History Of Back Pain Research Articles

Combined Wireless Spinal Cord Stimulation, Dorsal Root Ganglion Stimulation, and Peripheral Nerve Stimulation for Treating Low Back Pain

Background: Neuromodulation has undergone significant advances over the past decade, particularly when the DRG and PNS modalities evolved to target conditions that are hard to cover by conventional SCS. The availability of a variety of stimulation modalities allows for a customized approach. Case Presentation: A 49-year-old man presented with low back and buttock pain. The patient had a history of chronic lower back pain, L4/L5 and L5/S1 facet hypertrophy, a 3-mm left paracentral and foraminal disc protrusion minimally involving the left S1 nerve root, and right low back/buttock/hip pain after previous surgical removal of an episacroiliac lipoma on the right sacroiliac joint. Despite multiple therapies such as oral opioids, anticonvulsants, and physical therapy, the patient continued to experience right lower back and buttock pain. Conclusion: The patient’s pain scores decreased from a baseline score of 8 out of 10 without medication to a 1 out of 10 without medication. The wireless SCS and PNS significantly reduced pain scores for this patient suffering from lower back, buttock, and hip pain. Key words: Dorsal root ganglion, low back pain, peripheral nerve stimulation, spinal cord stimulation

The Effect of Hydrotherapy in Low Back Pain Patients

Background: Low back pain (NPB) is the first disease that causes disabilities at all ages, and its incidence increases withage. A number of previous studies have reported that hydrotherapy has an effect on improving low back pain andincreasing flexibility.Therefore, this study aims to determine the effect of hydrotherapy on pain intensity andlumbosacral flexibility in low back pain patients at dr. Mohammad Hoesin Palembang. Methods: This study is a pre-experimental study with a one group pretest-posttest design with a sample size of 35 NPB patients. Inclusion criteriawere NPB patients who did not undergo operative action, had no contraindications to undergo hydrotherapy, andwere > 29 years old. The exclusion criteria were patients with communication disabilities and a history of low backpain due to infection, tumor and metastases. Subjects dropped out of the study if they underwent hydrotherapy lessthan three times or withdrew. Pain intensity and lumbosacral flexibility data were obtained before and after thesubject underwent hydrotherapy once a week for one month. Results: There was a decrease in pain intensity from5.57 to 4.00 (p <0.001) and an increase in lumbosacral flexibility from 48.10 to 48.73 (p = 0.014) in low back painpatients undergoing hydrotherapy. Conclusion: There is an effect of hydrotherapy on reducing pain intensity andincreasing lumbosacral flexibility in low back pain patients undergoing hydrotherapy at the Medical RehabilitationInstallation Dr. Mohammad Hoesin Palembang

Successful Symptomatic Relief of a Patient with Recurrent Fibroids, Undergoing Laparoscopic Radiofrequency Fibroid Ablation

Study Objective To document, through a case report video, a successful Laparoscopic Radiofrequency Ablation (Lap RFA) treatment for multiple recurrent fibroids after myomectomy. Design Video Case Report, 7 month follow up. Setting Hospital OR, Straight Stick Laparoscopy with Laparoscopic Ultrasound and Guidance Mapping. Patients or Participants 36-year-old African American, G0 with history of open myomectomy in 2010, presented with 2-year history of urinary frequency, urgency, constipation, back pain and heavy menstrual bleeding. Ultrasound imaging showed multiple fibroids including: 4.6 cm type 5, 5.4cm type 2, 2.4cm type 2, 3.0 cm type 2, and 2.1 cm type 2. The patient was seeking a uterine sparing alternative to a repeat myomectomy. Interventions Hysteroscopy, D&C, and Laparoscopic Radiofrequency Ablation, July 2019, with six fibroids treated, and 13 minutes of total ablation time. EBL 15cc. No surgical or postoperative complications. Measurements and Main Results 6 week post op visit: patient reports soreness, that her pelvis subjectively feels lighter, and spotting/discharge for 2 weeks that resolved by 1 month. 3 month follow up: ultrasound shows a 7.3 × 7.2cm vs previous 9 × 9cm uterus, multiple fibroids, 3.9cm (from 5.4cm), 2.2cm (from 3.0cm) and 3.9cm (from 4.6cm) in their largest dimensions. 6 month follow up: ultrasound shows a 9 × 6 × 5cm uterus and persistence in fibroid sizes. 7 month follow up: patient notes subjective improvement in urinary frequency, urgency, constipation, back pain and heavy menstrual bleeding. Conclusion Laparoscopic radiofrequency ablation resulted in decreased uterine and fibroid size and provided symptomatic relief in this patient and should be considered as a safe, minimally invasive alternative to repeat myomectomy in patients desiring uterine sparing treatment for recurrent fibroids and for those with complex, multi-fibroid uterine anatomy.

Transverse abdominis activity and ultrasound biofeedback in college golfers with and without low back pain

ObjectivesTo compare transverse abdominis (TrA) muscle activity in college golfers with and without a history of low back pain (LBP) and examine the effects of ultrasound biofeedback and a functional golf-setup position on TrA activity. DesignCrossover study. SettingLaboratory. ParticipantsThirty-two (n = 32) collegiate golfers were stratified into either the LBP group (n = 16, 4.6 ± 4.5 LBP episodes) or non-LBP group (n = 16, 0.1 ± 0.3 LBP episodes) based on LBP episodes in the last 6-months. Main outcome measuresUltrasound measures of TrA activity were performed during standard contractions and contractions with ultrasound biofeedback. Contraction-type order was randomized between two visits. Testing was performed in two positions, supine and golf-setup positions. ResultsWe observed no significant differences in TrA activity between the LBP and non-LBP groups. Overall, TrA activity was greater during biofeedback contractions compared to standard contractions, and TrA activity was lower in the golf-setup position compared to the supine position. ConclusionsWe observed no differences in TrA activity between college golfers with and without LBP. College golfers with and without LBP demonstrated a greater ability to contract their TrA with real-time ultrasound biofeedback and a lower ability to contract their TrA in the functional golf-setup position compared to the traditional supine position.

People considering exercise to prevent low back pain recurrence prefer exercise programs that differ from programs known to be effective: a discrete choice experiment.

Do program and participant characteristics influence people's willingness to undertake exercise programs to prevent recurrence of low back pain? Discrete choice experiment. Six hundred and forty-seven people with a recent history of low back pain. Recruitment and participation occurred online. Participants were randomised to a block of 10 choice tasks, where the characteristics of the exercise program varied systematically. The characteristics that were presented for each exercise program were mode of exercise delivery, mode of supervision, setting, duration, weekly frequency, travel time, risk of recurrence, and costs. For each choice task, participants chose between no program or an exercise program with the characteristics as presented. Choices were analysed using mixed logit models. Latent class models examined preference heterogeneity and identified participant-level characteristics predictive of preferences. There appeared to be an underlying preference for exercise compared with no exercise, all else being equal. Preferences for programs were significantly influenced by the characteristics of the programs. Participants were less likely to choose exercise when programs were of a longer duration (OR 0.92, 95% CI 0.89 to 0.96 per extra month), but more likely to prefer programs offering greater reduction in the risk of recurrence of low back pain (OR 3.91, 95% CI 3.20 to 4.79 per 10% reduction in risk of recurrence). Preferences for engaging in exercise programs to prevent recurrent of low back pain were influenced by the characteristics of the programs themselves. However, there was mismatch between the preferred characteristics of exercise programs and the characteristics of known effective programs. People who have had low back pain should be advised explicitly about which exercise programs reduce recurrence. Understanding low back pain patients' preferences can help inform the implementation of existing prevention programs and guide the design of new prevention programs.

Study of sacrum in patients with low back pain

Patients above 20 years age group attending the Radiology OPD with the digital radiograph of the antero-posterior view of lumbo-sacral spine, with history of low back pain was considered. In the present study, it was proved that deficiency on the dorsal surface of the sacrum is higher among the low back pain patients in whom it is one of the causes of the disease firmly established a larger study involving the living patients suffering from low back pain.

Vertebral osteomyelitis: Clinical, microbiological and radiological characteristics of 116 patients

Introduction/ObjectivesTo describe the clinical, radiological and microbiological characteristics of vertebral osteomyelitis patients, analysing the factors that played a role on their outcome. Patients and methodsSingle-centre retrospective observational study including patients diagnosed with vertebral osteomyelitis, based on the combination of clinical presentation with either a definitive bacteriological diagnosis and/or imaging studies. Results116 adult patients were included with a mean age of 62.75 (14.98) years. Males predominated (68.10%). Eighteen patients (15.51%) were immunosuppressed. The most frequent symptom was back pain (99.14%) followed by fever, which was detected in 45 patients (38.79%). Puncture-aspiration or biopsy was performed in 84 patients (72.10%) and its culture was positive in 48 samples (57.14%). Gram positive species predominated (73.86%) on cultures, followed by Gram negative (12.5%), mycobacteria (10.23%) and fungi (3.41%). No microorganism was identified in 28 patients (24.14%). On imaging, most of the patients (92.24%) had paravertebral or epidural abscess. 63 cases (54.31%) showed vertebral destruction and 39 (33.62%) cord compression. Twenty-two patients (18.97%) required further surgical procedures and 13 (11.21%) died. ConclusionsThe average patient is middle aged (often male) with a history of subacute back pain, sometimes presenting fever and/or neurological damage on diagnosis. Acute phase reactants are frequently raised. Diabetes mellitus, endocarditis and immunosuppressed patients may have the worst chance of a good outcome, therefore these patients should be more carefully managed (always try to obtain an imaging-guided biopsy, correct antibiotic treatment, and a functional and clinical follow-up).

S2927 Prolonged Gastrointestinal Prodrome Leading to Severe Respiratory Insufficiency in a Case of E-Cigarette/Vaping-Associated Lung Injury (EVALI)

INTRODUCTION: E-cigarette/vaping product use-associated lung injury (EVALI) is a potentially life-threatening disease. Gastrointestinal manifestations have been noted in the past to shortly precede respiratory decline. A longer gastrointestinal prodrome may mean more EVALI patients will be referred to a gastroenterologist prior to respiratory decompensation making this an important consideration for providers. CASE DESCRIPTION/METHODS: A 32-year-old Caucasian male with a history of major depressive disorder and chronic low back pain presented to the emergency department (ED) with a one-month history of fever, weight-loss, anorexia, nausea, vomiting, ten-pound weight loss, and non-bloody diarrhea in the absence of abdominal pain. For these complaints, he had seen his primary care physician 3 weeks prior who had referred him to a gastroenterologist who the patient had not yet seen. The patient had no recent changes in diet, antibiotic usage or travel. Four days prior to presentation, he began having shortness of breath, pleuritic chest pain and watery diarrhea. He has been vaping “Dank Brand” THC via a cartridge nightly for the past six months. In the ED, he was tachycardic, diaphoretic, and had a new oxygen requirement. Initial WBC was 17,000 cells per microliter, AST 34 IU/L, ALT 22 IU/L, and AlkP 74 IU/L. He became increasingly hypoxic requiring transfer to the ICU and initiation of pulse dose steroids. CT chest with contrast showed scattered patchy ground-glass densities and consolidations bilaterally. KUB showed a normal gas pattern. Workup for Influenza A/B, blood cultures, rapid respiratory viral panel, sputum cultures, legionella, Pneumocystis jiroveci, and mycoplasma were negative. Multiplex Gastrointestinal PCR Panel was negative for infectious etiology. Bronchoalveolar lavage showed hemosiderin-laden macrophages. He had no serologic evidence of rheumatologic disease or occult neoplastic process. Patient had prone ventilation for four days, was treated with broad spectrum antibiotics and steroids. He improved by day seven, was extubated, and downgraded to the floor where is he was ultimately discharged on a slow taper of prednisone. At discharge, all gastrointestinal symptoms had resolved. DISCUSSION: It is important for clinicians to note that there is often a highly variable gastrointestinal prodrome in nature and duration proceeding EVALI. This case demonstrates the variable gastrointestinal manifestations of EVALI. The case was reported to the Hawai'i Department of Health and confirmed as EVALI.Image 1.: AP, Upright chest Radiograph on day of admission. Bilateral Infiltrates. Arrow points to patient's bone necklace.Image 2.: AP, Upright chest Radiograph on day 1 of the admission. With ground glass opacities.Image 3.: CT chest, abdomen and pelvis with contrast day 1 of admission.

Observational study on the accuracy and speed of ultrasound guided transversus abdominis plane block with two different monitor positions

Aim of the study is to analyse the accuracy and speed of ultrasound guided transversus abdominis plane block with two different monitor positions. Prospective observational study was conducted after institutional hospital ethics committee. Twenty four male patients posted for open inguinal hernia repair posted under spinal anaesthesia were selected and divided randomly into two groups and at the end of surgery USG TAP block was given. Group I – USG monitor was kept in line, whereas in Group II – USG monitor was kept in perpendicular to the participant. Twelve anaesthetists who had performed more than 20 procedure were selected and they performed one procedure in each group. History of back pain and neck pain was elicited and any discomfort during procedure was recorded. Accuracy of USG image was recorded. Time taken for the procedure was recorded for both groups. Twelve anaesthetists were selected for this prospective study. Time taken to perform USG TAP in Group I vs Group II was (69.08 ± 8.19 s vs 80.16 ± 4.84s). Difference was statistically significant (p<0.001). Needle placement was significantly more accurate when anaesthetists had the monitor in front of them than to the side (Score was 15 vs 24). Out of 12 anaesthetists, 4 had history of neck pain previously and one was taking treatment for the same. When performed in Group I they had no discomfort but when performed in Group II, anaesthetists with positive history had discomfort during the procedure. It was concluded that the performance of USG TAP block was comfortable and more accurate and the procedure time was shorter, if the monitor was kept in line of the sight of the operator.

Endovascular repair combined with staged drainage for the treatment of infectious aortic aneurysm: a case report

BackgroundInfectious aortic aneurysm, defined as a focal dilation of an infectious arterial wall, is an uncommon life-threatening disease. Compared with open surgery, endovascular repair yields acceptable clinical outcomes. However, residual tissue infection may increase the risk of secondary intervention. Here, we present a successful case of endovascular repair combined with staged drainage for the treatment of infectious aortic aneurysm.Case presentationA 58-year-old man presented to hospital with a 3-day history of lower back pain radiating to the back associated with fever. The dynamic imaging characteristics revealed rapid progress of infectious abdominal aortic aneurysm with negative blood culture. The patient underwent endovascular repair and salmonella enteritidis was identified through drain culture.ConclusionsEndovascular procedure and staged drainage can be feasible and effective option in selected cases.

The Contribution of SPECT/CT Bone Scintigraphy in the Localization of an Infective (Purulent) Sacroiliitis – A Case Report

BACKGROUND: Infectious sacroiliitis (ISI) is an inflammation of one or both of the sacroiliac (SI) joints, relatively rare disorder, affecting between 1% and 2% of all patients with septic arthritis. The variety of symptom presentation makes the diagnosis quite challenging. Combination of laboratory hematological tests, together with diagnostic imaging tools, such as magnetic resonance imaging (MRI), computed tomography (CT), and bone scan (BS), as well as microbiological tests contribute the final diagnosis, which may take up to several months.
 CASE REPORT: We present a case of a 33-year-old male patient with a history of lower back pain with propagation of the pain in the right leg, accompanied by febrility and hematuria. Laboratory tests showed high values of C-reactive protein, high degradation products and hyperkalemia, leading to a diagnose of acute renal failure stage 3. MRI of the lower spine and pelvis revealed hetero- signal change more to the right where the spinal canal was expanded, accumulating contrast and involved the caudate and the right radix. Тhe displayed sequences were accompanied by an altered morphology of the spinal musculature, with intense accumulation of contrast in parts of the muscle. Paravertebral abscess was detected in the intercaudal and iliac muscles, along with inflammatory edema of the right SI with a suspicion of a sacroiliitis. One week after, a three phase BS showed positive accumulation in the right SI joint in all three phases. The SI index for the right SI joint was 2.09, while for the left SI joint was 1.125. The patient underwent surgical intervention for drainage of the paravertebral abscess.
 CONCLUSION: The condition of ISI may be sometimes very difficult to be recognized in many patients. Considering the diversity of the clinical manifestations, it is of great importance to select the right imaging modality. The nuclear medicine technique triple phase bone and the hybrid imaging SPECT/CT have been suggested to improve the sensitivity and specificity of the bone scan, providing better characterization of equivocal lesions, especially in the acute form for disease localization.

230. Racial and ethnic variation in sagittal spinopelvic parameters in an urban setting

230. Racial and ethnic variation in sagittal spinopelvic parameters in an urban setting

P98. Radiographic sagittal alignment in the asymptomatic elderly: what is normal for age?

BACKGROUND CONTEXT Over the past several years, there has been an increasing awareness of the impact of positive sagittal alignment in the overall health related quality of life (HRQOL). However, attempts to restore normal spino-pelvic parameters in the elderly population can introduce challenges with risk factors inherent in this age group, and complications such as proximal junctional failure are high. PURPOSE The purpose of this study was to help define ‘normal for age’ sagittal vertical axis (SVA) in asymptomatic individuals ranging 60 to 80 years in order to facilitate most appropriate care. STUDY DESIGN/SETTING This is a prospective cohort study. PATIENT SAMPLE One hundred and fifty-one volunteers were recruited and divided into age groups of 60, 65, 70, 75 and 80 years with equal numbers of men and women. Exclusion criteria included any history of back pain requiring medical attention within previous year, prior spinal surgery, neuromuscular condition, or compression fracture. OUTCOME MEASURES The primary outcome measure was the SVA and secondary measurements included thoracic kyphosis (T4-T12), total lumbar lordosis (L1-S1), lumbar lordosis (L4-S1), pelvic tilt (PT), pelvic incidence (PI), pelvic incidence lumbar lordosis mismatch (PI-LL), sacral slope (SS), and T1 spino-pelvic inclination (T1SPi) were made using Surgimap software. Oswestry Disability Index (ODI);Veterans Rand 12 (VR-12) HRQOL measures were completed. METHODS After informed consent, subjects completed PROMs and full-standing lateral radiographs were obtained. All statistical analysis was conducted with SAS/STAT version 9.4 (Carey, NC). Normality testing was performed and all radiographic measurements were normally distributed and the ODI and VR12 scores were not normally distributed. Measures of central tendency and variance were calculated. Kruskal Wallis tests were used to determine differences across age groups in the ODI and VR12 scores. An analysis of variance with a least square (LS) means test and a Tukey-Kramer adjustment was used to compare, unadjusted and adjusted by gender, differences in all radiographic measurements across age groups. RESULTS There was no significant (p=.07) difference in the gender adjusted LS mean SVA (mm) across age-groups. For the 60, 65, 70, 75 and 80-year old age groups were (20.2, 19.7, 27.7, 37.3, 37.9), respectively which are were in the normal range of CONCLUSIONS Elderly patients with ASD undergoing corrective surgery are vulnerable to increased complications which can negatively affect HRQL outcomes. Our study showed that asymptomatic elderly individuals maintain a normal sagittal profile with an average SVA FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.

Burden of pelvic girdle pain during pregnancy among women\xa0attending ante-natal clinic, Ethiopia:a cross-sectional study

BackgroundPelvic girdle pain (PGP) is a commonly reported maternal morbidity that negatively impacts the well-being of women during pregnancy and extends long term into the post-partum period. The burden of maternal morbidity; including pregnancy-related PGP; has been overlooked in Ethiopia to date. This study aimed to determine the prevalence and identify factors associated with pelvic girdle pain during pregnancy in North West Ethiopia.MethodsA hospital-based cross-sectional study was conducted among pregnant women visiting the antenatal care clinic in Obstetrics ‘outpatient department at the University of Gondar comprehensive specialized hospital in Gondar. Data were collected by interview method using structured questionnaires, patient medical record reviews, and physical measurements. Univariate and multivariable logistic regression model analyses were used to identify factors associated with PGP.ResultsA total of 424 participants with gestational ages ranging from 6 to 39 weeks participated in this study. The age of the study participants ranged from 18 to 44 years with a mean age of (27 ± 4.6 years). The overall cumulative prevalence of pelvic girdle pain among pregnant women was 103 (24.3%),95% CI (20.3, 28.8). The major associated factors with pelvic girdle pain were previous history of pelvic girdle pain (AOR 16.08; 95% CI, 8.47–30.51), previous history of back pain (AOR 1.66; 95% CI, 1.5–4.24) and having children (AOR 1.42; 95% CI, 1.29–3.76).ConclusionOne-quarter of pregnant Ethiopian women reported pelvic girdle pain. PGP must be considered as major pregnancy-related morbidity, and progress in the intervention of PGP is vital to enhance the quality of life in this population.

Opioid Use Is More Common in Nonalcoholic Fatty Liver Disease Patients with Cirrhosis, Higher BMI, and Psychiatric Disease

Background: Opioid use is a topic of growing concern among patients with nonalcoholic fatty liver disease (NAFLD). Given safety concerns of opioids, proactively identifying subgroups of patients with an increased probability of opioid use may encourage practitioners to recommend alternative therapies for pain, thus reducing the likelihood of opioid misuse. This work assessed the prevalence and patient characteristics associated with opioid use in a real-world cohort of patients with NAFLD. Methods: TARGET-NASH, an observational study of participants at 55 academic and community sites in the United States, includes patients with NAFLD defined by pragmatic case definitions. Opioid use was defined as any documented opioid prescriptions in the year prior to enrollment. The association between patient characteristics and the odds of opioid use were modeled with stepwise multivariable logistic regression and tree ensemble methods (Classification and regression tree/Boosted Tree). Results: The cohort included 3,474 adult patients with NAFLD including 18.0% with documented opioid use. Variables associated with opioid use included presence of cirrhosis (OR 1.51, 95% CI 1.16–1.98), BMI ≥32 kg/m2 (OR 1.29, 95% CI 1.05–1.59), depression (OR 1.87, 95% CI 1.50–2.33), and anxiety (OR 1.59, 95% CI 1.27–1.98). In the boosted tree analysis, history of back pain, depression, and fibromyalgia had the greatest relative importance in predicting opioid use. Conclusion: Prescription opioids were used in nearly 1 of 5 patients with NAFLD. Given the safety concerns of opioids in patients with NAFLD, alternative therapies including low-dose acetaminophen and nonpharmacologic treatments should be considered for these patients.

Single site video assisted thoracoscopic wedge resection for spontaneous pneumothorax in a pediatric patient

Abstract Surgical treatment for pediatric spontaneous pneumothorax has evolved over time from open thoracotomy to multiport Video Assisted Thoracoscopic Surgery (VATS) and perhaps now towards single site VATS. This is a case of a 16 year-old male with a one-week history of right upper back pain who was found to have a large right-sided spontaneous pneumothorax. Conservative management was attempted, but failed, and he was scheduled for right apical lung blebectomy and mechanical pleurodesis. The decision was made to use a single site approach to minimize sequelae of the surgery. Surgery was successful and the patient was discharged on postoperative day six after a minor air leak subsided. We present this case as evidence for technical feasibility as well as improved postsurgical outcome of single site VATS.

McKenzie-type Exercises Improve the Functional Abilities of a Patient with Recurrent Herniated Discs: A Case Report

This case is unique in which the patient had two previous lumbar spinal surgeries, recurrent herniated discs, and new bulged and herniated discs were developed. We aimed to investigate whether implementing the McKenzie method would reduce the symptoms of a long history of Low Back Pain (LBP) with multiple surgeries. A 2-months of McKenzie-type exercise program was performed at a rate of 5 days/week. Disability index, pain intensity, lumbar Range of Motion (ROM), and lower limb strength were tested before and after the exercise treatment intervention. Disability and pain were also measured at 3-months follow-up. The Oswestry disability index and pain visual analogue scale score reduced immediately after the treatment intervention and remained reduced at 3-months follow-up from 44% to 22%, and from 8 to 4, respectively. Lumbar ROM improved about 1.5 cm during standing flexion and 3 cm during extension. Unilateral leg extension of the affected leg and bilateral leg press increased by 16.5 kg and 70 kg, respectively. The current protocol has shown that Mckenzie-type exercise treatment can improve the physical functions and reduce pain in a patient with a history of lumbar spine surgeries and prolonged LBP. In addition, despite no additional exercise, McKenzie method increased the lower limb strength, possibly through nerve root decompression.

Vertebral Osteomyelitis in a Young Immunocompetent Adult: A Case Report

Vertebral osteomyelitis is a rare entity and primarily found in adult over 50 years with male predominance. We report a case of 19-year immunocompetent girl with the history of fever and lower back pain and spinal tenderness found to have vertebral osteomyelitis and started on antibiotics and rapid improvement was noted. It’s essential to suspect the possibility of vertebral osteomyelitis in young age group who are presenting with the pathognomonic signs and symptoms.

Comparação da força muscular e flexibilidade entre praticantes de Pilates e musculação

INTRODUÇÃO: Nos últimos anos, tem aumentado o número de estudos preocupados em investigar a relação entre a disfunção do músculo transverso do abdome e a história de dor lombar, assim como a deficiência na flexibilidade. OBJETIVO: comparar a força muscular do transverso do abdome e flexibilidade das praticantes do método Pilates e musculação. MÉTODO: Participaram do estudo 20 voluntárias do sexo feminino divididas em 2 grupos de 10 voluntárias, com no mínimo 6 meses de atividade em Pilates ou musculação. A força muscular do transverso do abdome foi avaliada pelo teste esfigmomanômetro modificado (TEM) e a flexibilidade pelo teste de sentar-alcançar (TSA). Foi utilizado a análise estatística descritiva para os dados coletados, sendo os valores expressos através da média e desvio padrão, bem como aplicabilidade do teste T de student (p<0,05). RESULTADOS: Foi verificado valores significativos de (p< 0,05) sendo superior para a força muscular do transverso do abdome do grupo Pilates quando comparado ao grupo musculação. Entretanto para o teste de flexibilidade, não foi encontrado diferenças estatísticas significativas entre os dois grupos. CONCLUSÃO: Foi possível observar que as praticantes do método Pilates obtiveram um melhor desempenho da musculatura do transverso do abdome e flexibilidade em comparação ao grupo musculação. O fortalecimento do músculo transverso do abdome bem como a flexibilidade torna-se uma medida corretiva e preventiva para redução e prevenção das algias e lesões lombares.

3D Slicer and Sina appilication for surgical planning of giant invasive spinal schwannoma with scoliosis: A case report and literature review

BackgroundThe surgical management of giant invasive spinal schwannomas (GISSs) has been discussed previously, and most cases are treated via the posterior approach. However, when the tumor grows beyond the spine and greatly pushes the surrounding tissues, the combined anterior-posterior approach may be a better choice. However, the anterior approach can be challenging when there is a lack of knowledge regarding the surrounding abdominal structures. Case descriptionA 67-year-old male suffered from slight scoliosis and an unstable spine due to GISS, which led to a long history of lower back pain and abnormal gait. Here, we report a novel method combining the use of 3D Slicer and the Sina application to help surgeons locate such lesions and better understand the three-dimensional (3D) relationship between the tumor and surrounding tissues. The proposed method promotes complete excision, shortens operation time, and reduces related complications. ConclusionWe recommend using the combination of 3D Slicer and Sina to assist surgeons in handling accurate 3D information of GISS while simultaneously simulating the surgery.