Incidence Of Back Pain Research Articles

Fibrocyte enrichment and myofibroblastic adaptation causes nucleus pulposus fibrosis and associates with disc degeneration severity

Fibrotic remodeling of nucleus pulposus (NP) leads to structural and mechanical anomalies of intervertebral discs that prone to degeneration, leading to low back pain incidence and disability. Emergence of fibroblastic cells in disc degeneration has been reported, yet their nature and origin remain elusive. In this study, we performed an integrative analysis of multiple single-cell RNA sequencing datasets to interrogate the cellular heterogeneity and fibroblast-like entities in degenerative human NP specimens. We found that disc degeneration severity is associated with an enrichment of fibrocyte phenotype, characterized by CD45 and collagen I dual positivity, and expression of myofibroblast marker α-smooth muscle actin. Refined clustering and classification distinguished the fibrocyte-like populations as subtypes in the NP cells - and immunocytes-clusters, expressing disc degeneration markers HTRA1 and ANGPTL4 and genes related to response to TGF-β. In injury-induced mouse disc degeneration model, fibrocytes were found recruited into the NP undergoing fibrosis and adopted a myofibroblast phenotype. Depleting the fibrocytes in CD11b-DTR mice in which myeloid-derived lineages were ablated by diphtheria toxin could markedly attenuate fibrous modeling and myofibroblast formation in the NP of the degenerative discs, and prevent disc height loss and histomorphological abnormalities. Marker analysis supports that disc degeneration progression is dependent on a function of CD45+COL1A1+ and αSMA+ cells. Our findings reveal that myeloid-derived fibrocytes play a pivotal role in NP fibrosis and may therefore be a target for modifying disc degeneration and promoting its repair.

Body Composition and Incident High-Intensity Back Pain and/or High Disability: A 10-Year Prospective Population-Based Male Cohort.

Back pain poses a significant global burden, within which individuals with more severe symptoms consume higher healthcare expenses than those with lesser back pain. Whether measures of body composition predict high-intensity back pain and/or high-disability in population-based cohorts is unknown. This study aimed to examine the association between body composition at baseline and their change in the prior 5 years (between 2001-2005 and 2006-2010) and incident high-intensity back pain and/or high-disability in long-term follow-up, 10 years later (2016-2021) in a population-based cohort of men. This study examined men with no or low-intensity back pain and disability (Graded Chronic Pain Scale) at back pain study baseline (2006-2010) within the Geelong Osteoporosis Study. Those developing high-intensity pain and/or high disability at follow-up (2016-2021) were identified. Weight, body mass index (BMI), abdominal circumferences, fat mass and lean mass (dual energy X-ray absorptiometry) were assessed prebaseline (2001-2005) and at baseline. The association of body composition at baseline and change in body composition from prebaseline to baseline with incident high-intensity pain and/or high disability at follow-up were examined using multivariable logistic regression. Of 695 participants with no or low-intensity pain and disability at baseline, 441 (62.3%) completed follow-up with a mean age of 54.3 ± 14.1 years: 37 (8.3%) developed high-intensity pain and/or high-disability, 33 (7.5%) developed high-intensity pain and 14 (3.2%) high disability. No measures of body composition at baseline were associated with incident high-intensity pain and/or high disability at follow-up in the whole population. In subgroup analysis, among men aged over 60 years, but not younger, higher lean mass was associated with decreased likelihood of high-intensity pain and/or high-disability (odds ratio [OR] 0.86, 95% confidence interval [CI] 0.76, 0.97, interaction p < 0.001). In the whole population, examination of the relationship between change in measures of body composition between prebaseline and baseline, only a one unit increase in BMI, equivalent to 3.1-kg weight gain, was associated with increased incident high disability (OR 1.63, 95% CI 1.06, 2.51). In a population-based sample, without severe back pain and disability, in older men aged ≥60 years, higher lean mass was protective of incident high-intensity pain and/or high disability. An increase in BMI, over 5 years, equivalent to 3.1-kg weight gain, was associated with incident back pain related high disability 10 years later. These results demonstrate another detrimental consequence of weight gain and highlight the importance of maintaining muscle mass in older men.

Overview of the Incidence of Post-Sectio Caesaria Back Pain with Spinal Anesthesia: A Literature Review

Post-cesarean back pain with spinal anesthesia is one of the most common complications and can affect the patient's quality of life. Although spinal anesthesia is a safe and commonly used option in surgical procedures, the risk of back pain remains, especially if the anesthesia technique is not optimal. This study aims to provide an overview of the incidence of post-cesarean section back pain with spinal anesthesia based on a literature review over the past 10 years. This study is a literature review that reviews 10 scientific journals published in the last 10 years. The focus of this study includes the prevalence of back pain, risk factors, anesthesia techniques, and post-cesarean section back pain management. The results of the review showed that the prevalence of post-cesarean back pain ranged from 30% to 50%, with the main risk factors being age, body mass index, and anesthesia techniques. The use of smaller atraumatic needles and careful anesthesia techniques can reduce the incidence of back pain. Back pain is generally temporary, but in some patients it can develop into chronic pain. Post-cesarean section back pain with spinal anesthesia can be prevented with proper anesthesia techniques and good pain management. A multidisciplinary approach is needed to reduce the prevalence of chronic pain and improve the patient's quality of life.

Description of The Incidence of Back Pain After Sectio Caesarea With Spinal Anesthesia

Background: Cesarean section (sectio caesarea) is a common surgical procedure for childbirth involving an incision in the uterine wall. Postoperative pain, particularly back pain associated with spinal anesthesia, is a prevalent concern. Previous research by Kurniawan (2022) indicated that 43.3% of patients experience moderate back pain postoperatively. However, comprehensive studies on the contributing factors to this back pain remain limited. Purpose: This study aims to analyze the incidence and determinants of back pain following cesarean section with spinal anesthesia at Siti Aminah Hospital, Bumiayu. Methods: A descriptive analytic study was conducted, employing a cross-sectional design with a survey method. The study population comprised 35 patients who underwent cesarean section with spinal anesthesia. Data were collected using structured observation sheets, focusing on variables such as patient age, needle size, anesthesia technique, patient positioning, and the severity of back pain. Findings: The majority of participants were aged 25-39 years (65.7%). A needle size of 25 gauge was used in 71.4% of cases. The median approach was the predominant anesthesia technique (82.9%), and 74.3% of procedures were performed with the patient in a sitting position. Notably, 51.4% of respondents reported mild back pain postoperatively. Conclusion: The findings suggest that patient age, needle size, anesthesia technique, and positioning during the procedure significantly influence the incidence of back pain following cesarean section with spinal anesthesia. Further research is recommended to develop strategies to minimize this complication and improve patient outcome.

Temporal Trends in the Epidemiology of Lower Back Pain in the United States.

This was an observational study. This study aims to explore sociodemographic and regional geographic variations in lower back pain (LBP) incidence, prevalence, and burden in the United States (US from 2000 to 2019). LBP is a major contributor to lost wages and disability in the United States. As LBP is associated with increasing age and sedentary lifestyle, the incidence of LBP is expected to rise. Due to LBP's multifactorial causes, US epidemiological trends lack sufficient data. Descriptive epidemiological data including disability-adjusted life years (DALYs), incidence, and prevalence per 100,000 population from 2000 to 2019 were collected from the Global Burden of Disease database. State-level data regarding poverty, insurance and employment status were obtained from the US Government Census Bureau and US Department of Labor. Statistical significance was indicated by P <0.05. From 2000 to 2019, the US demonstrated reductions in LBP incidence, prevalence, and DALYs. Regional analysis demonstrated the Midwest to have the greatest mean incidence, prevalence, and DALYs; with Midwestern females significantly more affected than females in other regions. Those aged 25 to 49 in the Midwest were impacted significantly more across all measures compared with age-matched populations in other regions. Nationally, there were no significant associations between unemployment and LBP. Poverty was inversely correlated with LBP incidence. Uninsured status was positively correlated with prevalence and DALYs. Although there has been progress in reducing the impact of LBP in the United States, the Midwest region has greater rates for all measures compared with other US regions. Further, females and those aged 25 to 49 in the Midwest were more likely to be affected by LBP compared with counterparts in other regions. Future studies should identify specific factors contributing to elevated LBP rates in the Midwest in order to guide targeted interventions to reduce the incidence and burden of LBP there.

Incidence and prognostic factors of residual back pain in patients treated for osteoporotic vertebral compression fractures: a systematic review and meta-analysis.

Osteoporotic vertebral compression fracture (OVCF) is a common consequence of osteoporosis and can significantly impact the quality of life for affected individuals. Despite treatment options such as vertebroplasty and kyphoplasty, many patients continue to experience residual back pain (RBP) even after the fracture has healed. The incidence of RBP after OVCF treatment varies among studies, and there is a need for further research to understand the risk factors associated with RBP. A systematic review and meta-analysis were conducted following the PRISMA guidelines. Electronic databases were searched, and relevant studies were selected based on inclusion and exclusion criteria. Data extraction and quality assessment were performed independently by two authors. Statistical analysis included single-proportion meta-analyses and pooling of odds ratios (OR) using the inverse-variance method, to calculate the overall incidences of RBP and cement leakage and identify risk factors associated with RBP. A total of 19 studies were included in the analysis. The overall incidences of RBP and cement leakage were found to be 16% and 18%, respectively. Several risk factors were identified, including gender, bone mineral density, depression, baseline visual analog scale (VAS) score, intravertebral vacuum cleft, number of fractured segments, cement distribution, history of vertebral fracture, thoracolumbar fascial injury, and fracture non-union. This study provides potential value within the scope of the incidence and risk factors of RBP following treatment of OVCFs. The identified risk factors can help clinicians identify high-risk patients and tailor appropriate interventions. Future research should focus on standardizing the definition of RBP and patient selection criteria to improve the accuracy of estimates and facilitate better management strategies for OVCF patients.

Comparison of Complication Rates Between Transforaminal Interbody Fusion and Anteroposterior Fusion for One- or Two-Level Degenerative Lumbar Spine Surgery: A Propensity Score Matched Analysis.

Introduction Although transforaminal interbody fusion (TLIF) and anterior lumbar interbody fusion (ALIF) combined with posterior fusion (AP) have similar fusion rates, it is unclear if choice of approach has an impact on post-operative complications. Research question Is the incidence of residual leg and/or back pain requiring additional treatment after one- or two-level TLIF and AP similar? Material and methods Adult patients who underwent one- or two-level TLIF or AP for degenerative pathology were identified and matched using age, sex, body mass index (BMI), American Society of Anesthesiologists (ASA), insurance status, smoking status, revision and number of levels fused. The incidence of radicular leg and back pain requiring emergency department visit/readmission or same level surgical intervention was compared between the two groups. Results Of the 319 TLIF and 288 AP cases, 119 cases in each cohort were matched. TLIF patients had shorter operative times (203 min vs 258 min, P<0.001) and hospital stays than the AP patients (3.76 days vs 4.98 days, P<0.001). The incidence of residual leg pain (7 vs 5, P=0.769) and back pain (13 vs 15, P=0.841) was similar between the two groups. Except for constipation, which was more common in the AP group, the incidence of complications was similar between the two groups. Conclusions Patients undergoing one- or two-level TLIF showed shorter operative time and hospital stay compared with those undergoing AP. The incidence of leg radiculopathy and back pain was similar between the two groups. Surgeons should consider these findings as part of the decision-making process regarding which approach to use in patients requiring a lumbar interbody fusion.

A trans-generation conundrum with implications in rehabilitation programs – what factors influence non-specific back pain in children?

Back pain in children and adolescents is one of the most frequent reasons for seeing a medical specialist worldwide. Many factors have been incriminated when it comes to influencing the appearance of non-specific back pain in children as well as in adults. For the younger population, some of the culprits seem to be sitting for long periods, us-ing harmful postural patterns, a forward head posture determined by incorrect positioning during prolonged studying hours, and carrying a too-heavy backpack, but do they really influence non-specific back pain in children? These ques-tions are valid for all generations and countries. This paper aimed to review the published literature to determine whether the factors mentioned above, sitting in mismatched school furniture, carrying heavy backpacks, and forward head posture, influence the incidence of non-specific back pain in children and whether there are any data or differences between the general population and Roma-nian students. For this purpose, we conducted database research using the keywords “non-specific back pain in chil-dren, sitting, school furniture, forward head posture, backpack carrying” and various combinations of these terms, which returned 37 eligible articles for this paper in PubMed - Center for Biotechnology Information (NCBI) and Sci-enceDirect. There was no time limit on the researched articles, and they had to refer to the pediatric population, be open-access and in extenso articles, and be written in English, French, or Spanish. After analyzing the results from these articles, the conclusion is that there is no evident or spe-cific connection between non-specific back pain in pediatric populations and harmful posture patterns while sitting or carrying a backpack. Also, more multicentered research using fewer variables and more objective measurement instruments is needed. Keywords: non-specific back pain in children, sitting, bad posture, school furniture, forward head posture, back-pack carrying

Studi Komparasi Sikap Kerja dengan Kejadian Low Back Pain Pada Perajin Rebana Desa Bungah Kecamatan Bungah Kabupaten Gresik

Musculoskeletal is a system that often experiences increased loads and injuries in every job, including tambourine craftsmen. Data shows that 95% of tambourine craftsmen experience musculoskeletal complaints, of which 55% occur in the lower back area, 20% in the right shoulder area, 15% in the left shoulder area and 10% experience cramps. Objective: This research is to analyze the comparison of work attitudes with the incidence of lower back pain in tambourine craftsmen in Bungah Village, Bungah District, Gresik Regency). Method: Cross sectional survey research design with observation. The population is all tambourine craftsmen in Bungah Village, Bungah District, Gresik Regency, totaling 150 people. Meanwhile, the sample size was 110 respondents taken using simple random sampling. The independent variables are sitting work attitude and standing work attitude, while the dependent variable is the incidence of low back pain. The instrument uses a closed questionnaire. Analysis uses the Chi-Square test with alpha 0.05. Results: Research shows that almost all of the working attitudes of tambourine craftsmen (83.6%) are ergonomic sitting working attitudes, while the majority (69.1%) are standing working attitudes with low risk. Almost all complaints of low back pain among tambourine crafters (79.1%) were not low back pain. The Chi-Square test results for the sitting work attitude have a p value = 0.000 &lt; 0.05 with OR = 18.400, and for the standing work attitude the p value = 0.000 &lt; 0.05 with OR = 3.091. Conclusion: There is a difference in work attitude regarding the incidence of low back pain in tambourine craftsmen with a sitting work attitude having a greater risk level than standing. Monotonous work positions should be avoided and stretching should be done so that muscles do not become stiff and symptoms of lower back pain can be avoided.

The prevalence of neck pain, back pain and low back pain among third-year medical students at universities in the metropolitan region of Porto Alegre in times of Covid-19

Objective: To determine the prevalence of cervical, dorsal and lumbar pain caused by switching to remote classes during the Covid-19 pandemic. Methods: This is an original article based on a cross-sectional study among men and women over the age of 18 who are third-year medical students to assess the incidence of neck pain, back pain and low back pain, using online forms with questions about physical and mental health. Results: Around 60% of the participants said they had adapted their study environment because of the remote classes, with a further 70% saying they were attending classes in the office, with their backs poorly supported. In addition, there was a low number of overweight students who performed daily stretching. Conclusion: The data was analyzed using tables, descriptive statistics and the statistical test: Mann-Whitney Non-parametric Test and Krsukal-Wallis Non-parametric Test and the importance of further research was highlighted, given that this research topic is essential for the prevention of possible comorbidities.

Associations between back pain incidence, and physical activity and sedentary behaviours: A prospective cohort study with data from over 365,000 participants.

OBJECTIVE: To examine the associations between (i) various types of physical activity and the risk of back pain incidence, and (ii) the influence of substituting sedentary behaviours with physical activities on back pain incidence. DESIGN: A prospective cohort study. METHODS: We analyzed UK Biobank data collected from 365,307 participants who were free of back pain at baseline. The exposures were total, light, moderate and vigorous physical activity, and sedentary behaviours. The outcome was back pain incidence. The main statistical models were the Cox proportional hazard model and the isotemporal substitution model. RESULTS: In the follow-up time (median, 12.97 years; inter-quartile range, 12.10-13.71), 25,189 individuals developed back pain. The associations between all types of physical activity and incident back pain were significantly non-linear (p < 0.001) among the general population and other subgroups. High physical activity was associated with a decreased risk of back pain compared with no physical activity. The lowest risk occurred in the 1801-2400 MET-min/week subgroup of total physical activity (HR 0.64, 95% CI 0.59-0.69), approximately consisting of 1200, 600, and 600 MET-min/week of light, moderate and vigorous physical activity, respectively. Extremely high vigorous physical activity was related to high risk, specifically in males (HR 1.13, 95% CI 1.02-1.25). Replacing 1 hour/day of sedentary behaviours with an equal time of physical activity reduced the risk of incident back pain by 2%-8% (p < 0.05). CONCLUSION: Physical activity was related to a reduced risk of back pain incidence (except over-high vigorous physical activity). Substituting sedentary behaviours with physical activities reduced the risk of future back pain.

Osteoporosis treatments for intervertebral disc degeneration and back pain: a perspective.

Low back pain derived from intervertebral disc (IVD) degeneration is a debilitating spinal condition that, despite its prevalence, does not have any intermediary guidelines for pharmacological treatment between palliative care and invasive surgery. The development of treatments for the IVD is complicated by the variety of resident cell types needed to maintain the regionally distinct structural properties of the IVD that permit the safe, complex motions of the spine. Osteoporosis of the spine increases the risk of vertebral bone fracture that can increase the incidence of back pain. Fortunately, there are a variety of pharmacological treatments for osteoporosis that target osteoblasts, osteoclasts and/or osteocytes to build bone and prevent vertebral fracture. Of particular note, clinical and preclinical studies suggest that commonly prescribed osteoporosis drugs like bisphosphonates, intermittent parathyroid hormone, anti-sclerostin antibody, selective estrogen receptor modulators and anti-receptor activator of nuclear factor-kappa B ligand inhibitor denosumab may also relieve back pain. Here, we cite clinical and preclinical studies and include unpublished data to support the argument that a subset of these therapeutics for osteoporosis may alleviate low back pain by also targeting the IVD.

Post-spinal Anesthesia Low Back Pain in Obese Female Patients: Comparison of the Median Versus Paramedian Approach.

A side effect of spinal anesthesia is post-dural puncture backache (PDPB), which is characterized by ongoing discomfort at the location of the spinal puncture without any radicular pain. This study aims to compare the incidence and severity of post-dural puncture back pain following spinal anesthesia by median versus paramedian technique in obese female patients. A prospective randomized comparative study on 120 female patients, aged 20-50 years with a BMI of 30-40 kg/m2 and American Society of Anesthesiologists physical status II, scheduled for elective surgery under spinal anesthesia, was included in the study. Patients were randomly divided into two groups, with 60 patients in each group. Group P uses the paramedian approach for spinal anesthesia, and group M uses the midline approach for spinal anesthesia. Low back pain incidence was lower in group P than in group M at seven days, but at one month and after, its incidence remained the same in both groups. No difference in the severity of pain was observed. The occurrence of back pain in the first seven days of surgery was significantly more frequent with the median approach. The pain severity decreased as the time passed from day seven to three months of follow-up. There is no difference in the severity of pain with either approach at different intervals.

Effectiveness of Back care education Programme among school children: a systematic review of randomized controlled trials

Study designSystematic review of Randomised controlled trials.ObjectivesWith the increasing incidence of back pain among children and its untold implications to their future, back education tailored in an effective way would be indicated. However literature appears unsettled. This study aims to review available literature to determine the effect of school-based back education in preventing and managing low back pain in school children.MethodsRandomized controlled trials carried out on elementary and secondary school children of ages 6 to 18 years and published in English language were included. Back education taught in hospitals or other settings were excluded. Primary outcome was back pain prevalence and secondary outcomes were constituted from the study characteristics of selected studies which includes: back behavior, knowledge, postural habits, physical activity, fear-avoidance beliefs, back pack carriage, pain intensity, skills and self efficacy. Databases searched were PEDro, HINARI, PubMed, Cochrane, and Google Scholar. Available stiudies from 2000 to March 2022 were retrieved. Quality of studies were assessed using the PEDro scale. Obtained studies were descriptively analyzed.ResultsA total 8420 studies were retrieved and 8 studies (with 1239 participants) were included in this review. Four studies each assessed back knowledge and back behavior, and two assessed back pain prevalence. There were improvements in back knowledge and back behaviour, but effectiveness of back care education on back pain prevalence was not conclusive.Forms of education used involved the indirect method of conditioning the environment and the direct method which made use of theory, practical lessons and educational books and materials.ConclusionBack care education programmes in schools are effective in improving back care knowledge, behavior and reduction in low back pain frequency. Reduction in back pain prevalence is not conclusive. Back care education could be incorporated as part of schools’ education programmes. Limitations include exclusion of non English language studies and inconsistent outcome measures.Funding sourceNone.RegistrationThis review protocol was registered under the International platform of Registered systematic review and meta-analysis protocol (INPLASY) with the registration number; INPLASY202310044 and DOI number; https://doi.org/10.37766/inplasy2023.1.0044

Comparison of analgesic effects of percutaneous and transthoracic intercostal nerve block in video-assisted thoracic surgery: a propensity score-matched study

BackgroundThis study aimed to compare the analgesic efficacy of transthoracic intercostal nerve block (TINB) and percutaneous intercostal nerve block (PINB) for video-assisted thoracic surgery (VATS) using a retrospective analysis.MethodsA total of 336 patients who underwent VATS between January 2021 and June 2022 were reviewed retrospectively. Of the participants, 194 received TINB and were assigned to the T group, while 142 patients received PINB and were assigned to the P group. Both groups received 25 ml of ropivacaine via TINB or PINB at the end of the surgery. The study measured opioid consumption, pain scores, analgesic satisfaction, and safety. Propensity score matching (PSM) analysis was performed to minimize selection bias due to nonrandom assignment.ResultsAfter propensity score matching, 86 patients from each group were selected for analysis. The P group had significantly lower cumulative opioid consumption than the T group (p < 0.01). The Visual Analogue Scale (VAS) scores were lower for the P group than the T group at 6 and 12 h post-surgery (p < 0.01); however, there was no significant difference in the scores between the two groups at 3, 24, and 48 h (p > 0.05). The analgesic satisfaction in the P group was higher than in the T group (p < 0.05). The incidence of back pain, nausea or vomiting, pruritus, dizziness, and skin numbness between the two groups was statistically insignificant (p > 0.05).ConclusionThe study suggests that PINB provides superior analgesia for patients undergoing thoracic surgery compared to TINB without any extra adverse effects.

The Effect of Physical Activity Level on the Low Back Pain Incidence Among Dentists in Yogyakarta City

Low back pain (LBP) is a complaint that dentists often encounter because of the tendency to work with static movements for a long duration of time. There are some indicated factors that may involve in the occurrence of the LBP, one of which is the level of physical activity. This study aimed to confirm and understand the association of physical activity level to the incidence of low back pain. The research method was analytical observation with a cross-sectional design. The study used questionnaires on physical activity level and low back pain which were distributed to 76 samples of dentists in the Yogyakarta City area. The data was further analyzed with a chi-square test. The results showed a value of 9.147 with degree of freedom 1 and significance of 0.002. This value is greater than the table's chi-square value of 3.841, which means that there was a significant proportion association between physical activity level and low back pain occurrence

Analysis of Factors Affecting Complaints of Lower Back Pain among Nurses at Bhayangkara Hospital Kendari

Background: One of the important factors that affect the quality of nurses’ work is occupational health and safety. One of the occupational diseases is Low Back Pain (LBP). Occupations that have a high risk of back pain are nurses. According to the Indonesian Neurological Association (INA) regarding the incidence of lower back pain in hospital nurses, the prevalence of lower back pain cases in nurses in Indonesia shows that 18,2% occurs in men and 13,6% in women. Then, based on the nursing management report at Bhayangkara Hospital Kendari in 2023, most of the nurses’ complaints were lower back pain due to the workload being too high for nurses. Method: This research was a quantitative analytical research with a cross-sectional design approach. The data analysis was carried out using SPSS statistical tests with multiple linear regression. The population in this study was 102 nurses, while the sample was 102 nurses (total sampling). Results: The results showed a significant p-value for workload 0,049&lt;0,05, physical activity 0,028&lt;0,05, body position 0,004&lt;0,05, working period 0,048&lt;0,05 and body mass index (BMI) 0,001&lt;0,05. Conclusion: This research concluded that there was an effect between workload, physical activity, body position, work period and body mass index on complaints of lower back pain in nurses at Bhayangkara Hospital Tk.III Kendari. This research can be a reference material for hospitals, health workers or nurses and can increase knowledge in preventing or reducing the occurrence of lower back pain while working.

Comparison of the Effect of Landmark-Based Midline and Paramedian Approaches on Spinal Anesthesia-Related Complications in Adult Patients: A Meta-Analysis of Randomized Controlled Trials.

Background and Objectives: Spinal anesthesia is widely used in various types of surgery. However, several complications can occur afterward. This study aimed to identify differences in the incidence of anesthesia-related complications according to the approach methods (midline versus paramedian) for landmark-based spinal anesthesia. Materials and Methods: We searched electronic databases, including PubMed, EMBASE, CENTRAL, Scopus, and Web of Science, for eligible randomized controlled trials. The primary outcome was post-dural puncture headache (PDPH) incidence, and secondary outcomes were low back pain (LBP) incidence and success rate in the first trial of spinal anesthesia. We estimated the odds ratio (OR) with 95% confidence intervals (CI) using a random-effects model. Results: In total, 2280 patients from 13 randomized controlled trials were included in the final analysis. The incidence rates of PDPH were 5.9% and 10.4% in the paramedian and midline approach groups, respectively. The pooled effect size revealed that the incidence of PDPH (OR: 0.43, 95% CI [0.22-0.83]; p = 0.01; I2 = 53%) and LBP (OR: 0.27, 95% CI [0.16-0.44]; p < 0.001; I2 = 16%) decreased, and the success rate in the first attempt was higher (OR: 2.30, 95% CI [1.36-3.87]; p = 0.002; I2 = 35%) with the paramedian than with the midline approach. Conclusions: Paramedian spinal anesthesia reduced PDPH and LBP and increased the success rate of the first attempt.

A comparative study of laparoscopic choledocholithotomy with primary suture and T-tube drainage.

To investigate the clinical efficacy of laparoscopic choledocholithotomy with one-stage suture. The clinical data of 68 patients who underwent laparoscopic choledocholithotomy in our hospital from January 2015 to December 2021 were retrospectively analyzed. Among them, 29 patients underwent laparoscopic primary closure (PC group) and 39 underwent T-tube drainage (T-tube group). All patients were diagnosed with choledocholithiasis by B-ultrasound, CT or MRCP. The operation time, intraoperative blood loss, pain index, incidence of shoulder and back pain, postoperative satisfaction, postoperative bowel function recovery time, hospitalization time and expenses, and operation-related complications in the 2 groups were compared. 29 cases in PC group were successfully operated, and 39 cases in the T-tube drainage group (T-tube group) were successfully operated. The average operation time, postoperative bowel function recovery time, postoperative pain index, hospitalization time and expenses in PC group were significantly shorter or lower than those in T-tube group (P < .05) and the patient satisfaction in PC group was significantly higher than that in T-tube group (P < .05). In addition, the intraoperative blood loss and the incidence of surgical complications were similar between the 2 groups (P > .05). After laparoscopic common bile duct exploration, primary suture of common bile duct is a safe and effective treatment method, but the incidence of bile leakage is high, and clinical indications for surgery should be strictly controlled.

Incidence and Severity of Neuraxial Anesthesia-Related Back Pain in Postpartum Women: Insights from a Cross-Sectional Study

Incidence and Severity of Neuraxial Anesthesia-Related Back Pain in Postpartum Women: Insights from a Cross-Sectional Study