Weight-Bearing MRI of the Lumbosacral Spine: Difference between Supine and Weight Bearing Positions and Additional Value in Patients with Low Back Pain

2020 ◽  
Vol 103 (10) ◽  
pp. 1057-1065
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Supine Position ◽  
Nerve Root ◽  
Weight Bearing ◽  
Lumbosacral Spine ◽  
Low Back ◽  
Nerve Root Compression ◽  
Significant Change ◽  
Additional Value

Objective: To study the difference of magnetic resonance imaging (MRI) parameters of the lumbosacral spine between weight-bearing and supine positions, and evaluate whether there is additional value in patients with low back pain. Materials and Methods: Eight-six patients with low back pain with or without leg pain who underwent MRI of the lumbosacral spine in weight-bearing and supine positions were included in the present retrospective study. The patients’ characteristics and MRI parameters were measured. The data were analyzed to find significant differences between these two positions. Results: MRI parameters which significantly increased in weight-bearing position compared to supine position (p<0.05) included lumbar lordotic angle, lumbosacral angle, presence of spondylolisthesis (at L4/L5 level), and presence of nerve root compression (at L3/L4, L4/L5, and L5/S1 levels). Parameters or findings that significantly decreased were spinal canal diameter (at L2/L3, L4/L5, and L5/S1 levels), and intervertebral disk height (at L2/L3, L4/L5, and L5/S1 levels). Older age group (mean age of 54.3 years versus 45.6 years as younger group) showed a significant change in number of nerve root compression. Forty-three percent of patients with radiating symptom showed a changed number of nerve root compression but this was not statistically significant. Conclusion: Multiple MRI parameters of the lumbosacral spine show significant change in weight-bearing compared to supine position. Increased presence of spondylolisthesis and nerve root compression might be beneficial in patients with radiating symptom unexplained by conventional MR studies in supine position. Older age group showed a significant change in number of nerve root compression. Keywords: Weight-bearing, MRI, Lumbar spine, Back pain

scholarly journals Oxygen-Ozone Therapy for Herniated Lumbar Disc in Patients with Subacute Partial Motor Weakness Due to Nerve Root Compression

2014 ◽  
Vol 20 (5) ◽  
pp. 547-554 ◽  
Author(s):  
Massimo Dall'Olio ◽  
Ciro Princiotta ◽  
Luigi Cirillo ◽  
Caterina Budai ◽  
Fabio de Santis ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Nerve Root ◽  
Lumbar Disc ◽  
Herniated Disc ◽  
Low Back ◽  
Nerve Root Compression ◽  
Disc Disease ◽  
Motor Weakness ◽  
Anti Inflammatory

Intradiscal oxygen-ozone (O2-O3) chemonucleolysis is a well-known effective treatment for pain caused by protruding disc disease and nerve root compression due to bulging or herniated disc. The most widely used therapeutic combination is intradiscal injection of an O2-O3 mixture (chemonucleolysis), followed by periradicular injection of O2-O3, steroid and local anaesthetic to enhance the anti-inflammatory and analgesic effect. The treatment is designed to resolve pain and is administered to patients without motor weakness, whereas patients with acute paralysis caused by nerve root compression undergo surgery 24–48h after the onset of neurological deficit. This paper reports on the efficacy of O2-O3 chemonucleolysis associated with anti-inflammatory foraminal injection in 13 patients with low back pain and cruralgia, low back pain and sciatica and subacute partial motor weakness caused by nerve root compression unresponsive to medical treatment. All patients were managed in conjunction with our colleagues in the Neurosurgery Unit of Bellaria Hospital and the IRCCS Institute of Neurological Sciences, Bologna. The outcomes obtained are promising: 100% patients had a resolution of motor weakness, while 84.6% had complete pain relief. Our results demonstrate that O2-O3 therapy can be considered a valid treatment option for this category of patients.

scholarly journals MRI Findings of Non-Degenerative Pathoanatomical Changes in Low Back Pain

2016 ◽  
Vol 12 (2) ◽  
pp. 59-62 ◽  
Author(s):  
Dan B Karki ◽  
Om B Panta ◽  
Ghanshyam Gurung
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Multimodality Imaging ◽  
Compression Fracture ◽  
Degenerative Changes ◽  
Lumbosacral Spine ◽  
Low Back ◽  
Neoplastic Lesion ◽  
Lower Lumbar ◽  
Meningeal Cysts

Non-degenerative pathoanatomical changes are far less common than degenerative changes but benefi ts most from imaging assessment. This study aimed to evaluate the non-degenerative pathoanatomical changes in patients undergoing MRI for low back pain.The study was a retrospective study conducted for the duration of 3 years in a multimodality-imaging center. All patients undergoing MRI of lumbosacral spine with complains of low back pain with or without radiculopathy were assessed for morphological changes and other abnormal fi ndings. After excluding patients with degenerative changes, non-degenerative pathologies were evaluated. Data was entered in predesigned proforma and analysis was done with SPSS 21.0.There were 183 patients who met the inclusion criteria and were included in the study. The mean age of the patients was 51.23 ±16.86 years. Compression fracture of the vertebra was the most common non-degenerative changes accounting for 34% cases followed by spinal meningeal cysts (26%) and infection (14%). Fractures were more common in upper lumbar level as compared to lower lumbar levels. Meningeal cysts were noted to involve the sacral spinal canal more frequently followed by lower lumbar levels. Infective lesions were equally distributed throughout the lumbar spine. Hemangioma was common lesion involving 16% of cases. Lumbosacral transitional vertebra was seen in 7(3.8%) patients.The common non-degenerative pathoanatomical changes associated with low back pain were traumatic lesion, infection, neoplastic lesion and lumbosacral transitional vertebra.Nepal Journal of Neuroscience 12:59-62, 2015

scholarly journals Treatment of degenerative chronic low back pain with fluoroscopically guided epidural procaine-corticosteroid injection

2008 ◽  
Vol 65 (7) ◽  
pp. 507-511 ◽  
Author(s):  
Slobodan Culafic ◽  
Dara Stefanovic ◽  
Dragan Dulovic ◽  
Ljubodrag Minic ◽  
Andrijana Culafic
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Conservative Therapy ◽  
Corticosteroid Injection ◽  
Pain Reduction ◽  
Lumbosacral Spine ◽  
Low Back ◽  
Military Medical Academy ◽  
Reduction Of Pain

Background/Aim. Low back pain is one of the most common painful conditions in the modern age. Therefore, it is very important to establish the most effective protocol for the treatment of this condition. The aim of this study was to find out if fluoroscopically, guided epidural procainecorticosteroid injection is effective in the treatment of degenerative chronic low back pain. Methods. This prospective cohort study was performed in the Military Medical Academy from September 2005 to June 2006 and included 60 patients of both sexes, 34-85 years of age. Degenerative changes of lumbosacral spine were determined by magnetic resonance imaging. The intensity of low back pain was evaluated by subjective (Roland's scale) and objective parameter (Lazarevic sign). Epidural procaine-corticosteroid injection was applied in the patients with low back pain not responding to conservative therapy. After the application of injection, effects of the therapy were followed up. Results. In 92% of the patients there was a reduction of pain intensity for three months, in 4.8% a reduction for a month, but after another injection they felt pain reduction for the next three months. One patient (2.3%) had pain reduction for one month. Conclusion. In the treatment of degenerative chronic low back pain, not responding to conservative therapy with nonsteroidal anti-inflammatory drugs, epidural procaine-corticosteroid injection have a satisfactory short-term as well as a long-term analgesic effect.

scholarly journals Spectrum and Prevalence of degenerative changes seen on Mri of Lumbosacral Spine in Patients with Low Back Pain

2017 ◽  
Vol 16 (01) ◽  
pp. 41-47
Author(s):  
Dr. Sai Sudha Angam ◽  
Dr. Nadeem Ahmed ◽  
Dr. Sreedevi Thakkallapelli ◽  
Dr.Swapna Chouhan ◽  
Dr. Madhavilatha Routhu ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Degenerative Changes ◽  
Lumbosacral Spine ◽  
Low Back

scholarly journals Gluteus medius muscle function in people with and without low back pain: a systematic review

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Sean Sadler ◽  
Samuel Cassidy ◽  
Benjamin Peterson ◽  
Martin Spink ◽  
Vivienne Chuter
Keyword(s):  
Systematic Review ◽  
Low Back Pain ◽  
Back Pain ◽  
Muscle Function ◽  
Weight Bearing ◽  
Gluteus Medius ◽  
Measurement Tool ◽  
Low Back ◽  
Case Control Studies ◽  
Gluteus Medius Muscle

Abstract Introduction Globally, low back pain (LBP) is one of the greatest causes of disability. In people with LBP, dysfunction of muscles such as the gluteus medius have been demonstrated to increase spinal loading and reduce spinal stability. Differences in gluteus medius function have been reported in those with LBP compared to those without, although this has only been reported in individual studies. The aim of this systematic review was to determine if adults with a history, or current LBP, demonstrate differences in measures of gluteus medius function when compared to adults without LBP. Methods MEDLINE, EMBASE, AMED, PsycINFO, PubMED, Pro Quest Database, CINAHL and SPORTDiscus were searched from inception until December 2018 for published journal articles and conference abstracts. No language restrictions were applied. Only case-control studies with participants 18 years and over were included. Participants could have had any type and duration of LBP. Studies could have assessed gluteus medius function with any quantifiable clinical assessment or measurement tool, with the participant non-weight bearing or weight bearing, and during static or dynamic activity. Quality appraisal and data extraction were independently performed by two authors. Results The 24 included articles involved 1088 participants with LBP and 998 without LBP. The gluteus medius muscle in participants with LBP tended to demonstrate reduced strength and more trigger points compared to the gluteus medius muscle of those without LBP. The level of activity, fatigability, time to activate, time to peak activation, cross sectional area, and muscle thickness showed unclear results. Meta-analysis was not performed due to the heterogeneity of included studies. Conclusion Clinically, the findings from this systematic review should be considered when assessing and managing patients with LBP. Future studies that clearly define the type and duration of LBP, and prospectively assess gluteus medius muscle function in those with and without LBP are needed. Trial registration PROSPERO (CRD42017076773).

Side-to-side weight-bearing asymmetry in subjects with low back pain

2003 ◽  
Vol 8 (3) ◽  
pp. 166-169 ◽  
Author(s):  
J D. Childs ◽  
S R. Piva ◽  
R E. Erhard ◽  
G Hicks
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Weight Bearing ◽  
Low Back
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