Lumbar Spine
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2021 ◽  
Vol 2021 ◽  
pp. 1-5
Yohei Yanagisawa ◽  
Yusuke Eda ◽  
Shotaro Teruya ◽  
Hisanori Gamada ◽  
Masashi Yamazaki

Introduction. Sacroiliac rod fixation (SIRF) preserves the mobility of L5/S1 (lumber in the pelvis), as a surgical procedure for high-energy pelvic ring fractures. The concept of SIRF method without pedicle screws into L4 and L5 is called ‘within ring’ concept. Case Presentation. We report here the clinical results of ‘within ring’ concept treatment with sacroiliac rod fixation for a case of displaced H-shaped Rommens and Hofmann classification type IVb fragility fractures of the pelvis (FFP), which A 79-year-old woman had been difficult to walk due to pain that had been prolonged for more than one month since her injury. The patient was successfully treated with SIRF, no pain waking with a walking stick and returned to most social activities including living independently within 6 months of the operation. Conclusion. SIRF is useful because it can preserve the mobility in the lumbar pelvis; not including the lumbar spine in the fixation range like spino pelvic fixation is a simple, safe, and low-invasive internal fixation method for displaced H-shaped type IVb fragility fractures of the pelvis.

Sevtap Arslan ◽  
Mehmet Ruhi Onur ◽  
Yasin Sarıkaya ◽  
H. Nursun Özcan ◽  
Mithat Haliloğlu ◽  

2021 ◽  
Vol 11 (1) ◽  
C. Maurer-Grubinger ◽  
J. Haenel ◽  
L. Fraeulin ◽  
F. Holzgreve ◽  
E. M. Wanke ◽  

AbstractMusculoskeletal disorders of the trunk and neck are common among cleaners. Vacuum cleaning is a demanding activity. The aim of this study was to present the movement profile of the trunk and neck during habitual vacuuming. The data were collected from 31 subjects (21f./10 m) using a 3D motion analysis system (Xsens). 10 cycles were analysed in vacuuming PVC and carpet floors with 8 vacuum cleaners. The joint angles and velocities were represented statistically descriptive. When vacuuming, the trunk is held in a forwardly inclined position by a flexion in the hip and rotated from this position. In the joint angles and velocities of the spine, the rotation proved to be dominant. A relatively large amount of movement took place in the cervical spine and also in the lumbar spine. The shown movement profile is rather a comfort area of vacuuming which may serve as a reference for ergonomics in vacuuming.

Healthcare ◽  
2021 ◽  
Vol 9 (10) ◽  
pp. 1370
Chan-Hee Park ◽  
Eunhee Park ◽  
Tae-Du Jung

Background: Typical cauda equina syndrome (CES) presents as low back pain, bilateral leg pain with motor and sensory deficits, genitourinary dysfunction, saddle anesthesia and fecal incontinence. In addition, it is a neurosurgical emergency, which is essential to diagnose as soon as possible, and needs prompt intervention. However, unilateral CES is rare. Here, we report a unique case of a patient who had unilateral symptoms of CES due to cancer metastasis and was diagnosed through electromyography. Methods: A 71-year-old man with diffuse large B cell lymphoma (DLBCL) suffered from severe pain, motor weakness in the right lower limb and urinary incontinence, and hemi-saddle anesthesia. It was easy to be confused with lumbar radiculopathy due to the unilateral symptoms. Lumbar spine magnetic resonance imaging (MRI) showed suspected multifocal bone metastasis in the TL spine, including T11-L5, the bilateral sacrum and iliac bones, and suspected epidural metastasis at L4/5, L5/S1 and the sacrum. PET CT conducted after the third R-CHOP showed residual hypermetabolic lesions in L5, the sacrum, and the right presacral area. Results: Nerve conduction studies (NCS) revealed peripheral neuropathy in both hands and feet. Electromyography (EMG) presented abnormal results indicating development of muscle membrane instability following neural injury, not only on the right symptomatic side, but also on the other side which was considered intact. Overall, he was diagnosed with cauda equina syndrome caused by DLBCL metastasis, and referred to neurosurgical department. Conclusions: Early diagnosis of unilateral CES may go unnoticed due to its unilateral symptoms. Failure to perform the intervention at the proper time can impede recovery and leave permanent complications. Therefore, physicians need to know not only the typical CES, but also the clinical features of atypical CES when encountering a patient, and further evaluation such as electrodiagnostic study or lumbar spine MRI have to be considered.

Kevin Phan ◽  
Alexander Nazareth ◽  
Awais K. Hussain ◽  
Adam A. Dmytriw ◽  
Mithun Nambiar ◽  

2021 ◽  
Chunli Yang ◽  
Chunxi Fu ◽  
Huawei Weng ◽  
Liqun Zou

Abstract Background Glucocorticoids-containing regimens are the standard first line treatment for most lymphoma patients, however, as the improvement of overall survival in these cases, glucocorticoids related osteopenia or osteoporosis attracted attention in clinical administration. We aim to investigate the efficacy of bisphosphonates in prevention bone mineral loss in glucocorticoids-treated lymphoma patients. Methods This is a prospective, randomized controlled phase 3 trial. Eligible lymphoma adults from China with first line glucocorticoids involved treatment, were randomly assigned 1:1 to receive either Zoledronic acid (ZA) for twice infusion or not. All patients received daily oral calcium and vitamin D3 for one year. The primary endpoint, alternations of bone mineral loss from enrollment to the twelfth month at the lumbar spine (L1-L4), left hip and left femoral neck, measured by the dual-energy, x-ray absorptiometry scanners, recorded as T score; and new bone fractures during the first year, were analyzed by intent-to-treat. This trial was registered with, number ChiCTR-INR-17010771. Results Between May, 2016 to July, 2019, 84 patients were randomly assigned to both Zoledronic acid and control groups, 29 patients completed the study and were on follow-up. We found a marked improvement of T score in ZA group compared with the control in a year at lumbar spine, T score changes of L1-4 in ZA group and control group were as following: L1, 0.14±0.61 vs. -0.33±0.40, p=0.009; L2, 0.28±0.41 vs. -0.35±0.54, p=0.003; L3, 0.23±0.42 vs. -0.23±0.66, p=0.020; L4, 0.28±0.44 vs. -0.35±0.54, p=0.020. Meanwhile, no severe adverse event was observed on both groups. Conclusions Glucocorticoids-treatment lymphoma patients that prophylactic ZA infusion could relieve BMD loss to prevent osteoporosis without increasing severe adverse effects in Chinese population, providing reference for clinicians to consider ZA application in this situation.

OrthoMedia ◽  
2021 ◽  

2021 ◽  
Vol 12 ◽  
Su-qin Shi ◽  
Shan-shan Li ◽  
Xiao-ya Zhang ◽  
Zhe Wei ◽  
Wen-zhen Fu ◽  

ObjectiveThe current study was conducted to determine whether peak bone mineral density (BMD) and obesity phenotypes are associated with certain LGR4 gene polymorphisms found in Chinese nuclear families with female children.MethodsA total of 22 single nucleotide polymorphisms (SNPs) located in and around the LGR4 gene were identified in 1,300 subjects who were members of 390 Chinese nuclear families with female children. Then, BMD readings of the femoral neck, total hip, and lumbar spine as well as measurements of the total lean mass (TLM), total fat mass (TFM), and trunk fat mass were obtained via dual-energy X-ray absorptiometry. The quantitative transmission disequilibrium test was used to analyze the associations between specific SNPs and LGR4 haplotypes and peak BMD as well as between LGR4 haplotypes and TLM, percent lean mass, TFM, percent fat mass, trunk fat mass, and body mass index (BMI).ResultsHere, rs7936621 was significantly associated with the BMD values for the total hip and lumbar spine, while rs10835171 and rs6484295 were associated with the trunk fat mass and BMI, respectively. Regarding the haplotypes, we found significant associations between GAA in block 2 and trunk fat mass and BMI, between AGCGT in block 3 and total hip BMD, between TGCTCC in block 5 and femoral neck BMD, and between TACTTC in block 5 and both lumbar spine and femoral neck BMD (all P-values < 0.05).ConclusionGenetic variations of the LGR4 gene are related to peak BMD, BMI, and trunk fat mass.

2021 ◽  
Vol 12 ◽  
pp. 518
Mohamed M. Arnaout ◽  
Magdy O. ElSheikh ◽  
Mansour A. Makia

Background: Transpedicular screws are extensively utilized in lumbar spine surgery. The placement of these screws is typically guided by anatomical landmarks and intraoperative fluoroscopy. Here, we utilized 2-week postoperative computed tomography (CT) studies to confirm the accuracy/inaccuracy of lumbar pedicle screw placement in 145 patients and correlated these findings with clinical outcomes. Methods: Over 6 months, we prospectively evaluated the location of 612 pedicle screws placed in 145 patients undergoing instrumented lumbar fusions addressing diverse pathology with instability. Routine anteroposterior and lateral plain radiographs were obtained 48 h after the surgery, while CT scans were obtained at 2 postoperative weeks (i.e., ideally these should have been performed intraoperatively or within 24–48 h of surgery). Results: Of the 612 screws, minor misplacement of screws (≤2 mm) was seen in 104 patients, moderate misplacement in 34 patients (2–4 mm), and severe misplacement in 7 patients (>4 mm). Notably, all the latter 7 (4.8% of the 145) patients required repeated operative intervention. Conclusion: Transpedicular screw insertion in the lumbar spine carries the risks of pedicle medial/lateral violation that is best confirmed on CT rather than X-rays/fluoroscopy alone. Here, we additional found 7 patients (4.8%) who with severe medial/lateral pedicle breach who warranting repeated operative intervention. In the future, CT studies should be performed intraoperatively or within 24–48 h of surgery to confirm the location of pedicle screws and rule in our out medial or lateral pedicle breaches.

2021 ◽  
Henry Knipe ◽  
Mohammad Niknejad

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