Patient with Lumbar Spondylosis and Diskogenic Pain

2016 ◽  
Author(s):  
Jianguo Cheng
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Clinical Manifestations ◽  
Compression Fracture ◽  
Treatment Modalities ◽  
Low Grade ◽  
Type I ◽  
Low Back ◽  
Positive Effects ◽  
Modic Type

Diskogenic low back pain (LBP), defined as pain that originates from a damaged vertebral disk, is a common cause of LBP. It is characterized by a three-phase cascade of degeneration marked by dysfunction, instability, and stabilization. A distinct pathologic characteristic of the disks from patients with diskogenic LBP has been found to be the formation of the zones of vascularized granulation tissue, with extensive innervation extending from the outer layer of the annulus fibrosus into the nucleus pulposus along a torn fissure. In addition, there appears to be an association between microbial infection and symptomatic disk degeneration. Low-virulence microorganisms, in particular Propionibacterium acnes, might be causing a chronic low-grade infection in the lower intervertebral disks in some patients. The diagnosis of diskogenic pain is primarily based on clinical manifestations, physical examinations, imaging studies, and provocative diskography. Diskogenic pain should be differentiated from other axial back pain conditions, such as facet arthropathy, sacroiliac joint pain, myofascial strain and pain, vertebral compression fracture, and other, less common conditions. Treatment options should be tailored to individual needs. Early and gradual physical and behavioral therapies are encouraged. Pharmacologic therapy, composed primarily of analgesics, nonsteroidal antiinflammatory drugs, muscle relaxants, and antidepressants, may have modest positive effects. A subset of patients with Modic type I changes in magnetic resonance imaging may benefit antibiotic therapy directed at the infected disks by P. acnes and other low-virulence microorganisms. There is evidence that supports the use of epidural steroid injections and intradiskal injections (methylene blue, ozone, steroids) for diskogenic pain. Additional options include intradiskal biacuplasty, gray ramus communicans nerve blocks/radiofrequency ablation, and intradiskal stem cell injections for disk repair/regeneration, all of which have gained support in clinical trials. These treatment modalities have shown promise to provide equal or even better outcomes compared with surgical spinal fusion or total disk replacement with an artificial disk.    This review contains 2 figures and 149 references. Keywords: collagen, diskogenic low back pain (LBP), herniation, intervertebral disk, spondylosis

Role of growth plate (apophyseal ring fracture) in causing modic type changes in pediatric low back pain patients

2021 ◽  
Author(s):  
Hiroaki Manabe ◽  
Toshinori Sakai ◽  
Yasuyuki Omichi ◽  
Kosuke Sugiura ◽  
Masatoshi Morimoto ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Growth Plate ◽  
Low Back ◽  
Ring Fracture ◽  
Modic Type ◽  
Pain Patients ◽  
Apophyseal Ring Fracture

scholarly journals MRI Findings of Non-Degenerative Pathoanatomical Changes in Low Back Pain

2016 ◽  
Vol 12 (2) ◽  
pp. 59-62 ◽  
Author(s):  
Dan B Karki ◽  
Om B Panta ◽  
Ghanshyam Gurung
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Multimodality Imaging ◽  
Compression Fracture ◽  
Degenerative Changes ◽  
Lumbosacral Spine ◽  
Low Back ◽  
Neoplastic Lesion ◽  
Lower Lumbar ◽  
Meningeal Cysts

Non-degenerative pathoanatomical changes are far less common than degenerative changes but benefi ts most from imaging assessment. This study aimed to evaluate the non-degenerative pathoanatomical changes in patients undergoing MRI for low back pain.The study was a retrospective study conducted for the duration of 3 years in a multimodality-imaging center. All patients undergoing MRI of lumbosacral spine with complains of low back pain with or without radiculopathy were assessed for morphological changes and other abnormal fi ndings. After excluding patients with degenerative changes, non-degenerative pathologies were evaluated. Data was entered in predesigned proforma and analysis was done with SPSS 21.0.There were 183 patients who met the inclusion criteria and were included in the study. The mean age of the patients was 51.23 ±16.86 years. Compression fracture of the vertebra was the most common non-degenerative changes accounting for 34% cases followed by spinal meningeal cysts (26%) and infection (14%). Fractures were more common in upper lumbar level as compared to lower lumbar levels. Meningeal cysts were noted to involve the sacral spinal canal more frequently followed by lower lumbar levels. Infective lesions were equally distributed throughout the lumbar spine. Hemangioma was common lesion involving 16% of cases. Lumbosacral transitional vertebra was seen in 7(3.8%) patients.The common non-degenerative pathoanatomical changes associated with low back pain were traumatic lesion, infection, neoplastic lesion and lumbosacral transitional vertebra.Nepal Journal of Neuroscience 12:59-62, 2015

scholarly journals PAIN MANAGEMENT IN KATISHOOLA: A CASE STUDY

2021 ◽  
Vol 9 (11) ◽  
pp. 2909-2913
Author(s):  
Kavita Kavita ◽  
Suresh N Hakkandi ◽  
Manjunath Akki
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Holistic Approach ◽  
Treatment Modalities ◽  
Low Back ◽  
Success Rates ◽  
Invasive Treatment ◽  
Lower Back ◽  
Treatment Measures ◽  
Work Family

Lower Back Pain can have causes that aren’t due to underlying diseases and this pain refers to the pain that usual- ly begins in the lower back region, radiating to the sacroiliac regions and buttocks.[1] People with chronic pain often find it difficult to cope with work, family and social activities which is the significant cause of disability worldwide. Eighty percent of the population is affected by this symptom sometimes in life.[2] Increased preva- lence of low back pain and temporary and reduced success rates in invasive contemporary treatment measures has drawn considerable attention towards alternative, effective, non-invasive treatment modalities. Katishoola, a Vata vyadhi diagnosed with cardinal symptoms as Pain in Kati Pradesha. In Ayurveda, a holistic approach has been adopted that includes the use of oral Ayurvedic formulations, Panchakarma procedures like Snehana karma (unc- tion therapy), Swedana karma (sudation therapy) etc. [3] Here In this article a case of low Back Pain treated with Kati Pichu with Masha taila with good outcomes are reported. Keywords: Katishoola, Low Back Pain, Masha Taila, Kati Pichu

scholarly journals ASSOCIATION OF LOW BACK PAIN AND SCIATICA WITH SIGNAL CHANGES IN THE VERTEBRAL ENDPLATE

2020 ◽  
Vol 19 (3) ◽  
pp. 213-217
Author(s):  
ALBERTO OFENHEJM GOTFRYD ◽  
DÉLIO EULÁLIO MARTINS FILHO ◽  
MARCELO WAJCHENBERG ◽  
MICHEL KANAS ◽  
SAULO DE TARSO DE SÁ PEREIRA SEGUNDO ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Type I ◽  
Low Back ◽  
Vertebral Endplate ◽  
Level Of Evidence ◽  
Signal Changes ◽  
Treatment Responses

ABSTRACT Objective To evaluate whether vertebral endplate signal changes (VESCs) influence the prognosis of patients submitted to conservative or surgical treatment for low back pain and lumbosciatica. Methods Study with 241 patients who underwent conservative treatment, infiltration or surgery with 12 months of follow-up. They were evaluated for pain by the Visual Analog Scale for Pain (VAS), for function by the Roland Morris questionnaire and for quality of life by the EuroQoI5 (EQ-5D). Results The VESCs did not have a significant effect on the treatment responses for the VAS (F = 0.03; P = 0.97), Roland Morris (F = 0.51; P = 0.60) and EQ-5D (F = 2.67; P = 0.07) variables, nor was there any interaction between VESC and treatment for VAS (F = 2.15; P = 0.08), Roland Morris (F = 1.55; P = 0.19) and EQ-5D (F = 2.15; P = 0.08). There was a significant effect for all treatments, however, the effect of the surgical procedure was superior when compared to the others (P <0.001). The VESC frequency was 48.33% for type 0, 29.17% for type I and 22.50% for type II. Conclusions The presence of VESC and its different types is not associated with a worse prognosis, nor was a higher prevalence of VESC observed in the patients with low back pain and lumbosciatica. Level of Evidence II; Retrospective cohort study.

scholarly journals Treatment of Low Back Pain With Opioids and Nonpharmacologic Treatment Modalities for Army Veterans

Medical Care ◽  
2018 ◽  
Vol 56 (10) ◽  
pp. 855-861 ◽  
Author(s):  
Megan E. Vanneman ◽  
Mary Jo Larson ◽  
Cheng Chen ◽  
Rachel Sayko Adams ◽  
Thomas V. Williams ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Treatment Modalities ◽  
Low Back ◽  
Nonpharmacologic Treatment

Reverse transformation of Modic Type 2 changes to Modic Type 1 changes during sustained chronic low-back pain severity

2007 ◽  
Vol 6 (2) ◽  
pp. 152-155 ◽  
Author(s):  
Laurence A. G. Marshman ◽  
Matthew Trewhella ◽  
Tai Friesem ◽  
Chandra K. Bhatia ◽  
Manoj Krishna
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Reverse Transformation ◽  
Pain Severity ◽  
Low Back ◽  
Modic Type ◽  
Generating Capacity

✓Modic Type 2 (MT2) neuroimaging changes are considered stable or invariant over time and relatively quiescent, whereas Modic Type 1 (MT1) changes are considered unstable and more symptomatic. The authors report two cases in which MT2 changes were symptomatic and evidently unstable, and in which chronic low-back pain severity remained unaltered despite a MT2–MT1 reverse transformation. Two women (41 and 48 years old) both presented with chronic low-back pain. Magnetic resonance (MR) images demonstrated degenerating discs at L5–S1 associated with well-established MT2 changes in adjacent vertebrae. Repeated MR imaging in these two patients after 11 months and 7 years, respectively, revealed reverse transformation of the MT2 changes into more florid MT1 changes, despite unaltered chronic low-back pain severity. Following anterior discectomy and disc arthroplasty, immediate abolition of chronic low-back pain was achieved in both patients and sustained at 3-year follow up. Modic Type 2 changes are therefore neither as stable nor as quiescent as originally believed. Each type can change, with equal symptom-generating capacity. More representative imaging–pathological correlates are required to determine the precise nature of MT changes.

scholarly journals The many faces of primary cauda equina myxopapillary ependymoma: clinicoradiological manifestations of two cases and review of the literature

2017 ◽  
Vol 31 (3) ◽  
pp. 385-390
Author(s):  
Mohammad Zare Mehrjardi ◽  
Samira Mirzaei ◽  
Hamid Reza Haghighatkhah
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Imaging Modality ◽  
Cauda Equina ◽  
Young Patients ◽  
Clinical Manifestations ◽  
Conus Medullaris ◽  
Lower Limbs ◽  
Myxopapillary Ependymoma ◽  
Low Back

Abstract Introduction: Myxopapillary ependymoma (MPE) is a benign and slow growing tumor that originates exclusively from the conus medullaris and cauda equina nervous tissue. It occurs more commonly in young patients. In addition, clinical presentations are non-specific and may mimic benign conditions. Magnetic resonance imaging (MRI) is the imaging modality of choice for evaluating this tumor. We hereby report on two young patients with long-lasting non-specific symptoms, which were clinically attributed to benign conditions. However, cauda equina tumor was revealed on MRI in both patients. Case report: Two cases of cauda equina MPE, a 19-year-old female and a 38-year-old male, with different clinical manifestations are reported. The first patient presented with paresis and paresthesia of the lower limbs, and the second patient’s complaint was chronic low-back pain and urinary incontinence. In both cases, MRI detected a tumor originated from the cauda equina, and histopathologic examination was compatible with MPE. Conclusion: Cauda equina tumors should be considered as a differential diagnosis in the young patients presented with neurologic deficits in the lower limbs, sphincter or erectile dysfunction, and even a simple low-back pain (particularly when symptoms are long-lasting and/or progressive).

scholarly journals Lomboradiculalgie Du Sujet Âgé En Consultation Rhumatologique À Lomé, Togo

2017 ◽  
Vol 13 (30) ◽  
pp. 222
Author(s):  
Kakpovi Kodjo ◽  
Fianyo Eyram ◽  
Houzou Prenam ◽  
Sogan Elias ◽  
Koffi-Tessio Viwalé Etonam Sika ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Teaching Hospital ◽  
Bone Tumors ◽  
Clinical Manifestations ◽  
The Elderly ◽  
Radicular Pain ◽  
Low Back ◽  
Degenerative Disc ◽  
The Mean

Objective: To study the epidemiological, diagnostic, therapeutic and outcome aspects of low back pain with radicular pain in rheumatology ward at Sylvanus Olympio Teaching Hospital at Lome, TOGO. Methods: It is a cross sectional study of 298 patients of 65 years and above, suffering from low back pain with radicular pain. They were admitted in the rheumatology ward of Sylvanus Olympio Teaching Hospital from January 2010 to December 2015. Results: 298 out of 768 patients examined within a period of five years (38.80%) were suffering from low back pain with radicular pain. These 298 patients comprises of 215 women (72.15%) and 83 men (27.85%) with an average age of 62.04 years at the onset. The mean age at the consultation was 70.72 ± 5.5 years. The mean duration of the diseases was 10.28 ± 23.81 months. The major diseases observed were degenerative disc (279 cases : 93.61%), bone tumors (16 cases : 5.38%), and spondylodiscitis (03 cases : 1.01%). The clinical manifestations of the degenerative disc of the lumbar spine were the LBP (209 cases : 74,91%) European Scientific Journal October 2017 edition Vol.13, No.30 ISSN: 1857 – 7881 (Print) e - ISSN 1857- 7431 223 and the narrowed lumbar canal (47 cases : 16.85%). The bone tumors were dominated by prostate cancer (five cases : 12,02%). The spondylodiscitis, probably of tuberculous origin, affected three patients, among whom was one Human Immunodeficiency Virus (HIV) patient. Conclusion: Degenerative disc is a frequent pathology nowadays, both in the Togolese population and in the elderly in particular. Nevertheless, efforts should be made to eliminate specific back pain in the elderly, whose clinical picture may be misleading.

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