Lower Spine Research Articles

Evaluation of Specific Spinal Segmental Stabilizing Exercises in the Treatment of Antenatal Low Back Pain

Aims: To investigate the effect of specific lumbar stabilizing exercises on relieving antenatal low back pain. Study design: A randomized clinical controlled trial. Place and Duration of study: Department of Obstetrics (antenatal clinic), Kafelsheikh general hospital - Kafelsheikh, between October 2014 and January 2015. Methodology: Twenty pregnant women (age 20-25 years) at 20-24 weeks gestation, clinically diagnosed with low back pain and divided into 2 equal groups (A&B). Patients in group A were treated by lumbar stabilizing exercises for 12 weeks, patients in group B without any treatment. Low back pain intensity and spine flexibility were measured by mean of a 100-mm horizontal visual analogue scale and side bending test before and after the treatment program. Results: Patients in group A showed significant decrease in low back pain intensity (P=0.01) and spine flexibility (P=0.01), while in group B there were significant increase in low back pain intensity (P=0.01) without difference in spine flexibility (Right and Left sides) (P=0.83 and 0.6) at the end of the study. There were no significant differences in low back pain intensity (P=0.82) and spine flexibility (Right and Left sides) (P=0.76 and 0.69) at the beginning of the study. But there were highly significant differences in low back pain intensity (P=0.001) and spine flexibility (Right and Left sides)(P=0.01) at the end of the study between both groups, Conclusion: lumbar stabilizing exercises decrease the pain intensity and increase the lumbar range of motion.

The effects of neuromuscular taping on gait walking strategy in a patient with joint hypermobility syndrome/Ehlers-Danlos syndrome hypermobility type.

In this case study, biomechanical alterations induced by neuromuscular taping (NMT) were quantified, during walking, in a patient with joint hypermobility syndrome/Ehlers-Danlos syndrome hypermobility type (JHS/EDS-HT). A female JHS/EDS-HT patient underwent NMT applications over the low back spine and bilaterally to the knee. Quantitative gait analyses were collected before the NMT application and at the end of the treatment (2 weeks after the first application of NMT). At the end of treatment following the NMT application, left step length showed improvements in cadence and velocity, the left knee showed a reduction in its flexed position at initial contact, and the right ankle joint improved its position at initial contact and in the swing phase. Improvements were also found in kinetics, in terms of the ankle moment and power. Results show that NMT seems to be a promising low-cost intervention for improving gait strategy in patients with JHS/EDS-HT. Further investigations are needed to assess the effects of this treatment intervention on pathological symptoms.

Off-Road Vehicle Seat Suspension Optimisation, Part II: Comparative Study between Meta-Heuristic Optimisation Algorithms

Clinical observations show that a significant number of low back pain, spine disorders and head injuries are related to exposure to vibration of vehicles. Implementation of seat to suspensions reduces the effects of vibration in vehicle operators in long terms. This paper discusses three evolutionary algorithms in off-road seat suspension design. Genetic algorithm (GA), particle swarm optimisation (PSO) and harmony search (HS) algorithm were used to minimise transmitted vibration to the driver's spine which was modelled by artificial neural network biodynamic model based on experimental data, as was discussed in part I. The reliability of results was studied by simulation of vibration in vertical direction. The suspension was tuned based on harmony search depicting lower values of seat to spine vibration transmissibility and mobility. Thus, the transmitted vibration to spine and risk of spine problem may be alleviated by using this tuned seat suspension.

Effects of 17β-estradiol on the cytoarchitecture of pyramidal CA1 neurons in normoglycemic and diabetic male spontaneously hypertensive rats

Previous work has shown a reduction of apical dendritic length and spine density in neurons from the CA1 hippocampus subfield of spontaneously hypertensive rats (SHRs). These abnormalities are prevented by treatment for 2weeks with 17β-estradiol. In view of the fact that diabetes and hypertension are comorbid diseases, we have now studied the effect of Streptozotocin-induced diabetes on the dendritic tree and spines of CA1 hippocampus neurons, and also compared the regulation of these parameters by 17β-estradiol in diabetic and normoglycemic SHR. Twenty-week-old male SHR received iv 40-mg/kg Streptozotocin or vehicle and studied 1month afterward. A group of normoglycemic and hyperglycemic SHR also received sc a single 17β-estradiol pellet or vehicle for 2weeks. Hippocampus sections were impregnated with silver nitrate following a modified Golgi’s method and the arbor of CA1 pyramidal neurons analyzed by Sholl’s method. 17β-Estradiol treatment of normoglycemic SHR reversed the reduced length of apical dendrites, the low spine density and additionally decreased blood pressure (BP). Diabetic SHR showed increased length of apical and basal dendrites but reduced spine density compared to normoglycemic SHR. Diabetes also decreased BP of SHR. Treatment with 17β-estradiol of diabetic SHR enhanced dendritic length, increased dendritic spine density and further decreased BP. Thus, changes of cytoarchitecture of CA1 neurons due to 17β-estradiol treatment of normoglycemic SHR persisted after diabetes induction. A decrease of BP may also contribute to the central effects of 17β-estradiol in SHR diabetic rats.

Dietary intervention restored menses in female athletes with exercise-associated menstrual dysfunction with limited impact on bone and muscle health.

Exercise-related menstrual dysfunction (ExMD) is associated with low energy availability (EA), decreased bone mineral density (BMD), and increased risk of musculoskeletal injury. We investigated whether a 6-month carbohydrate-protein (CHO-PRO) supplement (360 kcal/day, 54 g CHO/day, 20 g PRO/day) intervention would improve energy status and musculoskeletal health and restore menses in female athletes (n = 8) with ExMD. At pre/post-intervention, reproductive and thyroid hormones, bone health (BMD, bone mineral content, bone markers), muscle strength/power and protein metabolism markers, profile of mood state (POMS), and energy intake (EI)/energy expenditure (7 day food/activity records) were measured. Eumenorrheic athlete controls with normal menses (Eumen); n = 10) were measured at baseline. Multiple linear regressions were used to evaluate differences between groups and pre/post-intervention blocking on participants. Improvements in EI (+382 kcal/day; p = 0.12), EA (+417 kcal/day; p = 0.17) and energy balance (EB; +466 kcal/day; p = 0.14) were observed with the intervention but were not statistically significant. ExMD resumed menses (2.6 ± 2.2-months to first menses; 3.5 ± 1.9 cycles); one remaining anovulatory with menses. Female athletes with ExMD for >8 months took longer to resume menses/ovulation and had lower BMD (low spine (ExMD = 3; Eumen = 1); low hip (ExMD = 2)) than those with ExMD for <8 months; for 2 ExMD the intervention improved spinal BMD. POMS fatigue scores were 15% lower in ExMD vs. Eumen (p = 0.17); POMS depression scores improved by 8% in ExMD (p = 0.12). EI, EA, and EB were similar between groups, but the intervention (+360 kcal/day) improved energy status enough to reverse ExMD despite no statistically significant changes in EI. Similar baseline EA and EB between groups suggests that some ExMD athletes are more sensitive to EA and EB fluctuations.

GluN3A promotes dendritic spine pruning and destabilization during postnatal development.

Synaptic rearrangements during critical periods of postnatal brain development rely on the correct formation, strengthening, and elimination of synapses and associated dendritic spines to form functional networks. The correct balance of these processes is thought to be regulated by synapse-specific changes in the subunit composition of NMDA-type glutamate receptors (NMDARs). Among these, the nonconventional NMDAR subunit GluN3A has been suggested to play a role as a molecular brake in synaptic maturation. We tested here this hypothesis using confocal time-lapse imaging in rat hippocampal organotypic slices and assessed the role of GluN3A-containing NMDARs on spine dynamics. We found that overexpressing GluN3A reduced spine density over time, increased spine elimination, and decreased spine stability. The effect of GluN3A overexpression could be further enhanced by using an endocytosis-deficient GluN3A mutant and reproduced by silencing the adaptor protein PACSIN1, which prevents the endocytosis of endogenous GluN3A. Conversely, silencing of GluN3A reduced spine elimination and favored spine stability. Moreover, reexpression of GluN3A in more mature tissue reinstated an increased spine pruning and a low spine stability. Mechanistically, the decreased stability in GluN3A overexpressing neurons could be linked to a failure of plasticity-inducing protocols to selectively stabilize spines and was dependent on the ability of GluN3A to bind the postsynaptic scaffold GIT1. Together, these data provide strong evidence that GluN3A prevents the activity-dependent stabilization of synapses thereby promoting spine pruning, and suggest that GluN3A expression operates as a molecular signal for controlling the extent and timing of synapse maturation.

FRI0116 Prevalence of Vertebral Fractures and the Relation to Clinical and Radiological Outcome in Ankylosing Spondylitis Patients with Active Disease

BackgroundAnkylosing spondylitis (AS) is characterized by the combination of inflammation, excessive bone formation, and bone loss in the axial skeleton. This excessive bone loss may lead to the occurrence of...

13. Integrative action of axon’s membrane explored by sub threshold stimulation of the peripheral nerve fibres

Introduction Bostock et al. [J Physiol 564.3 93–1940, 2005] showed thatwhen the current of subthreshold intensity is applied to the peripheral nerve it will make the axon hyperexcitable. We experimented with a modified method of Bostock et al. by using multiple subthreshold stimuli to the median nerve. We were able to show integrative action of axon’s membrane. Method In 6 healthy subjects and 17 patients who underwent monitoring for low spine surgery, we stimulated the median nerve at the wrist (in most of them bilaterally) with percutaneous electrodes, using near-the-threshold one to nine, constant-current stimuli at a duration of 500 microseconds Interstimulus interval between stimuli was 2 ms. In the patient group recordings of the compound-muscle action-potential (CMAP) were done from opponens pollicis muscle using EEG needle electrodes, while in healthy subjects we used surface electrodes. TIVA without muscle relaxant was used in all patients and measurements were performed at the end of surgery. Result In all healthy subjects and patients a single near-the-threshold stimulus did not generate CMAP. When the number of near-the-threshold stimuli was increased to two, five, seven, or nine stimuli and packed in a short train with inter stimulus intervals of 2 ms, this resulted in the successful eliciting of CMAP amplitude from 100 to 200 microvolts. Conclusion We concluded that the described phenomenon might be explained by the integrative action of the axonal membrane which is capable of summating the trains of sub-threshold stimuli, increasing the resting potential to the firing level and consequently generating CMAP. This is due to the effect of sub threshold stimulus hyperexcitability. This phenomenon is not very well explored in clinical neurophysiology, and needs more attention. This could lead to explanations of some neurophysiologic phenomena during intraoperative monitoring.

Perceived barriers and enablers to accessing conservative and surgical care for osteoarthritis

Perceived barriers and enablers to accessing conservative and surgical care for osteoarthritis

Prevalence of musculoskeletal symptoms in hospital nurse technicians and licensed practical nurses: associations with demographic factors

Objective: This cross-sectional study aimed at analyzing: 1. the main musculoskeletal symptoms (MSS) presented by hospital nursing workers and; 2. personal, occupational, and health factors related to MSS among them. Method: Two questionnaires were filled in by 245 nurse technicians (NTs) and licensed practical nurses (LPNs) (response rate 95%) associated with direct patient care sectors from a hospital. These questionnaires were: the standardized version of the Nordic Musculoskeletal Questionnaire (NMQ) and one including questions on 15 demographic independent variables potentially related to outcomes from the NMQ. Univariate analyses and binary logistic regression analyses were performed to identify which variables would explain the occurrence of MSS in different body regions. Results: The low back (57%), shoulder (52%), and neck (48%) were identified as the most affected regions. The logistic regression analysis showed that low back symptoms in the last 12 months were significantly associated with LPN activities (OR=2.36; CI=1.24-4.5) and previous sick leave due to MSS (OR=5.97; CI=1.2-29.1). Smoking was significantly associated with symptoms in the low back (OR=2.77; CI=1.13-6.8) and thoracic spine (OR=2.37; CI=1.04-5.40). Physical exercise showed a protective effect on the cervical spine (OR=0.42; CI=0.23-0.77). Previous sick leave was significantly associated with pain in the knees (OR=4.24; CI=1.33-13.5) and in the upper limbs (OR=5.36; CI=1.07-26.7). Conclusions: The nursing workers who were evaluated presented a high prevalence of MSS. Previous history of sick leave was strongly associated with the presence of symptoms in various body regions. These results indicate the need for preventive programs in the hospital environment in order to control more severe MSS in nursing professionals.

Stress fracture of ulna due to excessive push-ups

Stress fractures are most common in the weight-bearing bones of the lower extremities and spine, but are rarely found in non-weight-bearing bones of the body. Stress fracture of the ulna is extremely rare. We report a case of complete stress fracture of ulna caused due to excessive push ups in a young athlete. Conservative management was successful in healing of fracture and returning this patient back to his previous activity level. Physician should have high index of suspicion, whenever they encounter a young athlete complaining of forearm pain.

Carrying and spine loading

The advantages and disadvantages of different methods of carrying objects on spine loading are still not fully understood. Previous studies have either examined the effects of carrying using physiological measures or examined isolated spine segments using biomechanical models. Additionally, most studies have been restricted to only a small number of carrying conditions. Very few studies have attempted to examine the various factors influencing spine loading together. To improve understanding of interacting factors on carrying, this study assessed the lumbar spine loads of 16 subjects as they assumed six styles of carrying at two weight levels and two activity levels (walking vs. standing). Concurrent with each trial, a subject-specific biomechanical model was used to assess spine forces over the full lumbar spine. Most carrying methods in the trials resulted in relatively low levels of spine loading. Anterior/posterior (A/P) shear loading was the only spine-loading dimension that reached biomechanically meaningful levels. Two carrying conditions, with bins carried in front of the body, significantly increased A/P shear compared with other carrying styles. This increase appeared to be due to the greater moment arms occurring in these conditions. Many of the other carrying styles produced A/P shears that were similar to those observed when carrying nothing at all. Of all the tasks, the backpack carry characteristically produced especially low spine loads. The findings of the study suggest that to achieve optimal carrying in terms of spine loading, loads should be positioned close to the body, even when carrying relatively light loads.

New Insights from Immunohistochemistry for the Characterization of Epidural Scar Tissue

Background: The association between epidural fibrosis and recurrent symptoms after lumbar spine surgery remains a matter of debate in scientific literature and the underlying pathophysiological mechanism has not been clearly elucidated. Objective: To investigate the presence of nerve fibers and the expression of osteopontin in epidural fibrous tissue after lumbar surgery in humans. Study Design: Laboratory study of human tissue samples. Methods: Twenty-four patients with persistent or recurrent low back and/or leg pain after lumbar spine surgery, in whom no relevant findings were present on magnetic resonance imaging (MRI) besides epidural scar tissue, were submitted to epiduroscopy. Biopsy samples of epidural scar tissue resting in the posterior epidural and periradicular space were obtained from 15 patients, using an endoscopic grasping forceps, in locations where the stimulation with the tip of a Fogarty consistently reproduced pain. Biopsy samples were processed for examination under optical and transmission electron microscopes and under a fluorescence microscope after incubation in primary antibodies against beta3- tubulin or against osteopontin. Results: Optical and transmission electron microscopy revealed a homogeneous fibrous tissue rich in collagen and lacking nerve fibers. No immunofluorescence was present in any of the samples immunoreacted against beta3-tubulin. In the samples immunoreacted against osteopontin, a punctate signal was detected around the collagen fibers. Limitations: Being a human study, there was no control group, so it is not possible to determine the contribution of osteopontin in the formation of epidural fibrosis and its relation to the patients’ symptoms. Additional animal studies are needed to investigate these issues. Conclusion: Rather than direct stimulation of nociceptors in the epidural scar tissue, other factors should relate epidural fibrosis and recurrent symptoms after lumbar spine surgery. Osteopontin seems to play a role in the formation of epidural fibrosis. Key words: Osteopontin, failed back surgery syndrome, epidural fibrosis, immunofluorescence, beta3-tubulin, epiduroscopy, nerve fibers, lumbar surgery

Percutaneous Endoscopic Lumbar Discectomy and Annuloplasty for Lumbar Disc Herniation at the Low Two Contiguous Levels: Single-Portal, Double Surgeries

Technical case report. The authors report surgical experience of treating contained or noncontained lumbar disc herniation (LDH) at the L3-L4 and L4-L5 or L4-L5 and L5-S1 levels by transforaminal percutaneous endoscopic lumbar discectomy and annuloplasty (PELDA) through the single entry point. When there are concurrent LDHs involving lower two levels simultaneously, PELDA has not been performed. Between March 2008 and May 2011, eight patients presented with back pain or radicular lower limb pain. Upon radiologic examination using magnetic resonance imaging, the patients were diagnosed with central or paramedian LDH at low spine levels (L3-L4 and L4-L5 or L4-L5 and L5-S1) consistent with their clinical presentations. We performed double PELDA at the affected two levels simultaneously through a single skin portal. The symptoms were relieved dramatically, and all patients were discharged the next day. There was no radiologic instability during the follow-up period. Transforaminal PELDA to treat two levels of LDH through a single portal could be considered as one of the minimally invasive treatment modalities that avoids conventional open surgery.

Dendritic spine dynamics in synaptogenesis after repeated LTP inductions: Dependence on pre-existing spine density

Not only from our daily experience but from learning experiments in animals, we know that the establishment of long-lasting memory requires repeated practice. However, cellular backgrounds underlying this repetition-dependent consolidation of memory remain largely unclear. We reported previously using organotypic slice cultures of rodent hippocampus that the repeated inductions of LTP (long-term potentiation) lead to a slowly developing long-lasting synaptic enhancement accompanied by synaptogenesis distinct from LTP itself, and proposed this phenomenon as a model system suitable for the analysis of the repetition-dependent consolidation of memory. Here we examined the dynamics of individual dendritic spines after repeated LTP-inductions and found the existence of two phases in the spines' stochastic behavior that eventually lead to the increase in spine density. This spine dynamics occurred preferentially in the dendritic segments having low pre-existing spine density. Our results may provide clues for understanding the cellular bases underlying the repetition-dependent consolidation of memory.

The repeatability of pressure algometry in asymptomatic individuals over consecutive days

BackgroundTo determine if electronic pressure algometry is a statistically stable measure of spinal pressure pain threshold (PPT) in asymptomatic individuals, in particular, to determine if repeated measurements at the same site changes the PPT, and to determine if repeatability differs in each of the spinal regions tested. DesignRepeated measures design. SettingUniversity teaching clinic. ParticipantsThirty-three asymptomatic participants. InterventionsThe PPT of three spinal segments (C6, T6 and L4) was measured three times in consecutive measures (10 s apart), then repeated one day and two days post-initial measurement. Measurements were taken using an electronic pressure algometer. Main outcome measuresPPT, intra-class correlation coefficient and test of significant equality. ResultsResults demonstrated that the PPT measurement is statistically stable both between days (p < 0.001) and within day (p < 0.001). The intra-class correlation coefficient (ICC) values between the mean scores of daily trials demonstrated excellent concordance for each spinal segment (ICC = 0.860–0.953), with the exception of the correlation between day 1 and day 3 at T6, demonstrating good concordance (ICC = 0.676). All trial-to-trial correlations demonstrated excellent concordance both within trials of the same day (ICC = 0.833–0.988) and subsequent days (ICC = 0.823–0.940). ConclusionElectronic pressure algometry is a repeatable and statistically stable measure of the spinal PPT, both between days and within-day. The results provide evidence that the use of this device may be of value as an outcome measure for primary spinal complaints such as low back or thoracic spine pain.

Quantitative analysis of the closure pattern of the neurocentral junction as related to preexistent rotation in the normal immature spine

Background contextThe normal spine is not a symmetrical structure. In recent studies, we demonstrated the presence of an axial rotational pattern that is similar to what is seen in the most prevalent curve patterns in idiopathic scoliosis at different ages. This suggests that if the spine starts to decompensate into scoliosis, it follows this preexistent rotational pattern. In scoliosis, the neurocentral junctions (NCJs) close asymmetrically, which leads to a different pedicle morphology in the convexity and concavity of the curve. The present study aimed to establish at which age the NCJ closes in different regions of the spine, whether it closes asymmetrically in the nonscoliotic spine as well and whether the closure pattern is related to the earlier demonstrated preexistent rotation. PurposeTo evaluate the closure pattern and surface area of the left and right NCJs throughout the normal immature spine in relation to the preexistent spinal rotation at different ages. Study designRetrospective cohort study using a systematic, semiautomatic analysis. Patient sampleComputed tomography (CT) scans of the thorax and abdomen of 199 nonscoliotic children (0–16 years old) were systemically analyzed. CT scans had been obtained for several reasons unrelated to this study, for example, recurrent respiratory infections, malignant disease (not involving the spine), or work up before bone marrow transplantation. Scans were categorized according to the criteria of the Scoliosis Research Society into infantile (0–3 years old), juvenile (4–9 years old), and adolescent (10–16 years old) age cohorts. Outcome measuresClosure, absolute surface area, and the angle between the longitudinal axis of the left and right NCJ and preexistent vertebral rotation at each spinal level. MethodsTransverse CT slices were systemically analyzed for closure and asymmetry of the absolute area of 4,992 NCJs from spinal levels T2–L5. The outcome measures were analyzed semiautomatically using custom-made software developed at our institution (ImageXplorer; Image Sciences Institute). Inter- and intraobserver reliabilities were calculated. ResultsFor all subjects, the entire thoracic area was available. Complete scans down to L5 of the lumbar spine were available in 43 cases. Closure of the NCJs was first observed in the lumbar spine, then in the high thoracic spine, and finally in the mid- and low thoracic spine. Closure occurred asymmetrically, left-right predominance depended on the age. In the mid- and low thoracic spine, the surface areas of the right NCJs were larger at the infantile age, whereas at the juvenile age the areas of the left NCJs were larger. This corresponded to the spine's preexistent rotation. Rotation of the high thoracic vertebrae was to the left in all age cohorts. Rotation in the mid- and low thoracic spine was to the left in the infantile cohort but reversed to the right in the juveniles and even more so in the adolescents. The lumbar spine was rotated to the left at the infantile age and not significantly rotated at the juvenile and adolescent ages. Orientation of the NCJs in relation to the vertebraes' longitudinal axis was symmetrical, not dependent on age, and more transverse at the midthoracic levels than at other spinal levels. ConclusionsThis study focuses on the asymmetry and the regional pattern of closure of the NCJs at different ages. It suggests that preexistent rotation of the spine is related to the asymmetrical closure of the NCJs. Whether the asymmetry is the cause of or is caused by the preexistent rotation cannot be derived from this study.

Subacute Delayed Ascending Myelopathy after Spinal Cord Injury from Flexion-distraction Injury of Low Thoracic Spine - A Case Report -

Study Design: A case report. Objectives: To report a rare case of subacute delayed ascending myelopathy. Summary of Literature Review: After low spinal cord injury, the cord injury may proceed to a proximal level and lead to subacute delayed ascending myelopathy. The patient suffered from orthostatic hypotension, weakness and sensory loss in the upper extremities and dyspnea. MRI showed more proximal progression of the spinal cord injury. There is no prevention or treatment for this condition. Materials and Methods: A 62-year-old man fell from heights and had 11th thoracic spine flexion-distraction injury. Upon arrival at the hospital, he was found to suffer from lower extremity weakness and sensory loss, but showed no neurologic symptom in his upper extremities. Two days later, we performed posterior instrumentation with fusion, and no postoperative neurologic symptom change was detected. One week after the fall, he suffered from dyspnea, upper extremity weakness and sensory loss. MRI was taken and we discovered that his spinal cord injury had proceeded to the 2nd cervical spine level. Results: Three months later, he showed little improvement in his upper extremity motor power, but not to the extent of the previous low spinal injury. Conclusion: Physicians should pay attention to the upper extremity and respiratory function of the patient with low spinal cord injury, because the level of spinal cord injury may proceed to a proximal level.

Sagittal Standing Posture and Its Association With Spinal Pain

Cross-sectional baseline data set on the sagittal standing posture of 1196 adolescents. To describe and quantify common variations in the sagittal standing alignment in boys and girls who are in the same phase of growth and to explore the association between habitual standing posture and measures for spinal pain. Data on postural characteristics and spinal pain measures in adolescence are sparse, especially when somatic and biological maturity status is to be considered. Our understanding of the relationship between standing posture in the sagittal plane and spinal pain is also deficient. A total of 639 boys (age [mean ± SD], 12.6 ± 0.54 yr) and 557 girls (10.6 ± 0.47 yr), with predicted years from peak height velocity (PHV) being 1.2 ± 0.71 and 1.2 ± 0.59 pre-PHV, respectively, were studied. Postural examination included the assessment of global alignment and local spinopelvic characteristics, using post hoc analyses of digital images and direct body measurements (palpation, digital inclinometry, and wheeled accelerometry). Spinal pain experience was assessed by questionnaire. A wide interindividual variation in sagittal posture characteristics was observed. Logistic regression analyses yielded global alignment parameters to be associated with low back pain (lifetime prevalence), neck pain (lifetime prevalence, 1-mo prevalence, and doctor visit), and thoracic spine pain (doctor visit) outcome measures. None of the included local spinopelvic parameters could be identified as an associated factor with measures of spinal pain. The orientation of gross body segments with respect to the gravity line seems superior to local spinopelvic features in terms of clinical importance, at least in the current pre-PHV cohort. Opportunities may exist for postural subgrouping strategies to begin with global alignment parameters in order to gain further insight into the relationship between sagittal alignment and the relative risk of developing spinal pain/seeking medical consultation for this pain.

Forensic pollen geolocation techniques used to identify the origin of boll weevil re-infestation

The boll weevil, Anthonomus grandis, entered the United States of America in the early twentieth century and became a major pest in cotton, Gossypium spp. Shortly after the passage of Tropical Storm Erin on 16 August 2007 through the South Texas/Winter Garden boll weevil eradication zone, over 150 boll weevils were captured in the Southern Rolling Plains (SRP) eradication zone that was essentially weevil-free since 2003. Pollen analyses were made of the SRP weevils and weevils collected in two suspected source zones, Cameron (Southern Blacklands eradication zone) and Uvalde (Winter Garden eradication zone). An additional examination of the palynological evidence and examination of additional pollen residue shed new light on this event and strengthens the conclusion that the Uvalde area was the source of the SRP weevils. A total of 192 pollen grains from 39 taxa were found in the SRP weevils: 1904 pollen grains from ten taxa from the Cameron weevils and 148 grains from 28 taxa in the Uvalde weevils. The SRP weevils shared 16 taxa, including Phermeranthus sp. (flameflower) with the Uvalde weevils and only five taxa with the Cameron weevils. Common taxa between SRP and Uvalde weevils and the lack of the dominant ‘low spine’ Asteraceae that occurred in all Cameron samples confirm that the SRP weevils originated from the South Texas/Winter Garden zone. Problems associated with this type of research are similar to those in forensic palynology. These problems include the unknown origin of the weevils, pollen contamination and care and storage of the samples.