Disc spaces, vertebral dimensions, and angle values at the lumbar region: a radioanatomical perspective in spines with L5–S1 transitions

2011 ◽  
Vol 15 (4) ◽  
pp. 371-379 ◽  
Author(s):  
Niladri Kumar Mahato

Object Low-back pain (LBP) has been associated with lumbar spines of normal morphology as well as those with L5–S1 “transitional” vertebrae. It is hard to find literature that quantifies the overall morphological changes in lumbar spines as related to transitional states. The object of this study was to investigate lumbar spine changes resulting from the presence of these transitional states. Methods The author quantified dimensions and angles and statistically compared the morphology of lumbar spines with or without L5–S1 transitions in the context of LBP. Anteroposterior and lateral radiographs were obtained from 50 patients suffering from LBP without transitional anomalies at the L5–S1 junction. These radiographs were compared with anteroposterior and lateral radiographs from patients suffering from LBP with L5–S1 transitional states involving accessory L5–S1 articulations, and with anteroposterior and lateral radiographs from patients with L5–S1 unilateral or bilateral fusions. Twelve linear dimensions from the anteroposterior views and 8 angles from the lateral radiographs were measured. Results The mean values of linear dimensions differed in 1) disc heights, 2) vertebral heights and widths, 3) pedicles and interpedicular distances, 4) angle values, and 5) overall configuration of the lumbar curvatures. Conclusions The L5–S1 accessory articulations led to increased lordotic curves, L-5 vertebral heights, and pedicle and angular dimensions. The L5–S1 fusions were related to smaller disc heights at all spaces, short and wide L-5 pedicles, taller and less wide transverse processes, and overall straighter spines with the least measures for all lumbar angles. Dimensional differences provided in this study may help in placing instrumentation at the lumbar vertebrae and working on intervertebral disc replacements in spines with specific L5–S1 transitional anomalies.

1983 ◽  
Vol 50 (2) ◽  
pp. 49-51
Author(s):  
Marte Bachynski ◽  
G.R. Cumming

Patients with physical disability due to leg amputation, stroke, or low back pain performed a graded exercise test on a bicycle or armcrank ergometer. Their voluntary maximum and pre-exercise heart rates were determined and used to calculate their heart rate or cardiac reserve. Patients were subsequently monitored by ambulatory electrocardiography during the occupational therapy activities which made up their respective treatment programs. The peak heart rates for each activity were determined and expressed as a percentage of the patient's cardiac reserve. The means and ranges of working intensity were calculated for patients grouped by disability. The mean values of 24% and 27% of cardiac reserve for the older amputees and hemiplegic patients respectively were low compared to the mean values of 55% found for both the traumatic amputees and patients with low back pain. Wide ranges in values were found, particularly for hemiplegic patients, and may reflect the disimilar degree of disability among patients with the same diagnosis as well as the presence of factors affecting heart rate via the sympathetic nervous system.


Author(s):  
Christos Tsigkanos ◽  
Theano Demestiha ◽  
Chara Spiliopoulou ◽  
Georgios Tsigkanos

BACKGROUND: Kinematic analysis has been a dominant tool for addressing the neuromuscular and proprioceptive alterations that occur in Low Back Pain (LBP) patients. Movement variability is a crucial component of this analysis. During the past years a promising approach appears to be the application of non-linear indices. OBJECTIVE: The aim of the study was to compare movement variability, as expressed mainly by non-linear indices, at the pelvis and lumbar between LBP patients and healthy participants during gait. METHODS: Sixteen (16) LBP patients and thirteen (13) healthy control subjects (non-athletes) participated in the study. Participants walked on a treadmill at different walking conditions while recorded by a 6-infrared camera optoelectronic system. Kinematic variability of pelvic and lumbar movement was analyzed using linear (standard deviation) and non-linear indices (Maximal Lyapunov Exponent – LyE and Approximate Entropy – ApEn). RESULTS: Healthy subjects were found to have significantly greater mean values than LBP patients at seven pelvic and lumbar components in LyE, ApEn and SD. Specifically, the calculated LyE at the pelvis during normal gait was proven to have a sensitivity of 92.3% and a specificity of 90% in the discrimination of healthy subjects from LBP patients. Female subjects presented with higher variability in gait measures than males. CONCLUSION: Healthy participants presented with higher movement variability in their kinematic behavior in comparison to LBP patients. Lower variability values may be partly explained by the attempt of LBP patients to avoid painful end of range of motion positions. In this perspective non-linear indices seem to relate to qualitive characteristics of movement that need to be taken into consideration during rehabilitation.


1970 ◽  
Vol 16 (10) ◽  
pp. 853-855
Author(s):  
Mala Herzberg ◽  
Z Oberman ◽  
O Khermosh ◽  
S L Weissman

Abstract Urinary excretion of hydroxyproline was measured in 12 cases of multiple fractures as an index of bone collagen metabolism. Measurements were made for 10 consecutive days after injury; 10 patients with low back pain served as the control group. With three exceptions, the mean daily excretion of hydroxyproline and the day-to-day variations were within the same range in the group with multiple fractures as in the control group.


2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 926.3-926
Author(s):  
R. Dhahri ◽  
A. Dghaies ◽  
M. Slouma ◽  
L. Metoui ◽  
I. Gharsallah ◽  
...  

Background:Common low back pain (LBP) is a common health problem affecting 50 to 80% of working age adults. It is one of the common and costly health problems in Tunisia. Actually, the role of the immune response and inflammatory cytokines in the pathogenesis of chronic pain has been of growing interest.Objectives:The aim of this study was to assess whether pro and anti-inflammatory cytokines could be detected in serum in patients with LBP compared with healthy subjects and whether they could be related to pain severity and to clinical findings.Methods:It was a an analytical cross-sectional study including 50 patients with at least three months of LBP, in the department of rheumatology, orthopedics and immunology at the Military Hospital of Tunis between January 1st and March 31, 2020. All patients had a standardized clinical assessment.Levels of serum cytokines IL-6, IL-8, IL-1β and TNF- α, were measured using the chimiluminescence technique. Serum concentration of IL-10 was assayed by the enzyme-linked immunosorbent assay technique (ELISA). The normal levels of cytokines were determined in 50 healthy controls.Results:The mean age of the patients was 41.9 ± 8.4 years and the sex ratio was 4.5. LBP duration was 66.4 months. The mean lumbar visual analog scale (VAS) was 4.5 ± 1.9, and the root VAS was 2.6 ± 2.5. Neuropathic pain was found in 26% of patients. The average BMI was 27 ± 3.7 kg/m2. Only serum level of IL-8 was significantly higher in subjects with LBP compared to healthy controls (p <10-3). IL-1β was indetectable in both patients and controls. Positive correlations were found between IL-8 levels and anxiety/functional scores (r = 0.3; p = 0.02/ r = 0.3; p = 0.04). IL-6 was positively correlated with BMI, and negatively correlated with the Schober test. No correlations were found between serum levels of IL-6, IL-8, IL-10, TNF-α and pain intensity (VAS), neuropathic pain (DN4), fibromyalgia (FIRST), depression (HAD) and various radiological data.Conclusion:Interleukin-8 is a biomarker of common low back pain and correlate with anxiety and functional disability. These results suggest that IL-8 may be a therapeutic target to reduce chronic back pain and reduce the social and profession impact.Disclosure of Interests:None declared


2021 ◽  
Author(s):  
Ouidade A. Tabesh ◽  
Roba Ghossan ◽  
Soha H Zebouni ◽  
Rafic Faddoul ◽  
Michel Revel ◽  
...  

Abstract Aim. To evaluate ultrasonography findings of Thoracolumbar Fascia (TLF) enthesis in patients with low back pain (LBP) due to iliac crest pain syndrome (ICPS). Method. The ultrasonographic and clinical findings of 60 patients with LBP due to ICPS were compared to those of 30 healthy volunteers with no LBP. Thickness of the TLF was measured with ultrasound (US) at its insertion on the iliac crest. Results. Forty-eight women and 12 men with a mean age of 42.1±11.3 years were diagnosed with ICPS. In patients, the mean thickness of the TLF was 2.51±0.70mm in affected sides compared to 1.81±0.44mm in the contralateral unaffected sides. The mean thickness difference of 0.82mm between the affected and non-affected sides was statistically significant (95%CI, 0.64-0.99, P<0.0001). In volunteers, the mean thickness of the TLF was 1.6±0.2mm. The mean thickness difference of 0.89mm between the affected sides of patients and volunteers was statistically significant (95%CI, 0.73-1.06, P<0.0001). Forty-two patients who didn’t improve with conservative therapy, received injections of methylprednisolone acetate and 1% lidocaine around the TLF enthesis. All patients reported complete relief of their LBP within 20 minutes of the injections thanks to the lidocaine anesthetic effect. Fifty-six (93.3%) patients were reached by phone for a long-term follow-up. Among them, 33 (58.9%) patients experienced a sustained complete pain relief after a mean follow-up of 45±19.3 months (range, 3-74 months). Conclusion. our findings suggest that TLF enthesopathy is a potential cause of nonspecific LBP that can be diagnosed using US.


2009 ◽  
Vol 89 (12) ◽  
pp. 1275-1286 ◽  
Author(s):  
Leonardo O.P. Costa ◽  
Christopher G. Maher ◽  
Jane Latimer ◽  
Paul W. Hodges ◽  
Robert D. Herbert ◽  
...  

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.


2020 ◽  
Vol 2 (2) ◽  
pp. 75
Author(s):  
Ni Luh Putu Sentania Widhi Permana Putri ◽  
Ni Wayan Suarniti ◽  
Ni Nyoman Budiani

Nyeri punggung bawah pada kehamilan digambarkan sebagai nyeri pada daerah lumbar, diatas sakrum yang menyebabkan ketidaknyamanan selama kehamilan. Akupresur titik bladder 23 merupakan metode non-farmakologi yang dapat mengurangi nyeri punggung bawah. Tujuan penelitian ini untuk mengetahui pengaruh akupresur titik bladder 23 terhadapintensitas nyeri punggung bawah ibu hamil trimester III di UPTD Puskesmas I Dinas Kesehatan Kecamatan Denpasar Utara. Penelitian ini menggunakan pre eksperimental dengan rancangan one grup pretest-posttest design.Sampel yang digunakan yaitu 12 orang ibu hamil trimester III dengan usia kehamilan 37-39 minggu dan di pilih secara purposive sampling. Data diambil dengan melakukan observasi intensitas nyeri punggung bawah sebelum dan sesudah dilakukan akupresur titik bladder 23. Responden melakukan akupresur sebanyak dua kali seminggu dengan durasi dua detik sebanyak 30 kali tekanan. Hasil intensitas nyeri punggung bawah sebelum perlakuan diperoleh nilai mean 4,17 dan setelah perlakuan berubah menjadi 2,67 dengan nilai ρ = 0,000 < α (0,05) dan nilai t (9,950). Simpulannya adalah ada pengaruh akupresur titik bladder 23 terhadap intensitas nyeri punggung bawah ibu hamil trimester III di UPTD Puskesmas I Dinas Kesehatan Kecamatan Denpasar Utara.Lower back pain in pregnancy described as pain in the lumbar region, above the sacrum which causes discomfort during pregnancy.Acupressurepoint bladder 23 is a non-pharmacological method that canreduce low back pain.This study aims to determine the effect of acupressure point bladder 23 on the low back pain level in third semester pregnant women in UPTD Puskesmas I of the Health Departement of North Denpasar. This is pre-experimental research with one group pretest-posttest design. The samples were 12pregnant women on third trimester with 37-39 weeks gestational age and were selected by purposive sampling. Data were collected byobserving the intensity of low back pain before and after treatment. Respondents did acupressure twice a week with the duration two seconds for each 30 times pressure. The results of low back pain intensity before treatment obtained a mean value of 4.17 and after the treatment there was reduce to 2.67 with a value of ρ = 0,000 <α (0.05) and t value (9,950). The conclusion is that there is an influence of acupressurepoint bladder 23 on the low back painintensityin third trimester pregnant women in UPTD Puskesmas I of the Health Departement of North Denpasar.  


Author(s):  
Yoshimasa Mera ◽  
Masatoshi Teraguchi ◽  
Hiroshi Hashizume ◽  
Hiroyuki Oka ◽  
Shigeyuki Muraki ◽  
...  

2013 ◽  
Vol 28 (3) ◽  
pp. 255-261 ◽  
Author(s):  
Sara P. Gombatto ◽  
Barbara J. Norton ◽  
Shirley A. Sahrmann ◽  
Michael J. Strube ◽  
Linda R. Van Dillen

2017 ◽  
Vol 17 (05) ◽  
pp. 1750086 ◽  
Author(s):  
MEISSAM SADEGHISANI ◽  
VAHID SOBHANI ◽  
MAJID MOHSENI KABIR ◽  
ALI ASNAASHARI ◽  
PEYMAN RAHMANI ◽  
...  

The asymmetrical loading applied to legs was proposed as a risk factor for low back pain development. However, this proposed mechanical risk factor was not investigated in the athletes with LBP engaged in rotational demand activities. The aim of the present study was to examine symmetry of weight-bearing in patients with rotational demand activities compared to that in healthy people during gait. In total, 35 subjects, 15 males with LBP and 20 males without LBP, participated in the study. The participants were asked to walk 12 trials in gait lab. Forces applied to legs were recorded by a force plate. Then, the peaks of anteroposterior, mediolateral, and vertical forces were measured. Next, the asymmetrical loads applied to the legs were calculated. The results of our study demonstrated that people with LBP exhibit more asymmetry of vertical peak forces in heel strike and mid-stance. They also exhibited more asymmetry of loading in the anterior direction. But the mean values of ASI of mediolateral and posterior forces in these participants were not significantly different compared to those in the control group. It can be concluded that, in comparison to the healthy subjects, patients with LBP walk with a greater magnitude of asymmetrical weight-bearing at a comfortable speed.


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