scholarly journals Resolution of the more anteriorly positioned psoas muscle following correction of spinal sagittal alignment from spondylolisthesis: case report

2017 ◽  
Vol 26 (4) ◽  
pp. 441-447 ◽  
Author(s):  
Hasan R. Syed ◽  
Kurt Yaeger ◽  
Faheem A. Sandhu
Keyword(s):  
Back Pain ◽  
Sagittal Alignment ◽  
Morphological Changes ◽  
Psoas Muscle ◽  
Lateral Approach ◽  
Neurological Injury ◽  
Direct Result ◽  
Low Back ◽  
Dynamic Nature ◽  
Spinal Sagittal Alignment

Several studies have described the radiographic, histological, and morphological changes to the paraspinal muscle in patients with chronic low-back pain due to degenerative diseases of the spine. Gross anatomical illustrations have shown that the psoas muscle lies lateral to the L4–5 vertebrae and subsequently thins and dissociates from the vertebral body at L5–S1 in a ventrolateral course. A “rising psoas” may influence the location of the lumbar plexus and result in transient neurological injury on lateral approach to the spine. It is postulated that axial back pain may be exacerbated by anatomical changes of paraspinal musculature as a direct result of degenerative spine conditions. To their knowledge, the authors present the first reported case of a more anteriorly positioned psoas muscle and its resolution following correction of spondylolisthesis in a 62-year-old woman. This case highlights the dynamic nature of degenerative spinal disorders and illustrates that psoas muscle position can be affected by sagittal balance. Normal anatomical positioning can be restored following correction of spinal alignment.

Effects of the difference between lumbar lordosis in the supine and standing positions on the clinical outcomes of decompression surgery for lumbar spinal stenosis

2021 ◽  
pp. 1-7
Author(s):  
Shiho Nakano ◽  
Masahiro Inoue ◽  
Hiroshi Takahashi ◽  
Go Kubota ◽  
Junya Saito ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Clinical Outcomes ◽  
Sagittal Alignment ◽  
Low Back ◽  
Strongly Correlated ◽  
Spinal Sagittal Alignment ◽  
The Difference ◽  
Lumbar Spinal ◽  
The Relationship

OBJECTIVE The authors sought to evaluate the relationship between the difference in lumbar lordosis (DiLL) in the preoperative supine and standing positions and spinal sagittal alignment in patients with lumbar spinal stenosis (LSS) and to determine whether this difference affects the clinical outcome of laminectomy. METHODS Sixty patients who underwent single-level unilateral laminectomy for bilateral decompression of LSS were evaluated. Spinopelvic parameters in the supine and standing positions were measured preoperatively and at 3 months and 2 years postoperatively. DiLL between the supine and standing positions was determined as follows: DiLL = supine LL − standing LL. On the basis of this determination patients were then categorized into DiLL(+) and DiLL(−) groups. The relationship between DiLL and preoperative spinopelvic parameters was evaluated using Pearson’s correlation coefficient. In addition, clinical outcomes such as visual analog scale (VAS) and Oswestry Disability Index (ODI) scores between the two groups were measured, and their relationship to DiLL was evaluated using two-group comparison and multivariate analysis. RESULTS There were 31 patients in the DiLL(+) group and 29 in the DiLL(−) group. DiLL was not associated with supine LL but was strongly correlated with standing LL and pelvic incidence (PI) − LL (PI − LL). In the preoperative spinopelvic alignment, LL and SS in the standing position were significantly smaller in the DiLL(+) group than in the DiLL(−) group, and PI − LL was significantly higher in the DiLL(+) group than in the DiLL(−) group. There was no difference in the clinical outcomes 3 months postoperatively, but low-back pain, especially in the sitting position, was significantly higher in the DiLL(+) group 2 years postoperatively. DiLL was associated with low-back pain in the sitting position, which was likely to persist in the DiLL(+) group postoperatively. CONCLUSIONS We evaluated the relationship between DiLL and spinal sagittal alignment and the influence of DiLL on postoperative outcomes in patients with LSS. DiLL was strongly correlated with PI − LL, and in the DiLL(+) group, postoperative low-back pain relapsed. DiLL can be useful as a new spinal alignment evaluation method that supports the conventional spinal sagittal alignment evaluation.

scholarly journals The change of pain and lumbosacral sagittal alignment after sling exercise therapy for patients with chronic low back pain

2016 ◽  
Vol 28 (10) ◽  
pp. 2789-2792 ◽  
Author(s):  
Hee Sook Roh ◽  
Won Je Cho ◽  
Won Jong Ryu ◽  
Seung Jin Park ◽  
Chang Sik An
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Exercise Therapy ◽  
Chronic Low Back Pain ◽  
Sagittal Alignment ◽  
Low Back ◽  
Sling Exercise Therapy

scholarly journals Accuracy of intraoperative neuromonitoring during percutaneous cement discoplasty

2021 ◽  
Vol 78 (3) ◽  
pp. 257-263
Author(s):  
Gaston Oscar Camino Willhuber ◽  
Mariana Bendersky ◽  
Carolina Vilte ◽  
Gonzalo Kido ◽  
Matias Pereira Duarte ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Minimally Invasive ◽  
Predictive Value ◽  
Invasive Procedure ◽  
Intraoperative Neuromonitoring ◽  
Neurological Injury ◽  
Low Back ◽  
Minimally Invasive Procedure ◽  
Percutaneous Cement Discoplasty

Introduction: Percutaneous cement discoplasty is a minimally invasive procedure to treat low back pain due to advanced degenerative disc disease in elderly patients. Complications of this procedure has been described such as infection, vertebral fracture, cement leakage and nerve injury. Intraoperative neuromonitoring is used to detect the latter. The objective of this study was to assess the usefulness of neuromonitoring during discoplasty to detect new neurological compromise. Methods: 100 consecutive patients were included in this retrospective study, (30 males and 70 females, mean age of 76.3 ± 5.71 years) with mechanical low back pain who underwent percutaneous cement discoplasty. Results: Sensitivity to detect neurological injury was 82% (CI 95% 66-98), specificity was of 99% (CI 95%98-100) with a positive predictive value of 0.95 (CI 95% 85-100) and a negative predictive value of 0.97 (CI 95% 95-99). In 5 patients neurological compromise was not detected by neuromonitoring. Discussion: Our study showed high sensitivity and specificity of neuromonitoring to detect neurological irritation during percutaneous discoplasty. Intraoperative neuromonitoring resulted an effective assistance during this minimally invasive procedure.  

scholarly journals EXTREME LATERAL INTERBODY FUSION IN PACIENTS WITH CHRONIC LOW BACK PAIN

2020 ◽  
Vol 28 (5) ◽  
pp. 256-260
Author(s):  
ALBERTO AUGUSTO NETO ◽  
RENNAN GUILHERME DIAS ◽  
MARCELO WAJCHENBERG ◽  
DELIO MARTINS
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Interbody Fusion ◽  
Randomized Clinical Trials ◽  
Cochrane Collaboration ◽  
Lateral Approach ◽  
Publication Date ◽  
Low Back ◽  
Disc Disease ◽  
Level Of Evidence

ABSTRACT Objective: To evaluate the effect of lateral lumbar interbody fusion (LLIF) or oblique interbody fusion (OLIF) on low back pain due to degenerative intervertebral disc disease. Methods: We systematically reviewed articles on surgical treatment of low back pain by LLIF and OLIF, according to the Cochrane Handbook for Systematic Reviews of Interventions. We searched through electronic databases, including Medline via PubMed, Lilacs through the Virtual Health Library (VHL), Cochrane Collaboration/Central and Cohrane/Dare Cochrane Controlled Trials Register, without language or publication date restrictions and with design for prospective cohorts and randomized clinical trials. Results: We have selected and presented three studies. Conclusion: The literature review showed great relevance in the improvement of the new surgical approach (LLIF) in relation to TLIF, but greater content availability in the databases is necessary to reach a satisfactory conclusion regarding the efficiency of the lateral approach and its advantages over other traditional procedures. Level of Evidence II, Systematic review of Level II studies.

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