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 SOCIODEMOGRAPHIC FACTORS AND LOW BACK PAIN IN MUNICIPALITY PHYSICAL ACTIVITY PROGRAMS FOR FEMALE PARTICIPANTS

2020 ◽  
pp. 447
Author(s):  
Ioannis Kosmas ◽  
Yannis Georgiou ◽  
Eleni Marmara ◽  
Aggeliki Fotiou
Keyword(s):  
Physical Activity ◽  
Low Back Pain ◽  
Back Pain ◽  
Sociodemographic Factors ◽  
Low Back ◽  
Fear Avoidance Beliefs ◽  
The Difference ◽  
Analysis Of Variation ◽  
Post Hoc ◽  
The Relationship

The purpose of this study was to investigate the relationship between low back pain (LBP) and factors such as education level and years of work in 131 women aged 42±1.10 years, participating in the "Sports for All" municipal physical activity (PA) programs in Greece. To evaluate how PA affects the intensity of pain, the questionnaires “Grading the Severity of Chronic Pain-GSCP” and the “A Fear-Avoidance Beliefs Questionnaire-FABQ” were used. Analysis of Variation and the Tuckey post hoc tests calculated the difference among the questions of each of the questionnaires. Statistically significant differences were determined for three questions. Female participants with a medium or low level of education show less or no improvement in LBP. Concerning years of work, participants with fewer years of work suffer from higher LBP levels than the ones already working for longer time. Future studies of the relationship between specific PA programs, the content and nature of one’s job and the appearance of LBP are needed.

scholarly journals A Study on the Relationship between Postural Control and Pain-Related Clinical Outcomes in Patients with Chronic Nonspecific Low Back Pain

2021 ◽  
Vol 2021 ◽  
pp. 1-12
Author(s):  
Qiuhua Yu ◽  
Yunxia Huo ◽  
Min Chen ◽  
Zhou Zhang ◽  
Zhicheng Li ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Postural Control ◽  
Clinical Outcomes ◽  
Onset Time ◽  
External Perturbation ◽  
Erector Spinae ◽  
Low Back ◽  
Postural Adjustments ◽  
The Relationship

Objectives. To explore the relationship between postural control and pain-related clinical outcomes in patients with chronic nonspecific low back pain (cNLBP). Methods. Participants with cNLBP and healthy individuals were recruited. Muscle activities were recorded during internal and external perturbation tasks. Postural control capacity was assessed by muscle onset time and integrals of electromyography (iEMGs) of postural muscles during the phases of anticipatory postural adjustments (APAs) and compensatory postural adjustments (CPAs). Correlation analysis was employed to investigate the relationship between postural control capacity, pain, and disability. Results. Twenty-seven patients with cNLBP and 27 healthy participants were recruited. Gastrocnemius (GA) muscle onset time was earlier in the cNLBP group than in the control group in the internal perturbation task. The onset time of GA and erector spinae (ES) of the cNLBP group was later than that of the controls in the external perturbation task. Disability level moderately correlated with the iEMGs of rectus abdominis (RA), GA, and external oblique (EO) during APAs. Pain score moderately correlated with the iEMGs of RA, EO, and ES during CPAs of perturbation tasks. Conclusion. cNLBP participants had altered muscle activation strategy to maintain postural stability in response to perturbation. This study further discovered that pain-related disabilities of cNLBP participants were likely related to the APAs capacity, whereas the pain intensity may relate to the CPAs capacity. Pain and disability may therefore be related to the control process of the posture-related muscles.

scholarly journals The influence of preoperative spinal sagittal balance on clinical outcomes after microendoscopic laminotomy in patients with lumbar spinal canal stenosis

2015 ◽  
Vol 23 (1) ◽  
pp. 49-54 ◽  
Author(s):  
Sho Dohzono ◽  
Hiromitsu Toyoda ◽  
Tomiya Matsumoto ◽  
Akinobu Suzuki ◽  
Hidetomi Terai ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Clinical Outcomes ◽  
Plumb Line ◽  
Leg Pain ◽  
Low Back ◽  
Vas Score ◽  
Canal Stenosis ◽  
Lumbar Spinal

OBJECT More information about the association between preoperative anterior translation of the C-7 plumb line and clinical outcomes after decompression surgery in patients with lumbar spinal canal stenosis (LSS) would help resolve problems for patients with sagittal imbalance. The authors evaluated whether preoperative sagittal alignment of the spine affects low-back pain and clinical outcomes after microendoscopic laminotomy. METHODS This study was a retrospective review of prospectively collected surgical data. The study comprised 88 patients with LSS (47 men and 41 women) who ranged in age from 39 to 86 years (mean age 68.7 years). All patients had undergone microendoscopic laminotomy at Osaka City University Graduate School of Medicine from May 2008 through October 2012. The minimum duration of clinical and radiological follow-up was 6 months. All patients were evaluated by Japanese Orthopaedic Association (JOA) and visual analog scale (VAS) scores for low-back pain, leg pain, and leg numbness before and after surgery. The distance between the C-7 plumb line and the posterior corner of the sacrum (sagittal vertical axis [SVA]) was measured on lateral standing radiographs of the entire spine obtained before surgery. Radiological factors and clinical outcomes were compared between patients with a preoperative SVA ≥ 50 mm (forward-bending trunk [F] group) and patients with a preoperative SVA < 50 mm (control [C] group). A total of 35 patients were allocated to the F group (19 male and 16 female) and 53 to the C group (28 male and 25 female). RESULTS The mean SVA was 81.0 mm for patients in the F group and 22.0 mm for those in the C group. At final follow-up evaluation, no significant differences between the groups were found for the JOA score improvement ratio (73.3% vs 77.1%) or the VAS score for leg numbness (23.6 vs 24.0 mm); the VAS score for low-back pain was significantly higher for those in the F group (21.1 mm) than for those in the C group (11.0 mm); and the VAS score for leg pain tended to be higher for those in the F group (18.9 ± 29.1 mm) than for those in the C group (9.4 ± 16.0 mm). CONCLUSIONS Preoperative alignment of the spine in the sagittal plane did not affect JOA scores after microendoscopic laminotomy in patients with LSS. However, low-back pain was worse for patients with preoperative anterior translation of the C-7 plumb line than for those without.

Correction of Posture Deviations in the Sagittal Plane Using the Pilates Method

2019 ◽  
pp. 3-13
Author(s):  
Alexandru Cîtea ◽  
George-Sebastian Iacob
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Postural Control ◽  
Human Body ◽  
Sagittal Plane ◽  
The Body ◽  
Lower Limbs ◽  
Low Back ◽  
Pilates Method ◽  
The Relationship

Posture is commonly perceived as the relationship between the segments of the human body upright. Certain parts of the body such as the cephalic extremity, neck, torso, upper and lower limbs are involved in the final posture of the body. Musculoskeletal instabilities and reduced postural control lead to the installation of nonstructural posture deviations in all 3 anatomical planes. When we talk about the sagittal plane, it was concluded that there are 4 main types of posture deviation: hyperlordotic posture, kyphotic posture, rectitude and "sway-back" posture.Pilates method has become in the last decade a much more popular formof exercise used in rehabilitation. The Pilates method is frequently prescribed to people with low back pain due to their orientation on the stabilizing muscles of the pelvis. Pilates exercise is thus theorized to help reactivate the muscles and, by doingso, increases lumbar support, reduces pain, and improves body alignment.

scholarly journals The Relationship between Pelvic Tilt Angle and Disability Associated with Low Back Pain

2013 ◽  
Vol 25 (1) ◽  
pp. 65-68 ◽  
Author(s):  
Hee Sung Lim ◽  
Su Yeon Roh ◽  
Suk Min Lee
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Tilt Angle ◽  
Pelvic Tilt ◽  
Low Back ◽  
The Relationship

scholarly journals Low Back Pain in Adolescents: A Comparison of Clinical Outcomes in Sports Participants and Nonparticipants

2010 ◽  
Vol 45 (1) ◽  
pp. 61-66 ◽  
Author(s):  
Julie M. Fritz ◽  
Shannon N. Clifford
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Physical Therapy ◽  
Treatment Outcomes ◽  
Clinical Outcomes ◽  
Sports Participation ◽  
Mean Difference ◽  
Analysis Of Covariance ◽  
Low Back ◽  
Baseline Characteristics

Abstract Context: Back pain is common in adolescents. Participation in sports has been identified as a risk factor for the development of back pain in adolescents, but the influence of sports participation on treatment outcomes in adolescents has not been adequately examined. Objective: To examine the clinical outcomes of rehabilitation for adolescents with low back pain (LBP) and to evaluate the influence of sports participation on outcomes. Design: Observational study. Setting: Outpatient physical therapy clinics. Patients or Other Participants: Fifty-eight adolescents (age  =  15.40 ± 1.44 years; 56.90% female) with LBP referred for treatment. Twenty-three patients (39.66%) had developed back pain from sports participation. Intervention(s): Patients completed the Modified Oswestry Disability Questionnaire and numeric pain rating before and after treatment. Treatment duration and content were at the clinician's discretion. Adolescents were categorized as sports participants if the onset of back pain was linked to organized sports. Additional data collected included diagnostic imaging before referral, clinical characteristics, and medical diagnosis. Main Outcome Measure(s): Baseline characteristics were compared based on sports participation. The influence of sports participation on outcomes was examined using a repeated-measures analysis of covariance with the Oswestry and pain scores as dependent variables. The number of sessions and duration of care were compared using t tests. Results: Many adolescents with LBP receiving outpatient physical therapy treatment were involved in sports and cited sports participation as a causative factor for their LBP. Some differences in baseline characteristics and clinical treatment outcomes were noted between sports participants and nonparticipants. Sports participants were more likely to undergo magnetic resonance imaging before referral (P  =  .013), attended more sessions (mean difference  =  1.40, 95% confidence interval [CI]  =  0.21, 2.59, P  =  .022) over a longer duration (mean difference  =  12.44 days, 95% CI  =  1.28, 23.10, P  =  .024), and experienced less improvement in disability (mean Oswestry difference  =  6.66, 95% CI  =  0.53, 12.78, P  =  .048) than nonparticipants. Overall, the pattern of clinical outcomes in this sample of adolescents with LBP was similar to that of adults with LBP. Conclusions: Adolescents with LBP due to sports participation received more treatment but experienced less improvement in disability than nonparticipants. This may indicate a worse prognosis for sports participants. Further research is required.

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