent low back pain? A systematic literature review

2020 ◽  
Vol 27 (11) ◽  
pp. 1-16
Author(s):  
Sara Gardiner ◽  
Helena Daniell ◽  
Benjamin Smith ◽  
Rachel Chester
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Confidence Interval ◽  
Patient Specific ◽  
Low Back ◽  
Fear Avoidance ◽  
Functional Scale ◽  
Disability Questionnaire ◽  
Randomised Controlled

Background/Aims Stabilisation exercises are commonly prescribed for people with persistent low back pain. However, for some patients, it has been hypothesised that stabilisation exercises could draw attention to protecting the core, promote hypervigilance and inhibit volitional movement. The aim of this study was to compare the effectiveness and reported adverse events, in particular fear avoidance, of stabilisation exercises compared with placebo or other treatments offered by physiotherapists on the outcome of disability and activity at 12- and 24-months' follow-up. Methods The following electronic databases were searched: Embase, Medline, AMED, CINAHL, from inception to June 2019. Only randomised controlled trails were included. Study selection, data extraction and appraisal of quality criteria using PEDro, were undertaken by two independent assessors. Results Seven studies (n=1820) were eligible. Of six studies that reported adverse effects in the group receiving stabilisation exercises, four reported none and two reported mild exacerbation of pain locally or elsewhere. Fear avoidance was not investigated in any of the studies. Across the studies, 12 analyses were reported and included seven different comparator groups and three outcome measures: Oswestry Disability Index (n=1), Roland Morris Disability Questionnaire (n=5), Patient Specific Functional Scale (n=4). Two studies included a 24-month follow up in addition to a 12-month follow up. Of the 12 studies, nine reported no significant differences between the effectiveness of stabilisation exercises and comparator groups. Stabilisation exercises were more effective than comparator groups for the following three analyses: compared to manual therapy or education at 12 but not 24 months for the Oswestry Disability Index (15.71, 95% confidence interval 19.3–10.01); compared to placebo for the Patient Specific Functional Scale (1.5, 95% confidence interval 0.7–2.2) but not the Roland Morris Disability Questionnaire; and compared to high load lifting for the Patient Specific Functional Scale (1.8 95% confidence interval 2.8–0.7). Conclusions Stabilisation exercises are safe and equally effective to other treatments, and possibly superior for some outcomes at some time points. No or only mild adverse effects were reported. However, none of the studies measured fear avoidance as an outcome and we recommend this be included in future randomised controlled trials measuring the effectiveness of stabilisation exercises.

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