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spine lumbar pain

Kentaro Mataki, Masao Koda, Kousei Miura, Yosuke Shibao, Hiroshi Kumagai, Katsuya Nagashima, Hiroshi Noguchi, Toru Funayama, Tetsuya Abe, Masashi Yamazaki
After spine fusion surgery, it is difficult to evaluate the spinal canal and nerve roots using magnetic resonance imaging (MRI) because of metallic implant-related artifacts. Digital tomosynthesis is a new radiographic technique that can acquire tomographic images with reduced metallic artifact effects compared with MRI. We report a case demonstrating the visualization of nerve roots nearby metallic implants using dynamic tomosynthesis-radiculography (DTRG) after spinal fusion surgery. A 77-year-old man, who 3 years earlier underwent spine fusion surgery at L3-L5, presented complaining of newly-onset low back pain and radicular symptoms in the right fifth lumbar (L5) nerve root area...
April 8, 2019: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Cheng Cheng, Kai Wang, Can Zhang, Hao Wu, Feng-Zeng Jian
BACKGROUND: Diagnosis and management of congenital anomalies of the spine can be a challenge because of their complex presentations. We present an uncommon case of congenital deformity of the spine with L4-L5 vertebral fusion, mimicking a single vertebra, and L3 spondylolisthesis treated by OLIF (oblique lumbar interbody fusion). CASE DESCRIPTION: A 69-year-old woman presented with increasing lower back pain radiating to the left leg, with aggravation of symptoms for the last 6 months, causing difficulty in walking...
April 8, 2019: World Neurosurgery
Christian C Støttrup, Andreas K Andresen, Leah Carreon, Mikkel Ø Andersen
BACKGROUND CONTEXT: Lumbar disc herniation (LDH) is associated with great morbidity and significant socioeconomic impact in many parts of the world. Studies have shown that most LDH can be treated effectively with nonoperative management. However, for some patients in whom pain and disability are unacceptable, surgical intervention provides effective clinical relief. Currently there is little consensus in the medical community on the timing of surgery for patients suffering from radicular pain due to LDH...
April 8, 2019: Spine Journal: Official Journal of the North American Spine Society
Adam P Goode, Rebecca J Cleveland, Todd A Schwartz, Amanda E Nelson, Virginia B Kraus, Howard J Hillstrom, Marian T Hannan, Portia Flowers, Jordan B Renner, Joanne M Jordan, Yvonne M Golightly
BACKGROUND: Chronic low back pain (cLBP) affects millions of Americans and costs billions. Studies suggest a link between cLBP and joint hypermobility. METHODS: We conducted cross-sectional primary analyses of joint hypermobility and cLBP, lumbar spine osteoarthritis (OA), and lumbar facet joint OA (FOA) in 3 large studies-the Generalized Osteoarthritis Study, Genetics of Generalized Osteoarthritis Study, and Johnston County Osteoarthritis Project (total n = 5072)...
April 9, 2019: BMC Musculoskeletal Disorders
Seyedali Sadeghi, Kevin Quinlan, Kirsten E Eilertson, Gregory G Billy, Jesse Bible, Megan Sions, Daniel Cortes
Multifidus function is important for active stabilization of the spine, but it can be compromised in patients with chronic low back pain and other spine pathologies. Force production and strength of back muscles are often evaluated using isometric or isokinetic tests, which lack the ability to quantify multifidi contribution independent of the erector spinae and adjacent hip musculature. The objective of this study is to evaluate localized force production capability in multifidus muscle using ultrasound Shear Wave Elastography (SWE) in healthy individuals...
April 9, 2019: Journal of Biomechanical Engineering
Shigeru Tadano, Hideki Tanabe, Sadao Arai, Keiji Fujino, Tokuhide Doi, Masami Akai
BACKGROUND: Lumbar traction is a traditional treatment modality for chronic low back pain (CLBP) in many countries. However, its effectiveness has not been demonstrated in clinical practice because of the following: (1) the lack of in vivo biomechanical confirmation of the mechanism of lumbar traction that occurs at the lumbar spine; (2) the lack of a precise delivery system for traction force and, subsequently, the lack of reproducibility; and (3) few randomized controlled trials proving its effectiveness and utility...
April 9, 2019: BMC Musculoskeletal Disorders
Egon Burian, Alexander Rohrmeier, Sarah Schlaeger, Michael Dieckmeyer, Maximilian N Diefenbach, Jan Syväri, Elisabeth Klupp, Dominik Weidlich, Claus Zimmer, Ernst J Rummeny, Dimitrios C Karampinos, Jan S Kirschke, Thomas Baum
BACKGROUND: Magnetic resonance imaging (MRI) is the modality of choice for diagnosing and monitoring muscular tissue pathologies and bone marrow alterations in the context of lower back pain, neuromuscular diseases and osteoporosis. Chemical shift encoding-based water-fat MRI allows for reliable determination of proton density fat fraction (PDFF) of the muscle and bone marrow. Prior to quantitative data extraction, segmentation of the examined structures is needed. Performed manually, the segmentation process is time consuming and therefore limiting the clinical applicability...
April 9, 2019: BMC Musculoskeletal Disorders
Md Abu B Siddiq, Mohammad A Rahim, Md Tariqul I Khan, Ahm Zakir H Shikder
Low back pain (LBP) is a frequent complaint in the working milieu of pain physicians. Common LBP generators are the lumbar spine, soft tissues around the spine, and intra-abdominal viscera; however, in recent times, lumbar spine ligament (LL) degeneration is increasingly getting more coverage as an important LBP source. Among various LLs, interspinous and supraspinatus ligaments' sprain-degeneration can perpetuate localized central LBP as described in the present case study. Localized LL sprain-degeneration in association with radiating LBP from prolapsed lumbar intervertebral disc (PLID) compressing adjacent nerve roots might further impair a patient's quality of life...
January 25, 2019: Curēus
Hanna Lotzke, Helena Brisby, Annelie Gutke, Olle Hägg, Max Jakobsson, Rob Smeets, Mari Lundberg
BACKGROUND: Prehabilitation programs have led to improved postoperative outcomes in several surgical contexts, but there are presently no guidelines for the prehabilitation phase before lumbar fusion surgery. OBJECTIVE: The objective was to investigate whether a person-centered physiotherapeutic prehabilitation program, based on a cognitive-behavioral approach, reduces disability and improves functioning after lumbar fusion surgery more than conventional care does in patients with degenerative disc disease...
February 21, 2019: Physical Therapy
Lauren K Dunn, Robert H Thiele, Michelle C Lin, Edward C Nemergut, Marcel E Durieux, Siny Tsang, Mark E Shaffrey, Justin S Smith, Christopher I Shaffrey, Bhiken I Naik
BACKGROUND: Pain management following major spine surgery requires high doses of opioids and is associated with a risk of opioid-induced constipation. Peripheral mu-receptor antagonists decrease the gastrointestinal complications of perioperative systemic opioid administration without antagonizing the analgesic benefits of these drugs. OBJECTIVE: To investigate the impact of alvimopan in opioid-naive patients undergoing major spine surgery. METHODS: Patients undergoing >3 levels of thoracic and/or lumbar spine surgery were enrolled in this prospective, randomized, double-blind study to receive either alvimopan or placebo prior to and following surgery...
February 14, 2019: Neurosurgery
Kimberly E Lind, Jonathan A Flug
PURPOSE: To evaluate the relationship between use of MRI of the lumbar spine for low back pain without prior conservative therapy and sociodemographic factors after the implementation of public reporting for Medicare's Hospital Outpatient Imaging Efficiency Measure for MRI Lumbar Spine for Low Back Pain (OP-8) metric. MATERIALS AND METHODS: We conducted a secondary data analysis using a nationally representative sample of 2009 to 2014 Medicare claims to evaluate trends in use of conservative therapy before MRI of the lumbar spine...
April 2019: Journal of the American College of Radiology: JACR
Rebecca J Crawford, Thomas Volken, Áine Ni Mhuiris, Cora C Bow, James M Elliott, Mark A Hoggarth, Dino Samartzis
STUDY DESIGN: Cross-sectional OBJECTIVE.: We quantified fatty infiltration (FI) geography of the lumbar spine to identify whether demographics, temporal low back pain (LBP), and disability influence FI patterns. SUMMARY OF BACKGROUND DATA: Lumbar paravertebral muscle FI has been associated with age, sex, LBP, and disability; yet, FI accumulation patterns are inadequately described to optimise interventions. METHODS: This cross-sectional study employed lumbar axial T1-weighted MRI in 107 Southern-Chinese adults (54 females, 53 males)...
April 2, 2019: Spine
Wangshu Yuan, Jianxiong Shen, Lixia Chen, Hai Wang, Keyi Yu, Hui Cong, Jingya Zhou, Youxi Lin
Study design: Retrospective characterization of nonspecific low back pain (NSLBP) in young adult female patients with and without lumbar scoliosis. Background: There is no consensus as to whether NSLBP in scoliosis patients is related to scoliosis per se or is just a normal symptom that could happen in anyone. Objectives: The aim of this study was to compare the differences in NSLBP between young adult female patients with and without lumbar scoliosis and to provide a theoretical basis for differential treatment of NSLBP in patients with and without lumbar scoliosis...
2019: Pain Research & Management: the Journal of the Canadian Pain Society
Kwan-Su Song, Chul-Woo Lee, Jae-Gon Moon
Total facetectomy with/without fusion and facet-preserving microforaminotomy have been performed as conventional surgical treatments for lumbar foraminal stenosis (LFS). Recently, endoscopic spinal surgery has been introduced as a minimally invasive therapeutic modality of LFS by several authors. We report two cases of bilateral LFS at lumbosacral junction level successfully treated with a novel biportal endoscopic spine surgery (BES) technique using primary 2 portals. Two patients presented with chronic onset of back pain and neurogenic claudication symptom...
March 2019: Neurospine
Muneyoshi Fujita, Hirotaka Kawano, Tomoaki Kitagawa, Hiroki Iwai, Yuichi Takano, Hirohiko Inanami, Hisashi Koga
OBJECTIVE: Full-endoscopic spine surgery (FESS) is a relatively less invasive treatment for lumbar disc herniation (LDH). This study investigated the optimal operative route of the posterolateral approach (PLA) of FESS for the treatment of L5/S1 LDH. METHODS: Between June 2016 and November 2018, a total of 21 patients with leg pain due to L5/S1 LDH underwent PLA of FESS. According to the partial removal of the superior articular process (SAP) of the L5/S1 facet joint (FJ), we categorized these patients into 2 groups...
March 2019: Neurospine
Christina Cuka, Amy W McDevitt, Ann Porter-Hoke, Steve Karas
BACKGROUND: Spinal fusion (SF)is a common surgical intervention for individuals with idiopathic scoliosis. However, individuals may experience continued pain and disability from suspected mechanical dysfunction. CASE DESCRIPTION: The purpose of this case report was to describe how specific thrust manipulation (TM) was used to treat a patient with scoliosis after multilevel SF. The 25-year-old female patient presented with left-sided pain in the rib, thoracic, and lumbar and sacroiliac joint regions that had been aggravated by trail running...
January 13, 2019: Journal of Manual & Manipulative Therapy
Bryan M Bond, Chris D Kinslow, Adam W Yoder, Wen Liu
OBJECTIVES: The long-term goal of our study is to improve the understanding of the biological mechanisms associated with spinal manipulative therapy (SMT) in low back pain. METHODS: This project involved a pilot randomized, blinded clinical trial ( registration number NCT03078114) of 3-week SMT in chronic nonspecific low back pain (CNSLBP) patients. We recruited 29 participants and randomly assigned them into either a SMT (n = 14) or sham SMT (n = 15) group...
March 5, 2019: Journal of Manual & Manipulative Therapy
Ellen M Soffin, Douglas S Wetmore, James D Beckman, Evan D Sheha, Avani S Vaishnav, Todd J Albert, Catherine H Gang, Sheeraz A Qureshi
OBJECTIVEEnhanced recovery after surgery (ERAS) and multimodal analgesia are established care models that minimize perioperative opioid consumption and promote positive outcomes after spine surgery. Opioid-free anesthesia (OFA) is an emerging technique that may achieve similar goals. The purpose of this study was to evaluate an OFA regimen within an ERAS pathway for lumbar decompressive surgery and to compare perioperative opioid requirements in a matched cohort of patients managed with traditional opioid-containing anesthesia (OCA)...
April 1, 2019: Neurosurgical Focus
Bertrand Debono, Marco V Corniola, Raphael Pietton, Pascal Sabatier, Olivier Hamel, Enrico Tessitore
OBJECTIVEEnhanced Recovery After Surgery (ERAS) proposes a multimodal, evidence-based approach to perioperative care. Thanks to the improvement in care protocols and the fluidity of the patient pathway, the first goal of ERAS is the improvement of surgical outcomes and patient experience, with a final impact on a reduction in the hospital length of stay (LOS). The implementation of ERAS in spinal surgery is in the early stages. The authors report on their initial experience in applying an ERAS program to several degenerative spinal fusion procedures...
April 1, 2019: Neurosurgical Focus
G Damian Brusko, John Paul G Kolcun, Julie A Heger, Allan D Levi, Glen R Manzano, Karthik Madhavan, Timur Urakov, Richard H Epstein, Michael Y Wang
OBJECTIVELumbar fusion is typically associated with high degrees of pain and immobility. The implementation of an enhanced recovery after surgery (ERAS) approach has been successful in speeding the recovery after other surgical procedures. In this paper, the authors examined the results of early implementation of ERAS for lumbar fusion.METHODSBeginning in March 2018 at the authors' institution, all patients undergoing posterior, 1- to 3-level lumbar fusion surgery by any of 3 spine surgeons received an intraoperative injection of liposomal bupivacaine, immediate single postoperative infusion of 1-g intravenous acetaminophen, and daily postoperative visits from the authors' multidisciplinary ERAS care team...
April 1, 2019: Neurosurgical Focus
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