Journal articles on the topic 'Pain associated with the spine'
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Benson, Curtis A., Marike L. Reimer, and Andrew M. Tan. "Dendritic Spines in the Spinal Cord: Live Action Pain." Neuroscience Insights 15 (January 2020): 263310552095116. http://dx.doi.org/10.1177/2633105520951164.
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Dendritic spines are microscopic protrusions on neurons that house the postsynaptic machinery necessary for neurotransmission between neurons. As such, dendritic spine structure is intimately linked with synaptic function. In pathology, dendritic spine behavior and its contribution to disease are not firmly understood. It is well known that dendritic spines are highly dynamic in vivo. In our recent publication, we used an intravital imaging approach, which permitted us to repeatedly visualize the same neurons located in lamina II, a nociceptive processing region of the spinal cord. Using this imaging platform, we analyzed the intravital dynamics of dendritic spine structure before and after nerve injury–induced pain. This effort revealed a time-dependent relationship between the progressive increase in pain outcome, and a switch in the steady-state fluctuations of dendritic spine structure. Collectively, our in vivo study demonstrates how injury that leads to abnormal pain may also contribute to synapse-associated structural remodeling in nociceptive regions of the spinal cord dorsal horn. By combining our live-imaging approach with measures of neuronal activity, such as with the use of calcium or other voltage-sensitive dyes, we expect to gain a more complete picture of the relationship between dendritic spine structure and nociceptive physiology.
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Kelani, Taiwo D., Annabelle Lee, Miny Walker, Louis J. Koizia, Melanie Dani, Michael B. Fertleman, and Angela E. Kedgley. "The Influence of Cervical Spine Angulation on Symptoms Associated With Wearing a Rigid Neck Collar." Geriatric Orthopaedic Surgery & Rehabilitation 12 (January 1, 2021): 215145932110123. http://dx.doi.org/10.1177/21514593211012391.
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Introduction: Rigid cervical spine collars can be used to maintain the position of the cervical spine following injury or surgery. However, they have been associated with difficulty swallowing, pressure sores and pain, particularly in older patients. We aimed to investigate the relationship between cervical spine angulation, a rigid neck collar and neck pain in healthy young and older adults. Methods: Twenty healthy young adults aged 25 ± 3 years and 17 healthy older adults aged 80 ± 8 years were tested. Magnetic resonance imaging scans of their cervical spines were taken before and after the rigid neck collar was worn for 1 hour. Measurement of vertebral angulation involved digitization of the scans and joint angle calculations using image processing software. Pain was quantified before and after the collar was worn, using a visual analogue scale. Results: Pain scores increased in the young group after the collar was worn (p = 0.001). The older group showed no difference in pain score after the collar was worn. Statistical tests showed no significant correlations between the change in cervical angles and the change in pain scores after the collar was worn. Discussion: The aging process may contribute to the changing distribution of subcutaneous tissue and increase risk of symptoms associated with wearing a collar. Oesophageal compression is not a result of collar use. Conclusion: There is no correlation between cervical spine vertebrae angulation and symptoms associated with wearing a neck collar. Generally, older individuals have greater cervical lordosis angles, and more straight and lordotic neck shapes. Older individuals may be more prone to skin-interface pressures from the neck collar than younger individuals.
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Pravdyuk, N. G., and N. A. Shostak. "DEGENERATIVE SPINE INJURY ASSOCIATED WITH BACK PAIN: MORPHOGENETIC ASPECTS." Clinician 11, no. 3-4 (June 7, 2018): 17–22. http://dx.doi.org/10.17650/1818-8338-2017-11-3-4-17-22.
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Kanda, Shotaro, Toru Akiyama, Hirotaka Chikuda, Takehiko Yamaguchi, and Kazuo Saita. "An Unusual Presentation of Adult Tethered Cord Syndrome Associated with Severe Chest and Upper Back Pain." Case Reports in Orthopedics 2015 (2015): 1–5. http://dx.doi.org/10.1155/2015/926185.
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Adult tethered cord syndrome (ATCS) is a rare entity that usually presents with multiple neurological symptoms, including lower extremity pain, backache, lower extremity muscle weakness, and bowel/bladder disturbances. Prompt surgical treatment is often necessary to avoid permanent sequelae. We report a 63-year-old man with sudden-onset severe right chest and upper back pain, followed by urinary retention. His initial workup included computed tomography of the abdomen and pelvis, which showed a presacral mass. His symptom-driven neurological workup focused on the cervical and thoracic spine, the results of which were normal. Pelvic radiographs and magnetic resonance imaging of the lumbosacral spine showed spina bifida occulta, meningocele, and presacral masses consistent with a teratomatous tumor. His symptoms, except for urinary retention, improved dramatically with surgical treatment. The excised specimen contained a teratomatous lesion plus an organized hematoma. Hematoma formation was suspected as the trigger of his sudden-onset right chest and upper back pain.
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Ortega-Santiago, Ricardo, Maite Maestre-Lerga, César Fernández-de-las-Peñas, Joshua A. Cleland, and Gustavo Plaza-Manzano. "Widespread Pressure Pain Sensitivity and Referred Pain from Trigger Points in Patients with Upper Thoracic Spine Pain." Pain Medicine 20, no. 7 (March 1, 2019): 1379–86. http://dx.doi.org/10.1093/pm/pnz020.
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Abstract Objectives The presence of trigger points (MTrPs) and pressure pain sensitivity has been well documented in subjects with neck and back pain; however, it has yet to be examined in people with upper thoracic spine pain. The purpose of this study was to investigate the presence of MTrPs and mechanical pain sensitivity in individuals with upper thoracic spine pain. Methods Seventeen subjects with upper thoracic spine pain and 17 pain-free controls without spine pain participated. MTrPs were examined bilaterally in the upper trapezius, rhomboid, iliocostalis thoracic, levator scapulae, infraspinatus, and anterior and middle scalene muscles. Pressure pain thresholds (PPTs) were assessed over T2, the C5-C6 zygapophyseal joint, the second metacarpal, and the tibialis anterior. Results The numbers of MTrPs between both groups were significantly different (P < 0.001) between patients and controls. The number of MTrPs for each patient with upper thoracic spine pain was 12.4 ± 2.8 (5.7 ± 4.0 active TrPs, 6.7 ± 3.4 latent TrPs). The distribution of MTrPs was significantly different between groups, and active MTrPs within the rhomboid (75%), anterior scalene (65%), and middle scalene (47%) were the most prevalent in patients with upper thoracic spine pain. A higher number of active MTrPs was associated with greater pain intensity and longer duration of pain history. Conclusions This study identified active MTrPs and widespread pain hypersensitivity in subjects with upper thoracic spine pain compared with asymptomatic people. Identifying proper treatment strategies might be able to reduce pain and improve function in individuals with upper thoracic spine pain. However, future studies are needed to examine this.
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Smuck, Matthew, Byron J. Schneider, Reza Ehsanian, Elizabeth Martin, and Ming-Chih J. Kao. "Smoking Is Associated with Pain in All Body Regions, with Greatest Influence on Spinal Pain." Pain Medicine 21, no. 9 (October 3, 2019): 1759–68. http://dx.doi.org/10.1093/pm/pnz224.
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Abstract Objective Examine the interrelationship between smoking and pain in the US population. Design A cross-sectional population-based study. Setting Nationwide survey. Methods Comprehensive pain reports categorically defined as head, spine, trunk, and limb pain; smoking history; demographics; medical history from a total of 2,307 subjects from the 2003–2004 National Health and Nutrition Examination Survey obtained from the Centers for Disease Control were analyzed. Unpaired t tests were used to analyze independent continuous variables, and chi-square tests were used to analyze categorical variables between smoker and nonsmoker groups. Weighted multivariate logistic regression analyses determined the association of current smoking with the presence of pain in various body regions. Results Smoking is most strongly associated with spine pain (odds ratio [OR] = 2.89, 95% confidence interval [CI] = 2.21–3.77), followed by headache (OR = 2.47, 95% CI = 1.73–3.53), trunk pain (OR = 2.17, 95% CI = 1.45–2.74), and limb pain (OR = 1.99, 95% CI = 1.45–2.73). Conclusions Current smoking is associated with pain in every region of the body. This association is strongest for spine and head pain. Given that pain is a strong motivator and that current smoking was associated with pain in all body regions, we recommend that these results be used to further raise public awareness about the potential harms of smoking.
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Lyzohub, Mykola, Marine Georgiyants, and Kseniia Lyzohub. "EVALUATION OF PAIN SYNDROME AND EFFICIENCY OF PAIN MANAGEMENT IN LUMBAR SPINE SURGERY." EUREKA: Health Sciences 6 (November 30, 2019): 29–34. http://dx.doi.org/10.21303/2504-5679.2019.001068.
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Multimodal analgesia for lumbar spine surgery is still a controversial problem, because of possible fusion problems, significant neuropathic component of pain, and influence of anesthesia type. Aim of the study was to assess the efficacy of pain management after lumbar spine surgery considering characteristics of pain, type of anesthesia and analgesic regimen. Material and methods. 254 ASA I-II patients with degenerative lumbar spine disease were enrolled into prospective study. Patients were operated either under spinal anesthesia (SA) or total intravenous anesthesia (TIVA). In postoperative period patients got either standard pain management (SPM – paracetamol±morphine) or multimodal analgesia (MMA – paracetamol+parecoxib+pregabalin±morphine). Results. We revealed neuropathic pain in 53.9 % of patients, who were elected for lumbar spine surgery. VAS pain score in patients with neuropathic pain was higher, than in patients with nociceptive pain. Total intravenous anesthesia was associated with greater opioid consumption during the first postoperative day. Multimodal analgesia based on paracetamol, parecoxib and pregabalin allowed to decrease requirements for opioids, postoperative nausea and dizziness. Pregabalin used for evening premedication had equipotential anxiolytic effect as phenazepam without postoperative cognitive disturbances. Conclusions. Multimodal analgesia is opioid-sparing technique that allows to decrease complications. Spinal anesthesia is associated to a decreased opioid consumption in the 1st postoperative day.
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Enel, Dominique, Arnaud Blamoutier, Philippe Bacon, and Marc E. Gentili. "Spine surgery associated with fatal cerebellar haemorrhage." European Journal of Anaesthesiology 26, no. 10 (October 2009): 891–92. http://dx.doi.org/10.1097/eja.0b013e3283300d3f.
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Boling. "Surgery for Spine Disease and Intractable Pain." Brain Sciences 10, no. 2 (January 24, 2020): 62. http://dx.doi.org/10.3390/brainsci10020062.
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Painful conditions, particularly due to head pain, spinal disease, and neuropathic pain, are highly prevalent in modern society, resulting in a significant impact on the individual due to the disability of the condition and the direct cost of associated treatments [...]
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Xu, Tao, Siyuan Zhou, Yutong Zhang, Yang Yu, Xiang Li, Jiao Chen, Jiarong Du, Ziwen Wang, and Ling Zhao. "Acupuncture for chronic uncomplicated musculoskeletal pain associated with the spine." Medicine 98, no. 2 (January 2019): e14055. http://dx.doi.org/10.1097/md.0000000000014055.
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Coronado, Rogelio A., Steven Z. George, Clinton J. Devin, Stephen T. Wegener, and Kristin R. Archer. "Pain Sensitivity and Pain Catastrophizing Are Associated With Persistent Pain and Disability After Lumbar Spine Surgery." Archives of Physical Medicine and Rehabilitation 96, no. 10 (October 2015): 1763–70. http://dx.doi.org/10.1016/j.apmr.2015.06.003.
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Järvimäki, Voitto, Hannu Kautiainen, Maija Haanpää, Hannu Koponen, Michael Spalding, Seppo Alahuhta, and Merja Vakkala. "Depressive symptoms are associated with poor outcome for lumbar spine surgery." Scandinavian Journal of Pain 12, no. 1 (July 1, 2016): 13–17. http://dx.doi.org/10.1016/j.sjpain.2016.01.008.
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AbstractBackground and aimsThe symptoms of pain and depression often present concomitantly, but little is known as to how the different subtypes of depression affect surgical outcome. The aim of this study was to determine whether there is a difference in outcome after lumbar spine surgery between non-depressed patients and patients with different subtypes of depressive symptoms: non-melancholic (NmDS) and melancholic depression (MDS).MethodsThis was a cross-sectional postal survey. A self-made questionnaire, the Beck Depression Inventory (BDI) and the Oswestery Low Back Disability Questionnaire (ODI) were sent to patients who had undergone lumbar spine surgery in the Oulu University Hospital between June, 2005 and May, 2008. BDI ≤ 10 were further classified into NmDS or MDS.ResultsA total of 537 patients (66%) completed the survey. Of these, 361 (67%) underwent disc surgery, 85 (16%) stabilizing surgery and 91 (17%) decompression. Participants were divided into three groups: BDI< 10 N=324 (60%), NmDS N=153 (29%) and MDS N=60 (11%). The mean ODI (SD) in the BDI<1 0 group was 16 (15), in the NmDS group 36 (15), and in the MDS group 41 (18) (p<0.001). The ODI profiles were different between the groups (p<0.001). Pain was more frequent in depressive patients (88% of MDS, 81% in NmDS and 40% in BDI < 10 patients experienced pain, p<0.001). The intensity of pain and pain-related disability was lowest among the patients in the BDI <10 group and highest among the MDS patients. Regular pain medication was used by 87% of patients in the MDS group, 93% of patients in the NmDS group, and 71% of patients in the BDI< 10 group (p<0.001). Response to pain medication with NRS (0–10) was 5.6 among MDS, 5.8 among NmDS and 6.5 among BDI< 10 patients (p<0.001).ConclusionDifferent types of depressive symptoms are associated with poor outcome after lumbar spine surgery. The outcome was worst in patients suffering from the MDS subtype. This was observed in pain intensity, functional disability and response to pain medication.ImplicationIt would be important to evaluate depression pre- and postoperatively. Offering a tailored rehabilitation programme to MDS patients should be considered.© 2016 Scandinavian Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.
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Avila-Guerra, Mauricio. "Chronic Neck Pain Associated with an Old Odontoid Fracture: A Rare Presentation." Case Reports in Emergency Medicine 2013 (2013): 1–4. http://dx.doi.org/10.1155/2013/372723.
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Cervical spine injuries represent a minority of injury cases in motor vehicles accidents but are a real threat to a patient’s life. In the wide range of cervical spine injuries, odontoid (dens) fractures represent the most common findings. These fractures are more usually found in the elderly population due to the changes associated with age. Neurological deficit is not frequently found in these injuries. The following is a case presentation of a chronic odontoid fracture with neurological deficit in a young man that was discovered 23 years after he sustained a motor vehicle accident.
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Agrawal, Amit, Vissa Santhi, Gali Kumar, and Yashwanth Sandeep. "Large Retropharyngeal Abscess Associated with Cervical Spine Tuberculosis." Indian Journal of Neurosurgery 07, no. 01 (March 2018): 036–38. http://dx.doi.org/10.1055/s-0038-1649556.
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AbstractThe authors report a case of a 25-year-old man who presented with the history of neck pain and weakness of the right hand of 6-month duration. He had history of fever with evening rise in temperature, loss of weight, and cough. Radiologic investigations of the cervical spine showed collapse of the C5 vertebral body and partial destruction of the C4 and C6 vertebral bodies with kyphotic deformity and a large retropharyngeal hyperintense collection. The patient underwent drainage of the abscess, and the histopathology was suggestive of tuberculosis. He was started on antitubercular treatment and doing well at follow-up.
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Puvanesarajah, Varun, Sheng-fu Larry Lo, Nafi Aygun, Jason A. Liauw, Ignacio Jusué-Torres, Ioan A. Lina, Uri Hadelsberg, et al. "Prognostic factors associated with pain palliation after spine stereotactic body radiation therapy." Journal of Neurosurgery: Spine 23, no. 5 (November 2015): 620–29. http://dx.doi.org/10.3171/2015.2.spine14618.
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OBJECT The number of patients with spinal tumors is rapidly increasing; spinal metastases develop in more than 30% of cancer patients during the course of their illness. Such lesions can significantly decrease quality of life, often necessitating treatment. Stereotactic radiosurgery has effectively achieved local control and symptomatic relief for these patients. The authors determined prognostic factors that predicted pain palliation and report overall institutional outcomes after spine stereotactic body radiation therapy (SBRT). METHODS Records of patients who had undergone treatment with SBRT for either primary spinal tumors or spinal metastases from June 2008 through June 2013 were retrospectively reviewed. Data were collected at the initial visit just before treatment and at 1-, 3-, 6-, and 12-month follow-up visits. Collected clinical data included Karnofsky Performance Scale scores, pain status, presence of neurological deficits, and prior radiation exposure at the level of interest. Radiation treatment plan parameters (dose, fractionation, and target coverage) were recorded. To determine the initial extent of epidural spinal cord compression (ESCC), the authors retrospectively reviewed MR images, assessed spinal instability according to the Bilsky scale, and evaluated lesion progression after treatment. RESULTS The study included 99 patients (mean age 60.4 years). The median survival time was 9.1 months (95% CI 6.9–17.2 months). Significant decreases in the proportion of patients reporting pain were observed at 3 months (p < 0.0001), 6 months (p = 0.0002), and 12 months (p = 0.0019) after treatment. Significant decreases in the number of patients reporting pain were also observed at the last follow-up visit (p = 0.00020) (median follow-up time 6.1 months, range 1.0–56.6 months). Univariate analyses revealed that significant predictors of persistent pain after intervention were initial ESCC grade, stratified by a Bilsky grade of 1c (p = 0.0058); initial American Spinal Injury Association grade of D (p = 0.011); initial Karnofsky Performance Scale score, stratified by a score of 80 (p = 0.002); the presence of multiple treated lesions (p = 0.044); and prior radiation at the site of interest (p < 0.0001). However, when multivariate analyses were performed on all variables with p values less than 0.05, the only predictor of pain at last follow-up visit was a prior history of radiation at the site of interest (p = 0.0038), although initial ESCC grade trended toward significance (p = 0.073). Using pain outcomes at 3 months, at this follow-up time point, pain could be predicted by receipt of radiation above a threshold biologically effective dose of 66.7 Gy. CONCLUSIONS Pain palliation occurs as early as 3 months after treatment; significant differences in pain reporting are also observed at 6 and 12 months. Pain palliation is limited for patients with spinal tumors with epidural extension that deforms the cord and for patients who have previously received radiation to the same site. Further investigation into the optimal dose and fractionation schedule are needed, but improved outcomes were observed in patients who received radiation at a biologically effective dose (with an a/b of 3.0) of 66.7 Gy or higher.
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Bozovic, Aleksandar, Zlatan Elek, Petar Jovanovic, Dejan Tabakovic, Nenad Milosevic, and Mirko Grajic. "Pregnancy- and lactation-associated osteoporosis with vertebral fractures." Srpski arhiv za celokupno lekarstvo 149, no. 7-8 (2021): 481–84. http://dx.doi.org/10.2298/sarh210329038b.
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Introduction. Pregnancy- and lactation- associated osteoporosis (PLO) is a rare disease for which the pathophysiological mechanism is as yet incompletely known. The incidence of PLO is 0.4 in 100,000 women. It is considered that the number of undiagnosed patients is even higher. PLO can lead to multiple fragility compression fractures in the spinal vertebrae. Case outline. We present the case of a 30 years old woman (first-born, breastfeeding child) who came for examination due to lower back pain that occured after childbirth without any apparent cause. The patient was found to have low levels of vitamin D and low bone mineral density on osteodensitometry (established osteoporosis). Magnetic resonance imaging (MRI) examination showed vertebral bodies fractures Th11, Th12 and L4. During therapy, we used vitamin D (800 IU/24 h), alendronate (70 mg once weekly), calcium 1000 mg/24h and thoracic lumbar sacral orthosis (TLSO) as support to spine. After 12 months of treatment osteodensitometry findings were close to normal, control MRI showed no further collapse of vertebral bodies and clinical examination of spine was orderly. Conclusion. PLO is a rare clinical condition and it must be kept in mind in the differential diagnosis in patients having low back pain during or after pregnancy. Early diagnosis and treatment of PLO and regular follow-up of these cases are particularly important. The the stability of the spine in patients with vertebral fractures must be carefully monitored as well as using the TLSO as a support for the spine.
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Candotti, Cláudia Tarragô, Matias Noll, Bárbara Vendramini Marchetti, Bruna Nichelle da Rosa, Maria da Graça Schultz Medeiros, Adriane Vieira, and Jefferson Fagundes Loss. "Prevalence of back pain, functional disability, and spinal postural changes." Fisioterapia em Movimento 28, no. 4 (December 2015): 711–22. http://dx.doi.org/10.1590/0103-5150.028.004.ao08.
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Abstract Objective : To evaluate the prevalence of back pain, disability, and postural changes in the spines of adults of different ages and with different levels of body mass index (BMI). Methodology : A total of 534 users of the Brazilian Public Health System in Porto Alegre, Brazil, were included in the study. An evaluation of the thoracic and lumbar spine was performed using the Flexicurve instrument. Data was analyzed using descriptive statistics and the calculation of prevalence ratios (PR) and their respective confidence intervals of 95% (CI 95%). Three analyses were performed with the dependent variables pain, functional disability, and posture. Results : A significant association between pain and female gender (p = 0.000), and pain and change in the lumbar spine (p = 0.014) were found. The variable disability was associated with BMI (p = 0.004) and age (p = 0.001). When we analyzed postural change, an association was found only with age group (p = 0.032). Conclusion : These findings highlight the need for prevention and primary care educational programs aimed at reducing postural aberrations in the adult population.
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Kutteruf, Rachel, Deva Wells, Linda Stephens, Karen L. Posner, Lorri A. Lee, and Karen B. Domino. "Injury and Liability Associated With Spine Surgery." Journal of Neurosurgical Anesthesiology 30, no. 2 (April 2018): 156–62. http://dx.doi.org/10.1097/ana.0000000000000448.
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Hong, Seok Woo, Ki Tae Park, Yoon-Sok Chung, Yong Jun Choi, and Jeong-Hyun Kang. "Bone mineral density, cervical spine degeneration, head and neck posture, and neck pain in the post-menopausal females: A pilot study." PLOS ONE 16, no. 9 (September 20, 2021): e0257735. http://dx.doi.org/10.1371/journal.pone.0257735.
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The purpose of the present study was to reveal the relationship between degenerative changes in the cervical spine, head and neck postures, neck pain, and bone mineral density (BMD) of the total hip, femoral neck, and lumbar spine in post-menopausal females. In total, 116 females (mean age 60.4 ± 7.1 years; age range 50–80 years) were included. Participants were classified into three groups based on the T-score criteria of the total hip, femoral neck, and lumbar spine set by World Health Organization, respectively. The degree of neck pain was assessed using self-administered questionnaire, the Neck Disability Index. Cervical spine degeneration and head and neck postures were identified using the lateral cephalograms. Grading system for cervical degeneration included three categories of the radiographic alterations including disc height loss, osteophyte formation, and diffuse sclerosis. The areal BMD of the total hip, femoral neck, and lumbar spine were determined using dual-energy x-ray absorptiometry. Females with lower BMD exhibited lesser degree of neck pain and forward head posture (FHP) compared to those with normal BMD. Higher BMD seemed to be associated with more notable loss of the disc height at the level of C4-5. More prominent degenerative changes in the cervical spine were associated with higher areal BMD of the hip, femoral neck, and lumbar spine, altered head posture, and development of neck pain.
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Seddighi, Afsoun, Amir Hasan Hoseini, Ashkan Divanbeygi, and Sajjad Alizadeh. "Cervical Spine and Degenerative Conditions." International Clinical Neuroscience Journal 6, no. 1 (March 20, 2019): 1–5. http://dx.doi.org/10.15171/icnj.2019.01.
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Degenerative disks and cervical spine ligaments diseases caused by the collapse of the anatomical position of vertebral structures and attempt to adapt. The Degenerative disorder of the neck disks has a prevalence of 20% to 25% in the population under the age of 59 and 70%-95% in the population 65 years and older. This study performed as a retrospective by reviewing the clinical files of patients with anterior neck discectomy in Shohada Tajrish hospital between 2014-2017. The severity of pain in the type of radiculopathy and neck pain measured from 1 to 10 based on the visual analog scale (VAS). The most common clinical manifestations of degenerative and cervical disks are neck pain, radiculopathy, and cervical myelopathy, alone or in combination. Generally, the disc hernia suddenly associated with acute symptoms.
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Ondreka, Nele, Sara Malberg, Emma Laws, Martin Schmidt, and Sabine Schulze. "Lipomeningocele associated with diplomyelia in a dog." Tierärztliche Praxis Ausgabe K: Kleintiere / Heimtiere 46, no. 05 (October 2018): 323–29. http://dx.doi.org/10.15654/tpk-170751.
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SummaryA 2-year-old male neutered mixed breed dog with a body weight of 30 kg was presented for evaluation of a soft subcutaneous mass on the dorsal midline at the level of the caudal thoracic spine. A further clinical sign was intermittent pain on palpation of the area of the subcutaneous mass. The owner also described a prolonged phase of urination with repeated interruption and re-initiation of voiding. The findings of the neurological examination were consistent with a lesion localization between the 3rd thoracic and 3rd lumbar spinal cord segments. Magnetic resonance imaging revealed a spina bifida with a lipomeningocele and diplomyelia (split cord malformation type I) at the level of thoracic vertebra 11 and 12 and secondary syringomyelia above the aforementioned defects in the caudal thoracic spinal cord. Surgical resection of the lipomeningocele via a hemilaminectomy was performed. After initial deterioration of the neurological status postsurgery with paraplegia and absent deep pain sensation the dog improved within 2 weeks to non-ambulatory paraparesis with voluntary urination. Six weeks postoperatively the dog was ambulatory, according to the owner. Two years after surgery the owner recorded that the dog showed a normal gait, a normal urination and no pain. Histopathological diagnosis of the biopsied material revealed a lipomeningocele which confirmed the radiological diagnosis.
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González-Gálvez, Noelia, María Carrasco-Poyatos, Raquel Vaquero-Cristóbal, and Pablo J. Marcos-Pardo. "Dolor de espalda en adolescentes: factores asociados desde un enfoque multifactorial (Back pain in adolescents: associated factors with a multifactorial approach)." Retos 43 (June 29, 2021): 81–87. http://dx.doi.org/10.47197/retos.v43i0.87389.
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El objetivo de la presente investigación fue analizar la prevalencia del dolor de espalda en adolescentes y hallar la relación entre el dolor de espalda y algunos factores asociados. La muestra estuvo constituida por 57 escolares con una edad media de 14,11±0,43 años. Se tomaron los datos relativos al peso y la talla, con los que se calculó el IMC; se administró la encuesta sobre el dolor de espalda en adolescentes para conocer los hábitos sobre práctica deportiva, sedentarismo, forma de llevar la mochila y dolor de espalda; y se midió la fuerza flexora y extensora del tronco y la flexibilidad de la musculatura isquiosural. Se encontró que el 43,86% de los sujetos habían sufrido dolor de espalda en algún momento de sus vidas, siendo el dolor lumbar el más habitual (36,84%). Entre un 15 y 25% aproximadamente de los adolescentes habían visitado al médico de cabecera o al fisioterapeuta a causa del dolor de espalda a lo largo de su vida. Se encontró cierta tendencia, sin que hubiera diferencias significativas, a que la presencia de dolor de espalda fuera mayor entre los practicantes de deporte (r=0,250; p=0,059), especialmente entre los que practicaban menos horas a la semana (r=0,348; p=0,076). Los escolares que presentaron dolor de espalda tenían tendencia a presentar menos fuerza flexora y extensora del tronco y una menor extensibilidad de la musculatura isquiosural, sin que hubiera diferencias significativas entre grupos (p>0,05). El sexo, el tiempo en actividades sedentarias, la forma de llevar la mochila y el IMC tampoco se relacionaron con el dolor de espalda (p>0,05). En conclusión, la práctica de deporte, la fuerza del tronco y la extensibilidad isquiosural son variables que podrían afectar a la incidencia de dolor de espalda en adolescentes.
Abstract. The objective of the current study was to analyze the prevalence of spine pain in adolescents and to show the relationship between back pain and some associated factors. The sample consisted of 57 schoolchildren, mean age 14.11±0.43 years-old. Body mass and height were measured to calculate BMI; the survey about back pain in adolescents was completed to register the prevalence of PA, sedentary lifestyle, way of carrying a backpack and spine pain; and the strength of the flexor and extensor muscles and hamstring extensibility was evaluated. It was found that a 43.86% of the subjects had spine pain, with low back pain as the most common (36.84%). Approximately 15 to 25% of the adolescents had visited the family doctor or physiotherapist because of spine pain throughout their lives. A tendency, with no significant differences, was found for a greater presence of spine pain in sport practitioners (r=0.250; p=0.059), especially among those who practiced fewer hours a week (r=0.348; p=0.076). The schoolchildren who presented spine pain tended to have less flexor and extensor strength of the trunk and less hamstring extensibility, with no significant differences between groups (p>0.05). Sex, time spent in sedentary activities, way of carrying a backpack and BMI were not related to spine pain (p>0.05). In conclusion, the sport practice, trunk strength and hamstring extensibility are variables that could affect the incidence of spine pain in adolescents.
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Yang, Michael M. H., Jay Riva-Cambrin, Jonathan Cunningham, Nathalie Jetté, Tolulope T. Sajobi, Alex Soroceanu, Peter Lewkonia, W. Bradley Jacobs, and Steven Casha. "Development and validation of a clinical prediction score for poor postoperative pain control following elective spine surgery." Journal of Neurosurgery: Spine 34, no. 1 (January 2021): 3–12. http://dx.doi.org/10.3171/2020.5.spine20347.
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OBJECTIVEThirty percent to sixty-four percent of patients experience poorly controlled pain following spine surgery, leading to patient dissatisfaction and poor outcomes. Identification of at-risk patients before surgery could facilitate patient education and personalized clinical care pathways to improve postoperative pain management. Accordingly, the aim of this study was to develop and internally validate a prediction score for poorly controlled postoperative pain in patients undergoing elective spine surgery.METHODSA retrospective cohort study was performed in adult patients (≥ 18 years old) consecutively enrolled in the Canadian Spine Outcomes and Research Network registry. All patients underwent elective cervical or thoracolumbar spine surgery and were admitted to the hospital. Poorly controlled postoperative pain was defined as a mean numeric rating scale score for pain at rest of > 4 during the first 24 hours after surgery. Univariable analysis followed by multivariable logistic regression on 25 candidate variables, selected through a systematic review and expert consensus, was used to develop a prediction model using a random 70% sample of the data. The model was transformed into an eight-tier risk-based score that was further simplified into the three-tier Calgary Postoperative Pain After Spine Surgery (CAPPS) score to maximize clinical utility. The CAPPS score was validated using the remaining 30% of the data.RESULTSOverall, 57% of 1300 spine surgery patients experienced poorly controlled pain during the first 24 hours after surgery. Seven significant variables associated with poor pain control were incorporated into a prediction model: younger age, female sex, preoperative daily use of opioid medication, higher preoperative neck or back pain intensity, higher Patient Health Questionnaire–9 depression score, surgery involving ≥ 3 motion segments, and fusion surgery. Notably, minimally invasive surgery, body mass index, and revision surgery were not associated with poorly controlled pain. The model was discriminative (C-statistic 0.74, 95% CI 0.71–0.77) and calibrated (Hosmer-Lemeshow goodness-of-fit, p = 0.99) at predicting the outcome. Low-, high-, and extreme-risk groups stratified using the CAPPS score had 32%, 63%, and 85% predicted probability of experiencing poorly controlled pain, respectively, which was mirrored closely by the observed incidence of 37%, 62%, and 81% in the validation cohort.CONCLUSIONSInadequate pain control is common after spine surgery. The internally validated CAPPS score based on 7 easily acquired variables accurately predicted the probability of experiencing poorly controlled pain after spine surgery.
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Walczyńska-Dragon, Karolina, Stefan Baron, Aleksandra Nitecka-Buchta, and Ewaryst Tkacz. "Correlation between TMD and Cervical Spine Pain and Mobility: Is the Whole Body Balance TMJ Related?" BioMed Research International 2014 (2014): 1–7. http://dx.doi.org/10.1155/2014/582414.
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Temporomandibular dysfunction (TMD) is considered to be associated with imbalance of the whole body. This study aimed to evaluate the influence of TMD therapy on cervical spine range of movement (ROM) and reduction of spinal pain. The study group consisted of 60 patients with TMD, cervical spine pain, and limited cervical spine range of movements. Subjects were interviewed by a questionnaire about symptoms of TMD and neck pain and had also masticatory motor system physically examined (according to RDC-TMD) and analysed by JMA ultrasound device. The cervical spine motion was analysed using an MCS device. Subjects were randomly admitted to two groups, treated and control. Patients from the treated group were treated with an occlusal splint. Patients from control group were ordered to self-control parafunctional habits. Subsequent examinations were planned in both groups 3 weeks and 3 months after treatment was introduced. The results of tests performed 3 months after the beginning of occlusal splint therapy showed a significant improvement in TMJ function(P>0.05), cervical spine ROM, and a reduction of spinal pain. The conclusion is that there is a significant association between TMD treatment and reduction of cervical spine pain, as far as improvement of cervical spine mobility.
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Steilen, Danielle, Ross Hauser, Barbara Woldin, and Sarah Sawyer. "Chronic Neck Pain: Making the Connection Between Capsular Ligament Laxity and Cervical Instability." Open Orthopaedics Journal 8, no. 1 (October 1, 2014): 326–45. http://dx.doi.org/10.2174/1874325001408010326.
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The use of conventional modalities for chronic neck pain remains debatable, primarily because most treatments have had limited success. We conducted a review of the literature published up to December 2013 on the diagnostic and treatment modalities of disorders related to chronic neck pain and concluded that, despite providing temporary relief of symptoms, these treatments do not address the specific problems of healing and are not likely to offer long-term cures. The objectives of this narrative review are to provide an overview of chronic neck pain as it relates to cervical instability, to describe the anatomical features of the cervical spine and the impact of capsular ligament laxity, to discuss the disorders causing chronic neck pain and their current treatments, and lastly, to present prolotherapy as a viable treatment option that heals injured ligaments, restores stability to the spine, and resolves chronic neck pain. The capsular ligaments are the main stabilizing structures of the facet joints in the cervical spine and have been implicated as a major source of chronic neck pain. Chronic neck pain often reflects a state of instability in the cervical spine and is a symptom common to a number of conditions described herein, including disc herniation, cervical spondylosis, whiplash injury and whiplash associated disorder, postconcussion syndrome, vertebrobasilar insufficiency, and Barré-Liéou syndrome. When the capsular ligaments are injured, they become elongated and exhibit laxity, which causes excessive movement of the cervical vertebrae. In the upper cervical spine (C0-C2), this can cause a number of other symptoms including, but not limited to, nerve irritation and vertebrobasilar insufficiency with associated vertigo, tinnitus, dizziness, facial pain, arm pain, and migraine headaches. In the lower cervical spine (C3-C7), this can cause muscle spasms, crepitation, and/or paresthesia in addition to chronic neck pain. In either case, the presence of excessive motion between two adjacent cervical vertebrae and these associated symptoms is described as cervical instability. Therefore, we propose that in many cases of chronic neck pain, the cause may be underlying joint instability due to capsular ligament laxity. Currently, curative treatment options for this type of cervical instability are inconclusive and inadequate. Based on clinical studies and experience with patients who have visited our chronic pain clinic with complaints of chronic neck pain, we contend that prolotherapy offers a potentially curative treatment option for chronic neck pain related to capsular ligament laxity and underlying cervical instability.
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Rodriguez, William J., and Jason Gromelski. "Vitamin D Status and Spine Surgery Outcomes." ISRN Orthopedics 2013 (April 11, 2013): 1–12. http://dx.doi.org/10.1155/2013/471695.
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There is a high prevalence of hypovitaminosis D in patients with back pain regardless of whether or not they require surgical intervention. Furthermore, the risk of hypovitaminosis D is not limited to individuals with traditional clinical risk factors. Vitamin D plays an essential role in bone formation, maintenance, and remodeling, as well as muscle function. Published data indicate that hypovitaminosis D could adversely affect bone formation and muscle function in multiple ways. The literature contains numerous reports of myopathy and/or musculoskeletal pain associated with hypovitaminosis D. In terms of spinal fusion outcomes, a patient may have a significant decrease in pain and the presence of de novo bone on an X-ray, yet their functional ability may remain severely limited. Hypovitaminosis D may be a contributing factor to the persistent postoperative pain experienced by these patients. Indeed, hypovitaminosis D is not asymptomatic, and symptoms can manifest themselves independent of the musculoskeletal pathological changes associated with conditions like osteomalacia. It appears that vitamin D status is routinely overlooked, and there is a need to raise awareness about its importance among all healthcare practitioners who treat spine patients.
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Mahmutovic, Elvis, Radoslava Doder, Zana Dolicanin, Bozana Radanovic, Tanja Jankovic, and Ksenija Boskovic. "Prevalence, prevention and risk factors for lumbar spine pain in dental practitioners." Medical review 70, no. 9-10 (2017): 312–17. http://dx.doi.org/10.2298/mpns1710312m.
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Introduction. Lumbar spine pain is among the most common conditions affecting daily activities in modern-day societies, as well as the second most common cause of absenteeism from work. The aim of the paper was to determine the incidence of lumbar spine pain in dental professionals of the Dental Clinic of Vojvodina, the effects of lumbar spine pain on their general health and work ability, their attitude to treatment options, as well as potential etiological factors for the appearance of lumbar spine pain. Material and Methods. A prospective study included 45 employees of the Dental Clinic of Vojvodina. We investigated the association between the appearance of lumbar spine pain and the work of dental professionals. The data were gathered via a questionnaire analyzing musculoskeletal disorders, and the probable risk factors for their appearance. Results. There were 75.6% (34/45) of women and 24.4% (11/45) of men, aged from 22 to 64 years, with a total work experience of 13?9.6 years. Lumbar spine pain was recorded in 60% of examinees. They were mostly localized in the lower back (52.2%), but also spreading down along both legs (17.4%) and into the right hip (13%) (p < 0.01). The incidence of low back pain was higher in dentists (72.4%) than in dental assistants (45.5%) and dental technicians (20%) (p < 0.05). Conclusion. Lumbar spine disorders are among the most frequent occupational diseases in dental practice, associated with multifactorial causes. Ergonomics and ergonomic education are primary factors in the prevention and therapy of lumbar spine conditions.
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Loriaut, Philippe, Sylvie Rozenberg, Patrick Boyer, Benjamin Dallaudière, Frederic Khiami, Elhadi Sariali, and Hugues Pascal-Moussellard. "Charcot Spine and Parkinson’s Disease." Case Reports in Orthopedics 2014 (2014): 1–5. http://dx.doi.org/10.1155/2014/631346.
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Charcot spine is rare condition whose association with Parkinson’s disease (PD) has not been reported yet. The authors reported the cases of two patients with PD who developed Charcot spine. Both patients presented with a history of back pain and bilateral radicular leg pain. They had complete clinical and radiological assessment. Lumbar spine was involved in both patients. Clinical features and response to treatment were described. In the first case, circumferential fusion and stabilization were performed on the dislocated vertebral levels. A solid and stable fusion of the spine was obtained with satisfactory clinical outcome. Surgical treatment has been recommended to the other patient. In both cases, no other neurological etiology was found to account for Charcot spine. In conclusion, Charcot spine is associated with several neurological affections but has not previously been reported in association with Parkinson’s disease.
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Vogiatzi, Maria, Eric Macklin, Robert Schneider, Joseph Lane, Irina Chaikodinov, Nancy Olivieri, Melanie Kirby, et al. "Vertebral Abnormalities by Spine Morphometry in Thalassemia." Blood 108, no. 11 (November 16, 2006): 3829. http://dx.doi.org/10.1182/blood.v108.11.3829.3829.
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Abstract Background: The Thalassemia Clinical Research Network previously reported a high prevalence of low bone mass in thalassemia (thal) despite current treatment practices. Currently we report the association of vertebral compression fractures (frs) and vertebral (vert) growth disturbances with bone pain, bone mass, bone turnover and therapies in thal. Methods: Vert frs (T10-L4) were assessed by morphometry. Vert compression frs by quantitative assessment (Fr-qt) were defined as anterior or mid-vert hts at least 25% shorter than posterior hts or average vert ht at least 25% shorter than hts of adjacent vert. Frs by qualitative assessment (Fr-ql) and growth plate (GP) abnormalities were determined. Bone mineral density by DXA and bone turnover markers were measured. Results: 353 thal pts were studied 64% beta-thal major (beta-TM) 12% beta-thal Intermedia 11% E/beta-thal 11% HbH 1% alpha thal 1% stem cell transplant pts, mean age 23 (SD 12 yrs, range 6 – 75 yrs). General bone pain and back pain were self-reported for the 30 days prior to morphometry by 34% and 26% pts, respectively. Fr-qt occurred in 41 (12%) and Fr-ql in 9 (2.5%), while only 7 pts (2%) had a history of vertebral fr and prevalence did not differ by type of thal or gender. Fr-qt and Fr-ql prevalence increased with age (Fr-qt p < 0.1; Fr-ql p < 0.001). After controlling for age, lumbar DXA Z or T scores were negatively associated with frs (odds ratio for 1-SD increase: Fr-qt 0.670, 95% CI 0.488 to 0.921, p = 0.01; Fr-ql 0.303, 95% CI 0.125 to 0.730, p < 0.01). Hypertransfusion, yrs or onset of chelation, serum transferrin receptor or ferritin did not correlate with frs after controlling for age. Decreased ht Z score (p < 0.01) and growth hormone deficiency (GHD) (p = 0.01) were associated with higher risk for Fr-qt after correcting for age. Hypogonadism was also associated with Fr-qt but not after correction for age (odds ratio 1.916, 95% CI 0.927 to 3.959 p = 0.08). Presence of Fr-ql but not Fr-qt was correlated with generalized bone and back pain specifically (Fr-ql vs. back pain odds ratio 11.05, 95% CI 2.035 to 110.2, p = 0.001). GP abnormalities were present in 30 pts (9%), including 7 (2%) who also had Fr-qt. Prevalence of GP did not differ by gender but was more common in beta-TM pts (13%), E-beta thal (5%) and among all others (0%) (p=0.04). In beta-TM pts, lumbar DXA Z or T scores (p < 0.01), ht Z scores (p < 0.001) and age that chelation was started (p < 0.01) were all negatively associated with GP abnormalities after controlling for age. Hypogonadism (p = 0.001) and GHD (p = 0.04) were positively associated with GP abnormalities after controlling for age. Presence of GP was not correlated with either general bone pain or back pain specifically. Conclusions: Morphometry identified vert abnormalities in 18% of thal pts. These included moderate to severe vert wedging or GP disturbances. A subgroup of pts (2.5%) also had vert compression frs by radiologic assessment. Morphometry vert lesions were associated with low bone mass. Back pain was strongly correlated with radiologic frs but not with other lesions seen by morphometry.
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Mikhailovsky, Mikhail Vitalyevich, Vyacheslav Viktorovich Novikov, Aleksandr Sergeyevich Vasyura, and Maya Nikolayevna Lebedeva. "SURGICAL CORRECTION OF KYPHOSIS ASSOCIATED WITH SCHEUERMANN’S DISEASE." Hirurgiâ pozvonočnika, no. 2 (May 26, 2005): 050–55. http://dx.doi.org/10.14531/ss2005.2.50-55.
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Objective. To analyze the results of two-stage surgical treatment of progressive kyphosis associated with Scheuermann’s disease performed in the Spine Surgery Department for Children and Adolescents from 1996 till 2004. Material and Methods. Fourteen patients were surgically treated. Surgical intervention included segmental vertebrectomy, interbody fusion, and kyphosis correction with Cotrel – Dubousset Instrumentation (CDI). Results. Kyphosis was reduced from 78.1° to 43.4°; the loss of correction during the follow-up period (minimum 2 years) was 4.4°. Sagittal contour of the lower thoracic and lumbar spine was also normalized. Conclusion. Two-stage surgical intervention permits to achieve significant cosmetic and pain-reducing effect in patients with major kyphosis associated with Scheuermann’s disease.
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Rahman, Rafa, Alvaro Ibaseta, Jay S. Reidler, Nicholas S. Andrade, Richard L. Skolasky, Lee H. Riley, David B. Cohen, Daniel M. Sciubba, Khaled M. Kebaish, and Brian J. Neuman. "Changes in patients’ depression and anxiety associated with changes in patient-reported outcomes after spine surgery." Journal of Neurosurgery: Spine 32, no. 6 (June 2020): 871–90. http://dx.doi.org/10.3171/2019.11.spine19586.
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OBJECTIVEThe authors conducted a study to analyze associations between changes in depression/anxiety before and 12 months after spine surgery, as well as changes in scores using the Patient-Reported Outcomes Measurement Information System (PROMIS) at the same time points.METHODSPreoperatively and 12 months postoperatively, the authors assessed PROMIS scores for depression, anxiety, pain, physical function, sleep disturbance, and satisfaction with participation in social roles among 206 patients undergoing spine surgery for deformity correction or degenerative disease. Patients were stratified according to preoperative/postoperative changes in depression and anxiety, which were categorized as persistent, improved, newly developed postoperatively, or absent. Multivariate regression was used to control for confounders and to compare changes in patient-reported outcomes (PROs).RESULTSFifty patients (24%) had preoperative depression, which improved in 26 (52%). Ninety-four patients (46%) had preoperative anxiety, which improved in 70 (74%). Household income was the only preoperative characteristic that differed significantly between patients whose depression persisted and those whose depression improved. Compared with the no-depression group, patients with persistent depression had less improvement in all 4 domains, and patients with postoperatively developed depression had less improvement in pain, physical function, and satisfaction with social roles. Compared with the group of patients with postoperatively improved depression, patients with persistent depression had less improvement in pain and physical function, and patients with postoperatively developed depression had less improvement in pain. Compared with patients with no anxiety, those with persistent anxiety had less improvement in physical function, sleep disturbance, and satisfaction with social roles, and patients with postoperatively developed anxiety had less improvement in pain, physical function, and satisfaction with social roles. Compared with patients with postoperatively improved anxiety, patients with persistent anxiety had less improvement in pain, physical function, and satisfaction with social roles, and those with postoperatively developed anxiety had less improvement in pain, physical function, and satisfaction with social roles. All reported differences were significant at p < 0.05.CONCLUSIONSMany spine surgery patients experienced postoperative improvements in depression/anxiety. Improvements in 12-month PROs were smaller among patients with persistent or postoperatively developed depression/anxiety compared with patients who had no depression or anxiety before or after surgery and those whose depression/anxiety improved after surgery. Postoperative changes in depression/anxiety may have a greater effect than preoperative depression/anxiety on changes in PROs after spine surgery. Addressing the mental health of spine surgery patients may improve postoperative PROs.■ CLASSIFICATION OF EVIDENCE Type of question: causation; study design: prospective cohort study; evidence: class III.
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Sterling, Michele. "Testing for Sensory Hypersensitivity or Central Hyperexcitability Associated With Cervical Spine Pain." Journal of Manipulative and Physiological Therapeutics 31, no. 7 (September 2008): 534–39. http://dx.doi.org/10.1016/j.jmpt.2008.08.002.
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Hodges, Paul W., and Carolyn A. Richardson. "Inefficient Muscular Stabilization of the Lumbar Spine Associated With Low Back Pain." Spine 21, no. 22 (November 1996): 2640–50. http://dx.doi.org/10.1097/00007632-199611150-00014.
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Pinto, Brendan L., Daniel Viggiani, and Jack P. Callaghan. "Exposure to Sustained Flexion Impacts Lumbar Extensor Spinae Muscle Fiber Orientation." Journal of Applied Biomechanics 37, no. 3 (June 1, 2021): 248–53. http://dx.doi.org/10.1123/jab.2020-0238.
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The lumbar extensor spinae (LES) has an oblique orientation with respect to the compressive axis of the lumbar spine, allowing it to counteract anterior shear forces. This mechanical advantage is lost as spine flexion angle increases. The LES orientation can also alter over time as obliquity decreases with age and is associated with decreased strength and low back pain. However, it is unknown if LES orientation is impacted by recent exposures causing adaptations over shorter timescales. Hence, the effects of a 10-minute sustained spine flexion exposure on LES orientation, thickness, and activity were investigated. Three different submaximally flexed spine postures were observed before and after the exposure. At baseline, orientation (P < .001) and thickness (P = .004) decreased with increasingly flexed postures. After the exposure, obliquity further decreased at low (pairwise comparison P < .001) and moderately (pairwise comparison P = .008) flexed postures. Low back creep occurred, but LES thickness did not change, indicating that decreases in orientation were not solely due to changes in muscle length at a given posture. Activation did not change to counteract decreases in obliquity. These changes encompass a reduced ability to offset anterior shear forces, thus increasing the potential risk of anterior shear-related injury or pain after low back creep-generating exposures.
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Lee, Byeongcheol, Sang Eun Lee, Yong Han Kim, Jae Hong Park, Ki Hwa Lee, Eunsu Kang, Sehun Kim, Nakyung Lee, and Daeseok Oh. "Severe Atrophy of the Ipsilateral Psoas Muscle Associated with Hip Osteoarthritis and Spinal Stenosis—A Case Report." Medicina 57, no. 1 (January 15, 2021): 73. http://dx.doi.org/10.3390/medicina57010073.
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Pathology of the lumbar spine and hip joint can commonly coexist in the elderly. Anterior and lateral leg pain as symptoms of hip osteoarthritis and spinal stenosis can closely resemble each other, with only subtle differences in both history and physical examinations. It is not easy to identify the origin of this kind of hip pain. The possibility of hip osteoarthritis should not be underestimated, as this could lead to an incorrect diagnosis and inappropriate spinal surgery. We report the case of a 54-year-old female with chronic right anterior and lateral leg pain who did not respond to repeated spinal blocks based on lumbar MRI, but in whom hip osteoarthritis was considered since severe atrophy of the ipsilateral psoas muscle was identified. We suggest that severe psoas muscle atrophy can be a clinical clue to identify hip osteoarthritis and is related to lower extremity pain, even if there is a coexisting lumbar spine pathology.
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Clements, Nathan D., Zachary L. McCormick, Darrell Vydra, Ameet Nagpal, Venu Akuthota, David J. Kennedy, and Daniel M. Cushman. "Serious Complications Associated with Interventional Spine Procedures—Results of a Spine Intervention Society Survey." Pain Medicine 21, no. 3 (June 12, 2019): 651–53. http://dx.doi.org/10.1093/pm/pnz135.
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Amini, Amin, Rudolf Beisse, and Meic H. Schmidt. "Thoracoscopic spine surgery for decompression and stabilization of the anterolateral thoracolumbar spine." Neurosurgical Focus 19, no. 6 (December 2005): 1–9. http://dx.doi.org/10.3171/foc.2005.19.6.5.
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The anterior thoracolumbar spine can be exposed via a variety of approaches. Historically, open anterolateral or pos-terolateral approaches have been used to gain access to the anterior thoracolumbar spinal column. Although the exposure is excellent, open approaches are associated with significant pain and respiratory problems, substantial blood loss, poor cosmesis, and prolonged hospitalization. With the increasing use of the endoscope in surgical procedures and recent advances in video-assisted thoracoscopic surgery, minimally invasive thoracoscopic spine surgery has been developed to decrease the morbidity associated with open thoracotomy. The purpose of this article is to illustrate the surgical technique of a minimally invasive thoracoscopic approach to the anterolateral thoracolumbar spine and to discuss its potential indications and contraindications in patients with diseases involving the anterior thoracic and lumbar regions.
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Groseanu, Laura, Laura Heretiu, Tania Gudu, Ovidiu Bajenaru, and Ruxandra Ionescu. "NEUROPATHIC ARTHROPATHY OF THE HAND ASSOCIATED WITH CERVICAL SYRINGOMYELIA." Romanian Journal of Rheumatology 24, no. 1 (March 31, 2015): 50–54. http://dx.doi.org/10.37897/rjr.2015.1.8.
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Neuropathic osteoarthropathy is a rare chronic, degenerative arthropathy associated with decreased sensory innervation. Numerous causes of this arthropathy have been described, syringomyelia, fluid-filled intramedular cavity, being among them. Neuropathic osteoarthropathy associated with syringomyelia is usually mono/oligo-articular, asymmetrical, involving the elbow, shoulder, rarely the wrist. Skin and nails trophic changes sometimes may appear. The present case is that of a female patient with asymmetrical oligoarthritis of right wrist and metacapophalangean joints with rapid reumathoid-like deformity of the hand. The diagnosis key was the radiologic aspect with both lytic and sclerotic lesions but also the thermal sensory impairment, minimized by the patient, longtime considered to be related to cervival spine osteoarthritis. The MRI examination of the cervical spine confirmed the fluid-filled cavity of the whole cervival region with secondary medular atrophy.
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Rintala, Harri, Roope Sovelius, Pirjo Rintala, Heini Huhtala, Simo Siitonen, and Heikki Kyröläinen. "MRI findings and physical performance as predictors of flight-induced musculoskeletal pain incidence among fighter pilots." Biomedical Human Kinetics 9, no. 1 (September 26, 2017): 133–39. http://dx.doi.org/10.1515/bhk-2017-0019.
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Summary Study aim: The aim of this study was to evaluate the possible association of pre-career magnetic resonance imaging (MRI) findings and physical performance level with possible musculoskeletal disorders during jet flight training. Material and methods: The study group consisted of 73 fighter pilots who had undergone pre-career cervical and lumbar spine MRI. Physical performance of a subgroup of the pilots (n = 67) was measured initially at the same time and followed up to the fast jet training phase (ranging from 3.8 to 7.0 years). Musculoskeletal pain history during pilot training was taken from the medical charts. MRI findings and physical performance were associated with perceived clinical complaints during the follow-up. Results: 82% of the cervical and 92% of the lumbar spines showed abnormalities at at least one disk level. MRI did not reveal significant cervical degeneration. Thirteen disk bulges in the lumbar spine were discovered, while 5 pilots had listhesis and/or osteophyte formation on the spine (lumbar vertebra 4/sacroiliac joint level, L4-SI). 41% of the studied pilots suffered spinal symptoms during the follow-up, but only 16% and 17% of the cervical and lumbar MRI findings, respectively, were associated with subsequent symptoms. Endurance and strength levels were not, but lower body motor skills were, strongly (relative risk, RR 0.46) associated with a decreased number of flight-induced medical appointments in the early flight career. Conclusions: Minor MRI findings have no predictable value in the very early flight career. Nevertheless, versatile, skills/power-oriented exercises before the flight career seem to be occupationally beneficial in reducing musculoskeletal disorders.
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Kosińska, Barabara, Paweł Turczyn, Krzysztof Wesołowski, Beata Tarnacka, and Małgorzata Malec-Milewska. "Central sensitization in chronic lumbar spine pain – pathophysiology and diagnostics." BÓL 21, no. 1 (July 31, 2020): 1–9. http://dx.doi.org/10.5604/01.3001.0014.3421.
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Chronic low back pain is a substantial clinical problem because of its high prevalence, incidence, complex and heterogeneous symptomatology. The majority of patients experience nociceptive pain only, but in almost 40% of patients neuropathic component may be present. In many patients with low back pain symptoms associated with central sensitization may be present as well and therefore their pain can be classified as nocyplastic. (functional) This paper describes how clinicians can differentiate these types of pain, taking into account that in a given patient several mechanisms may contribute to chronic pain development, and pain results from complex mechanisms. In the second part, therapeutic options are presented for people with symptoms of central sensitization, with emphasis on non-pharmacological methods.
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Marras, William S. "The Complex Spine." Human Factors: The Journal of the Human Factors and Ergonomics Society 54, no. 6 (July 13, 2012): 881–89. http://dx.doi.org/10.1177/0018720812452129.
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Objective: The aim of this study was to examine the logic behind the knowledge of low-back problem causal pathways. Background: Low-back pain and low-back disorders (LBDs) continue to represent the major musculoskeletal risk problem in the workplace, with the prevalence and costs of such disorders increasing over time. In recent years, there has been much criticism of the ability of ergonomics methods to control the risk of LBDs. Method: Logical assessment of the systems logic associated with our understanding and prevention of LBDs. Results: Current spine loading as well as spine tolerance research efforts are bringing the field to the point where there is a better systems understanding of the inextricable link between the musculoskeletal system and the cognitive system. Loading is influenced by both the physical environment factors as well as mental demands, whereas tolerances are defined by both physical tissue tolerance and biochemically based tissue sensitivities to pain. However, the logic used in many low-back risk assessment tools may be overly simplistic, given what is understood about causal pathways. Current tools typically assess only load or position in a very cursory manner. Conclusion: Efforts must work toward satisfying both the physical environment and the cognitive environment for the worker if one is to reliably lower the risk of low-back problems. Application: This systems representation of LBD development may serve as a guide to identify gaps in our understanding of LBDs.
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Marchi, Luis, Joes Nogueira-Neto, Vivian Amaral, Rodrigo Amaral, Nicholai Faulhaber, Etevaldo Coutinho, Leonardo Oliveira, Rubens Jensen, and Luiz Pimenta. "WORKERS' COMPENSATION IS ASSOCIATED WITH WORST CLINICAL RESULTS AFTER LUMBAR FUSION." Coluna/Columna 16, no. 4 (December 2017): 310–13. http://dx.doi.org/10.1590/s1808-185120171604174270.
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ABSTRACT Objective: The objective of this study was to evaluate the association of clinical results with preoperative situation of worker compensation (WC) in patients submitted to spine surgery. Methods: This was a retrospective, comparative, single center study. Patients who underwent lumbar spine arthrodesis were included. The outcomes were pain scores (VAS), physical constraint (ODI) and quality of life (EQ-5D). Outcomes were analyzed before surgery and after surgery (minimum follow-up of six months and maximum of 12). Two groups were compared: individuals with or without WC at preoperative visit. Results: A total of 132 cases were analyzed (mean age 54 years and 51% female), 29 (22%) assigned to the WC group. The groups were matched for age, sex, and preoperative depression levels. In the preoperative period, the groups showed equal pain and physical constraint; however the CT group had lower quality of life (p=0.05). Although both groups showed improvement in clinical outcomes after surgery (p<0.05), worse scores were observed for the WC group compared to the non-WC group, respectively: VAS 4.9 vs. 3.2 (p=0.02), ODI 34.7 vs. 23.4 (p=0.002), and EQ-5D 0.56 vs. 0.75 (p=0.01). Conclusion: In this study it was possible to observe that WC is associated with worse clinical results following elective surgical treatment of the lumbar spine.
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Oliveira, Bruna Duarte Nunes de, Mirelle de Oliveira Saes, Karla Pereira Machado, Elaine Thumé, and Alitéia Santiago Dilélio. "Musculoskeletal Pain in Elderly in a City in Southern Brazil: Prevalence and associated factors." Research, Society and Development 10, no. 7 (June 20, 2021): e25210716532. http://dx.doi.org/10.33448/rsd-v10i7.16532.
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Musculoskeletal pain in the elderly affects functional capacity and influences increased frailty, comorbidities and mortality. The aim of the study was to evaluate the prevalence of musculoskeletal pain and associated factors in the elderly population. This is a cross-sectional study, using data from the Elderly Cohort Project in Bagé-RS: health situation and relationship with the Family Health Strategy (FHS), carried out during the 2016/2017 follow-up. The sample consisted of 735 elderly people, aged 68 or over, residing in the area covered by primary health care services in the urban area of the municipality of Bagé / RS. The Nordic Musculoskeletal Questionnaire (NMQ) was used to analyze prevalence of pain in the upper limbs, spine and lower limbs and to verify associated factors. Information on the symptoms in these regions of the body was used. The majority elderly of whom were female (65.4%) aged between 68 and 79 years (68.7%) and white skin color (82.2%). Prevalence of musculoskeletal pain in the spine was 42.5%, 33.7% in the upper limbs and 31.0% in the lower limbs. In the crude and adjusted analysis association of pain was maintained with the presence of multimorbidity, greater satisfaction with health and use of emergency services in the last year. The results of this study reinforcing the pattern of pain and musculoskeletal symptoms in the elderly and justifying the need for training professionals and health services to serve this growing portion of the population.
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Ohno, Hirofumi, Shinsuke Takeda, So Mitsuya, Hisatake Yoshihara, and Ken-ichi Yamauchi. "A Young Boy with Neck Pain." Clinical Practice and Cases in Emergency Medicine 2, no. 5 (March 24, 2021): 253–54. http://dx.doi.org/10.5811/cpcem.2020.12.50242.
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Case Presentation: A five-year-old boy presented to our emergency department with severe posterior neck pain that was exacerbated upon neck movement. Cervical spine radiography revealed calcification in the cervical intervertebral disk 3-4. Discussion: Pediatric idiopathic intervertebral disk calcification is a benign, rare condition that might be complicated by associated severe neurological symptoms. In this case, the symptoms gradually subsided with conservative management alone.
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Ferreira, Giovanni E., Gustavo C. Machado, Christina Abdel Shaheed, Chung-Wei Christine Lin, Chris Needs, James Edwards, Rochelle Facer, Eileen Rogan, Bethan Richards, and Christopher G. Maher. "Management of low back pain in Australian emergency departments." BMJ Quality & Safety 28, no. 10 (June 4, 2019): 826–34. http://dx.doi.org/10.1136/bmjqs-2019-009383.
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BackgroundTo describe the diagnoses of people who present to the emergency department (ED) with low back pain (LBP), the proportion of people with a lumbar spine condition who arrived by ambulance, received imaging, opioids and were admitted to hospital; and to explore factors associated with these four outcomes.MethodsIn this retrospective study, we analysed electronic medical records for all adults presenting with LBP at three Australian EDs from January 2016 to June 2018. Outcomes included discharge diagnoses and key aspects of care (ambulance transport, lumbar spine imaging, provision of opioids, admission). We explored factors associated with these care outcomes using multilevel mixed-effects logistic regression models and reported data as ORs.ResultsThere were 14 024 presentations with a ‘visit reason’ for low back pain, of which 6393 (45.6%) had a diagnosis of a lumbar spine condition. Of these, 31.4% arrived by ambulance, 23.6% received lumbar imaging, 69.6% received opioids and 17.6% were admitted to hospital. Older patients (OR 1.79, 95% CI 1.56 to 2.04) were more likely to be imaged. Opioids were less used during working hours (OR 0.81, 95% CI 0.67 to 0.98) and in patients with non-serious LBP compared with patients with serious spinal pathology (OR 1.65, 95% CI 1.07 to 2.55). Hospital admission was more likely to occur during working hours (OR 1.74, 95% CI 1.48 to 2.05) and for those who arrived by ambulance (OR 2.98, 95% CI 2.53 to 3.51).ConclusionMany ED presentations of LBP were not due to a lumbar spine condition. Of those that were, we noted relatively high rates of lumbar imaging, opioid use and hospital admission.
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Kim, Juneki, Jin-gyu Choi, and Byung-chul Son. "Bilateral Ganglion Cysts of the Ligamentum Flavum in the Cervical Spine Causing a Progressive Cervical Radiculomyelopathy and Literature Review." Case Reports in Neurological Medicine 2017 (2017): 1–5. http://dx.doi.org/10.1155/2017/3953641.
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Here we report a unique case of bilateral ganglion cysts originating from the ligamentum flavum in the cervical spine. Degenerative cysts of the ligamentum flavum are rare lesions, and most had been reported in the lumbar spine. Its occurrence in the cervical spine is extremely rare: only eight have been reported. A 66-year-old male patient presented with progressive paraparesis, pain, and paresthesia in his bilateral T1 dermatomes that had lasted for three weeks. Magnetic resonance imaging of the cervical spine demonstrated a well-demarcated cystic lesion in the bilateral dorsolateral aspects of the C7/T1 segment and significant compression of the cervical cord. All case reports of ganglion cysts of the cervical ligamentum flavum including the present one showed characteristic symptoms and signs of myelopathy such as paraparesis or quadriparesis associated with varying degrees of paresthesia or pain in the upper extremities. Ganglion cysts of the cervical ligamentum flavum are considered a cause of cervical radiculomyelopathy due to cervical intraspinal cystic lesions. Bilateral occurrence and associated subluxation of the involved cervical segments again support the degenerative pathogenesis of ganglion cysts of the ligamentum flavum in the cervical spine.
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Landman, Zachary C., Shannon Beres, and Michael D. Cabana. "A Pain in the Buttock." Case Reports in Pediatrics 2011 (2011): 1–3. http://dx.doi.org/10.1155/2011/414693.
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Spondylolysis, a fracture of the pars interarticularis, is a common source back pain in children and adolescents. While the incidence is significantly higher in Asian and Inuit populations, it is never seen in nonambulatory children and is most commonly associated with athletic activities that involve extension or rotational deformity about the spine suggesting a functional component. Given that the associated pain is typically insidious in onset, lacks preceding trauma, and is accompanied by muscular spasm, prompt diagnosis requires a high index of suspicion, familiarity with provocative testing, and knowledge of the appropriate radiographic evaluation. Treatment requires cessation of athletic activity, bracing, and rest for a minimum of four to six weeks, or until symptomatic and radiographic resolution.
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Pravdyuk, N., N. Shvyreva, N. Shostak, A. Novikova, and E. Zakharova. "THU0494 BACK PAIN, SPINE OSTEOARTHRITIS AND ‘CANDIDATE GENES’ POLYMORPHISM." Annals of the Rheumatic Diseases 79, Suppl 1 (June 2020): 483.3–483. http://dx.doi.org/10.1136/annrheumdis-2020-eular.6407.
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Background:Low back pain (LBP) and spine osteoarthritis are among the leading health-related causes of disability and reduction in patient quality of life. More recent work suggested that the factors that lead to disc degeneration may have important genetic components. Genetic predisposition has been confirmed by recent findings of associations between degeneration and gene polymorphisms of matrix macromolecules.Objectives:Evaluation of genetic polymorphisms of genes collagen 1A1 (COL1A1), interleikin 1β (IL-1β), interleikin 6 (IL-6), vitamin D receptor (VDR) in patients with LBP, associated with spine osteoarthritis.Methods:We examined 33 patients (men-17, women-16, middle age 28, 7±3,77) with LBP end onset, verified by magnetic resonance imaging (MRI) and 15 controls was carried out. Assessed the intensity of pain syndrome on visual analog scale (VAS, mm) and the nature of its current (IASP, 1994). Polymerase chain reaction and restriction fragments length polymorphism was used to detect the polymorphism of COL1A1 (rs 1800012), IL-1 (rs 1143627), IL-6 (rs 1800795), VDR (rs 1544410).Results:The severity of the pain (VAS) average was 60 mm, all the patients revealed chronic option currents pain syndrome. In 86 % of patients detected changes disc in the form of protrusions and hernias, 17 % of patients had a characteristic reducing the height of the intervertebral disc of lower height disc and osteophytes, arthritis facet joints identified in 20 % of patients in 34% of patients diagnosed changes type Modic II. In 83% of patients with LBP identified homozygous variant allele (GG) Col1A1 gene. The absence of T-alleles in the gene IL 1β in the group of patients was associated with severity of the disease. Carriage of allele in heterozygous AG found in 54% of patients of the main group and was not observed in the control that requires further accumulation of facts. Identified association GG-genotype of IL-6 clinical and instrumental signs of the syndrome Modic-II.Conclusion:These findings may be the reason for the patient-specific approach to diagnosing and treatment of back pain. It proves the necessity of research of genetic polymorphisms in patients with spine osteoarthritis.Disclosure of Interests: :None declared
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Cheng, L. T. E., and W. E. H. Lim. "Spinal Epidural Haemangioma Associated with Extensive Gastrointestinal Haemangiomas." Interventional Neuroradiology 11, no. 2 (June 2005): 161–66. http://dx.doi.org/10.1177/159101990501100207.
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A case of spinal epidural cavernous haemangioma associated with gastrointestinal haemangiomas is discussed. The patient was a young Chinese female presenting with chronic lower back pain. She had a history of extensive gastric and small bowel haemangiomas. Lumbar spine MRI showed a heterogeneously enhancing epidural mass infiltrating the paravertebral muscles. Open biopsy confirmed an epidural cavernous haemangioma. To our knowledge, an association between spinal epidural cavernous haemangiomas and gastrointestinal haemangiomas has not been reported.
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Comberg, Hans-Ulrich, and Siegfried Schach. "Hyperuricemia is Associated with Musculo-skeletal Pain - Results from a Cross-sectional Study." Open Pain Journal 9, no. 1 (September 26, 2016): 15–25. http://dx.doi.org/10.2174/1876386301609010015.
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Background: The use of urate lowering therapy in patients without gouty arthritis and slightly elevated uric acid levels (so called “asymptomatic” hyperuricemia) is still under debate. Introduction/Objectives: This study explores whether slightly elevated urate levels are associated with musculo-skeletal pain. Method: This cross-sectional study was conducted in a single German center. Generally healthy subjects (including patients with controlled mild hypertension, hyperlipidemia, and/or not insulin dependent type 2 diabetes) aged 20-75 years presenting for their annual routine check-up were invited to participate. Documented parameters included a full blood count, blood pressure, weight, height, prescribed medication, purine and alcohol intake, and pain assessment during the two preceding years. The sample size was determined by the requirement that in comparing major groups (such as men vs. women, hyperuricemia vs. normal uric levels) a difference between these groups in an attribute (such as joint pain) should be discovered with a probability of at least 90 percent. Results: In total, 600 patients (54.7%) male, (55.2% ± 13 7 years) were included in the survey. Urate levels were closely correlated to the number of patients complaining about joint pain (r=0.978). Higher urate levels were associated with a higher percentage of patients with joint pain. There was a marked increase in the percentage of patients experiencing joint pain from urate level 5 (30.8%) to 5.5 (60.9%). Lumbar spine, cervical spine, shoulder, and knee were the most common locations for joint pain. Multivariate analysis indicated weight, purine intake, alcohol consumption, administration of diuretics, creatinine, and triglycerides as factors with significant impact on the urate level. Of all tested variables, only serum urate had a significant impact on joint pain (OR 1.996; 95% CI 1.626-2.451; p<0.0001). A significant correlation between pain in various joints and urate levels was found for all most commonly affected regions. Conclusion: In this population of generally healthy subjects presenting for their annual routine check-up, results indicate the possibility of a significant impact of urate levels on joint pain.