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Lumbar back pain

Dexin Zou, Junlin Zhou, Xiaobing Jiang
Tuberculosis combined with brucellosis is a very rare condition. Overlapping clinical presentation and laboratory parameters of tuberculosis and brucellosis may lead to misdiagnosis or delayed diagnosis of the condition. The current study presents the case of a 45-year-old male with symptoms of lower back pain, non-tender swelling in the right flank, intermittent hyperpyrexia, sweating, body aches and numbness and weakness of right lower limb. A lumbar computed tomograph (CT) scan and magnetic resonance imaging indicated vertebral destruction and the formation of sequestra and thecal sac compression...
April 2018: Experimental and Therapeutic Medicine
Jack Zigler, Nicole Ferko, Chris Cameron, Leena Patel
AIM: To compare the efficacy and safety of total disc replacement, lumbar fusion, and conservative care in the treatment of single-level lumbar degenerative disc disease (DDD). MATERIALS & METHODS: A network meta-analysis was conducted to determine the relative impact of lumbar DDD therapies on Oswestry Disability Index (ODI) success, back pain score, patient satisfaction, employment status, and reoperation. Odds ratios or mean differences and 95% credible intervals were reported...
March 2018: Journal of Comparative Effectiveness Research
Catherine E Ferland, Diana-Luk Ye, Jean A Ouellet
This case report illustrates the value of a comprehensive perioperative pain assessment composed of quantitative sensory testing and self-reported measures that highlight the impact of pain experienced by a 14-year-old boy suffering from chronic low back pain and sciatica. Before surgery, the pain assessment revealed inefficient endogenous inhibitory pain control with presence of temporal summation of pain. The severe pain was constant and lasted for 18 months. The patient was in a high-anxiety state, and reported significant functional disability and poor sleep quality...
March 12, 2018: Journal of Pediatric Health Care
Xiaoming Liu, Fumin Pan, Zhaoyu Ba, Shanjin Wang, Desheng Wu
BACKGROUND: Diabetes mellitus (DM) and low back pain which is mainly caused by degeneration of the intervertebral discs (IVDs) both are major public health problem worldwide. The present study was designed to investigate the association between type 2 diabetes mellitus (T2D) and severity of lumbar disc degeneration (LDD). METHODS: We retrospectively reviewed patients with low back pain visiting our spine clinic in 2014. Low back pain patients all have the lumbar MRI imaging and no previous treatment...
March 14, 2018: Journal of Orthopaedic Surgery and Research
Cordula Netzer, Pascal Distel, Uwe Wolfram, Hans Deyhle, Gregory F Jost, Stefan Schären, Jeroen Geurts
Facet joint osteoarthritis is a prominent feature of degenerative spine disorders, highly prevalent in ageing populations, and considered a major cause for chronic lower back pain. Since there is no targeted pharmacological therapy, clinical management of disease includes analgesic or surgical treatment. The specific cellular, molecular, and structural changes underpinning facet joint osteoarthritis remain largely elusive. The aim of this study was to determine osteoarthritis-related structural alterations in cortical and trabecular subchondral bone compartments...
March 14, 2018: International Journal of Molecular Sciences
Mark W Werneke, Susan Edmond, Michelle Young, David Grigsby, Brian McClenahan, Troy McGill
BACKGROUND AND PURPOSE: Physiotherapy has an important role in managing patients with non-specific low back pain who experience elevated psychosocial distress or risk for chronic disability. In terms of evidence-based physiotherapy practice, cognitive-behavioural approaches for patients at high psychosocial risk are the recommended management to improve patient treatment outcomes. Evidence also suggests that directional preference (DP) is an important treatment effect modifier for prescribing specific exercises for patients to improve outcomes...
March 14, 2018: Physiotherapy Research International: the Journal for Researchers and Clinicians in Physical Therapy
Koji Otani, Shin-Ichi Kikuchi, Shoji Yabuki, Akira Onda, Takuya Nikaido, Kazuyuki Watanabe, Shin-Ichi Konno
Purpose: Lumbar spinal stenosis (LSS) is a common condition in the aging population. However, limited information exists on discrepancies between LSS symptoms and imaging findings and/or prognostic factors of LSS, as well as the relationship between changes in LSS symptoms and quality of life (QoL) during the natural course of LSS. The purpose of the current study was to clarify any changes in clinically diagnosed LSS at a one-year follow-up, and identify its prognostic factors, using a community-dwelling cohort...
2018: Journal of Pain Research
Costansia Bureta, Hiroyuki Tominaga, Takuya Yamamoto, Takao Setoguchi, Hideki Kawamura, Satoshi Nagano, Ichiro Kawamura, Masahiko Abematsu, Hironori Kakoi, Yasuhiro Ishidou, Setsuro Komiya
BACKGROUND: Here we report a rare case of lumbar spine epidural abscess and facet joint septic arthritis caused by Streptococcus agalactiae, which had spread to the iliopsoas muscles, leading to urine retention. CASE PRESENTATION: A 68-year-old woman with low back pain experienced a sudden onset of bilateral lower limb weakness, it was followed 14 days later by urine retention. At consultation, magnetic resonance imaging and identification of serum β-hemolytic streptococci provided a diagnosis of Streptococcus agalactiae infection...
March 13, 2018: BMC Surgery
Haiying Wang, Bing Lv
PURPOSE: The purpose was to compare the outcomes between KDSS and PLIF for lumbar degenerative disease. METHODS: This study retrospectively reviewed 98 patients who were treated with lumbar surgery from March 2012 to June 2014, including 48 managed with KDSS (KDSS group) and 50 underwent PLIF (PLIF group). All patients were followed up for at least two years. Duration of operation, blood loss, hospital stay, complications and patient satisfaction survey were recorded and analyzed...
March 9, 2018: World Neurosurgery
Manabu Akahane, Akie Maeyashiki, Yasuhito Tanaka, Tomoaki Imamura
OBJECTIVE: We assessed the impact of musculoskeletal diseases, depressive mental state, and hypertension on locomotive syndrome, a condition of reduced mobility requiring nursing care. Since locomotive syndrome is a major public health issue that needs attention, its relationship with functional inconvenience in performing daily activities was also investigated. METHODS: We conducted a cross-sectional study using an Internet panel survey, comprising 747 persons aged 30-90 years...
March 12, 2018: Modern Rheumatology
John P Kleimeyer, Ivan Cheng, Todd F Alamin, Serena S Hu, Thomas Cha, Vijay Yanamadala, Kirkham B Wood
STUDY DESIGN: This is a retrospective cohort study. OBJECTIVE: To evaluate the long-term outcomes of selective one- to two-level anterior lumbar interbody fusions (ALIFs) in the lower lumbar spine versus continued nonsurgical management. SUMMARY OF BACKGROUND DATA: Low back pain associated with lumbar intervertebral disc degeneration is common with substantial economic impact, yet treatment remains controversial. Surgical fusion has previously provided mixed results with limited durable improvement of pain and function...
March 9, 2018: Spine
Vinayak Narayan, Nasser Mohammed, Amey R Savardekar, Devi Prasad Patra, Anil Nanda
INTRODUCTION: Spinal tuberculosis [TB] is a common infectious disease prevalent in developing countries and a rising disaster in developed countries. The association of tuberculosis with spondylolisthesis is rarely reported in literature. The aim of our review is to analyse the clinical features and radiologic characteristics of TB spondylolisthesis along with providing a concise update on its surgical management, based on current literature. METHODS: A systematic review is performed after conducting a thorough search in the PubMed database...
March 8, 2018: World Neurosurgery
Salah G Aoun, Nicole Bedros, Tarek Y El Ahmadieh, Jake Kreck, Nikhil Mehta, Mazin Al Tamimi
BACKGROUND: Venous thromboembolism can be a significant cause of morbidity in the trauma population. Medical and surgical specialties have been pushing the indication for prophylactic filter placement. CASE DESCRIPTION: A 36-year-old man presented with axial lower back pain with a radicular right L2 component after lifting a heavy object. He had a history of penetrating brain trauma 3 years prior, with placement of a prophylactic inferior vena cava filter. His x-ray, computed tomography, and magnetic resonance imaging of the lumbar spine showed fracture of his filter, with migration of the fractured fragment through the inferior vena cava and into the L2-L3 disc space, and surrounding bony lysis and severe osteodiscitis...
March 7, 2018: World Neurosurgery
P Elkan, T Lagerbäck, H Möller, Paul Gerdhem
PURPOSE: Quality registers give unique possibilities to achieve information from large groups of patients, but outcome must be interpreted carefully due to less stringent data collection and lower follow-up rates than in research projects. We tried to quantify any outcome differences between a national spine quality register and a prospective observational study. METHODS: Adult patients treated with lumbar discectomy between 2004 and 2010 were retrieved from the Swedish Spine register (Swespine) (n = 7791) and from the single center lumbar disc herniation study (LDHS) in Stockholm (n = 177)...
March 9, 2018: European Spine Journal
Richard A Deyo, Sara E Hallvik, Christi Hildebran, Miguel Marino, Nicole OʼKane, Jody Carson, Joshua Van Otterloo, Dagan A Wright, Lisa M Millet, Wayne Wakeland
Lumbar fusion surgery is usually prompted by chronic back pain, and many patients receive long-term preoperative opioid analgesics. Many expect surgery to eliminate the need for opioids. We sought to determine what fraction of long-term preoperative opioid users discontinue or reduce dosage postoperatively; what fraction of patients with little preoperative use initiate long-term use; and what predicts long-term postoperative use. This retrospective cohort study included 2,491 adults undergoing lumbar fusion surgery for degenerative conditions, using Oregon's prescription drug monitoring program to quantify opioid use before and after hospitalization...
March 6, 2018: Pain
Kyoung Min Lee, Seung-Baik Kang, Chin Youb Chung, Moon Seok Park, Dong-Wan Kang, Chong Bum Chang
OBJECTIVE: This study was performed to investigate the factors associated with the level of knee pain in a nationally representative sample of noninstitutionalized women aged 50 years or older. METHODS: Women aged 50 years or older were selected and included in the data analyses from the Korean National Health and Nutrition Examination Surveys (2010-2013). Those having malignant diseases or using osteoarthritis medication were excluded. Significant factors associated with the level of knee pain were analyzed using multivariate regression analysis...
2018: PloS One
Sara Khor, Danielle Lavallee, Amy M Cizik, Carlo Bellabarba, Jens R Chapman, Christopher R Howe, Dawei Lu, A Alex Mohit, Rod J Oskouian, Jeffrey R Roh, Neal Shonnard, Armagan Dagal, David R Flum
Importance: Functional impairment and pain are common indications for the initiation of lumbar spine surgery, but information about expected improvement in these patient-reported outcome (PRO) domains is not readily available to most patients and clinicians considering this type of surgery. Objective: To assess population-level PRO response after lumbar spine surgery, and develop/validate a prediction tool for PRO improvement. Design, Setting, and Participants: This statewide multicenter cohort was based at 15 Washington state hospitals representing approximately 75% of the state's spine fusion procedures...
March 7, 2018: JAMA Surgery
Xuanqi Xiong, Zhengwei Zhou, Matteo Figini, Junjie Shangguan, Zhuoli Zhang, Wei Chen
Objective: To quantitatively evaluate lumbar disc degeneration with recently-developed quantitative magnetic resonance imaging (MRI) techniques. A series of MRI parameters, including T2*, T1rho relaxation time, apparent diffusion coefficient and gagCEST, were compared and correlated with the Pfirrmann semi-quantitative classification of lumbar intervertebral disc degeneration; the most accurate and relevant MRI parameters of lumbar disc degeneration were identified. Materials and Methods: Thirty-seven subjects (age range, 18-74 years) with non-specific low back pain (LBP) for more than 6 months were enrolled...
2018: American Journal of Translational Research
Amin Joukar, Anoli Shah, Ali Kiapour, Ardalan Seyed Vosoughi, Bradley Duhon, Anand K Agarwal, Hossein Elgafy, Nabil Ebraheim, Vijay K Goel
STUDY DESIGN: The comparison of sacroiliac joint (SIJ) angular motions, pelvis ligaments strain, load sharing, and stress distribution across the joint for male and female spine-pelvis-femur models using finite element analysis. OBJECTIVE: To quantify biomechanical parameters at SIJ for all motions for both male and female models. SUMMARY OF BACKGROUND DATA: SIJ has been recognized as a main source of pain in 13% to 30% of patients with low back pain...
March 5, 2018: Spine
Anne Tabard-Fougère, Romain Dayer, Stéphane Armand, Nicolas Vuillerme
STUDY DESIGN: A cross-sectional comparative study. OBJECTIVE: This study aimed to investigate the flexion-relaxation phenomenon (FRP), in standing trunk flexion and slumped sitting tasks, by comparing children and adolescents suffering from nonspecific chronic low back pain (NSCLBP) with controls (CTRL). SUMMARY OF BACKGROUND DATA: The absence of the FRP can accurately discriminate adults with NSCLBP from those without during standing trunk flexion and slumped sitting tasks...
March 5, 2018: Spine
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