Does Unilateral Lumbosacral Radiculopathy Affect the Association between Lumbar Spinal Muscle Morphometry and Bone Mineral Density?

Age-related degenerative changes lead to a gradual decrease in bone mineral density (BMD) and muscle mass. We aimed to assess the effects of decreased BMD and lumbar denervation on lumbar spinal muscle morphometry and the relationship between BMD and lumbar spinal muscular morphometry, respectively. Eighty-one patients, aged 50–85 years, diagnosed with unilateral lumbosacral radiculopathy based on electrodiagnostic studies between January 2016 and April 2021 were enrolled. BMD T scores in the lumbar spine and hip were measured using dual-energy X-ray absorptiometry. The cross-sectional area (CSA) of the psoas, multifidus, and erector spinae located in the middle of the lumbar spine, between the L3 and L4 and between the L4 and L5 levels, respectively, was measured using axial MRI. Functional CSA (FCSA) was defined as the CSA of lean muscle mass. Pearson correlation analyses were performed to evaluate the association between BMD T scores and the CSA, FCSA, and the ratio of the FCSA to the CSA (functional ratio) for each side. The CSA of lumbar spinal muscles showed no significant correlation with lumbar BMD. The FCSA and functional ratio of lumbar spinal muscles were significantly correlated with lumbar BMD. There was no correlation between femur BMD and lumbar spinal muscle morphometry.

Mechanical Properties of Lumbar and Cervical Paravertebral Muscles in Patients with Axial Spondyloarthritis: A Case-Control Study

Background: Axial spondyloarthritis (axSpA) affects spinal muscles, due to inflammation and structural damage. The mechanical properties of the muscles, such as tone or stiffness, could be altered in axSpA. The aim of this work is to analyze the mechanical properties of cervical and lumbar spine muscles in axSpA patients and their relationship with metrology measures, function, disease activity, structural damage and quality of life. Methods: axSpA patients and age/gender/BMI matched healthy controls were recruited. The muscle mechanical properties (MMPs), such as tone or frequency, stiffness, decrement (linear elastic properties), relaxation and creep (viscoelastic properties), of cervical (semispinalis capitis) and lumbar (erector spinae) muscles were bilaterally measured at rest using myotonometry. Additionally, conventional metrology, BASMI (metrology index), BASDAI (disease activity index), mSASSS (radiological structural damage index) and SF-12 (health-related quality of life questionnaire) were used in the axSpA group. Between-groups comparison, intra-group correlations and multivariable regression analyses were performed to achieve the study aims. Results: Thirty-four axSpA patients (mean age: 46.21 ± 8.53 y) and 34 healthy volunteers (mean age: 43.97 ± 8.49 y) were recruited. Both in cervical and lumbar spine, linear elastic parameters were significantly higher in axSpA patients in comparison with controls, while viscoelastic parameters were significantly lower. Lumbar muscle frequency, stiffness, relaxation, creep and cervical muscle elasticity were fair to strongly correlated (|0.346|<r<|0.774|) with age, functional status, activity of disease, structural damage and quality of life in axSpA patients. Furthermore, moderate to good fitted multivariate models (0.328<R2<0.697) were obtained combining age, conventional metrology, activity of the disease and function for the estimation of cervical and lumbar MMPs. Conclusion: Mechanical properties of spinal muscles of axSpA patients differ from controls. Lumbar and cervical muscles exhibit greater linear elastic properties and lower viscoelastic properties, which are related with age, clinical and psychophysiological features of axSpA.

Diagnosis of tuberculous spondylitis

Diagnosis of tuberculous spondylitis in adults, especially in the absence of kyphosis and a characteristic response to the load of the spine, is often very difficult. Barr (Bulk md., No. 10, 1923) advises in such cases to pay special attention to various "neuralgic" phenomena, unilateral increase in tendon reflexes and Babinsk'oro symptom, as well as to limited rigidity of the spinal muscles.

Back-Support Exoskeleton Control Strategy for Pulling Activities: Design and Preliminary Evaluation

The execution of manual material handling activities in the workplace exposes workers to large lumbar loads that increase the risk of musculoskeletal disorders and low back pain. In particular, the redesign of the workplace is making the execution of pulling activities more common, as an alternative to lifting and carrying tasks. The biomechanical analysis of the task revealed a substantial activation of the spinal muscles. This suggests that the user may benefit from the assistance of a back-support exoskeleton that reduces the spinal muscle activity and their contribution to lumbar compression. This work addresses this challenge by exploiting the versatility of an active back-support exoskeleton. A control strategy was specifically designed for assisting pulling that modulates the assistive torques using the forearm muscle activity. These torques are expected to adapt to the user’s assistance needs and the pulled object mass, as forearm muscle activity is considered an indicator of grip strength. We devised laboratory experiments to assess the feasibility and effectiveness of the proposed strategy. We found that, for the majority of the subjects, back muscle activity reductions were associated with the exoskeleton use. Furthermore, subjective measurements reveal advantages in terms of perceived support, comfort, ease of use, and intuitiveness.

Safety Analysis of Freshwater Fish

The results presented in this paper demonstrate that the microbial population in the hydroecosystem has seasonal variations. The bacterial contamination of water and fish in November was 140 and 11 times less than in July respectively. It was found that fish caught in natural reservoirs in the autumn-winter period had different dynamics in the development of postmortem changes in comparison with those caught in the summer period. Postmortem secretion of mucus was not as pronounced in autumn-winter as in summer. Postmortem rigidity on the contrary was pronounced; gill covers were tightly fitting; and spinal muscles were tensed and of dense texture. Storing fresh river fish at a temperature of 3-5°C for 24 hours did not lead to a change in sensory evaluation. Physic-chemical indicators corresponded to the values characterizing fresh, healthy fish. During storage, the bacterial contamination of fish increased by more than 100 times, while the maximum permissible number of microorganisms (5.0 × 104 CFU / g) was not exceeded. Keywords: fish, microbiological control, organoleptic and physic-chemical indicators

Intervertebral disc degeneration and regeneration: a motion segment perspective

Back and neck pain have become primary reasons for disability and healthcare spending globally. While the causes of back pain are multifactorial, intervertebral disc degeneration is frequently cited as a primary source of pain. The annulus fibrosus (AF) and nucleus pulposus (NP) subcomponents of the disc are common targets for regenerative therapeutics. However, disc degeneration is also associated with degenerative changes to adjacent spinal tissues, and successful regenerative therapies will likely need to consider and address the pathology of adjacent spinal structures beyond solely the disc subcomponents. This review summarises the current state of knowledge in the field regarding associations between back pain, disc degeneration, and degeneration of the cartilaginous and bony endplates, the AF-vertebral body interface, the facet joints and spinal muscles, in addition to a discussion of regenerative strategies for treating pain and degeneration from a whole motion segment perspective.

Quantification of the Elastic Moduli of Lumbar Erector Spinae and Multifidus Muscles Using Shear-Wave Ultrasound Elastography

Although spinal surgeries with minimal incisions and a minimal amount of X-ray exposure (MIMA) mostly occur in a prone posture on a Wilson table, the prone posture’s effects on spinal muscles have not been investigated. Thus, this study used ultrasound shear-wave elastography (SWE) to compare the material properties of the erector spinae and multifidus muscles when subjects lay on the Wilson table used for spinal surgery and the flat table as a control condition. Thirteen male subjects participated in the study. Using ultrasound SWE, the shear elastic moduli (SEM) of the erector spinae and multifidus muscles were investigated. Significant increases were found in the SEM of erector spinae muscle 1, erector spinae muscle 2, and multifidus muscles on the Wilson table (W) compared to in the flat table (F; W:22.19 ± 7.15 kPa, F:10.40 ± 3.20 kPa, p < 0.001; W:12.10 ± 3.31 kPa, F: 7.17 ± 1.71 kPa, p < 0.001; W: 18.39 ± 4.80 kPa, F: 11.43 ± 2.81 kPa, p < 0.001, respectively). Our results indicate that muscle material properties measured by SWE can be changed due to table posture, which should be considered in biomechanical modeling by guiding surgical planning to develop minimal-incision surgical procedures.

CYSTICERCOSIS OF THE PARASPINAL MUSCLES: A CASE REPORT AND REVIEW OF LITERATURE

Introduction: Cysticercosis is a disease of public health importance which causes significant morbidity and mortality in developing countries including India. The clinical presentation of cysticercosis is variable and involves various body tissues. Isolated muscle involvement of cysticercosis is relatively rare. Case Presentation: We report a case of 28 year old female with complaints of mid back pain. Investigations revealed cysticercosis of the para-spinal muscles. Due to non-resolution of symptoms with oral medication, patient was managed surgically and the lesion was removed. Conclusion: Cysticercosis should always be included in differential diagnosis of muscle swelling in countries endemic for Taenia infection. Surgical resection may be required in muscular form of cysticercosis if significant improvement is not observed with conventional oral treatment.