An Intramuscular Epidermal Cyst of Erector Spinae Muscles: A Case Report

An intramuscular epidermal cyst without subcutaneous involvement is extremely rare. The patient presented with low back pain. Spinal magnetic resonance imaging indicated spindle-shaped mass in the right erector spinae muscles located at L3 to L5 level without any connection with subcutaneous tissue. The patient underwent operation for removal of intramuscular cystic lesion. The tumor was totally removed and pathologically confirmed with epidermal cyst. Unlike typical epidermal cyst, the patient had a characteristic clinical manifestation of mild low back pain without palpable mass and local tenderness.

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MRI Assessment of Degeneration of Multifidus and Erector Spinae Muscles in Patients with Chronic Low Back Pain

10.21203/rs.3.rs-549319/v2 ◽

2021 ◽

Author(s):

Alikemal Yazici ◽

Tuba Yerlikaya ◽

Adile Oniz

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Chronic Low Back Pain ◽

Erector Spinae ◽

Low Back ◽

Cross Sectional ◽

Fat Infiltration ◽

Significant Difference ◽

Healthy Control ◽

The Right

Abstract Background The aim of this study was to examine degeneration in the lumbar musculus multifidus (L.MF) and lumbar musculus erector spina (L.ES) muscles in patients with mechanical chronic low back pain, non-radiculopathy chronic low back pain with discopathy, and healthy individuals. The relationships with low back pain were examined by comparing the results according to gender, pain, and lumbar segments. Material and Method: Evaluation was made of 36 healthy control subjects (Group 1), 37 patients with mechanical low back pain (Group 2) and 41 non-radiculopathy, lumbar discopathy patients (Group 3). On axial magnetic resonance images at the L3-S1 level, asymmetry between the left and right sides was examined in respect of L.MF and L.ES surface cross-sectional areas (CSA), total surface cross-sectional area (TCSA = L.MF + L.ES), and fat infiltration. Results The mean CSA values showed a significant difference only in the right L.MF in the healthy control group (p = 0.011). No statistically significant difference was seen between the groups in the comparisons of TCSA, and a statistically significant difference was determined in respect of fat infiltration in the right and left L.MF and the left L.ES (p = 0.011, p = 0.001, p = 0.027, respectively). When the CSA and TCSA were examined according to gender within the groups, the values were found to be statistically significantly higher in males (p < 0.001). The CSA and TCSA values of the L.MF and L.ES showed a significant difference between segments (L3-L4, L4-L5, L5-S1) (p < 0.001). No asymmetry was observed between the left /right CSA and TCSA values of the groups. Fat infiltration showed a significant difference according to gender and segments (p < 0.001). Conclusion Fat infiltration in the L.MF muscle is related to mechanical low back pain and lumbar discopathy. That there was no difference between the groups in the CSA and TCSA values demonstrates the need for measurement of muscle atrophy associated with fat infiltration or functional cross-section area rather than CSA and TCSA.

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MRI Assessment of Degeneration of Multifidus and Erector Spinae Muscles in Patients With Chronic Low Back Pain

10.21203/rs.3.rs-549319/v1 ◽

2021 ◽

Author(s):

Alikemal Yazici ◽

Tuba Yerlikaya ◽

Adile Oniz

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Erector Spinae ◽

Low Back ◽

Sectional Area ◽

Healthy Individuals ◽

Cross Sectional ◽

Fat Infiltration ◽

Significant Difference ◽

The Right

Abstract Background: The aim of this study was to investigate the degeneration of lumbar musculus multifidus (L.MF) and lumbar musculus erector spinae (L.ES) muscles in healthy individuals and patients with mechanical low back pain and lumbar discopathy without root compression (radiculopathy), and to examine the relationship between low back pain by comparing the results according to gender, pain and lumbar segments between the groups. Methods: The study included 30 healthy individuals (Group 1), 30 patients with mechanical low back pain (Group 2) and 30 patients with lumbar discopathy without root compression (radiculopathy) (Group 3). Pain severity was evaluated using a Visual Analogue Scale (VAS). Right and left L.MF and L.ES cross-sectional areas (CSA), total cross-sectional areas (TCSA =L.MF+L.ES), fat infiltrations, and asymmetries between the right and left sides were evaluated. L.MF and L.ES muscles CSA and TCSA, fat infiltrations, asymmetries between the right and left sides were evaluated in the patients at the L3-S1 level, in axial Magnetic Resonance Imaging.Results: The mean value of the CSA differed between the groups only in the right L.MF and in the healthy group (p=0.011). No statistically significant difference was observed between the TCSA values of the groups, but a significant difference was found between the groups in terms of fat infiltration in right and left L.MF and left L.ES (p=0.011, p=0.001, p=0.027, respectively). When CSA and TCSA were examined according to gender within the group, the values were found to be significantly higher in males (p<0.001). The CSA and TCSA values of L.MF and L.ES differed between segments (L3-L4, L4-L5, L5-S1) (p<0.001). There was no asymmetry between the right/left CSA and TCSA of the groups. Fat infiltration differed according to gender (p=0.001) and segments (p<0.001).Conclusion: Fat infiltration in the lumbar multifidus muscle was associated with mechanical low back pain and lumbar discopathy. The fact that there was no difference between the cross-sectional area and the total cross-sectional area between the groups indicates the need to measure the FCSA or muscle atrophy due to fat infiltration in the evaluation of muscle mass, rather than CSA and TCSA.

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Comparison of MET and AIS on Erector Spinae Muscle in Low Back Pain

Case Medical Research ◽

10.31525/ct1-nct04156776 ◽

2019 ◽

Author(s):

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Erector Spinae ◽

Low Back ◽

Erector Spinae Muscle

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Rowers with a recent history of low back pain engage different regions of the lumbar erector spinae during rowing

Journal of Science and Medicine in Sport ◽

10.1016/j.jsams.2019.07.007 ◽

2019 ◽

Vol 22 (11) ◽

pp. 1206-1212 ◽

Cited By ~ 7

Author(s):

Eduardo Martinez-Valdes ◽

Fiona Wilson ◽

Neil Fleming ◽

Sarah-Jane McDonnell ◽

Alex Horgan ◽

...

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Erector Spinae ◽

Recent History ◽

Low Back ◽

History Of

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Low Back Pain in Hidradenitis Suppurativa: A Diagnosis Not to Miss!

Case Reports in Dermatology ◽

10.1159/000490880 ◽

2018 ◽

Vol 10 (2) ◽

pp. 187-189

Author(s):

Benjamin Schnebert ◽

Véronique del Marmol ◽

Farida Benhadou

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Hidradenitis Suppurativa ◽

Combined Therapy ◽

Skin Lesions ◽

Skin Area ◽

Low Back ◽

Inflammatory Drugs ◽

The Right ◽

Altered Sensitivity

We report the case of a patient suffering from hidradenitis suppurativa since puberty and complaining of chronic low back pain associated to altered sensitivity and muscular weakness in the right leg. A diagnosis of lumbosciatica was confirmed. Symptoms were not relieved after the use of nonsteroidal anti-inflammatory drugs and analgesics. A surgical decompression was then indicated but heavily debated. Indeed, extended inflammatory and fibrotic hidradenitis suppurativa lesions were located regarding the skin area eligible for the proposed surgery. A combined therapy with clindamycine/rifampicin was started and the surgery was postponed. A complete remission of the articular symptoms was observed 1 month after the start of the antibiotherapy and the inflammatory skin lesions were greatly improved. With the presentation of this clinical case, we would like to discuss the spectrum of rheumatic disorders associated to hidradenitis suppurativa that needs to be correctly diagnosed and taken into consideration in the therapeutic management of the patient.

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The Anatomy of the Lateral Branches of the Sacral Dorsal Rami: Implications for Radiofrequency Ablation

January 2018 - Pain Physician ◽

10.36076/ppj.2014/17/459 ◽

2014 ◽

Vol 5;17 (5;9) ◽

pp. 459-464

Author(s):

Joseph Fortin

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Radiofrequency Ablation ◽

Sacroiliac Joint ◽

Low Back ◽

Sacral Foramina ◽

Dorsal Rami ◽

Lateral Branches ◽

The Right ◽

Segmental Innervation

Background: The sacroiliac joint (SIJ) is a major source of pain in patients with chronic low back pain. Radiofrequency ablation (RFA) of the lateral branches of the dorsal sacral rami that supply the joint is a treatment option gaining considerable attention. However, the position of the lateral branches (commonly targeted with RFA) is variable and the segmental innervation to the SIJ is not well understood. Objectives: Our objective was to clarify the lateral branches’ innervation of the SIJ and their specific locations in relation to the dorsal sacral foramina, which are the standard RFA landmark. Methods: Dissections and photography of the L5 to S4 sacral dorsal rami were performed on 12 hemipelves from 9 donated cadaveric specimens. Results: There was a broad range of exit points from the dorsal sacral foramina: ranging from 12:00 – 6:00 position on the right side and 6:00 – 12:00 on the left positions. Nine of 12 of the hemipelves showed anastomosing branches from L5 dorsal rami to the S1 lateral plexus. Limitations: The limitations of this study include the use of a posterior approach to the pelvic dissection only, thus discounting any possible nerve contribution to the anterior aspect of the SIJ, as well as the possible destruction of some L5 or sacral dorsal rami branches with the removal of the ligaments and muscles of the low back. Conclusion: Widespread variability of lateral branch exit points from the dorsal sacral foramen and possible contributions from L5 dorsal rami and superior gluteal nerve were disclosed by the current study. Hence, SIJ RFA treatment approaches need to incorporate techniques which address the diverse SIJ innervation. Key words: Sacroiliac joint pain, radiofrequency ablation, dorsal sacral rami, low back pain

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Deficits in the Star Excursion Balance Test and Golf Performance in Elite Golfers with Chronic Low Back Pain

Journal of Sports Science and Medicine ◽

10.52082/jssm.2021.229 ◽

2021 ◽

pp. 229-236

Author(s):

Yi-Chien Peng ◽

Chung-Yuan Hsu ◽

Wen-Tzu Tang

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Chronic Low Back Pain ◽

Golf Swing ◽

Control Group ◽

Low Back ◽

Balance Test ◽

Star Excursion Balance Test ◽

Pain Symptoms ◽

The Right

The purpose of this study was to investigate whether low-handicap elite golfers with chronic low back pain (CLBP) exhibit deficits in dynamic postural control and whether CLBP affects golfers in terms of their golf swing parameters. A total of fifteen Division 1 college golfers were recruited as participants. Of these, six of whom experienced CLBP, while the remaining participants were healthy. In this study, CLBP was defined as experiencing chronic pain symptoms for more than six months. The Star Excursion Balance Test (SEBT) was administered to examine dynamic posture control in both groups. The TrackMan Golf Launch Monitor Simulator was used to collect data on the performance parameters of the swing of the participants. The results for both feet in the medial, lateral, posterior, posteromedial, and posterolateral directions indicated that the CLBP group scored lower than the control group. However, the CLBP group scored higher for the right foot in the anterolateral direction. The parameters for the club speed and ball carry of the CLBP group were lower than those of the control group. Further, the CLBP group exhibited a more upright swing plane relative to the control group. Taken together, our findings suggest that SEBT may be feasible and highly accessible to assess golf swing performance of elite players with CLBP.

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Association between spectral characteristics of paraspinal muscles and functional disability in patients with low back pain: a cohort study

BMJ Open ◽

10.1136/bmjopen-2017-017091 ◽

2018 ◽

Vol 8 (2) ◽

pp. e017091 ◽

Cited By ~ 2

Author(s):

Shin-Yi Chiou ◽

Ermis Koutsos ◽

Pantelis Georgiou ◽

Paul H Strutton

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Peak Power ◽

Functional Disability ◽

Spectral Characteristics ◽

Peak Torque ◽

Healthy Adults ◽

Erector Spinae ◽

Emg Activity ◽

Low Back

ObjectivesCharacteristics of muscle activity, represented by surface electromyography (EMG), have revealed differences between patients with low back pain (LBP) and healthy adults; how they relate to functional and clinical parameters remains unclear. The purpose of the current study was to examine the correlation between frequency characteristics of EMG (analysed using continuous wavelet transform (CWT) analysis) and patients’ self-rated score of disability.Design and settingThis is a case-control study with 15 patients with mechanical LBP without radicular symptoms. Patients were recruited from the orthopaedic clinic at Charing Cross Hospital. Ten healthy adults were recruited from the staff working in the hospital and associated university. Patients completed the Roland-Morris Disability Questionnaire (RMDQ) and bilateral EMG activity was obtained from erector spinae at vertebral levels L4 and T12. Subjects performed three brief maximal voluntary isometric contractions (MVICs) of the back extensors and the torque was measured using a dynamometer. CWT was applied to the EMG signals of each muscle in a 200 ms window centred around the peak torque obtained during the MVICs. The ratio (low/high frequencies) of the energy, the peak power and the frequency of the peak power were calculated for each recording site, averaged and correlated with the individual’s RMDQ score.ResultsPatients had lower peak power (T12 and L4) and lower frequency of the peak power (at T12) than the healthy adults. Additionally, RMDQ positively correlated to the average ratio of energy at T12 (r=0.63; p=0.012), that is, greater self-rated disability corresponded to a dominant distribution of energy in the lower frequencies.ConclusionThe current findings reveal alterations in EMG profile and its association with self-related back pain disability, suggesting that spectral characteristics of EMG reflect muscle function.

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Erector spinae plane block: a new option for managing acute axial low back pain in the emergency department

Pain Management ◽

10.2217/pmt-2021-0004 ◽

2021 ◽

Author(s):

Alexander J Anshus ◽

Jessica Oswald

Keyword(s):

Emergency Department ◽

Low Back Pain ◽

Back Pain ◽

Length Of Stay ◽

Case Series ◽

Erector Spinae ◽

Low Back ◽

Analog Scale ◽

Acute Low Back Pain ◽

Erector Spinae Plane Block

Aim: To evaluate pain and length of stay outcomes in six patients who received an erector spinae plane block (ESPB) in the emergency department (ED) for low back pain. Materials & methods: A case series of six patients who received unilateral or bilateral ESPB after presenting to the ED for acute atraumatic axial low back pain. Results: The average visual analog scale pain score reduction was 81.8%, and length of stay after ESPB was 73.5 min. No postprocedure opiates in the ED or after discharge were required. Conclusion: The ESPB is a rapid, safe and opiate-sparing option for the treatment of acute low back pain.

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