Unusual cause of acute low-back pain: sudden annulus fibrosus rupture

Low-back pain is a common problem in neurosurgery practice, and an algorithm has been developed for assessing these cases. However, one subgroup of these patients shares several clinical features and these individuals are not easy to categorize and diagnose. We present our observations for 8 of these patients, individuals with low-back pain caused by atypical annulus fibrosus rupture (AAR). The aim of this study is to show the consequences of overlooked annular tears on acute onset of low back pain. Eight patients with acute-onset severe low-back pain were admitted. Physical examinations were normal and each individual was examined neurologically and assessed with neuroradiologic studies [plain x-rays, magnetic resonance imaging (MRI), discography and computed tomography (CT) discography]. AAR was ultimately diagnosed with provocative discography. In all cases, MRI showed a healthy disc or mild degeneration, whereas discography and CT discography demonstrated disc disease. Anterior interbody cage implantation was performed in 3 of the 8 cases and posterior dynamic stabilization was carried out in 3 cases. The other 2 individuals refused surgery, and we were informed that one of them developed disc herniation at the affected level 1 year after our diagnosis. Clinical and radiological outcomes were evaluated. In cases where AAR is suspected, MRI, discography, and CT discography should be performed in addition to routine neuroradiologic studies.

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ACUTE LOW BACK PAIN

The Professional Medical Journal ◽

10.29309/tpmj/2016.23.04.1518 ◽

2016 ◽

Vol 23 (04) ◽

pp. 484-488

Author(s):

Muhammad Imran Hameed Daula ◽

Saima Amin ◽

Asma Bano

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Spina Bifida ◽

Young Patients ◽

Lumbosacral Spine ◽

Low Back ◽

X Rays ◽

Acute Low Back Pain ◽

Transitional Vertebra ◽

Lumbosacral Transitional Vertebra

Objectives: X ray of the lumbosacral spine is widely used in our clinical settingearly on in the management of patients presenting with nonspecific acute low back pain. Thispractice is in contradiction to the clinical practice guidelines however patient satisfaction isusually the main motive declared by clinicians following this practice. This study was conductedto detect the radiologic prevalence of the most commonly diagnosed congenital anomaliesin lumbosacral spine X rays done for patients presenting with nonspecific acute low backpain. Study Design & Setting: Prospective descriptive study at Shalamar Hospital Lahore,Pakistan. Duration of Study: Six months from September 2014 to February 2015. Subjectsand Methods: Radiographs of 400 patients presenting with non-specific acute low back painand fulfilling the inclusion / exclusion criteria were examined. Data was analyzed on SPSSversion 13 and percentage and frequency of patients with non-specific acute low back painwith lumbosacral transitional vertebra (LSTV), spina bifida and spondylolysis was calculated.Results: Out of 400 patients 185 were males and 215 were females. Age of the patients rangedfrom 15 to 36 years with mean age of 28 (SD ±4.84). 145 patients (36.25%) were found to havecongenital anomalies of lumbosacral vertebrae in question. The prevalence of LSTV was 19.5%(78 patients), spina bifida was 10% (40 patients) and spondylolysis was 9% (36 patients). 2%(9 patients) had more than one anomaly. Conclusions: This study shows a higher prevalenceof lumbosacral transitional vertebra (LSTV) and spondylolysis in Pakistani patients presentingwith non-specific acute low backache, compared to that quoted in literature. This arguably mayconstitute a convincing argument in favor of obtaining lumbosacral spine X-rays early on in themanagement of young patients presenting with non-specific acute low backache.

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MRIs Done for Acute Low Back Pain Rarely Show New Changes

Rheumatology News ◽

10.1016/s1541-9800(06)71574-5 ◽

2006 ◽

Vol 5 (12) ◽

pp. 33

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Low Back ◽

Acute Low Back Pain

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Acute low back pain: Diagnostics and treatment

Clinical Excellence for Nurse Practitioners ◽

10.1054/xc.2001.19730 ◽

2001 ◽

Vol 5 (2) ◽

pp. 80-84 ◽

Cited By ~ 1

Author(s):

Faith Coleman Becker

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Low Back ◽

Acute Low Back Pain

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Practitioner Self-confidence and Patient Outcomes in Acute Low Back Pain

Archives of Family Medicine ◽

10.1001/archfami.7.3.223 ◽

1998 ◽

Vol 7 (3) ◽

pp. 223-228 ◽

Cited By ~ 20

Author(s):

D. R. Smucker

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Patient Outcomes ◽

Low Back ◽

Acute Low Back Pain ◽

Self Confidence

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Low Back Pain in Commercial Airline Pilots

Aerospace Medicine and Human Performance ◽

10.3357/amhp.5656.2020 ◽

2020 ◽

Vol 91 (12) ◽

pp. 940-947

Author(s):

Matthias Albermann ◽

Maria Lehmann ◽

Christian Eiche ◽

Joachim Schmidt ◽

Johannes Prottengeier

Keyword(s):

Risk Factors ◽

Low Back Pain ◽

Back Pain ◽

Online Survey ◽

German Population ◽

Low Back ◽

Airline Pilots ◽

Acute Low Back Pain ◽

Commercial Airline ◽

Negative Effect

BACKGROUND: In their working life, airline pilots are exposed to particular risk factors that promote nonspecific low back pain (LBP). Because of the varying incidence internationally, we evaluated the point prevalences of acute, subacute, and chronic nonspecific LBP, as well as the current prevalences in German airline pilots. Furthermore, we compared the prevalence to the general German population and to European counterparts.METHODS: An anonymous online survey of 698 participating German airline pilots was evaluated. The impairment between groups was analyzed. Prevalences from our data were compared to existing data.RESULTS: The following point prevalences were found: 8.2% acute, 2.4% subacute, 82.7% chronic LBP; 74.1% of all individuals were suffering from current LBP when answered the questionnaire. A total time spent flying greater than 600 h within the last 12 mo was significantly related to acute nonspecific LBP. Individuals with any type of LBP were significantly impaired compared to those unaffected. It was found that German airline pilots suffer more often from current LBP than the general population and have a higher point prevalence of total LBP than their European counterparts.CONCLUSIONS: The evaluation showed a surprisingly high, previously unidentified, prevalence of nonspecific LBP in German airline pilots. Why German airline pilots suffer more often from LBP remains uncertain. The number of flying hours appears to have a negative effect on developing acute low back pain, but causation cannot be concluded. Other risk factors could not be confirmed.Albermann M, Lehmann M, Eiche C, Schmidt J, Prottengeier J. Low back pain in commercial airline pilots. Aerosp Med Hum Perform. 2020; 91(12):940947.

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