Denoising of Degenerative Lumbar Spine Lesions MRI Images Using Block-Matching and 3D Filtering

This work was aimed to explore the application of the L2-block-matching and 3-dimentional filtering (BM3D) (L2-BM3D) denoising algorithm in the treatment of lumbar degeneration with long- and short-segment fixation of posterior decompression. 120 patients with degenerative lumbar scoliosis were randomly divided into group A (MRI images were not processed), group B (MRI images were processed by the BM3D denoising algorithm), and group C (MRI images were processed by the BM3D denoising algorithm based on weighted norm L2). This denoising algorithm was comprehensively evaluated in terms of mean square error (MSE), peak signal-to-noise ratio (PSNR), structural similarity index measure (SSIM), and running time. Besides, the results of surgeries based on different denoising methods were assessed through the surgical time, intraoperative blood loss, postoperative drainage, and postoperative follow-up. The results showed the following: (1) PSNR (peak signal-to-noise ratio) and SSIM (structural similarity index measure) of the L2-BM3D algorithm are better than those of the BM3D algorithm (31.21 dB versus 29.33 dB, 0.83 versus 0.72), while mean square error (MSE) was less than that of the BM3D algorithm ( P < 0.05 ). (2) The operation time, intraoperative bleeding, and postoperative drainage volume in group C were lower than those in group B and group A ( P < 0.05 ). The postoperative follow-up results showed that, in group C, the postoperative VAS (visual analysis scale) score (1.03 ± 0.29) and ODI (Oswestry disability index) (9.29 ± 0.32) were lower, indicating that the postoperative recovery effect of patients was better. Therefore, the patient’s postoperative recovery effect was better. In conclusion, the L2-BM3D algorithm had an ideal denoising effect on MRI images of lumbar degeneration and was worthy of clinical promotion.

The Multi-Modal Risk Analysis and Medical Prevention of Lumbar Degeneration, Fatigue, and Injury Based on FEM/BMD for Elderly Chinese Women Who Act as Stay-Home Grandchildren Sitters

Background: An increasing number of Chinese elderly women stay at home and act as grandchildren sitters. In consequence of the frequent load-bearing, chronic lumbar fatigue probably caused a higher risk of lumbar degeneration, fatigue, and injury which has become one of the most important aging and health problems in China. In this study, a multi-mode lumbar finite element model (FEM) with specific bone mineral density (BMD) were developed and validated for further spine injury prevention and control.Methods: The material properties of lumbar vertebra were modified according to degenerated bone mineral density, and geometry was adjusted based on intervertebral disc height. The motion of lifting children was simulated by a 76 year-old Chinese women's FEM, and the stress distribution was calculated and predicted.Results: The pressure of L5-S intervertebral disc in the bending 3-year-old dummy lifting posture was significantly higher than the same posture without lifting, the maximum effective stress of endplate cartilage in the upright child lifting posture was 1.6 times that of the bending without lifting posture. And the fatigue risk limitation frequency of the upright with dummy posture was predicted with the functional equation of fatigue and stress which was deduced by genetic algorithm, which combined with the effective stress of lumbar vertebrae spongy bone calculated from FEM.Conclusions: The child-lifting motion could increase the risk of lumbar degeneration, fatigue, and injury in elderly women, and they should keep below the frequency limit of the motion of lifting children in their daily life. This study could put forward scientific injury prevention guidance to Chinese elderly women who lift children in daily life frequently.

Clinical Characteristics of Geriatric Patients With Non-Specific Chronic Low Back Pain

Although the prevalence and the associated burden of LBP increase with age, research on LBP has primarily focused on young people and adults, and little attention has been given to the elderly population. Chronic inflammation is well-known as senescence associated secretory phenotype (SASP), which produces numerous proinflammatory cytokines leading to age-related inflammation. We enrolled 203 patients with an average age of 79.0 years, with non-specific CLBP; the patients were compared with age- and sex-matched controls without CLBP using a propensity score-matched analysis. We performed laboratory analysis, radiographic evaluations for global spinal parameter and lumbar degeneration assessment, and body composition analysis using whole-body dual-energy X-ray absorptiometry. We observed a higher red blood cell distribution width (RDW), as well as a lower skeletal muscle mass index and a higher fat mass in patients with CLBP. Moreover, patients with geriatric CLBP had significantly lower lumbar lordosis, and higher sagittal vertical axis was correlated with lower muscle mass in the extremities and trunk, independent of lumbar degeneration. Geriatric CLBP is associated with senescence. RDW, which is an index of aging, was high among elderly patients with CLBP. Furthermore, geriatric patients with CLBP often have age-related skeletal muscle mass reduction and spinal sagittal malalignment.

Incidence and Temporal Changes in Lumbar Degeneration and Low Back Pain in Child and Adolescent Weightlifters: Prospective 5-Year Cohort Study

PurposeTo investigate the incidence of lumbar degeneration findings and low back pain (LBP) over a 5-year period in children and adolescent weightlifters using magnetic resonance imaging (MRI) and medical questionnaires. Furthermore, to reveal the temporal changes in the lumbar vertebrae caused by long-term hard weightlifting training during the growth period.MethodsTwelve children and adolescent weightlifters who participated in weightlifting for >2 years (six boys, six girls, 11.4±2.0 years) were enrolled. Participants underwent annual medical questionnaire surveys including practice frequency, competition history, presence of LBP, and lumbar examinations using MRI during the 5-year follow-up.ResultsLumbar disc degeneration was detected in all participants after 4 years, and lumbar disc herniation findings were detected in 33% of participants after 5 years; one underwent herniotomy during the follow-up period. Lumbar spondylolysis was detected in 58% of patients at 5 years. Although there were three participants who had LBP in the final year, none had LBP that prevented them from returning to weightlifting.ConclusionA 5-year cohort study of 12 children and adolescent weightlifters detected lumbar degeneration in all participants. Long-term hard weightlifting training during the growth period may increase the risk of developing current and future LBP.