Evaluation and Comparison of the Effectiveness of Rehabilitation Procedures in the Area of ​Pain in the Lumbosacral Spine Performed in Sanatoria and Outpatient Conditions

2019 ◽  
Vol 21 (4) ◽  
pp. 279-288
Author(s):  
Jakub Szewczyk ◽  
Katarzyna Polińska-Szewczyk ◽  
Wiesław Tomaszewski
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Thermal Imaging ◽  
Young Patients ◽  
Lumbosacral Spine ◽  
Low Back ◽  
Pain Sensation ◽  
Spine Pain ◽  
High Prevalence ◽  
Imaging Camera

Background. Low back pain is among the most frequent conditions of nowadays and due to its high prevalence, it is defined as a social and civilization-related disease.Today, increasingly young patients present with this condition affecting about 80% of the population. In Poland, 70% of the population complain of back pain and the prevalence rate increases with age. The treatment includes application of various procedures, both in outpatient conditions and in sanatoria. The aim of the study was to compare the effects of sanatorium treatment with those of outpatient treatment. Material and methods. 240 patients with low back pain participated in the study. The sample was divided into two groups: 120 pa­tients undergoing treated in outpatient conditions and next, 120 patients undergoing sanatorium treatment. The research was based on survey in a form of a questionnaire, selected mobility tests and assessment of pain using thermal imaging camera and an algometer. Results. The patients undergoing rehabilitation procedures in a sanatorium obtain improvement in terms of pain sensation (5.39 points in VAS scale) as compared with the patients undergoing rehabilitation in outpatient conditions (4.13 points in VAS scale) ; their results also indicate improvement in low back mobility (the obtained values, however, turned out statistically insignificant). Better results can be obtained by combining conventional rehabilitation with the approaches applied in sanatorium treatment, as confirmed by the assessment of each group of patients. Conclusions. 1. Rehabilitation of patients with lumbar spine pain conditions conducted in spa conditions is a more effective treat­ment method than in an outpatient clinic and should be used universally. 2. Research is indicated to determine the effect of rest in a sanatorium (the ambience) involving low back pain relief.

Central sensitization in chronic lumbar spine pain – pathophysiology and diagnostics

Ból ◽  
2020 ◽  
Vol 21 (1) ◽  
pp. 1-9
Author(s):  
Barabara Kosińska ◽  
Paweł Turczyn ◽  
Krzysztof Wesołowski ◽  
Beata Tarnacka ◽  
Małgorzata Malec-Milewska
Keyword(s):  
Chronic Pain ◽  
Low Back Pain ◽  
Back Pain ◽  
Central Sensitization ◽  
Clinical Problem ◽  
Low Back ◽  
Spine Pain ◽  
High Prevalence ◽  
Pain Symptoms ◽  
Patients Experience

Chronic low back pain is a substantial clinical problem because of its high prevalence, incidence, complex and heterogeneous symptomatology. The majority of patients experience nociceptive pain only, but in almost 40% of patients neuropathic component may be present. In many patients with low back pain symptoms associated with central sensitization may be present as well and therefore their pain can be classified as nocyplastic. (functional) This paper describes how clinicians can differentiate these types of pain, taking into account that in a given patient several mechanisms may contribute to chronic pain development, and pain results from complex mechanisms. In the second part, therapeutic options are presented for people with symptoms of central sensitization, with emphasis on non-pharmacological methods.

scholarly journals ACUTE LOW BACK PAIN

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.

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 Effect of age on outcomes after allogeneic disc tissue supplementation in patients with chronic discogenic low back pain in the VAST trial

2021 ◽  
Author(s):  
Corey W Hunter ◽  
Richard Guyer ◽  
Mark Froimson ◽  
Michael J DePalma
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Controlled Trial ◽  
Young Patients ◽  
Functional Improvement ◽  
Low Back ◽  
Disc Tissue ◽  
Discogenic Low Back Pain ◽  
Post Hoc ◽  
Significant Functional Improvement

Aim: To explore the effects of viable allogeneic disc tissue supplementation in younger patients with discogenic chronic low back pain (CLBP). Patients & methods: VAST was a randomized placebo-controlled trial of disc allograft supplementation in 218 patients with discogenic CLBP. We conducted a post hoc analysis of change from baseline to 12 months in Oswestry Disability Index (ODI) and visual analog scale for pain intensity scores stratified by patient age. Results: Patients aged <42 years receiving allograft experienced greater improvement in ODI (p = 0.042) and a higher ODI response rate (≥10-, ≥15- and ≥20-point reductions in ODI) than those receiving saline (p = 0.001, p = 0.002 and p = 0.021, respectively). Conclusion: Young patients with discogenic CLBP may have significant functional improvement following nonsurgical disc allograft supplementation.

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

Automated detection of sacroiliitis on plain radiograph using EfficientDet algorithm in young patients with back pain: a pilot study

2021 ◽  
Author(s):  
Sung Hyun Noh ◽  
Chansik An ◽  
Dain Kim ◽  
Seung Hyun Lee ◽  
Min-Yung Chang ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Deep Learning ◽  
Back Pain ◽  
Object Detection ◽  
Sacroiliac Joint ◽  
Plain Radiograph ◽  
Young Patients ◽  
Training Dataset ◽  
Detection Accuracy ◽  
Low Back

Abstract Background A computer algorithm that automatically detects sacroiliac joint abnormalities on plain radiograph would help radiologists avoid missing sacroiliitis. This study aimed to develop and validate a deep learning model to detect and diagnose sacroiliitis on plain radiograph in young patients with low back pain. Methods This Institutional Review Board-approved retrospective study included 478 and 468 plain radiographs from 241 and 433 young (< 40 years) patients who complained of low back pain with and without ankylosing spondylitis, respectively. They were randomly split into training and test datasets with a ratio of 8:2. Radiologists reviewed the images and labeled the coordinates of a bounding box and determined the presence or absence of sacroiliitis for each sacroiliac joint. We fine-tined and optimized the EfficientDet-D4 object detection model pre-trained on the COCO 2107 dataset on the training dataset and validated the final model on the test dataset. Results The mean average precision, an evaluation metric for object detection accuracy, was 0.918 at 0.5 intersection over union. In the diagnosis of sacroiliitis, the area under the curve, sensitivity, specificity, accuracy, and F1-score were 0.932 (95% confidence interval, 0.903–0.961), 96.9% (92.9–99.0), 86.8% (81.5–90.9), 91.1% (87.7–93.7), and 90.2% (85.0–93.9), respectively. Conclusions The EfficientDet, a deep learning-based object detection algorithm, could be used to automatically diagnose sacroiliitis on plain radiograph.

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