Erector Spinae Research Articles

Reduced-dose deep learning iterative reconstruction for abdominal computed tomography with low tube voltage and tube current

BackgroundThe low tube-voltage technique (e.g., 80 kV) can efficiently reduce the radiation dose and increase the contrast enhancement of vascular and parenchymal structures in abdominal CT. However, a high tube current is always required in this setting and limits the dose reduction potential. This study investigated the feasibility of a deep learning iterative reconstruction algorithm (Deep IR) in reducing the radiation dose while improving the image quality for abdominal computed tomography (CT) with low tube voltage and current.MethodsSixty patients (male/female, 36/24; Age, 57.72 ± 10.19 years) undergoing the abdominal portal venous phase CT were randomly divided into groups A (100 kV, automatic exposure control [AEC] with reference tube-current of 213 mAs) and B (80 kV, AEC with reference of 130 mAs). Images were reconstructed via hybrid iterative reconstruction (HIR) and Deep IR (levels 1–5). The mean CT and standard deviation (SD) values of four regions of interest (ROI), i.e. liver, spleen, main portal vein and erector spinae at the porta hepatis level in each image serial were measured, and the signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated. The image quality was subjectively scored by two radiologists using a 5-point criterion.ResultsA significant reduction in the radiation dose of 69.94% (5.09 ± 0.91 mSv vs. 1.53 ± 0.37 mSv) was detected in Group B compared with Group A. After application of the Deep IR, there was no significant change in the CT value, but the SD gradually increased. Group B had higher CT values than group A, and the portal vein CT values significantly differed between the groups (P < 0.003). The SNR and CNR in Group B with Deep IR at levels 1–5 were greater than those in Group A and significantly differed when HIR and Deep IR were applied at levels 1–3 of HIR and Deep IR (P < 0.003). The subjective scores (distortion, clarity of the portal vein, visibility of small structures and overall image quality) with Deep IR at levels 4–5 in Group B were significantly higher than those in group A with HIR (P < 0.003).ConclusionDeep IR algorithm can meet the clinical requirements and reduce the radiation dose by 69.94% in portal venous phase abdominal CT with a low tube voltage of 80 kV and a low tube current. Deep IR at levels 4–5 can significantly improve the image quality of the abdominal parenchymal organs and the clarity of the portal vein.

Ultrasound-Guided Erector Spinae Plane Block in the Emergency Department: A Treatment for Intractable Sciatica

Ultrasound-Guided Erector Spinae Plane Block in the Emergency Department: A Treatment for Intractable Sciatica

Pericapsular Nerve Group (PENG) Block Versus Lumbar Erector Spinae Plane Block (ESPB) in Pediatric Hip Surgery: A Randomized, Double-Blinded, Controlled Trial.

The effectiveness and safety of the pericapsular nerve group (PENG) block and lumbar erector spinae plane block (ESPB) in pediatric hip surgeries is limited mainly to case reports. This study assessed the efficacy of ultrasound-guided PENG block versus lumbar ESPB under spinal anesthesia. Ninety patients aged 2 to 7 years, ASA I-III scheduled for hip surgery were randomly assigned to 3 equal groups, each receiving the PENG block group (n=30), the ESPB group (n=30), or the control group (n=30). After the spinal anesthesia, the block was performed with 0.5kg/mL of 0.2% ropivacaine. The primary outcome was the pain scores (FLACC) 48 hours after surgery. The secondary outcomes included postoperative FLACC pain scores, neutrophile-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and total opioid consumption. The FLACC score was significantly lower in the lumbar ESPB and PENG groups compared with the control group (P<0.0001) at all time points. The NLR and PLR levels were substantially lower in the PENG and lumbar ESPB groups (P<0.0001) compared with the control group. The NLR and PLR levels were significantly lower in the PENG and lumbar ESPB groups compared with the control group (P<0.0001). The total opioid consumption was significantly lower in the PENG and lumbar ESPB groups compared with the control group (P<0.0001). Forty-three percent of children in the PENG group and 50% of children in the lumbar ESPB group did not require opioids postoperatively. The PENG block and the lumbar ESPB provide efficient postoperative analgesia in children undergoing hip surgery. The PENG block and lumbar ESPB lower cumulative opioid consumption and the stress response to surgery, expressed by NLR and PLR levels. Level I.

EFFECTS OF STRETCHING ON ADOLESCENT TRACK AND FIELD ATHLETES

Introduction. Flexibility, or joint range of motion, is often highlighted as a crucial aspect of physical fitness. It is commonly believed that improving flexibility can enhance performance and help lower the risk of injury. Methodology. This study involved a sample of 30 Track and Field athletes who were tested once before the stretching programs were applied (April 2024) and once after (October 2024). Results. The data from descriptive analyses for both tests before and after the application of stretching programs showed slight improvements in the SLJ, VJ, BOMBT, and SSPMBT metrics. The results from the comparative analysis of the VJ, SLJ 30-meter Flying Start, and BOMBTS indicators showed a statistically significant improvement from Test 1 to Test 2. The data from the descriptive analysis: M. Triceps Surae: Test 1 mean of 13.27 and Test 2 mean of 16.57 for the right limb; Test 1 mean of 13,2 and Test 2 mean of 17,4 for the left limb; Hamstring: Test 1 mean of 79.47 and Test 2 mean of 86.3, for right limb. Test 1 mean 79.37 and Test 2 mean 85.87 for the left limb; M. Rectus Femoris: Test 1 mean 151.33 and Test 2 mean 153.83 for the right limb. Test 1 mean of 150,9 and Test 2 of 154 for the left limb; M. Erector Spinae: Test 1 mean of 26.77 and Test 2 mean of 28.9. The improvement in the M. Triceps Surae R/L flexibility (The t-value of -2.35/-2.81 at a significance level of α = .05 suggests a statistically significant difference between the two test results, indicating the effectiveness of the applied intervention or training program. Conclusions. The comparative analysis of the Vertical Jump, Standing Long Jump, 30-meter Flying Start, and Backward Overhead Medicine Ball Throw indicators showed a statistically significant improvement from Test 1 to Test 2, indicating a positive effect on the development of speed and strength qualities during the application of the stretching programs. Additionally, Welch’s t-test results highlighted the effectiveness of the intervention program, demonstrating a statistically significant improvement in the flexibility of the M. Triceps Surae R/L between Test 1 and Test 2.

The Influence of Anesthesia on Neuromonitoring During Scoliosis Surgery: A Systematic Review

Background: Intraoperative neuromonitoring (IONM) is crucial for the safety of scoliosis surgery, providing real-time feedback on the spinal cord and nerve function, primarily through motor-evoked potentials (MEPs). The choice of anesthesia plays a crucial role in influencing the quality and reliability of these neuromonitoring signals. This systematic review evaluates how different anesthetic techniques—total intravenous anesthesia (TIVA), volatile anesthetics, and regional anesthesia approaches such as Erector Spinae Plane Block (ESPB), spinal, and epidural anesthesia—affect IONM during scoliosis surgery. Methods: A systematic review was conducted following PRISMA guidelines. PubMed, MEDLINE, EMBASE, and Cochrane databases were searched for studies published between 2017 and 2024 that examined the impact of anesthetic techniques on neuromonitoring during scoliosis surgery. The focus was on studies reporting MEP outcomes, anesthetic protocols, and postoperative neurological and analgesic effects. Results: The search initially identified 998 articles. After applying inclusion criteria based on relevance, recency, methodological quality, and citation frequency, 45 studies were selected for detailed review. Conclusion: The erector Spinae Plane Block (ESPB) provides distinct benefits over spinal and epidural anesthesia in scoliosis surgery, particularly in maintaining neuromonitoring accuracy, reducing hemodynamic instability, and minimizing complications. The ESPB’s ability to deliver effective segmental analgesia without compromising motor function makes it a safer and more efficient option for postoperative pain management, enhancing patient outcomes.

Quality of lumbar paraspinal muscles in patients with chronic low back pain and its relationship to pain duration, pain intensity, and quality of life.

To examine the relationship between the quality of paraspinal muscles and pain intensity, duration, and quality of life in patients with chronic low back pain (cLBP). Between January 2022 and December 2023, 119 individuals with no-back pain (no-BP) and 136 cLBP patients were enrolled. Both groups underwent health surveys and magnetic resonance imaging. Cross-sectional area (CSA), functional cross-sectional area (FCSA), and fat infiltration (FI) of multifidus (MF) and erector spinae (ES) were measured. Data were analyzed using multiple linear and binary logistic regression. Compared to the cLBP group, the no-BP group had smaller CSA influenced by FI of ES at L5/S1 (p = 0.01), higher FCSA of ES (p < 0.01) at L4/L5, and lower FI of ES and MF at L4/L5 and L5/S1 (p < 0.01). CSA, FCSA, and FI showed no significant correlation with cLBP intensity except for the CSA (p = 0.02) and FCSA (p = 0.03) of the L2/3 MF. Pain duration positively correlated with FI at L2/3, L3/4, and L4/5 of MF and ES (p < 0.05) and CSA of the L1/2 MF (p = 0.02). CSA (L3/4, L4/5, and L5/S1) and FCSA (L4/5, L5/S1) of MF correlated positively with SF36 scores (p < 0.05), while ES muscles did not (p > 0.05). FI of MF and ES showed no correlation with SF36 scores. CSA and FI were significantly higher, and FCSA significantly lower in paraspinal muscles of cLBP patients compared to asymptomatic participants. Increased FI correlated with prolonged cLBP duration, indicating FI and FCSA alterations may play a significant role in cLBP development and duration. Question What is the relationship between paraspinal muscle quality and cLBP, including its intensity, duration, and impact on quality of life? Findings cLBP patients had increased FI and reduced functional muscle area in paraspinal muscles, with FI correlating with prolonged pain duration. Clinical relevance Understanding the changes in lumbar paraspinal muscles provides insight into cLBP progression, guiding personalized interventions to improve pain management and patient quality of life.

Pro's and con's of different blocks for postoperative analgesia after video-assisted thoracic surgery.

Although there are a lot of studies examining the effects of different blocks for postoperative analgesia after video-assisted thoracic surgery (VATS), the results are controversial. Paravertebral block, serratus anterior plane block and erector spinae plane block appear to be effective and beneficial for post-VATS analgesia, but probably in different manners. All three blocks can be suggested for daily practice, the choice should be based on personal experience and preference of the anesthetist. Better studies are required for objective decision.

Enhancing ergonomics in E-waste disassembly: the impact of collaborative robotics on muscle activation and coordination

Disassembly, as a part of the electronic waste (e-waste) management process, is a labour-intensive task. The emergence of collaborative robots (cobots) provides a robotic solution to reduce the human efforts during disassembly. This study evaluated muscle activation patterns during cobot-assisted e-waste disassembly using surface electromyography (EMG). Twenty-two participants were recruited to perform disassembly tasks with and without cobot assistance. EMG signals from biceps brachii (BB), brachioradialis (BR), upper trapezius (UT), and erector spinae (ES) were collected simultaneously. Six features were then calculated to determine muscle activation patterns. Additionally, EMG-EMG coherence analysis was conducted for BR and ES muscles. Results showed a significant reduction in muscle activity with cobot assistance, particularly in the left ES muscle (46.4% decrease). Moreover, coherence between BR and ES muscles significantly increased. These findings indicate the proposed collaboration strategy not only reduces the muscle activity but also sheds light on enhancing muscle coordination during e-waste disassembly.

Ultrasound-guided bilateral erector spinae plane block in the management of postoperative analgesia in living liver donors: a randomized, prospective study.

Living donor hepatectomy is a procedure associated with notable postoperative pain, impacting patient recovery and satisfaction. Addressing this challenge, we aimed to examine the effect of ultrasound-guided bilateral erector spinae plane block (ESPB) in postoperative analgesia management of patients undergoing living donor hepatectomy for liver transplantation. A single-center prospective, randomized, controlled study was conducted on ASA I-II patients aged 18-65 who underwent elective living donor hepatectomy. Participants were randomized into ESPB (N.=20) and control (N.=21) groups. ESPB was performed under ultrasound guidance with 0.25% bupivacaine (20 mL bilaterally) at T7-T9 levels. The control group received no block. Postoperative analgesia included IV acetaminophen, opioids, alongside fentanyl patient-controlled analgesia. Pain intensity was assessed using Numeric Rating Scale (NRS) at various time intervals. Primary outcome was to compare postoperative opioid consumption levels and secondary outcomes were to evaluate postoperative pain scores, requirement of rescue analgesia, and opioid-related side effects. Patients in ESBP group exhibited lower total fentanyl consumption (P=0.023) and lower meperidine use for rescue analgesia (P=0.001) compared to controls. While static pain scores showed no significant difference, Group ESPB reported lower dynamic pain scores in the immediate postoperative period (P=0.047). The incidence of nausea was lower in Group ESPB (6 vs. 17, P=0.002) with no observed complications. ESPB displayed promise in effectively managing post-living donor hepatectomy pain, resulting in decreased opioid consumption, improved pain relief, and reduced rescue analgesia requirements. This technique holds potential to enhance recovery and patient satisfaction following donor hepatectomy.

Comparison of erector spinae plane block and transverse abdominis plane block in postoperative recovery after laparoscopic colorectal surgery: a randomized, double-blind, controlled trial

BackgroundPatients experience significant postoperative pain after laparoscopic resection of colorectal cancer. Transversus abdominis plane block (TAPB) provides effective analgesia, and recent studies have also shown that erector spinae plane block (ESPB) can be used for postoperative analgesia in abdominal surgery. However, there is a lack of comparison between the two methods regarding recovery quality following laparoscopic colorectal surgery.MethodsSixty patients scheduled for laparoscopic radical resection of colorectal cancer were randomly assigned to receive either a ESPB with TAPB (n = 30). Both groups received a single injection of 20 mL of 0.25% ropivacaine bilaterally. The primary outcome was the quality of recovery (QoR) at 24 h postoperatively, using the quality of recovery-15 (QoR-15) scale. Secondary outcomes included the QoR at 48 h postoperatively, visual analogue scale (VAS) pain scores during the first 48 h postoperatively in both resting and active states, requirements for rescue analgesia, cumulative postoperative opioid consumption, patient satisfaction, incidence of postoperative nausea and vomiting (PONV), time to first flatus and ambulation, the Comprehensive Complication Index (CCI) score, and postoperative hospital stay.ResultsAt 24 h postoperatively, the QoR-15 score (mean ± standard deviation) was significantly higher in the ESPB group (109.2 ± 8.7) compared to the TAPB group (101 ± 10.1) (p = 0.001). Similarly, at 48 h postoperatively, the QoR-15 score remained higher in the ESPB group (118.5 ± 8.8) than in the TAPB group (113.8 ± 8.1) (p = 0.035). Patients in the ESPB group reported lower visual analog scale (VAS) pain scores during the first 24 h postoperatively (all p < 0.05) compared to those in the TAPB group. The sufentanil consumption median (interquartile range) in the ESPB group at 24 h postoperatively was lower (62, 61–65 μg) compared to the TAPB group (66, 63–70 μg) (p < 0.001). Hospital stay median was 7 (6–9) days for the ESPB group and 8 (7–10) days for the TAPB group (p = 0.037).ConclusionsPatients who received ESPB showed better recovery quality, improved analgesic effects, and higher postoperative satisfaction compared to those who underwent preoperative TAPB.Trial registrationhttps://www.chictr.org.cn (ChiCTR2400081157); date of registration: February 24, 2024. The first participant was enrolled on February 27, 2024.

Opioid-sparing effect of Continuous Erector Spinae Plane Block in Robotic Cardiac Surgery: Preliminary Results of a Randomized Clinical Trial

Opioid-sparing effect of Continuous Erector Spinae Plane Block in Robotic Cardiac Surgery: Preliminary Results of a Randomized Clinical Trial

Comparison of Intrathecal Morphine versus Ultrasound-Guided Regional Analgaesia Techniques for Post-Caesarean Recovery Quality.

To investigate the impact of ultrasound-guided regional analgaesia techniques on postoperative recovery and compare them with those of intratecal morphine (ITM) in obstetric patients undergoing elective caesarean delivery (CD). Observational study. Place and Duration of the Study: Department of Anaesthesiology and Reanimation, Konya City Hospital, Konya, Turkiye, from January to December 2022. The study involved six groups of 30 patients each, categorised by postoperative analgaesia: ITM, posterior transversus abdominis plane block (TAPB), lateral TAPB, transversalis fascia plane block, posterior quadratus lumborum block, and erector spinae plane block. Recovery was assessed using the Obstetric Quality of Recovery Score-10 (ObsQoR-10) at 24 hours, whereas satisfaction was measured with a Likert scale. Time to the first analgaesia, total opioid consumption, nausea, and the need for antiemetics were compared. ObsQoR-10, satisfaction, and numerical rating scale scores were consistent across groups (p >0.05). The lateral TAPB group required more opioids and had earlier analgaesic requests (p = 0.009 and p = 0.05, respectively). ITM was more likely to cause nausea and pruritus compared to regional analgaesia techniques (p = 0.062 and p <0.001). Ultrasound-guided regional analgaesia techniques provided similar postoperative recovery and patient satisfaction levels as ITM. Moreover, regional analgaesia techniques, except lateral TAPB, may offer similar alternatives to ITM within multimodal analgaesia strategies for CD. Caesarean delivery, Multimodal analgaesia, Patient-reported outcome, Regional analgaesia techniques, Quality of recovery.

Quantitative observation based on magnetic resonance imaging: the effects of marathon running on lumbar vertebrae, paraspinal muscles, and lumbar disc components.

Lumbar spine injuries and lumbar disc degeneration are common spinal health problems that seriously affect people's quality of life and efficiency at work. Marathon running enhances skeletal muscle strength and endurance, and promotes increased bone mineral density. This study aimed to investigate the effects of marathon running on the lumbar spine and surrounding tissue components. In total, 54 amateur marathon runners (age: 41.7±7.2 years), who were randomly recruited from an amateur marathon runners club in Hangzhou, and 30 healthy volunteer participants (age: 37.7±5.3 years) were enrolled in this prospective cross-sectional study. The Dixon-volumetric interpolated breath-hold examination (VIBE), T2* mapping, and conventional T2 sequences were used to evaluate the proton density fat fraction (PDFF) and cross-sectional area (CSA) of the vertebral bodies, and bilateral paraspinal muscles (PMs), as well as the T2 relaxation times of the intervertebral discs (IVDs). There were significant differences in the fat fraction (FF) of each vertebral segment between the marathon runners and healthy participants (P<0.05). There were also significant differences between the healthy participants and marathon runners in terms of the T2 relaxation times of the anterior nucleus pulposus (ANP) (41.28±14.36 vs. 38.04±13.12 ms; P=0.008), central nucleus pulposus (54.67±17.85 vs. 50.24±17.46 ms; P=0.003), and posterior annulus fibrosus (PAF) (25.80±7.67 vs. 22.63±6.88 ms; P<0.001). The CSA of the psoas major at the L3 (8.25±2.17 vs. 9.70±1.81 cm2, P=0.002), L4 (11.82±2.65 vs. 13.62±1.97 cm2, P<0.001), and L5 (12.59±2.47 vs. 14.25±2.38 cm2, P<0.001) levels and that of the erector spinae at the L2 (16.59±4.87 vs. 20.13±3.71 cm2, P<0.001), and L3 (18.04±4.63 vs. 21.65±3.38 cm2, P<0.001) levels were lower in the marathon runner group than the control group. The PDFF of the psoas major at all levels was significantly lower in the marathon runner group than the control group (P<0.001). Annulus fibrosus (AF) at the L4/5 (r=-0.342, P=0.011) and L5/S1 (r=-0.304, P=0.026) levels were negatively correlated with the monthly running distance. Additionally, the PDFF of the psoas major was weakly and negatively correlated with the monthly running distance at the L3 level (r=-0.396, P=0.003). Marathon running may benefit the structure of the lumbar spine in a number of ways, including by reducing the lumbar vertebral body and psoas major muscle FFs and by reducing lumbar disc degeneration. However, in terms of building muscle strength, marathon running should be combined with some intensity of resistance training to minimize muscle loss due to excessive aerobic exercise.

Continuous regional anesthesia with erector spinae plane catheters for patients with multiple rib fractures.

Opioids are commonly used for acute pain management in patients with rib fractures, but their use poses known risks of addiction and respiratory depression. Regional anesthesia, namely the erector spinae plane(ESP) block, has shown promise as an alternative to opioids in case series. Our aim was to evaluate the efficacy and safety of continuous ropivacaine infusion ESP catheters performed by emergency physicians (EP) for patients with multiple unilateral rib fractures. This retrospective case control study identified polytrauma patients with rib fractures in a 1-year period between 2019 and 2020 who had an ESP catheter placed by EP. The control group consisted of polytrauma patients who did not receive regional anesthesia and were matched by number of rib fractures and age. Our primary outcome was opioid use in morphine milligram equivalents per day (MMED). We compared MMED before and after catheter placement in the treatment group and overall MMED between the control and catheter group. Secondary outcomes included length of hospitalization, rate of intubation, and complications. Subgroup analysis of the same variables was performed on the group of patients whose only injury was rib fractures. The catheter group included 89 patients, matched with an equal number in the control group. Opioid use decreased from 89 to 67 MMED after catheter placement in the treatment group (P=0.003). Overall opioid use during hospitalization did not significantly differ between treatment and control groups (P=0.57). There was a trend toward fewer days of mechanical ventilation and shorter hospital length of stay in the catheter group in patients with isolated rib fractures, but neither of these trends reached statistical significance. Opioid use decreased after ESP catheter implementation and there were no meaningful complications. Although there was no significant difference in opioid use between groups, ESP catheter placement and continuous regional anesthesia by EP is a safe, reasonable adjunct to treat pain from rib fractures.

New insights into the impact of bed rest on lumbopelvic muscles: A computer-vision model approach to measure fat fraction changes.

Space agencies plan crewed missions to the Moon and Mars. However, microgravity-induced lumbopelvic deconditioning, characterized by an increased fat fraction (FF) due to reduced physical activity, poses a significant challenge to spine health. This study investigates the spatial distribution of FF in the lumbopelvic muscles to identify the most affected regions by deconditioning, utilizing a computer-vision model and a tile-based approach to assess FF changes. Twenty-four healthy individuals (8F) were recruited, and automatic segmentation of the lumbopelvic muscles was applied before and after 59 days of head-down tilt bed rest (HDTBR+59) and 13 days of reconditioning (R+13). Axial Dixon sequence images were acquired from 3T magnetic resonance imaging. FF in the lumbar multifidus (LM), lumbar erector spinae (LES), quadratus lumborum, psoas major, gluteus maximus (GMax), gluteus medius (GMed) and gluteus minimus (GMin) muscles from the upper margin of L1 vertebra to the inferior border of GMax muscle were automatically derived using a computer-vision model. Lumbar muscles were segmented into eight tiles (superficial and deep, lateral to medial), and gluteal muscles into regions (anterior/superior for GMed and GMin, superior/inferior for GMax). At HDTBR+59, the deep centro-lateral region at L5/S1 for LM (18.7±15.7%, p<0.001; d=0.97) and the deep medial region at Upper L4 for LES (5.4±5.9%, p<0.001; d=0.34) showed the largest increase in FF compared to BDC. These regions did not recover at R+13 (p<0.05; d≥0.25). These findings highlight the need to target deep fascicles of LM and LES in countermeasure strategies to mitigate microgravity-induced lumbopelvic deconditioning, optimizing spine health and performance.

Bi‐Level Ultrasound Guided Erector Spinae Block V/S Paravertebral Block in Post Operative Analgesia After Breast Cancer Surgeries

Bi‐Level Ultrasound Guided Erector Spinae Block V/S Paravertebral Block in Post Operative Analgesia After Breast Cancer Surgeries

Risk factors for secondary vertebral compression fracture after percutaneous vertebral augmentation: a single-centre retrospective study

ObjectiveTo determine the incidence of secondary vertebral compression fracture (SVCF) after percutaneous vertebral augmentation (PVA) and its correlative risk factors, and to provide theoretical evidence for clinical practice.MethodsA retrospective analysis of 288 cases of PVA completed in our hospital from June 2020 to June 2023 was performed, and the patients were divided into the non-secondary vertebral compression fracture group (N-SVCF group) and the secondary vertebral compression fracture group (SVCF group) according to whether SVCF occurred during the postoperative follow-up review. Gender, age, body mass index (BMI), T value of bone mineral density (BMD-T), underlying diseases (hypertension, diabetes mellitus, coronary heart disease, chronic obstructive pulmonary disease), intravertebral vacuum cleft (IVC), amount of bone cement injected, classification of cement diffusion, anterior vertebral recovery ratio, local Cobb angle correction rate, leakage of bone cement into the intervertebral space, and fat infiltration rate (FIR) of paraspinal muscles were collected from the patients. The incidence and risk factors of SVCF after PVA were evaluated using univariate and multivariate logistic regression analysis, and the predictive value of the independent risk factors was evaluated using receiver operating characteristic curve (ROC) to determine the cut-off points at which they were meaningful for the development of SVCF.ResultsIn our study, the incidence of SVCF was 14.60% (42/288) in 288 patients who underwent PVA. Univariate analysis showed that age, BMI, fat infiltration rate of paraspinal muscles, cement leakage into the intervertebral space, unilateral/bilateral pedicle puncture approach and presence of IVC were statistically different between N-SVCF and SVCF (P < 0.05). Multifactorial regression analysis and ROC regression analysis revealed that the fat infiltration rate of the psoas major and erector spinae muscles, cement leakage into the intervertebral space, and IVC (P < 0.05) were risk factors for the incident of SVCF after PVA (P < 0.05). Psoas major (FIR) more than 5.490% and erector spinae (FIR) more than 52.413% had a high possibility of the occurrence of SVCF after PVA.ConclusionIn this study, logistic regression combined with ROC curve analysis indicated that FIR of psoas major and erector spinae, cement leakage in the intervertebral space, and IVC were risk factors for the occurrence of SVCF after PVA. Psoas major (FIR) more than 5.490% and erector spinae (FIR) more than 52.413% had a high possibility of the occurrence of SVCF after PVA.

Power yoga induced acute para-spinal compartment syndrome: a case report and review of literature.

Acute Paraspinal compartment syndrome (PCS) is a very rare clinical condition resulting from high pressures within the erector spinae muscle compartment due to intense edema of the erector spinae muscles and can be associated with rhabdomyolysis and renal injury. Though several causes have been identified, PCS caused by power yoga has not been reported. Power yoga is a form of fast and vigorous yoga, and involves intense flexion-extension of the spine and other parts of the body in a repetitive manner. We report the case of a 36-year-old male who presented with acute onset of intense low back pain following power yoga practice. His lower limb neurology was normal and MRI showed diffuse intramuscular oedema of the bilateral para-spinal erector spinae muscles around the lumbar region indicative of PCS. Laboratory values of elevated urine myoglobin and serum creatinine phosphate kinase (CPK) confirmed the presence of rhabdomyolysis. He was monitored closely for renal injury and treated by rest, analgesics, fluid management and supportive care. Serial CPK values indicated a decreasing trend and at sixth week, the value was normal. Follow-up MRI at 6 weeks showed complete resolution of muscle oedema. Patient had full recovery and returned to normal activities in 6 months. This report highlights the importance of vigilance and performing early MRI for diagnosing yoga-induced PCS, so that appropriate treatment can be initiated avoiding serious sequelae of rhabdomyolysis and paraspinal muscle loss. This report highlights the need for suspicion and early MRI for diagnosing yoga-induced PCS and appropriate care.

Bobath And Pilates Therapy On Sitting And Standing Balance In Children With Cerebral Palsy

Cerebral Palsy is the most common neurological disorder in children that affects movement and posture due to damage to the brain which controls motor skills, causing balance problems when sitting and standing. This balance is affected by the strength of the erector spine and abdominal muscles that straighten and control the trunk. If low trunk muscle tone causes problems with balance and mobility so that the child has difficulty sitting, playing in a sitting position, functional hand movements such as eating and activities of daily living. This research is an experiment with a pre test – post one group design which aims to analyze the effectiveness of bobath and pilates therapy on sitting and standing balance in children with cerebral palsy. A total of 17 children with cerebral palsy were given bobath and pilates therapy for 16 weeks, with a dose of: 1 time/day, 3 times a week with a treatment time of 45 minutes for each child. The research subjects were children with cerebral palsy with the following criteria: 1-year old, unbalanced sitting and standing. It will be carried out from February to June 2023. Sitting balance is measured with a sitting level scale and standing balance with a pediatric balance scale. The research subjects consisted of 13 men (76.47%) and 4 women (23.53%) with the GMFCS categories being III and IV. The average age of research subjects: 36.5758 ± 15.02504. The results of statistical tests with Wilcoxon obtained a value of p = 0.001 at the sitting level of the scale and p = 0.002 on the pediatric balance scale. Conclusion: Bobath and pilates therapy are effective in increasing the value of the sitting level of the scale and the pediatric balance scale in children with cerebral palsy.

Ergonomic challenges in healthcare: mapping physical load during patient transfers using electromyographic field measurements.

Work-related musculoskeletal disorders are prevalent among healthcare workers. These workers experience high rates of low-back pain; partly due to the high physical demands of patient transfers. Understanding the specific transfer scenarios that contribute to high physical loads is therefore crucial for developing strategies to improve working conditions. This study utilized electromyography to measure muscle activity in the erector spinae muscles during patient transfers, performing measurements in real-life hospital settings to identify the physical load associated with different transfer scenarios. Using linear mixed models, the 95th percentile ranks of the normalized root mean square (nRMS) values were analyzed for a range of different patient transfers. The results revealed significant differences in physical load across various patient transfer scenarios. High-load activities included sitting to lying down or lying down to sitting (nRMS 32.7, 95% CI: 28.9-36.6) and lifting the upper body (32.4, 95% CI: 28.8-35.9), while low-load activities such as supporting patients while walking or standing (21.9, 95% CI: 18.6-25.1) and mobilizing in bed (19.9, 95% CI: 16.1-23.8) required less muscle activation. Moderate-load activities included bed to chair transfers (28.1, 95% CI: 24.9-31.3) and lifting the head (26.3, 95% CI: 22.7-29.9). Understanding the physical load associated with different patient transfer scenarios allows for better organization of work in healthcare settings. These novel findings emphasize the need for effective task allocation, rotational schedules, and the use of assistive devices to distribute physical load and reduce injury risk.