Low Back Pain Disability Index Research Articles

Comparative effects of shockwave therapy and Maitland lumbar mobilization on pain, disability, and range of motion in patients with mechanical low back pain: A pilot study

Objectives: Low back pain (LBP) has been considered a neuromusculoskeletal issue that affects a wide variety of populations around the globe at some stage in their life. This paper aimed to see the comparative effects of shockwave therapy and Maitland lumbar mobilizations on pain severity, disability, and range of motion (ROM) values in subjects with mechanical LBP. Methods: A randomized clinical trial was carried out involving 26 subjects divided into two groups using a random number generator table. After baseline therapy (lumbar stretches and core strengthening exercises), shockwave therapy was administered to Group A (2000 shocks/session, pressure of 2 bars, frequency 10 Hz), while Group B received Maitland lumbar mobilizations (starting from Grade 1, with 3–4 sets of oscillations with 40 counts/set, two sets of oscillation to one level below and above the affected vertebras). Both therapeutic interventions were administered for 30 days, twice a week (total of eight sessions) for individual groups. Results: Numeric pain rating scale, Oswestry LBP disability index, lumbar flexion, and extension ROM pre- and post-treatment values showed significant differences with P < 0.05. A greater difference in mean values was observed in group B receiving Maitland mobilization as compared to group A receiving shockwave therapy. Between-group analysis showed a statistically significant difference in both groups with P < 0.005. Conclusion: Both groups showed significant effects in reducing pain levels, functional disability scores, and improving flexion and extension ROM values. However, participants receiving Maitland mobilization showed more significant improvement in all variables than shockwave therapy.

The analgesic and disability improvement effects of trigger points electroacupuncture on chronic low back pain patients: an uncontrolled before-and-after study

Low back pain (LBP) is the most common cause of disability in patients aged 45 to 65. Traditional medicine plays an important role in the treatment of this disease. Especially, electroacupuncture at 100 Hz is effective in the improvement of pain and symptoms. In addition, clinical and research evidence shows that trigger points acupuncture is effective in LBP treatment. However, these studies have small sample sizes, so their reliability is not high. Thus, our study aims to evaluate the effect of trigger points electroacupuncture (TrP-EA) at 100 Hz on chronic LBP patients with larger sample sizes. 37 patients diagnosed with chronic LBP received TrP-EA at 100 Hz for 4 weeks. Outcome measures were the visual analogue scale (VAS), roland morris questionnaire (RMQ), and Oswestry low back pain disability index (ODI). Compared with the pre-treatment baseline, VAS, RMQ, and ODI improved dramatically after 1 week of treatment (p<0.01), 2 weeks of treatment (p<0.01), 3 weeks of treatment (p<0.01) and 4 weeks of treatment (p<0.01). The results suggest that TrP-EA at 100 Hz had analgesic efficacy and may have the potential to improve disability in patients with chronic LBP.

The analgesic and disability improvement effects of trigger points electroacupuncture on chronic low back pain patients: an uncontrolled before-and-after study

Low back pain (LBP) is the most common cause of disability in patients aged 45 to 65. Traditional medicine plays an important role in the treatment of this disease. Especially, electroacupuncture at 100 Hz is effective in the improvement of pain and symptoms. In addition, clinical and research evidence shows that trigger points acupuncture is effective in LBP treatment. However, these studies have small sample sizes, so their reliability is not high. Thus, our study aims to evaluate the effect of trigger points electroacupuncture (TrP-EA) at 100 Hz on chronic LBP patients with larger sample sizes. 37 patients diagnosed with chronic LBP received TrP-EA at 100 Hz for 4 weeks. Outcome measures were the visual analogue scale (VAS), roland morris questionnaire (RMQ), and Oswestry low back pain disability index (ODI). Compared with the pre-treatment baseline, VAS, RMQ, and ODI improved dramatically after 1 week of treatment (p<0.01), 2 weeks of treatment (p<0.01), 3 weeks of treatment (p<0.01) and 4 weeks of treatment (p<0.01). The results suggest that TrP-EA at 100 Hz had analgesic efficacy and may have the potential to improve disability in patients with chronic LBP.

Efficiency of William’s versus McKenzie’s therapy for patients diagnosed with low back pain

From the category of musculoskeletal disorders, lumbar pathology registered a 50% increase between 1990 and 2019, directly correlated with an age decrease for the onset of symptoms among patients diagnosed with lumbar pain. Consequently, we are witnessing a younger population experiencing lumbar pain and at times, functional disability. According to statistical analysis, the economic impact of low back pain (LBP) in highly industrialized countries produces costs of up to 134 billion dollars annually. In this context, the appropriate therapeutic approach of LBP becomes a factor of major interest. This review uses 137 primary articles and specialized literature published between 2010-2022. Article selection was based on keywords and focused on comparing the effectiveness of William's and McKenzie's exercises. As the two rehabilitation programs are founded on different principles - William's therapy emphasizes flexion exercises while McKenzie's therapy focuses on extension exercises - patient assessment was conducted using evaluation scales. The evaluation employed the Visual Analogue Scale (VAS), the Oswestry Low Back Pain Disability Index (OSLBPDI), and the Short Form 36 (SF 36). The comparative analysis revealed modified scale scores following completion of the therapeutic protocol: 50-65% reduction in pain, 10-40 % increase in flexibility, and significant improvement in mental state. Based on these findings, an advancement in the patient’s condition can be observed for both William’s and McKenzie protocols. Nonetheless, the reviewed articles underscore the importance of selecting and adapting the therapeutic approach to the characteristics of lumbar pain.

Comparison of instrumented and stand-alone lateral lumbar interbody fusion for lumbar degenerative disease: a systematic review and meta-analysis

BackgroundBoth instrumented and stand-alone lateral lumbar interbody fusion (LLIF) have been widely used to treat lumbar degenerative disease. However, it remains controversial as whether posterior internal fixation is required when LLIF is performed. This meta-analysis aims to compare the radiographic and clinical results between instrumented and stand-alone LLIF.MethodsPubMed, EMBASE and Cochrane Collaboration Library up to March 2023 were searched for studies that compared instrumented and stand-alone LLIF in the treatment of lumbar degenerative disease. The following outcomes were extracted for comparison: interbody fusion rate, cage subsidence rate, reoperation rate, restoration of disc height, segmental lordosis, lumbar lordosis, visual analog scale (VAS) scores of low-back and leg pain and Oswestry Disability Index (ODI) scores.Results13 studies involving 1063 patients were included. The pooled results showed that instrumented LLIF had higher fusion rate (OR 2.09; 95% CI 1.16–3.75; P = 0.01), lower cage subsidence (OR 0.50; 95% CI 0.37–0.68; P < 0.001) and reoperation rate (OR 0.28; 95% CI 0.10–0.79; P = 0.02), and more restoration of disc height (MD 0.85; 95% CI 0.18–1.53; P = 0.01) than stand-alone LLIF. The ODI and VAS scores were similar between instrumented and stand-alone LLIF at the last follow-up.ConclusionsBased on this meta-analysis, instrumented LLIF is associated with higher rate of fusion, lower rate of cage subsidence and reoperation, and more restoration of disc height than stand-alone LLIF. For patients with high risk factors of cage subsidence, instrumented LLIF should be applied to reduce postoperative complications.

Prevalence of Low Back Pain and Its Related Risk Factors and Disability Following Lumbar Discectomy: A Single-Center Study.

Background Lumbar disc herniation is considered the most common cause of sciatica, which is a contributing factor to disability. Surgical management of lumbar disc herniation in the form of discectomy is superior to conservative management in terms of better recovery and pain relief. However, recurrence, residual back pain, and disability are common expected complications following surgery. Therefore, this study aims to determine the prevalence of low back pain and its related risk factors and disability following discectomy at King Fahad Hospital in the Al-Ahsa region. Methodology A cross-sectional study was conducted at King Fahad Hofuf Hospital in the Al-Ahsa region among patients who were admitted and underwent lumbar spine discectomy in the last six years either due to traumatic or degenerative causes. The study used an anonymous questionnaire consisting of the patient's sociodemographic data, medical and surgical history, spine disease history, and surgical history. The preoperative Glasgow Coma Scale score, neurological status, and American Spinal Cord Impairment Scale score were noted. In addition, immediate postoperative neurological status and minor complications were recorded. Moreover, more than six months postoperatively, the Numeric Analogue Scale and the Oswestry low back pain disability index questionnaire were administered. Results A total of 201 patients were included in the study. The majority of the patients were male (59.7%), with ages ranging from 41 to 60 years (51.7). Most patients underwent one surgery (83.6%) in the form of discectomy alone (90.5%) at L3-L4 (58.7%), for which the intervertebral disc was the most common degenerative indication for surgery. All patients (100%) had low back pain preoperatively, and most patients (50.7%) had no back pain six months postoperatively. Preoperatively, 58.2% had diminished neurological status, while only 29.9% showed a deficit postoperatively. Postoperative low back pain was significantly associated with office-based jobs (p = 0.021, 60.5%) and a high number of surgeries (p = 0.004, 74.1%). The following factors were observed to be risk factors for having lower back pain: six months postoperatively, being unemployed (p = 0.024, odds ratio = 4.38, 338% increased risk), having an office-based job (p = 0.012, odds ratio = 3.98, 298% increased risk), and the underlying cause of the problem being degenerative (p = 0.003, odds ratio = 3.34, 234% increased risk). Low back pain-related severe disability postoperatively was significantly associated with increased age >40 (28-50%; p = 0.045), female gender (p = 0.012, 44.4%), and being unemployed (p = 0.002, 51.4%). The level of disability six months postoperatively was moderate in 40.4% of the patients. Conclusions Lumbar discectomy is a successful procedure for relieving low back pain among patients with degenerative spine disease, with an improvement that involves neurological status. However, residual back pain may still occur in less than half of the patients despite appropriate management, such as being unemployed or office-based employees and having multiple spine surgeries. However, low back pain-related disability is often moderate, with increasing severity seen with increased age, being female, and being unemployed.

Chronic Low Back Pain: Prevalence, Impact on Quality of Life, and Predictors of Future Disability.

In primary healthcare settings, chronic low back pain (cLBP) is a widespread health issue with a great global impact. A cross-sectional analytical study was performed on 918 adults attending primary healthcare settings in Makkah, Saudi Arabia, to estimate the cLBP prevalence, its effect on health-related quality of life (QOL), and predictors of subsequent disability. The visual analog scale of pain(VAS), World Health Organization Quality of Life Scale (WHO-QOL), and Oswestry low back pain disability index (ODI) were used to assess back pain severity, impact on QOL, and physical disability, respectively. The prevalence of cLBP among adults attending primary care settings in Makkah City was 25.9%, and 88.6% of them had a limited range of motion of the spine. About 58.1% had abnormal radiological findings detected by MRI. Based on the VAS scale, most patients (83.8%) had mild pain. The median (IQR) QOL score was 70 (60-80). Minimal and moderate disability scores were prevalent among 16.2% and 65.7% of patients, respectively. Disability scores were independently predicted by a lower QOL score (beta = -0.39, 95%CI = -0.49 to -0.29, p < 0.001) and higher VAS scores (beta = 0.47, 95%CI = 0.38-0.56, p < 0.001). Furthermore, disability was independently associated with having post-void residual volume (PVRV) (beta = 5.84, 95%CI = 1.97-9.72, p = 0.004) and abnormal X-ray findings (beta = 7.10, 95%CI = 1.77-12.4, p = 0.010). cLBP is common among adults attending primary care settings in Makkah City; it is associated with moderate disability and lower health-related QOL.

RELIABILITY AND VALIDITY OF THE TURKISH VERSION OF THE GRADED CHRONIC PAIN SCALE 2.0

Purpose: To investigate the translation and cultural adaptation, the reliability and validity of the Turkish version of the Graded Chronic Pain Scale (GCPS) 2.0.&#x0D; Methods: The study was an observational and cross-sectional study translated and adapted into Turkish according to the Beaton protocol. Data was collected from eighty participants diagnosed with chronic low back pain (LBP) by a physician. Due to the pandemic, the scales were sent to patients via online form. Reliability was assessed using the test-retest method, parallel form method, and internal consistency. Validity was assessed using face, content, and construct validity analyses. &#x0D; Results: Cronbach's alpha was calculated as 0.89 to determine internal consistency. The intraclass correlation coefficient (ICC) was found to be 0.92 for the GCPS 2.0 total. Statisticaly significant correlation was found betweeen the GCPS 2.0 and the Oswestry Low Back Pain Disability Index (ODI) ( r = 0.759 p = 0.001) and between the GCPS 2.0 and the Roland-Morris Disability Questionnaire (RMDQ) (r = 0.777 p = 0.001). Factor analysis revealed a 2-factor structure.&#x0D; Conclusion: The Turkish version of the GCPS 2.0 is a valid and reliable measurement tool for patients with chronic LBP.

Evaluating the Changes in Sagittal Balance via EOS Imaging before and after Total Hip Arthroplasty

Background and Aim: Sagittal imbalance is often presented as one of the major problems in individuals suffering from orthopedic pain, particularly those affected by destructive hip joint osteoarthritis. In this regard, total hip arthroplasty (THA) as a therapeutic procedure for such patients has resulted in the restoration of sagittal balance. Therefore, the present study aimed to evaluate the changes in sagittal balance using EOS imaging before and after THA and also reflect on its effect on hip joint function, knee pain, and disability percentage due to low back pain (LBP). Methods: Utilizing a prospective cohort study, a total number of 24 patients suffering from extreme unilateral hip osteoarthritis and in need of unilateral THA were selected based on the inclusion and exclusion criteria, and then, sagittal balance parameters, including pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), sacrofemoral angle (SFA), sacrofemoral distance (SFD), lumbar lordosis (LL), and stem angle (SA) were investigated after performing standing radiographs by means of the EOS device. One year after THA, all the above-mentioned parameters were also measured by EOS imaging before and after the surgery and the patients completed some questionnaires, which is the Oswestry Low Back Pain Disability Index (OLBPDI) to evaluate disability percentage resulting in LBP, the Knee Injury and Osteoarthritis Outcome Score (KOOS) instrument to assess knee pain, and the Harris Hip Score (HHS) measure to rate hip joint function, and then the results were analyzed using the SPSS Statistics software (ver. 17). Results: The patients consisted of 13 males (54.2%) and 11 females (45.8%) with the mean age of 52.87±13.05. The mean score of the preoperative PI was also equal to 54.74±10.66 and it was 58.19±11.58 after the surgery (p=0.025). However, the mean values of other parameters at the preoperative stage did not show any significant changes. As well, hip joint function and knee pain resulting from LBP improved in the patients after the surgery (p&lt;0.001). Conclusion: The study findings demonstrated that THA probably influenced sagittal balance through PI. Moreover, the postoperative hip joint function, knee pain, and disability percentage caused by LBP significantly enhanced compared with those before the surgery. Thus, it was concluded that the evaluation of sagittal balance parameters could help patients with orthopedic pain.

CIRCADIAN BLOOD PRESSURE PROFILE IN RELATION TO LOW BACK PAIN DISABILITY INDEX

Objective: Cross-sectional observations within population cohorts have linked low back pain with hypertension in men, but not in women. The aim of the current study was to analyze 24-hour blood pressure profile in hypertensive men and women reporting low back pain. Design and method: The study group included 85 hypertensive patients (29 M/56 F, mean age 60.6 +/- 8.3 years) with episodes of low back pain during 3 weeks before examination. All patients received antihypertensive medications in the scheme of combination therapy and none of them was on chronic painkillers. Standardized questionnaire was used to collect information on life style factors. Twenty-four hour blood pressure monitoring was provided (Spacelabs 90207) and values of 24h, daytime and nighttime blood pressure were calculated, as well as nighttime blood pressure dipping. Oswestry Low Back Pain Disability Questionnaire was used to calculate disability index. Multivariable regression was used to asses the association between blood pressure an disability index, while accounting for covariates. Results: In the whole study population, no association was found between disability index and 24-hour systolic (parameter estimate: -0.053 +/- 0.23 mm Hg per 1 point increase in disability index, p = 0.86) or diastolic blood pressure (-0.018 +/ 0.14 mm Hg per 1 point increase, p = 0.90). When analyzing men and women separately, we observed in women increased daytime diastolic blood pressure with increasing disability index (+0.29 +/- 0.16 mm Hg, p = 0.044), that resulted in more prominent day-night difference with increasing disability index (+0.42 +/- 0.14% per 1 point increase in disability index). Blood pressure values over 24 hours or nighttime blood pressure was not associated with disability index. None of associations between blood pressure values and low back pain disability index were not found in men. Conclusions: Low back pain, as assessed by standardized questionnaire of disability index, is associated with elevated daytime blood pressure in hypertensive women, that might lead to more difficulties in achieving target blood pressure in this group of patients.

Effects of breathing methods on patients with chronic back pain during plank exercise

Objective: The purpose of this study is to provide an exercise method for effective trunk stabilization by analyzing the thickness of the abdominal muscles, low back pain, and lumbar spine dysfunction by applying the simultaneous contraction of the plank exercise and the maximal expiratory method to patients with chronic back pain. Method: The number of subjects was 20 in total, 10 in the experimental group and 10 in the control group. The control group applied a plank exercise program, and the experimental group was provided with a plank exercise program in parallel with maximal exhalation. The exercise time was about 10 minutes. It was conducted 5 times a week for a total of 2 weeks. In both groups, the thickness of the abdominis muscle, pain level(NRS), and Korean-osweatry disability index(K-ODI) level were evaluated before and after the intervention. Results: All subjects who participated in the exercise program showed a common result: low back pain and low back pain disability index, and increased abdominal muscle thickness. In the case of the experimental group, there were more significant changes in the thickness of the abdominal muscles, the degree of low back pain, and the degree of low back pain disability index compared to the control group(p&lt;.05). However, there was no significant difference between the two groups. Conclusion: It is considered that plank exercise accompanied by maximum exhalation will be an effective plank exercise method to reduce low back pain and low back pain disability index by activating deep abdominal muscles.

Virtual reality in the management of patients with low back and neck pain: a retrospective analysis of 82 people treated solely in the metaverse

BackgroundClinically, neck pain disorders (NPD) and non-specific low back pain (NS-LBP) are respectively the fourth and first most common conditions associated with the greatest number of years lived with disability. Remote delivery of care may benefit healthcare sustainability, reduce environmental pollution, and free up space for those requiring care non-virtual care.MethodsA retrospective analysis was performed on 82 participants with NS-LBP and/or NPD who received exercise therapy delivered solely in the metaverse using virtually reality. The study was to determine if this was achievable, safe, had appropriate outcome measures that could be collected, and if there was any early evidence of beneficial effects.ResultsThe study demonstrated that virtual reality treatment delivered via the metaverse appears to be safe (no adverse events or side effects). Data for more than 40 outcome measures were collected. Disability from NS-LBP was significantly reduced (Modified Oswestry Low Back Pain Disability Index) by 17.8% (p < 0.001) and from NPD (Neck Disability Index) by 23.2% (p = 0.02).ConclusionsThe data suggest that this method of providing exercise therapy was feasible, and safe (no adverse events reported), that complete reports were obtained from a large selection of patients, and that software acquired outcomes were obtainable over a range of time points. Further prospective research is necessary to better understand our clinical findings.

Transforaminal Injections of Platelet-Rich Plasma Compared with Steroid in Lumbar radiculopathy: A Prospective, Double-Blind Randomized Study.

To evaluate and compare the clinical efficacy of transforaminal steroid and platelet-rich plasma (PRP) injections in patients with discogenic lumbar radiculopathy. 60 patients were randomized to be treated with single transforaminal injection of PRP (n = 29) or steroid (methylprednisolone acetate [n = 31]). Clinical assessment was done with Visual analogue scale (VAS), modified Oswestry low back pain disability index (MODI), and straight leg raise test (SLRT). Baseline assessment of outcomes was done followed by post-intervention evaluation at 1, 3, and 6months. Both groups had similar baseline characteristics. There was a significant statistical improvement of VAS and MODI in both groups at follow-up (P < 0.05). In PRP group, minimal clinically important change (> 2cm difference of mean for VAS and > 10-point change in MODI) for both outcome scores was achieved at all follow-up intervals (1, 3, 6months), while as in steroid group, it was seen only at 1 and 3months for both VAS and MODI. On intergroup comparison, better results were seen in steroid group at 1month (P < 0.001 for both VAS and MODI), and in PRP group at 6months (P < 0.001 for both VAS and MODI) with non-significant difference at 3months (P = 0.605 for MODI and P = 0.612 for VAS). More than 90% tested SLRT negative in PRP group and 62% in steroid group at 6months. No serious complications were seen. Transforaminal injections of PRP and steroid improve short-term (up to 3months) clinical outcome scores in discogenic lumbar radiculopathy, but clinically meaningful improvements sustaining for 6months were provided by PRP only.

Effect Of Feldenkrais Method And Conventional Exercise Protocol On Neck Pain And Low Back Pain In Corporate Employees Working From Home : A Comparative Study

BACKGROUND- As current shift from working in the office setup to work from home setup , many of the people especially corporate employees are forced to work in a less than ideal ergonomic environment. Although, there is significant evidence of developing Orthopaedic disorders such as neck pain and back pain in them due to prolonged sitting and body posture at their workplace, there are more possibilities to develop the neck pain and low back pain in them while doing their office work even at home. There is lack of research on this topic, indeed this made us to study the effect of comparison of Feldenkrais Method and Conventional Exercise Protocol on neck pain and low back pain in corporate employees working from home in COVID-19. AIMS AND OBJECTIVES- To study and find out the effect of comparison of FM and Conventional Exercise Protocol on neck pain and back pain in corporate employees working from home in COVID-19.To determine the effect of FM on neck pain and low back pain in corporate employees in COVID-19 phase. To determine the effect of Conventional Exercise Protocol on neck pain and low back pain in corporate employees in COVID-19 phase. To compare the effect of FM and Conventional Exercise Protocol on neck pain and low back pain in corporate employees in COVID-19 phase. METHODOLOGY- In this comparative study, 42 corporate employees working from home in age group 25 to 55 years were included. Neck pain and low back pain was assessed through Northwich Park Neck Pain Questionnaire and Oswestry Low Back Pain Disability Index before and after the exercise session, respectively. The participants were divided into two groups of 21 each: Group A as a control group and Group B as an experimental group. Group A was instructed to follow only the Conventional Exercise Protocol. Group B was instructed to follow the FM along with Conventional Exercise Protocol. Later data was collected and analysis was done. RESULTS- Neck pain and low back pain was significantly reduced in the post exercise session in group B&nbsp; as compared to group A. Statistical analysis was done using unpaired t- test. Statistical significance: p value differed from pre- data to post- data. CONCLUSION- A significant reduction was found in neck pain and low back pain with FM along with Conventional Exercise Protocol in corporate employees working from home in COVID-19. &nbsp

Proprioceptive neuromuscular facilitation in chronic low back and neck pain and disability: A systematic review and meta-analysis

BACKGROUND: Proprioceptive neuromuscular facilitation (PNF) is one of the neurophysiological techniques aimed at reducing pain and disability. This systematic review objective addresses the current evidence on PNF techniques’ effectiveness in chronic low back and neck pain. METHODS: Literature search in PubMed, Scopus, Cochrane, Wiley and Ovid databases were searched until 2021. The content of the titles and the abstracts were analysed to gather information about the effects of PNF in chronic back and neck pain with outcomes of pain and disability. The quality of the studies was analysed by the Joanna Briggs Institute (JBI) critical appraisal score. Meta-analysis was performed on Visual Analogue Scale (VAS), Numerical Rating Scale (NRS) for chronic low back pain and Oswestry Disability Index (ODI), Roland Morris Disability Questionnaire (RMDQ) for disability. RESULTS: Nine studies addressed the different PNF based interventions on chronic low back pain, with a total of 416 participants. The intervention period ranged 3–6 weeks, and two studies conducted 12-weeks follow-up. Many studies measured pain using a VAS and NRS, whereas the disability through ODI and RMDQ. The JBI score ranged from 6/13 to 11/13. None of the PNF studies treated chronic neck pain. CONCLUSION: PNF might be beneficial for reducing low back pain and related disability. The long term effects of PNF on chronic low back pain, and also to determine its benefits on chronic neck pain are warranted in future studies.

Hamstring Muscle Tightness and Chronic Low Back Pain an Analytical Study on General Population

Background: The low back is a common disorder prevalent in general population having an association with hamstring tightness which needs to be addressed while its prevention or management strategies. The objective was to find if there is any link between CLBP severity and hamstring muscle tightness. Methods: A cross-sectional analytical study was carried out on 160 patients with persistent LBP, fulfilling the criteria of the study. After ethical approval, data was gathered from Ayesha Sadiqa Hospital Lahore. The low back pain disability index was measured using Oswestry Disability Index and Hamstring tightness was evaluated using clinical Active knee extension test. The data were analysed using SPSS V.23 and Chi square was used to determine association between outcomes. Result: There were 160 participants, among them 114 (71.25%) experiencing hamstring tightness and 46 (28.75%) not having hamstring tightness. Females had a greater prevalence than males. The findings suggest that hamstring tightness affected 61% patients with moderate impairment. There was an association of hamstring tightness with disability Index among the participants at p Value &lt;.01. Conclusion: In subjects with back pain, hamstring tightness has an association with activities of daily life other than sexual preferences, community interactions, and journey. The chronic low back pain has direct association with hamstring muscle tightness in our target population. Keywords: Association, Chronic Low Back Pain, Hamstring Muscle, Tightness

Intraoperative Endplate Injury Following Transforaminal Lumbar Interbody Fusion

To investigate the incidence, distribution characteristics, risk factors, and clinical outcomes of intraoperative endplate injury (EI) following transforaminal lumbar interbody fusion. Patients who underwent single-level transforaminal lumbar interbody fusion from January 2018 to December 2020 were included. The patients were separated into EI and non-EI groups based on computed tomography obtained immediately postoperatively. Demographic, clinical, and radiographic parameters of all patients were analyzed. Clinical outcomes were evaluated by visual analog scale for low back pain and Oswestry Disability Index. This study enrolled 576 patients. Rates of EI were 19.6% (113/576) of patients and 9.9% (114/1152) of endplates. The rate of superior EI was significantly higher than that of inferior EI. The results showed that older age, lower disc height index, and taller cage height were independent risk factors for intraoperative EI. Postoperative drain output, total blood loss, postoperative duration of drainage tube, and postoperative hospital stay in the EI group were significantly greater than in the non-EI group. There were no statistical differences in Oswestry Disability Index and visual analog scale scores at the same time point between the groups. Rates of EI were 19.6% of patients and 9.9% of endplates. Superior endplates were more susceptible to injury than inferior endplates. Older age, lower disc height index, and taller cage height were independent risk factors for intraoperative EI. Clinical outcomes were not affected by intraoperative EI during early postoperative follow-up.

Analysis of Chronic Low Back Pain Caused by Lumbar Microinstability After Percutaneous Endoscopic Transforaminal Discectomy: A Retrospective Study.

ObjectiveChronic low back pain (CLBP) after percutaneous endoscopic transforaminal discectomy (PTED) surgery may be caused by preoperative lumbar microinstability (MI). However, there is a paucity of research on the relationship between lumbar microinstability and chronic low back pain. The purpose of this article is to assess the preoperative radiographic characteristics of patients and evaluate the effects of lumbar microinstability on patient-reported outcomes among single-level lumbar disc herniation (LDH) patients who underwent PTED.MethodsThis study retrospectively reviewed the radiographic characteristics of a consecutive series of 127 patients with low back pain and leg pain caused by single-level LDH underwent PTED from August 2018 to March 2021. They were divided into three groups according to the radiographic parameters: the stable group (Group S), the dysfunctional group (Group D), and the microinstability group (Group M). The visual analogue scale (VAS) scores for leg and low back pain and Oswestry Disability Index (ODI) were evaluated preoperatively and postoperatively. Logistic regression analysis was used to identify independent risk factors for CLBP.ResultsCompared with Group D and Group S, Group M had the highest ODI scores (P < 0.01) and VAS scores (low back pain) (P < 0.01) after 1 year, while there were no significant differences in the VAS scores for leg pain at different time points after surgery (P > 0.05). In addition, the logistic regression analysis results regarding CLBP revealed that muscle fatty degeneration on MRI (95% CI, 1.20–8.51, P = 0.02), and facet tropism (95% CI, 1.39 −11.37, P = 0.01) may be independent risk factors.ConclusionPatients with lumbar microinstability may have CLBP after PTED, so patients with lumbar microinstability may need to take internal fixation surgery to solve their symptoms.

Long-term outcome of patients with adolescent idiopathic scoliosis seeking nonoperative treatment after a mean follow-up of 42 years

PurposeAdolescent idiopathic scoliosis (AIS) affects up to 3% of otherwise healthy adolescents. The extreme long-term outcomes of nonoperative treatment are underreported. This study aimed to investigate the long-term outcome of nonoperative-treated AIS patients. Comparison between a bracing and an observation approach were performed.MethodsIn a retrospective cohort study, 20 nonoperatively treated AIS patients were observed concerning patient-related outcome measures (PROM) (visual analog scale (VAS), Short Form Health Survey 36 item (SF 36), Scoliosis Research Society (SRS 24), Oswestry Low Back Pain Disability Index (ODI), Psychological General Well-Being Index (PGWBI)), radiological curve progression and health-related quality of life (HRQoL). Baseline characteristics and radiological imaging were collected. At follow-up, anteroposterior and lateral X-rays as well as questionnaires were analyzed.ResultsTwenty patients (16 females, mean age: 14.6 ± 3.2 years) with a follow-up time of 42 ± 9 years were included. Nine patients (initial Cobb 35° ± 19°) were treated with bracing for a mean time of 26 ± 9 months, while the other 11 patients (initial Cobb 29° ± 11°) were observed. The primary curve progressed from 32° ± 15° to 52° ± 25° in average with no significant difference between the cohorts (p = 0.371). At final follow-up, a mean ODI score of 7 ± 7.9 points with no difference depending on the treatment (p = 0.668) was seen. No significant differences were observed for PROMs. Curve magnitude correlated neither at diagnosis (p = 0.617) nor at follow-up (p = 0.535) with the ODI score at final follow-up.ConclusionAfter a mean of 42 years, patients with nonoperative treatment of moderate AIS demonstrated a good clinical outcome despite progression of the deformity.Level of evidenceLevel IV, therapeutic study.

Evaluation of the correlation between the Istanbul Low Back Pain Disability Index, Back Pain Functional Scale and other back pain disability scales in Turkish patients with low back pain.

Low back pain is an important health problem that may cause functional loss. Several back pain disability scales have been developed in different languages. The present study evaluates the correlation between the Istanbul Low Back Pain Disability Index (ILBPDI) the Back Pain Functional Scale (BPFS) and other back pain disability scales in patients with mechanical low back pain. Included in the study were 105 patients who presented to our outpatient clinics and who were diagnosed with mechanical low back pain. The ILBPDI, BPFS, Quebec back pain disability scale (QBPDS) and Oswestry low back pain disability questionnaire (ODI) were administered to all participants, and Visual analogue scale (VAS) scores were recorded. A strongly negative correlation was identified between ILBPDI and BPFS (p< 0.05), and a strongly positive correlation was noted between ILBPDI and QBPDS, ODI and VAS. A strong correlation exists between ILBPDI and BPFS, and a further strong correlation between ILBPDI ODI and QBPDS. These questionnaires can be used interchangeably to evaluate disability associated with chronic mechanical low back pain.