scholarly journals ACUTE LOW BACK PAIN

2016 ◽  
Vol 23 (04) ◽  
pp. 484-488
Author(s):  
Muhammad Imran Hameed Daula ◽  
Saima Amin ◽  
Asma Bano
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Spina Bifida ◽  
Young Patients ◽  
Lumbosacral Spine ◽  
Low Back ◽  
X Rays ◽  
Acute Low Back Pain ◽  
Transitional Vertebra ◽  
Lumbosacral Transitional Vertebra

Objectives: X ray of the lumbosacral spine is widely used in our clinical settingearly on in the management of patients presenting with nonspecific acute low back pain. Thispractice is in contradiction to the clinical practice guidelines however patient satisfaction isusually the main motive declared by clinicians following this practice. This study was conductedto detect the radiologic prevalence of the most commonly diagnosed congenital anomaliesin lumbosacral spine X rays done for patients presenting with nonspecific acute low backpain. Study Design & Setting: Prospective descriptive study at Shalamar Hospital Lahore,Pakistan. Duration of Study: Six months from September 2014 to February 2015. Subjectsand Methods: Radiographs of 400 patients presenting with non-specific acute low back painand fulfilling the inclusion / exclusion criteria were examined. Data was analyzed on SPSSversion 13 and percentage and frequency of patients with non-specific acute low back painwith lumbosacral transitional vertebra (LSTV), spina bifida and spondylolysis was calculated.Results: Out of 400 patients 185 were males and 215 were females. Age of the patients rangedfrom 15 to 36 years with mean age of 28 (SD ±4.84). 145 patients (36.25%) were found to havecongenital anomalies of lumbosacral vertebrae in question. The prevalence of LSTV was 19.5%(78 patients), spina bifida was 10% (40 patients) and spondylolysis was 9% (36 patients). 2%(9 patients) had more than one anomaly. Conclusions: This study shows a higher prevalenceof lumbosacral transitional vertebra (LSTV) and spondylolysis in Pakistani patients presentingwith non-specific acute low backache, compared to that quoted in literature. This arguably mayconstitute a convincing argument in favor of obtaining lumbosacral spine X-rays early on in themanagement of young patients presenting with non-specific acute low backache.

Bertolotti Syndrome

2016 ◽  
Author(s):  
Jiang Wu ◽  
Jianguo Cheng
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Compression Fracture ◽  
Lumbar Vertebra ◽  
Transverse Process ◽  
Lumbosacral Spine ◽  
Medial Branch ◽  
Low Back ◽  
Transitional Vertebra ◽  
Lumbosacral Transitional Vertebra

Bertolotti syndrome is caused by a lumbosacral transitional vertebra,  a congenital variation of the most caudal lumbar vertebra, characterized by an enlarged transverse process that articulates or fuses with the sacrum, ilium, or both. This syndrome accounts for 4.6 to 7% of cases of low back pain in adults and for more than 11% of patients with low back pain who are under 30 years old. The primary effect of lumbosacral transitional vertebra is reduced and asymmetrical motion between the transitional vertebra and the sacrum, resulting in early arthritic changes at pseudoarticulation; the secondary effect is the progressively compensatory modifications in the biomechanics of the mobile vertebral segments superior to the transitional vertebra related to restriction in rotation and bending motion at the lumbosacral articulation. Bertolotti syndrome should be considered in the differential diagnosis of low back pain. Clinical findings include low back pain in the midline or paramedian area that is reproduced with palpation along the base of the lumbosacral spine and near the posterosuperior iliac spine and aggravated by forward flexion, excessive extension, or lateralization of the back to the same side of the mega-apophysis. A plain x-ray is diagnostic; the extension-flexion lumbosacral radiographs in anteroposterior, lateral, and oblique views demonstrate lumbosacral transitional vertebra, with an enlarged unilateral or bilateral transverse process of the most distal lumbar vertebra, abnormally articulating with the ala of the sacrum and degenerative changes of the pseudarthrosis. Other imaging studies, such as computed tomography and magnetic resonance imaging of the lumbosacral spine and selective radiculography of the spinal nerve, could provide additional detailed anatomic information. Major differential diagnoses of Bertolotti syndrome include sacroiliac joint pain, myofascial pain, lumbar facet pain, lumbar disk herniation, compression fracture, and Baastrup disease/interspinous bursitis. These conditions are not mutually exclusive and, in fact, often coexist. A course of conservative management, including activity modification, medication management with nonsteroidal antiinflammatory drugs, muscle relaxants, and rehabilitative physical therapy, should be offered initially. Due to the multifactorial etiology of low back pain in patients with Bertolotti syndrome, procedures such as diagnostic intrapseudoarticular block for arthritis, medial branch block for facet arthropathy, diskography for diskogenic pain, and selective nerve roots block for radiculopathy can potentially help identify the primary and secondary origins of the pain. Surgical treatment of Bertolotti syndrome was only slightly better than conservative treatment and should only be used in very selective patients with disk pathology. To achieve long-term improvement by any of these therapeutic options, a continuing physical rehabilitation program is often needed. Key words: Bertolotti syndrome, intrapseudoarticular block, transitional lumbosacral vertebra, transverse process  

scholarly journals Transitional Vertebra and Spina Bifida Occulta Related with Chronic Low Back Pain in a Young Patient

Cureus ◽  
2016 ◽  
Author(s):  
Maryam Kundi ◽  
Maham Habib ◽  
Sumbal Babar ◽  
Asif K Kundi ◽  
Salman Assad ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Spina Bifida ◽  
Young Patient ◽  
Chronic Low Back Pain ◽  
Spina Bifida Occulta ◽  
Low Back ◽  
Transitional Vertebra

scholarly journals Unusual cause of acute low-back pain: sudden annulus fibrosus rupture

2012 ◽  
Vol 4 (2) ◽  
pp. 22 ◽  
Author(s):  
Ali Fahir Ozer ◽  
Tunc Oktenoglu ◽  
Mehdi Sasani ◽  
Tuncay Kaner ◽  
Omur Ercelen ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Annulus Fibrosus ◽  
Acute Onset ◽  
Low Back ◽  
X Rays ◽  
Disc Disease ◽  
Acute Low Back Pain ◽  
Magnetic Resonance Imaging Mri ◽  
Provocative Discography

Low-back pain is a common problem in neurosurgery practice, and an algorithm has been developed for assessing these cases. However, one subgroup of these patients shares several clinical features and these individuals are not easy to categorize and diagnose. We present our observations for 8 of these patients, individuals with low-back pain caused by atypical annulus fibrosus rupture (AAR). The aim of this study is to show the consequences of overlooked annular tears on acute onset of low back pain. Eight patients with acute-onset severe low-back pain were admitted. Physical examinations were normal and each individual was examined neurologically and assessed with neuroradiologic studies [plain x-rays, magnetic resonance imaging (MRI), discography and computed tomography (CT) discography]. AAR was ultimately diagnosed with provocative discography. In all cases, MRI showed a healthy disc or mild degeneration, whereas discography and CT discography demonstrated disc disease. Anterior interbody cage implantation was performed in 3 of the 8 cases and posterior dynamic stabilization was carried out in 3 cases. The other 2 individuals refused surgery, and we were informed that one of them developed disc herniation at the affected level 1 year after our diagnosis. Clinical and radiological outcomes were evaluated. In cases where AAR is suspected, MRI, discography, and CT discography should be performed in addition to routine neuroradiologic studies.

scholarly journals Lumbosacral Transitional Vertebra-Related Low Back Pain: Resolving the Controversy

2018 ◽  
Vol 12 (3) ◽  
pp. 407-415 ◽  
Author(s):  
Balachandar Gopalan ◽  
Janardhan Srinivas Yerramshetty
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Low Back ◽  
Transitional Vertebra ◽  
Lumbosacral Transitional Vertebra

scholarly journals Distribution and imaging characteristics of spina bifida occulta in young people with low back pain: a retrospective cross-sectional study

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Wenhao Li ◽  
Zhencheng Xiong ◽  
Chunke Dong ◽  
Jipeng Song ◽  
Liubo Zhang ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Young People ◽  
Spina Bifida ◽  
Spinous Process ◽  
Young Patients ◽  
Spina Bifida Occulta ◽  
Low Back ◽  
Cross Sectional ◽  
Imaging Characteristics

Abstract Purpose Spina bifida occulta (SBO) is one of the most common congenital spinal deformities. Although many studies have demonstrated the influence of lumbosacral dysplasia on low back pain (LBP) in young athletes, there have been few studies on SBO among young people in other occupations. The purpose of this study is to investigate the distribution of SBO in young people with LBP and to classify SBO from the perspective of lamina development. Methods The X-ray films of 148 young patients with LBP were analyzed to quantify the distribution of SBO and classify abnormal laminae. Results Of the 148 patients, 93 (61.49%) had SBO: 83 cases involved S1 alone, 2 involved L5–S1, 5 involved S1–2, 2 involved S1–4, and 1 involved L4–S4. According to the degree of the defect, the patients with SBO were divided on the basis of five grades: 9 patients with grade I, 53 with grade II, 23 with grade III, and 8 with grade IV. The cases were classified by the shape of the laminae into 4 types: 15 cases of type a, 11 cases of type b, 37 cases of type c, and 30 cases of type d. Conclusion Among the young people with LBP that we surveyed, SBO is the most common lumbosacral dysplasia, which frequently involves the S1 segment. Most laminae in SBO are in the developmental stage of the spinous process, and an abnormal laminar growth direction and laminar stenosis are the most common laminar morphologies in SBO.

Evaluation and Comparison of the Effectiveness of Rehabilitation Procedures in the Area of ​Pain in the Lumbosacral Spine Performed in Sanatoria and Outpatient Conditions

2019 ◽  
Vol 21 (4) ◽  
pp. 279-288
Author(s):  
Jakub Szewczyk ◽  
Katarzyna Polińska-Szewczyk ◽  
Wiesław Tomaszewski
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Thermal Imaging ◽  
Young Patients ◽  
Lumbosacral Spine ◽  
Low Back ◽  
Pain Sensation ◽  
Spine Pain ◽  
High Prevalence ◽  
Imaging Camera

Background. Low back pain is among the most frequent conditions of nowadays and due to its high prevalence, it is defined as a social and civilization-related disease.Today, increasingly young patients present with this condition affecting about 80% of the population. In Poland, 70% of the population complain of back pain and the prevalence rate increases with age. The treatment includes application of various procedures, both in outpatient conditions and in sanatoria. The aim of the study was to compare the effects of sanatorium treatment with those of outpatient treatment. Material and methods. 240 patients with low back pain participated in the study. The sample was divided into two groups: 120 pa­tients undergoing treated in outpatient conditions and next, 120 patients undergoing sanatorium treatment. The research was based on survey in a form of a questionnaire, selected mobility tests and assessment of pain using thermal imaging camera and an algometer. Results. The patients undergoing rehabilitation procedures in a sanatorium obtain improvement in terms of pain sensation (5.39 points in VAS scale) as compared with the patients undergoing rehabilitation in outpatient conditions (4.13 points in VAS scale) ; their results also indicate improvement in low back mobility (the obtained values, however, turned out statistically insignificant). Better results can be obtained by combining conventional rehabilitation with the approaches applied in sanatorium treatment, as confirmed by the assessment of each group of patients. Conclusions. 1. Rehabilitation of patients with lumbar spine pain conditions conducted in spa conditions is a more effective treat­ment method than in an outpatient clinic and should be used universally. 2. Research is indicated to determine the effect of rest in a sanatorium (the ambience) involving low back pain relief.

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