Korelasi Sudut Lumbosakral Berdasarkan MRI Lumbosakral dengan Oswestry Disability Index (ODI Score) pada Degenerative Disk Disease

Pengukuran sudut lumbosacral merupakan salah satu parameter dalam mengevaluasi kemungkinan etiologi dari nyeri punggung bawah yang disebabkan oleh degenerative disc disease. Oswestry Disability Index (ODI) Score digunakan untuk mengukur disabilitas pada nyeri punggung bawah. Penelitian ini bertujuan untuk mengetahui apakah ada korelasi antara sudut lumbosakral berdasarkan MRI Lumbosakral dengan Oswestry Disability Index (ODI) Score pada degenerative disk disease. Penelitian ini menggunakan desain cross sectional yang dilaksanakan di Departemen Radiologi RS dr. Wahidin Sudirohusodo Makassar mulai bulan Mei sampai September 2020, didapatkan sampel sebanyak 67 pasien dengan keluhan nyeri punggung bawah dan telah mengisi kuisioner Oswestry Disability Index (ODI) Score serta menjalani pemeriksaan MRI lumbosacral. Pengukuran sudut lumbosacral dilakukan pada irisan mid sagital di work station MRI, derajat degenerative disc disease dinilai berdasarkan klasifikasi Pfirrmann. Metode yang digunakan adalah uji korelasi Spearman dan Chi Square. Hasil penelitian menunjukkan adanya korelasi antara sudut lumbal lordosis (p=0,014), sudut sacral inclination (p=0,002), sudut sacral horizontal (p=0,034), umur (p=0,0001) dengan degenerative disk disease. Tidak terdapat korelasi antara sudut lumbosacral disc (p=0,250), jenis kelamin (p=0,796), index massa tubuh (p=0,707) dengan degenerative disk disease. Adanya korelasi antara sudut lumbal lordosis (p=0,046), umur (p=0,0001), index massa tubuh (p0,0001) dengan ODI score. Tidak terdapat korelasi antara sudut lumbosacral disc (p=0,072), sudut sacral inclination (p=0,090), sudut sacral horizontal (p=0,143), jenis kelamin (p=0,337) dengan ODI score. Adanya korelasi antara derajat degenerative disk disease dengan derajat ODI score (p=0,0001)

Spinal Perineural Cysts among European Patients

Background A perineural (Tarlov) cyst is a fluid-filled lesion occurring between the perineurium and the endoneurium of spinal nerve roots. The aim of the study was to evaluate the prevalence and morphology of perineural cysts, detected incidentally in patients with symptomatic degenerative disk disease. Materials/methods The study was based on the retrospective data gathered during magnetic resonance imaging (MRI) examinations. Results and Conclusions Out of 3,128 spinal MRI examinations, perineural cysts were detected in 286 patients (9%). The cysts were most commonly observed in the sacral region, followed by thoracic, cervical, and lumbar regions. Cysts were more common in women than in men and the average age of patients was 54.8 years. In the majority, a single cyst was found. The average longest dimension of the lesion was 11.72 mm.

ASSESSMENT OF THE QUALITY OF LIFE OF PATIENTS WITH VERTEBRAL PAIN SYNDROME

The aim of the study was to determine the relationship between neurological manifestations of degenerative disk disease, visceral pathology and temporal characteristics of pain syndrome with an assessment of the quality of life of patients. 50 patients with non-specific back pain were examined. Diagnostics of neurological manifestations of degenerative disk disease, concomitant visceral pathology, assessment of the quality of life according to the SF-36 questionnaire, testing according to the hospital scale of anxiety and depression HADS were carried out. Results: most patients achieve remission (66%), 34% of patients develop relapses of varying duration. In 44% of patients, there were no neurological manifestations of degenerative disk disease. In 50% of cases, concomitant visceral pathology was detected. 38% of patients were diagnosed with deviations on the HADS scale. The duration of pain syndrome over one year significantly affected the decrease in the physical component of health according to the SF-36 questionnaire. The indicators of work activity (56%), daily activity due to the intensity of pain (44%) and emotional state (30%) deteriorated the most. This dictates the need to introduce an individual, integrated, multidisciplinary approach in the management of patients with vertebral pain syndrome in degenerative disk disease of the spine.

Retroperitoneal Exposure of the Anterior Lumbar Spine

BACKGROUND Anterior lumbar spine procedures such as anterior lumbar interbody fusion (ALIF) are used commonly to treat multiple pathologies, including pseudoarthrosis and degenerative disk disease. It is generally a safe and effective procedure, but an anterior approach to the lumbar spine requires critical navigation of the surgical window to avoid delicate structures. An operative technique should maximize the exposure without an increased risk of iatrogenic injury. OBJECTIVE To describe in detail a retroperitoneal exposure of the anterior lumbar spine. METHODS This surgical approach is a unique variation of standard anterior lumbar spine exposure techniques. This technique is described and illustrated in detail with an accompanying Supplemental Digital Content: video. Institutional Review Board (IRB) approval was not required because this is a variation of current techniques. Patient consent was obtained for the procedure and use of operative pictures and videos. RESULTS Precise details of the technique are described. The surgical video demonstrates the technique for the L5-S1 ALIF approach. CONCLUSION This technique is a novel variation of the standard retroperitoneal exposure of the anterior lumbar spine. The incision placement, size, and dynamic blunt retraction of this approach limit tissue disruption and provide an efficient exposure that has not been previously described in the literature.