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Lower back pain

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
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
Audrey Petit, Cyril Begue, Isabelle Richard, Yves Roquelaure
OBJECTIVES: To assess the attitudes and beliefs of physiotherapists (PTs) regarding the management of chronic LBP and to investigate the factors which influence them. METHODS: A cross-sectional study conducted in the French Loire Valley region by a questionnaire sent to the private PTs between June and September 2014. Demographic data and modalities of practices were collected in association with the Pain Attitudes and Beliefs Scale (PABS) which is a specific self-administered questionnaire designed to assess the "biomedical" or "behavioral" (i...
March 9, 2018: Physiotherapy Theory and Practice
Abdulhadi A AlAmodi, Mohamad H Farhoud, Najwa Mohammad, Rawan Alatassi, Dana Alolayet, Noor AlQeshtaini, Raghad AlMamlouk, Mohamed Hussein Ahmed, Mahmoud Ashour, Sara S Kayyali, Abdullah AlShammari
BACKGROUND Leiomyomas are benign neoplasms of the smooth muscle. When found in the pulmonary system, a rare occurrence, leiomyomas can result in hypertrophic osteoarthropathy, or significant clubbing, associated with proliferation of long bone periosteum. Bronchopulmonary fistulas, or communications between the bronchial tree and pleural space, are an uncommon postoperative complication of pneumonectomies. Even more infrequent is the presence of a bronchopulmonary fistula that is determined to be sterile. CASE REPORT The patient presented in the current case report is a 40-year-old previously healthy woman who presented with a 5-year history of chronic cough, right-sided chest discomfort, and dyspnea associated with back pain, and lower leg pain...
March 9, 2018: American Journal of Case Reports
Mauricio Silva, Gal Sadlik, Tigran Avoian, Edward Ebramzadeh
BACKGROUND: The ideal type of immobilization for nondisplaced pediatric elbow fractures has not been established. We hypothesized that the use of a long-arm cylinder made of soft cast material will result in similar outcomes to those obtained with a traditional long-arm hard cast. METHODS: We randomly assigned 100 consecutive children who presented with a closed, nondisplaced, type I supracondylar humeral fracture or an occult, closed, acute elbow injury, to 1 of 2 groups: group A (n=50) received a long-arm, traditional fiberglass (hard) cast...
April 2018: Journal of Pediatric Orthopedics
Xiaoke Li, Shuo Qi, Yuntao Jiao, Jing Gao, Hongbo Du
RATIONALE: Primary central nervous system lymphoma (PCNSL) with initial manifestations of constipation and intestinal obstruction (IO) is rare. PATIENT CONCERNS: A 50-year-old Chinese male patient was admitted to the gastroenterology department due to constipation and abdominal distention for 8 days. He had experienced intermittent back pain for 3 years prior to admission. Based on abdominal radiography, he was initially diagnosed with IO and treated with meal restriction and enemas...
March 2018: Medicine (Baltimore)
Danika Paulo, Alexa Semonche, Rachana Tyagi
BACKGROUND: Giant invasive spinal schwannomas (GISS) comprise a rare, specific subtype of schwannomas that extend over two spinal levels, erode vertebral bodies and invade extraspinal tissues. Optimal surgical management of resulting spinal instability has yet to be determined, and overall there is limited published literature on GISS. We report an innovative method used to treat a rare case of lumbosacral GISS using a triangular frame reconstruction to reconnect the spinal column to the pelvis after tumor debulking...
March 3, 2018: World Neurosurgery
Nicola Holt, Gemma Mansell, Jonathan C Hill, Tamar Pincus
OBJECTIVES: Reassurance is an essential part of treatment for low back pain (LBP), but evidence on effective methods to deliver reassurance remains scarce. The interaction between consultation-based reassurance and patients' psychological risk is unknown. Our objective was to investigate the relationship between consultation-based reassurance and clinical outcomes at follow-up, in people with and without psychological risk. METHODS: We tested the associations between specific reassurance components (data gathering, relationship building, generic reassurance, and cognitive reassurance), patients' psychological risk (the presence of depression, anxiety, catastrophizing, or fear-avoidance), and postconsultation outcomes including, satisfaction and enablement, disability, pain, and mood at 3-month follow-up...
April 2018: Clinical Journal of Pain
Hongmin Chu, Jaehyun Kim, Wonbae Ha, Eunbyul Cho, Geon Kang, Seongjun Park, Jongwon Jang, Seung Bum Yang, Yeonseok Kang, Sanghun Lee, Jae-Hyo Kim
Acupoint GB21 (Jianjing) is used for treating back and shoulder pain but is associated with a risk of pneumothorax. We aimed to determine the SND (safe needling depth) at GB21 according to posture and breathing in real time. Ultrasonographic images of GB21 during normal breathing, inspiration, and expiration in a SP (sitting position) were acquired for 52 healthy volunteers. Images were also acquired during normal respiration in the PP (prone position) with arms raised and lowered. The average SND was greater for men than for women ( p < 0...
2018: Evidence-based Complementary and Alternative Medicine: ECAM
Jianzhong Lin, Yang Yu, Yi Chen, Ming Zheng, Dan Zhou
RATIONALE: The incidence of heterotopic pancreas (HP) is relatively rare and mainly found in the upper gastrointestinal tract, and no case of HP cyst in the adrenal gland has been reported. Informed consent has been obtained from the patient for the publication of the case details. PATIENT CONCERNS: A 21-year-old woman who presented with chronic lower back pain for a week without urinary disturbance or gastrointestinal discomfortable. DIAGNOSES: Ultrasound (US) revealed a left renal cyst, and computed tomography (CT) showed a cyst in the area of the adrenal gland...
January 2018: Medicine (Baltimore)
Go Kubota, Hiroto Kamoda, Sumihisa Orita, Kazuhidee Inage, Michihiro Ito, Masaomi Yamashita, Takeo Furuya, Tsutomu Akazawa, Yasuhiro Shiga, Seiji Ohtori
Study Design: Retrospective case series. Purpose: To examine the efficacy of platelet-rich plasma (PRP) for bone fusion in transforaminal lumbar interbody fusion (TLIF) using local bone grafting. Overview of Literature: Several authors have reported the efficacy of PRP for bone union in animal models. However, the use of PRP for bone fusion in TLIF surgery has not been fully explored. Methods: Twenty patients underwent single-level TLIF surgery because of L4 spondylolisthesis...
February 2018: Asian Spine Journal
Michael P Webb, Erik M Helander, Bethany L Menard, Richard D Urman, Alan D Kaye
Chronic lower back pain is a significant disease that affects nearly 20% of the worldwide population. Along with hindering patients' quality of life, chronic lower back pain is considered to be the second most common cause of disability among Americans. Treating chronic lower back pain is often a challenge for providers, especially in light of our current opioid epidemic. With this epidemic and an increased aging population, there is an imminent need for development of new pharmacologic therapeutic options, which are not only effective but also pose minimal adverse effects to the patient...
2018: Therapeutics and Clinical Risk Management
Saif Yousif, Martin Wood
Bertolotti syndrome describes lower back pain secondary to an anatomical lumbosacral transitional vertebrae. We present the case of a 37 year old female with chronic lower back pain with radiological evidence of an anatomical lumbosacral pseudojoint. The patient underwent minimally invasive resection of her pseudojoint with complete resolution of symptoms postoperatively. We, as the authors would like to highlight that in patients with pain secondary to an aberrant lumbosacral articulation, consideration should be given to treatment via a minimally invasive technique...
March 1, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Jonathan Schaffir, Anne Kunkler, Courtney D Lynch, Jason Benedict, Loriana Soma, Andrew Doering
OBJECTIVE: Postpartum depression may be associated with higher levels of postpartum pain, but the association with discomfort in general is unclear. We sought to describe an association between postpartum mood disturbances and quantitatively measured physical symptoms at the time of the routine postpartum encounter. METHODS: We designed a novel quantitative measurement of postpartum symptoms, the Postpartum Symptom Inventory (PSI), to allow comparison to scores of postpartum mood...
April 2018: Journal of Psychosomatic Research
A Pranata, L Perraton, D El-Ansary, R Clark, B Mentiplay, K Fortin, B Long, R Brandham, A L Bryant
Differences in synchronous movement between the trunk and lower limb during lifting have been reported in chronic low back pain (CLBP) patients compared to healthy people. However, the relationship between movement coordination and disability in CLBP patients has not been investigated. A cross-sectional study was conducted to compare regional lumbar and lower limb coordination between CLBP (n = 43) and control (n = 29) groups. The CLBP group was divided into high- and low-disability groups based on their Oswestry Disability Index (ODI) score...
February 20, 2018: Journal of Biomechanics
Elodie Degroote, Halil Yildiz, Frederic Lecouvet, Alexia Verroken, Leila Belkhir
OBJECTIVE AND IMPORTANCE: New methods of microbiology identification as MALDI-TOF MS increased the rate of Aerococci detection in microbiological samples making this germ an emerging pathogen. The purpose of this case report and literature review is to highlight the role of A. urinae in spine infection and discuss the management of this type of infection. CLINICAL PRESENTATION AND INTERVENTION: A 32-year-old man, with a medical history of paraplegia secondary to a relapsing form of multiple sclerosis, was admitted because of lower back-pain following complaints suggestive of urinary tract infection...
March 2, 2018: Acta Clinica Belgica
Jo-Anne Geere, Jamie Bartram, Laura Bates, Leslie Danquah, Barbara Evans, Michael B Fisher, Nora Groce, Batsirai Majuru, Michael M Mokoena, Murembiwa S Mukhola, Hung Nguyen-Viet, Phuc Pham Duc, Ashley Rhoderick Williams, Wolf-Peter Schmidt, Paul R Hunter
Background: The Sustainable Development Goals include commitments to end poverty, and promote education for all, gender equality, the availability of water and decent work for all. An important constraint is the fact that each day, many millions of women and children, and much less frequently men, carry their household's water home from off-plot sources. The burden of fetching water exacerbates gender inequality by keeping women out of education and paid employment. Despite speculation about the potential health impacts of fetching water, there is very little empirical evidence...
June 2018: Journal of Global Health
Daniela Antolová, Martin Janičko, Monika Halánová, Peter Jarčuška, Andrea Madarasová Gecková, Ingrid Babinská, Zuzana Kalinová, Daniel Pella, Mária Mareková, Eduard Veseliny
The lifestyle, health and social status of the Roma are generally below the standards characteristic for the non-Roma population. This study aimed to find out the seropositivity to Toxoplasma gondii ( T. gondii ) in the population of Roma living in segregated settlements and to compare it with the prevalence of antibodies in the non-Roma population from the catchment area of eastern Slovakia. The seroprevalence of antibodies to T. gondii was significantly higher in the Roma group (45.0%) than in non-Roma inhabitants (24...
February 27, 2018: International Journal of Environmental Research and Public Health
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