scholarly journals Severe Atrophy of the Ipsilateral Psoas Muscle Associated with Hip Osteoarthritis and Spinal Stenosis—A Case Report

Medicina ◽  
2021 ◽  
Vol 57 (1) ◽  
pp. 73
Author(s):  
Byeongcheol Lee ◽  
Sang Eun Lee ◽  
Yong Han Kim ◽  
Jae Hong Park ◽  
Ki Hwa Lee ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Spinal Stenosis ◽  
Hip Osteoarthritis ◽  
Psoas Muscle ◽  
The Elderly ◽  
Leg Pain ◽  
Spine Pathology ◽  
Lumbar Mri ◽  
Physical Examinations ◽  
Clinical Clue

Pathology of the lumbar spine and hip joint can commonly coexist in the elderly. Anterior and lateral leg pain as symptoms of hip osteoarthritis and spinal stenosis can closely resemble each other, with only subtle differences in both history and physical examinations. It is not easy to identify the origin of this kind of hip pain. The possibility of hip osteoarthritis should not be underestimated, as this could lead to an incorrect diagnosis and inappropriate spinal surgery. We report the case of a 54-year-old female with chronic right anterior and lateral leg pain who did not respond to repeated spinal blocks based on lumbar MRI, but in whom hip osteoarthritis was considered since severe atrophy of the ipsilateral psoas muscle was identified. We suggest that severe psoas muscle atrophy can be a clinical clue to identify hip osteoarthritis and is related to lower extremity pain, even if there is a coexisting lumbar spine pathology.

scholarly journals Evolutive particularities in Diffuse Idiopathic Skeletal Hyperostosis associated with Spinal Stenosis – case report

2016 ◽  
Vol 22 (1) ◽  
pp. 30-36
Author(s):  
Andreea Lupu ◽  
Sandica Albina ◽  
Ramona Balta ◽  
Alina Lupsa ◽  
Madalina Iliescu
Keyword(s):  
Case Report ◽  
Lumbar Spine ◽  
Spinal Stenosis ◽  
Thoracic Spine ◽  
Diffuse Idiopathic Skeletal Hyperostosis ◽  
Correct Diagnosis ◽  
Clinical Manifestations ◽  
Spine Pathology ◽  
Spinal Ligaments ◽  
Lumbar Spinal

Abstract Diffuse idiopathic skeletal hyperostosis is a non-inflammatory disease, that affects mostly males and the principal manifestations are calcification and ossification of spinal ligaments, calcification of the tendons and ligaments in the vertebral body insertion. Clinical manifestations of the disease are mainly in the thoracic spine, but it may involve also the cervical and the lumbar spine. Extraspinal involvements are frequently present at patients with diffuse idiopathic skeletal hyperostosis. Spinal stenosis is associated with this disease. The present case is of a 56 years old man, initially diagnosed with Ankyloses spondylitis, who was under a treatment with Sulfasalazin for approximately 7 years, afterwards the diagnosis was infirmed and he was diagnosed with “Diffuse idiopathic skeletal hyperostosis”. The patient has multiple extra spinal manifestations of the disease (shoulders, elbows, hips, knees), cervical and lumbar spinal stenosis with clinical manifestations and imagistic confirmation, and also treated in neurosurgical service for several times, for the lumbar spine pathology. Particularities of this case are related with the delay of a correct diagnosis which means that the anterior treatments, both medical and surgical are under the questions.

scholarly journals Do Orthopedic Surgeons or Neurosurgeons Detect More Hip Disorders in Patients with Hip-Spine Syndrome? A Nationwide Database Study

2021 ◽  
Vol 11 (4) ◽  
pp. 485
Author(s):  
Tsung-Cheng Yin ◽  
Adam M. Wegner ◽  
Meng-Ling Lu ◽  
Yao-Hsu Yang ◽  
Yao-Chin Wang ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Spine Surgery ◽  
Hip Surgery ◽  
Lumbar Spine Surgery ◽  
Research Database ◽  
X Rays ◽  
Replacement Surgery ◽  
Orthopedic Surgeons ◽  
Spine Pathology ◽  
Sh Group

Background: Disorders of the hip and lumbar spine can create similar patterns of pain and dysfunction. It is unknown whether all surgeons, regardless of orthopedic or neurosurgery training, investigate and diagnose concurrent hip and spine pathology at the same rate. Methods: Data were retrieved from Taiwan’s National Health Insurance Research Database (NHIRD). Enrolled patients were stratified into hip and spine surgery at the same admission (Both), hip surgery before spine surgery (HS), or spine surgery before hip surgery (SH). The SH group was further subdivided based on whether spine surgery was performed by an orthopedic surgeon (OS) or neurosurgeon (NS), and differences in preoperative radiographic examinations and diagnoses were collected and analyzed. Results: In total, 1824 patients received lumbar spine surgery within 1 year before or after hip replacement surgery. Of these, 103 patients had spine and hip surgery in the same admission (Both), 1290 patients had spine surgery before hip surgery (SH), and 431 patients had hip surgery before spine surgery (HS). In the SH group, patients were categorized into spine surgery by orthopedic surgeons (OS) (n = 679) or neurosurgeons (NS) (n = 522). In the SH group, orthopedic surgeons investigated hip pathology with X-rays more often (52.6% vs. 38.1%, p < 0.001) and diagnosed more cases of hip disease (43.6% vs. 28.9%, p < 0.001) than neurosurgeons. Conclusions: Of patients in Taiwan’s NHIRD who had concurrent surgical degenerative hip and lumbar spine disorders who had spine surgery before hip surgery, orthopedic surgeons obtained hip images and made hip-related diagnoses more frequently than did neurosurgeons.

Gait analysis in the elderly patients with lumbar spinal stenosis

2021 ◽  
Vol 45 (3) ◽  
pp. 673-679
Author(s):  
Yong-Gang Li ◽  
Li-Ping Li ◽  
Zhen-Jiang Li ◽  
Hui Li ◽  
Yuan Li ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Gait Analysis ◽  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
The Elderly ◽  
Lumbar Spinal

scholarly journals Patient Screening by a Physical Therapist for Nonmusculoskeletal Hip Pain

2009 ◽  
Vol 89 (3) ◽  
pp. 248-256 ◽  
Author(s):  
William R VanWye
Keyword(s):  
Lumbar Spine ◽  
Physical Therapists ◽  
Physical Therapist ◽  
Hip Osteoarthritis ◽  
Care Physician ◽  
Hip Pain ◽  
Screening Tools ◽  
Positive Sign ◽  
Diagnostic Challenge ◽  
Trochanteric Bursitis

Background and Purpose Mechanical hip pain and disease-based hip pain can have similar signs and symptoms, thereby presenting a differential diagnostic challenge for clinicians. Hip pain is a common complaint addressed by physical therapists; therefore, it would be advantageous for them to be knowledgeable about differential diagnosis for hip pain, so that they can screen for possible serious conditions outside the realm of physical therapist practice and make the appropriate referral. Case Description A 77-year-old man was referred for physical therapy by his primary care physician (PCP) with diagnoses of lumbar spine and left hip osteoarthritis and possible trochanteric bursitis. After the examination, the physical therapist determined that the patient should return to his PCP for further testing. Findings leading to this conclusion were pain severity out of proportion to the reported injury, the presence of night pain, a positive “sign of the buttock,” and empty end feels of all hip joint motions, which represented a noncapsular pattern of joint restriction. Outcomes The patient was diagnosed later with primary lung adenocarcinoma with widespread metastases. A computerized tomography scan of the left hip revealed a metastatic lesion at the left proximal femur. Discussion Physical therapists’ ability to adequately screen for conditions requiring examination by a physician can lead to a more timely diagnosis of serious medical conditions. Investigators have found published descriptions of end feels, capsular versus noncapsular patterns of restriction, and the sign of the buttock to be beneficial screening tools for use in people with hip, pelvis, or lumbar spine pain.

Psoas Muscle Architectural Design, In Vivo Sarcomere Length Range, and Passive Tensile Properties Support Its Role as a Lumbar Spine Stabilizer

Spine ◽  
2011 ◽  
Vol 36 (26) ◽  
pp. E1666-E1674 ◽  
Author(s):  
Gilad J. Regev ◽  
Choll W. Kim ◽  
Akihito Tomiya ◽  
Yu Po Lee ◽  
Hossein Ghofrani ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Tensile Properties ◽  
Architectural Design ◽  
Sarcomere Length ◽  
Psoas Muscle ◽  
Length Range

Lumbar Spine Surgery in the Elderly

Spine ◽  
1994 ◽  
Vol 19 (13) ◽  
pp. 1431-1435 ◽  
Author(s):  
Bo Jönsson ◽  
Björn Strömqvist
Keyword(s):  
Lumbar Spine ◽  
Spine Surgery ◽  
The Elderly ◽  
Lumbar Spine Surgery ◽  
Surgery In The Elderly

Minimally Invasive versus Open Thoracolumbar Surgery for Lumbar Spinal Stenosis in Patients with Diabetes: A CSORN Study

2021 ◽  
pp. 13
Author(s):  
Kalpesh Hathi
Keyword(s):  
Back Pain ◽  
Minimally Invasive ◽  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Research Network ◽  
Leg Pain ◽  
Number Of Patients ◽  
Patients With Diabetes ◽  
One Year ◽  
Lumbar Spinal

Introduction: This study was aimed at comparing outcomes of minimally invasive (MIS) versus OPEN surgery for lumbar spinal stenosis (LSS) in patients with diabetes. Methodology: This retrospective cohort study included patients with diabetes who underwent spinal decompression alone or with fusion for LSS within the Canadian Spine Outcomes and Research Network (CSORN) database. Outcomes of MIS and OPEN approaches were compared for two cohorts: (i) patients with diabetes who underwent decompression alone (N = 116; MIS, n = 58, OPEN, n = 58) and (ii) patients with diabetes who underwent decompression with fusion (N = 108; MIS, n = 54, OPEN, n = 54). Mixed measures analyses of covariance compared modified Oswestry Disability Index (mODI) and back and leg pain at one-year post operation. The number of patients meeting minimum clinically important difference (MCID) or minimum pain/disability at one year were compared. Result: MIS approaches had less blood loss (decompression alone difference 99.66 mL, p = 0.002; with fusion difference 244.23, p < 0.001) and shorter LOS (decompression alone difference 1.15 days, p = 0.008; with fusion difference 1.23 days, p = 0.026). MIS compared to OPEN decompression with fusion had less patients experience an adverse event (difference, 13 patients, p = 0.007). The MIS decompression with fusion group had lower one-year mODI (difference, 14.25, p < 0.001) and back pain (difference, 1.64, p = 0.002) compared to OPEN. More patients in the MIS decompression with fusion group exceeded MCID at one year for mODI (MIS 75.9% vs OPEN 53.7%, p = 0.028) and back pain (MIS 85.2% vs OPEN 70.4%, p = 0.017). Conclusion: MIS approaches were associated with more favorable outcomes for patients with diabetes undergoing decompression with fusion for LSS.

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