The Real Time Geometric Effect of a Lordotic Curve-Controlled Spinal Traction Device: A Randomized Cross Over Study

Background: A standard spinal traction (ST) device was designed to straighten the spine without considering physiological lumbar lordosis. Using lordotic curve-controlled traction (LCCT), which maintains the lordotic curve during traction, the traction force would be applied to the posterior spinal structure effectively. Thus, the purpose of our study was to evaluate real-time biomechanical changes while applying the LCCT and ST. Methods: In this study, 40 subjects with mild non-radicular low back pain (LBP) were included. The participants underwent LCCT and ST in random order. Anterior and posterior intervertebral distance, ratios of anterior/posterior intervertebral distance (A/P ratio), and lordotic angles of intervertebral bodies (L2~L5) were measured by radiography. Results: Mean intervertebral distances were greater during LCCT than those measured prior to applying traction (p < 0.05). Mean A/P ratio was also significantly greater during LCCT than during ST or initially (p < 0.05). In particular, for the L4/5 intervertebral segment, which is responsible for most of the lordotic curve, mean LCCT angle was similar to mean lordotic angle in the standing position (10.9°). Conclusions: Based on measurements of radiologic geometrical changes with real-time clinical setting, the newly developed LCCT appears to be a useful traction device for increasing intervertebral disc spaces by maintaining lordotic curves.

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Artificial Intelligence-Assisted Colonoscopy for Detection of Colon Polyps: a Prospective, Randomized Cohort Study

Journal of Gastrointestinal Surgery ◽

10.1007/s11605-020-04802-4 ◽

2020 ◽

Author(s):

Yuchen Luo ◽

Yi Zhang ◽

Ming Liu ◽

Yihong Lai ◽

Panpan Liu ◽

...

Keyword(s):

Artificial Intelligence ◽

Real Time ◽

High Performance ◽

Detection System ◽

Random Order ◽

Colon Polyps ◽

Clinical Environment ◽

Polyp Detection ◽

Link Type ◽

Polyp Detection Rate

Abstract Background and aims Improving the rate of polyp detection is an important measure to prevent colorectal cancer (CRC). Real-time automatic polyp detection systems, through deep learning methods, can learn and perform specific endoscopic tasks previously performed by endoscopists. The purpose of this study was to explore whether a high-performance, real-time automatic polyp detection system could improve the polyp detection rate (PDR) in the actual clinical environment. Methods The selected patients underwent same-day, back-to-back colonoscopies in a random order, with either traditional colonoscopy or artificial intelligence (AI)-assisted colonoscopy performed first by different experienced endoscopists (> 3000 colonoscopies). The primary outcome was the PDR. It was registered with clinicaltrials.gov. (NCT047126265). Results In this study, we randomized 150 patients. The AI system significantly increased the PDR (34.0% vs 38.7%, p < 0.001). In addition, AI-assisted colonoscopy increased the detection of polyps smaller than 6 mm (69 vs 91, p < 0.001), but no difference was found with regard to larger lesions. Conclusions A real-time automatic polyp detection system can increase the PDR, primarily for diminutive polyps. However, a larger sample size is still needed in the follow-up study to further verify this conclusion. Trial Registration clinicaltrials.gov Identifier: NCT047126265

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Facial Nerve EMG: Low-Tech Monitoring with a Stopwatch

Journal of Neurological Surgery Part A Central European Neurosurgery ◽

10.1055/s-0040-1701616 ◽

2021 ◽

Author(s):

Julian Prell ◽

Christian Scheller ◽

Sebastian Simmermacher ◽

Christian Strauss ◽

Stefan Rampp

Keyword(s):

Facial Nerve ◽

Real Time ◽

Random Order ◽

Automated Analysis ◽

Data Sets ◽

Time Analysis ◽

Frequency Pattern ◽

Real Time Analysis ◽

Offline Analysis ◽

Automated Algorithms

Abstract Objective The quantity of A-trains, a high-frequency pattern of free-running facial nerve electromyography, is correlated with the risk for postoperative high-grade facial nerve paresis. This correlation has been confirmed by automated analysis with dedicated algorithms and by visual offline analysis but not by audiovisual real-time analysis. Methods An investigator was presented with 29 complete data sets measured during actual surgeries in real time and without breaks in a random order. Data were presented either strictly via loudspeaker (audio) or simultaneously by loudspeaker and computer screen (audiovisual). Visible and/or audible A-train activity was then quantified by the investigator with the computerized equivalent of a stopwatch. The same data were also analyzed with quantification of A-trains by automated algorithms. Results Automated (auto) traintime (TT), known to be a small, yet highly representative fraction of overall A-train activity, ranged from 0.01 to 10.86 s (median: 0.58 s). In contrast, audio-TT ranged from 0 to 1,357.44 s (median: 29.69 s), and audiovisual-TT ranged from 0 to 786.57 s (median: 46.19 s). All three modalities were correlated to each other in a highly significant way. Likewise, all three modalities correlated significantly with the extent of postoperative facial paresis. As a rule of thumb, patients with visible/audible A-train activity < 1 minute presented with a more favorable clinical outcome than patients with > 1 minute of A-train activity. Conclusion Detection and even quantification of A-trains is technically possible not only with intraoperative automated real-time calculation or postoperative visual offline analysis, but also with very basic monitoring equipment and real-time good quality audiovisual analysis. However, the investigator found audiovisual real-time-analysis to be very demanding; thus tools for automated quantification can be very helpful in this respect.

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The relationships between low back pain and lumbar lordosis: a systematic review and meta-analysis

The Spine Journal ◽

10.1016/j.spinee.2017.04.034 ◽

2017 ◽

Vol 17 (8) ◽

pp. 1180-1191 ◽

Cited By ~ 41

Author(s):

Se-Woong Chun ◽

Chai-Young Lim ◽

Keewon Kim ◽

Jinseub Hwang ◽

Sun G. Chung

Keyword(s):

Systematic Review ◽

Low Back Pain ◽

Back Pain ◽

Lumbar Lordosis ◽

Meta Analysis ◽

Low Back

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Increasing the cervical and lumbar lordosis is possible despite overt osteoarthritis and spinal stenosis using extension traction to relieve low back and leg pain in a 66-year-old surgical candidate: a CBP® case report

Journal of Physical Therapy Science ◽

10.1589/jpts.30.1364 ◽

2018 ◽

Vol 30 (11) ◽

pp. 1364-1369 ◽

Cited By ~ 5

Author(s):

Michael T. Weiner ◽

Paul A. Oakley ◽

Alyssa K. Dennis ◽

David A. Shapiro ◽

Deed E. Harrison

Keyword(s):

Case Report ◽

Spinal Stenosis ◽

Lumbar Lordosis ◽

Leg Pain ◽

Low Back

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Lumbar Lordosis, Pain Intensity and Type of Work in Women Participating in Fitness Activities

Polish Journal of Sport and Tourism ◽

10.2478/pjst-2019-0022 ◽

2019 ◽

Vol 26 (4) ◽

pp. 22-27

Author(s):

Patrycja Proskura ◽

Małgorzata Sobera

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Everyday Life ◽

Oswestry Disability Index ◽

Lumbar Lordosis ◽

Daily Activities ◽

Sitting Position ◽

Low Back ◽

Digital Inclinometer ◽

Postural Muscles

AbstractIntroduction. The aim of this study was to examine women participating in fitness activities regarding their level of disability in daily activities and lumbar lordosis.Material and methods. Data were collected from 68 females between the ages of 25-70 participating in fitness exercises. The Oswestry Disability Index was applied to measure the level of disability due to the low back pain in everyday life. The angle of lumbar lordosis was measured using a Saunders’ digital inclinometer.Results. The results of the study confirmed the existence of problems related to low back pain in people performing sedentary work. There were no correlations between lumbar lordosis angle and the level of disability in daily activities of the groups. The low back pain increases especially among people performing sedentary work.Conclusions. The results of this study suggest that work in a sitting position is not associated with a decrease in the angle of lordosis in relation to another work than in a sitting position. Sitting work can be an indirect cause of back pain and slight disability in everyday life by weakening postural muscles.

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