Analysis of balance in adults with chronic axial spinal pain receiving medial branch block or radiofrequency ablation procedures.

Novel Interventional Techniques for Lumbar and Cervical Pain.

Introduction. The concept of quality of life is multidimensional and depends on objective factors, such as physical and mental health, and subjective factors related to satisfaction and goal achievement. Cervical and lumbar spine pain syndromes can significantly reduce quality of life, leading to sleep disturbances and functional limitations. Objective. The purpose of this study is to determine whether practicing yoga can contribute to improving women's quality of life by reducing spinal pain and its impact on sleep and sexual satisfaction. Materials and Methods. The present study was conducted among 42 healthy women (mean age: 47.64 years; BMI: 23.44) who had practiced yoga for at least one year. The participants completed standardized questionnaires assessing quality of life (WHOQOL-BREF), sexual satisfaction (SSS-W-R15), disability related to lumbosacral pain (Oswestry Disability Index, ODI) and cervical pain (Neck Disability Index, NDI), and degree of insomnia (Insomnia Severity Index, ISI). Results. The study found that neck pain (NDI) had a significant impact on the quality of life of women practicing yoga (p = 0.0264). In contrast, lumbosacral pain (ODI, p = 0.0974) and insomnia (ISI, p = 0.322) showed no significant effect. The correlation between WHOQOL-BREF and NDI exhibited a moderately negative relationship (r = -0.42, p < 0.05). Linear regression analysis revealed that none of the variables had a significant impact on quality of life (p > 0.05). Conclusion. Disability of the cervical spine due to pain has an impact on the quality of life of women practicing yoga.

This study aims to evaluate the effects of percutaneous large-channel spinal endoscopic decompression on stress response, lumbar stability, and disability index in elderly patients with single-segment degenerative lumbar spinal stenosis (LSS). A retrospective analysis was performed on 120 elderly patients with single-segment degenerative LSS treated from January 2020 to January 2024. Fifty-seven underwent percutaneous transforaminal endoscopic discectomy group, and 63 underwent percutaneous large-channel spinal endoscopic decompression (large-channel group). Surgical indicators, complications, stress response, lumbar and leg pain, lumbar function [Japanese Orthopaedic Association (JOA) score, Oswestry Disability Index (ODI) score], and lumbar stability were compared. The large-channel group had shorter operative time and fewer intraoperative fluoroscopy sessions than the percutaneous transforaminal endoscopic discectomy group (P<.05), while intraoperative blood loss and incision length were greater (P<.05). Hospital stay and complication rates showed no difference (P>.05). At 3 days postoperatively, serum NE, DA, and 5-HT levels were elevated in both groups (P<.05) but were lower in the large-channel group (P<.05). Lumbar and leg visual analogue scale scores at 1 week, 3 months, and 6 months were lower than preoperative values in both groups (P<.05), with greater improvement in the large-channel group at 3 and 6 months (P<.05). At 1, 3, and 6 months, JOA scores increased and ODI scores decreased in both groups (P<.05). At 3 and 6 months, JOA scores were higher and ODI scores lower in the large-channel group (P<.05). At 6 months, lumbar curvature, lordosis angle, pelvic tilt, and intervertebral space height improved in both groups (P<.05), with greater gains in the large-channel group (P<.05). Percutaneous large-channel spinal endoscopic decompression for elderly patients with single-segment degenerative LSS can shorten operative time, alleviate stenosis and stress response, improve function, and enhance lumbar stability. Its definite efficacy supports clinical application.

Central sensitization of pain (CSP) is defined as the “increased responsiveness of nociceptive neurons in the central nervous system (CNS) to normal or subthreshold afferent input” The primary objective of this study is to compare the prevalence of CSP between patients presenting with foot and ankle conditions and those presenting with low back pain. Materials and Methods: A cross-sectional study was conducted comparing a cohort of patients with a first consultation for foot and ankle disorders to another cohort with a first consultation for lumbar spine pain at the same institution. Demographic variables, pain duration, main diagnosis, and a series of questionnaires assessing pain and disability were collected. The Central Sensitization Inventory (CSI) was administered to determine the presence of CSP within the groups. Statistical analyses were performed using STATA. Results: A total of 195 patients presenting with foot/ankle conditions and 252 patients with low back pain were included. Among the foot/ankle cohort, 16.4% (95% CI, 10.92–21.9%) were classified as having CSP, compared to 22.2% (95% CI, 16.85–27.6%) in the lumbar pain cohort. The difference in CSP prevalence between groups was not statistically significant (difference 5.79%, Chi2 = 2.357, p = 0.125). However, the difference in mean scores on Part A of the CSI was statistically significant (31.82 ± 13.88 vs. 25.20 ± 14.31, z = 4.237, p &lt; 0.001). Among foot/ankle pathologies, plantar fasciitis showed the highest prevalence of CSP (21.9%), followed by hallux valgus (18.8%). A significant association was observed between CSP and higher levels of pain and disability. Female patients demonstrated a higher prevalence of CSP. Conclusions: Patients with low back pain exhibited higher CSI scores and a greater prevalence of central sensitization compared with those with foot and ankle disorders. Recognizing these mechanisms may help clinicians tailor more effective, multidisciplinary treatment strategies.

This study aims to assess the outcomes of combining oblique lumbar interbody fusion (OLIF) with anterolateral screw fixation (ASF) and stress endplate augmentation (SEA) in comparison to OLIF combined with pedicle screw fixation (PSF) for the treatment of degenerative lumbar spinal stenosis (DLSS) in patients with osteoporosis (OP). We performed a retrospective analysis of patients diagnosed with DLSS who underwent OLIF in conjunction with either SEA and ASF (SEA-ASF group) or PSF (PSF group). Clinical outcomes, including the visual analog scale (VAS) scores for lumbar and leg pain, as well as the Oswestry Disability Index (ODI), were assessed at various postoperative intervals and compared to preoperative values. Additionally, radiographic outcomes such as disc height (DH), lumbar lordosis (LL), segmental lordosis (SL), cage subsidence (CS), and fusion rate were evaluated at different postoperative intervals and compared to their preoperative measurements. A total of 65 patients were enrolled in the study, comprising 30 individuals in the SEA-ASF group and 35 in the PSF group. No statistically significant differences were observed in surgery-related complications between the groups. While VAS and ODI scores did not differ significantly at the 24-month follow-up, the SEA-ASF group exhibited superior scores at both 1day and 1 month post-surgery (P < 0.05). Significant differences were observed in DH, LL, and SL at both 12 and 24 months postoperatively between the two groups (P < 0.05). At the 24-month postoperative follow-up, the incidence of CS was observed to be 16.67% (5 out of 30) in the SEA-ASF cohort and 11.43% (4 out of 35) in the PSF cohort. Statistical analysis revealed no significant difference between the two groups (P = 0.542). Fusion rates at the 24-month postoperative follow-up were 83.33% (25/30) in the SEA-ASF group and 85.71% (30/35) in the PSF group, also showing no significant difference (P = 0.791). For the management of DLSS patients with osteoporosis, we propose that the integration of OLIF with SEA and ASF constitutes a viable therapeutic option. This approach demonstrates comparable clinical and radiological outcomes to OLIF-PSF, while offering benefits such as reduce operative duration, decrease blood loss, and minimize tissue trauma.

A young female in her 30s presented with right lumbar and flank pain after performing deadlift exercises at the gym. Whilst initially thought to have a presentation of acute musculoskeletal back pain, she had two unexpected syncopal episodes whilst in the waiting room. She went on to be diagnosed with an unexpected grade V renal injury and active retroperitoneal haemorrhage. She became haemodynamically unstable and was treated using the hospital major haemorrhage protocol. The patient was ultimately transferred to a tertiary centre, where she underwent renal artery embolisation successfully.Atraumatic renal injury is rare and has only been described in a few case reports. Classic signs, as well as point-of-care ultrasound, are sometimes unreliable for diagnosing retroperitoneal haemorrhage. Therefore, emergency physicians must keep renal injuries within the differential diagnosis of flank pain even in the absence of overt trauma.

Pelvic and lower limb gait pattern differ between sex but not between chronic low back pain patients and pain-free individuals under strict inclusion criteria.

Degenerative disc disease (DDD) is the most common cause of chronic low back pain (CLBP). In DDD, proteoglycans within the nucleus pulposus break down and lose their ability to retain water, thereby reducing the volume of intervertebral discs and decreasing their weight-bearing capacity. Mechanical loading shifts to the annulus fibrosus, creating fissures and tears that leak crucial factors in the pain to cascade into the intradiscal space and trigger inflammation. When conventional treatments for CLBP fail, surgical options may be required. These surgeries carry risks and require months to heal. For intervertebral discs requiring augmentation, an implant in the form of an injectable, polymer-based hydrogel was developed for the percutaneous treatment of CLBP secondary to lumbar DDD. We hypothesize that the implant's hydrophilic properties will increase water retention and hydration, improve biomechanics, distribute axial loading more evenly across the annulus fibrosus, and reduce some mechanical sources of discogenic disc pain. To evaluate the safety and efficacy of a novel, injectable hydrogel implant for the treatment of CLBP. Prospective, single-arm, multicenter feasibility and safety study. Patients with CLBP lasting for longer than 6 months, DDD (modified Pfirrmann grades 4-8), competent outer annuli, numeric rating scale (NRS) scores >= 4, and Oswestry Disability Index (ODI) scores >= 30 were enrolled in 3 outpatient clinics in Canada and Colombia. The hydrogel implant, melted and equilibrated to 65°C, was injected intradiscally with a 17G needle under local anesthesia, using fluoroscopic guidance. The hydrogel cooled to approximately 42°C as it exited the needle directly into the nucleus. Patients were discharged that day. Clinical assessments included ODI and NRS (taken at one, 3, 6, and 12 months), radiographs, computed tomography, and magnetic resonance imaging (MRI) scans. The primary outcome was the successful insertion of the implant in a lumbar disc nucleus. Sixty patients (36 women, 24 men), 49.0 ± 9.3 years old, received 83 implants (one disc-level: n = 37; 2 disc-levels: n = 23). All patients were implanted successfully without complications during the procedure or at discharge. One patient died (for reasons unrelated to the device/procedure), and one patient was lost to follow-up, for n = 58 at the 12-month follow-up. Five patients (8.6%) experienced increased low back pain (LBP) or leg pain and/or leg paresthesia, due to what radiological procedures confirmed was partial implant migration. Migrated implant portions were removed endoscopically from those patients 2 weeks to 10 months after implantation, constituting a 6% (5/83) failure rate. Mean (standard error [SE]) ODI scores in the patients was 9.6 (1.7) at the final follow-up. In the full cohort, ODI scores improved from the baseline mean (SE) of 57.4 (1.5) to 12.7 (1.8) at one month and 11.2 (2.0) at 12 months (P < 0.001). NRS back pain scores improved from the baseline of 7.3 (0.2) to 2.2 (0.3) at one month and 2.1 (0.3) at 12 months (P < 0.001). NRS leg pain scores improved from the baseline of 5.5 (0.4) to 1.1 (0.2) at one month and 1.4 (0.3) at 12 months (P < 0.001). The number of disc levels treated was not correlated with outcomes. As was inherent to a feasibility and safety study, limitations included a relatively small patient cohort and lack of a control group. A novel, injectable, polymer-based hydrogel implant was successfully inserted in 83 of the intervertebral discs of 60 patients for the effective treatment of CLBP secondary to DDD. Clinically significant improvements in function, LBP, and low leg pain were maintained through 12 months.

Pertinence of magnetic resonance imaging in lumbar pain: a prospective surgeon-based evaluation of diagnostic concordance and therapeutic impact.

Background. The Nutcracker Syndrome (NCS) is a rare vascular disorder resulting from the compression of the Left Renal Vein (LRV), most frequently between the superior mesenteric artery and the abdominal aorta. Although epidemiological data are limited, NCS primarily affects females, typically manifesting in the second and third decades of life. Clinical features commonly include hematuria, orthostatic proteinuria, left-sided lumbosacral pain, renal dysfunction, varicocele in men, and pelvic symptoms with vulvar varicosities in women. Aim. This systematic review aims to analyze the vascular implications of NCS in the diagnosis of lumbar pain and hematuria, and to summarize the key diagnostic methods for this syndrome. Material and methods. The pathophysiological mechanism involves compression of the LRV, which leads to reduced blood flow in the LRV and consequently to a decreased Glomerular Filtration Rate (GFR). Diagnosis of NCS relies primarily on non-invasive imaging studies, such as Doppler Ultrasonography (Doppler US), Computed Tomography (CT), and Magnetic Resonance Imaging (MRI), supplemented by invasive procedures like Intravascular Ultrasonography (IVUS) and venography when necessary. Results. The anterior variant of NCS is significantly more common than the posterior type. Imaging findings demonstrating severe LRV stenosis are crucial for diagnosis. Conclusions. The lack of universally accepted diagnostic criteria significantly complicates the diagnosis of NCS and necessitates their formal establishment. Defining clear criteria would greatly facilitate the recognition and subsequent treatment of this syndrome.

A 33-year-old woman with sickle cell disease presented with severe lumbar pain. Initially stable, she experienced rapid deterioration within the first 24 hours, developing respiratory failure, fever, and impaired consciousness. Chest imaging revealed extensive bilateral infiltrates, and laboratory tests showed severe anemia, thrombocytopenia, and elevated inflammatory markers. She required mechanical ventilation, exchange transfusions, and antibiotics. Parvovirus B19 infection was confirmed. After nine days, she improved, but neurological recovery was delayed. Magnetic resonance imaging revealed cerebral microhemorrhages consistent with critical illness-associated cerebral microbleeds. She was discharged after a 34-day hospitalization. This case highlights two severe and potentially life-threatening complications of sickle cell disease, namely acute chest syndrome and critical illness-associated cerebral microbleeds, underscoring the importance of early recognition and aggressive management.

Supervisor II, dr. Leny Candra, A. Md. Akp., MM Lumbar pain due to Lumbosacral Instability is one of the musculoskeletal complaints that is often found. Acupuncture as a complementary therapy has been used to reduce pain in cases of low back pain. This study is to determine the benefits of Acupuncture Care for Clients with Low Back Pain Due to Lumbosacral Instability at Griya Sehat BSA Holistik Pontianak comprehensively. The subject of the study was a 43-year-old male client who experienced lumbar pain and underwent acupuncture therapy at Griya Sehat BSA Holistik Pontianak. The research design uses a qualitative approach of the case study type. In-depth data collection is carried out using instruments in the form of Client Data Sheets. The data was processed based on Observation (Wang), Hearing and Smell (Wen), Interview (Wen), and Touch (Qie), hence the diagnosis of client syndrome Cold Moist Pathogen Attacking the Taiyang Meridians of the Bladder Leg. The intervention was carried out by needle insertion at acupuncture points according to the syndrome from the results of diangnose six meetings with an interval of three days. The results showed a significant decrease in the level of lumbar pain in clients after receiving acupuncture care. Pain complaints disappear, movement reflexes increase. In order for clients to stay healthy, it is recommended to avoid lifting heavy objects, exercise regularly, air conditioning or fans do not be directed at the body directly, drink enough water, and sunbathe every morning.

Rationale:Ureteral injury from sutures during total hysterectomy is a relatively uncommon but potentially severe complication that can lead to serious sequelae such as ureterovaginal fistula or renal insufficiency. The management of such injuries remains challenging, and there is a need for effective and minimally invasive approaches to mitigate complications and enhance patient recovery. This study aims to introduce a novel minimally invasive alternative – transvaginal suture removal and ureteral stenting under local anesthesia – and to evaluate its efficacy in reducing complications and improving patient outcomes.Patient concerns:A 49-year-old female experienced mild lumbar pain on the fourth day after total laparoscopic hysterectomy for uterine fibroids and adenomyosis. She had no prior kidney issues but developed postoperative right low back pain, microscopic hematuria, and ultrasound evidence of right hydronephrosis and ureteral dilation.Diagnoses:The patient was diagnosed with iatrogenic ureteral injury due to sutures, confirmed by ultrasound and surgical video review showing the right ureter partially sutured to the vaginal stump.Interventions:We performed transvaginal suture removal and ureteral stenting under local anesthesia. This minimally invasive approach avoided general anesthesia and secondary laparoscopic surgery.Outcomes:The procedure was successful, with smooth suture removal and stent implantation. The patient’s symptoms significantly improved on the second postoperative day. Follow-up at 1 month revealed no discomfort, and the ureteral stent was removed 3 months later.Lessons:This case highlights transvaginal suture removal as a novel, minimally invasive treatment for iatrogenic lower ureteral injuries. This approach may be performed by gynecologists under local anesthesia, potentially preventing severe complications and reducing patient discomfort and costs.

Pyonephrosis is a rare condition characterized by the destruction of renal parenchyma, which can lead to severe complications such as secondary peritonitis in cases of rupture. In this article, we report a rare case of acute peritonitis in a 12-year-old girl caused by ruptured pyonephrosis, occurring in a rural setting in Chad. The patient, with no prior medical history, was admitted for acute abdominal syndrome. She had experienced intermittent lumbar pain for six months, self-medicated without medical consultation. Radiological assessment revealed a markedly dilated right kidney with echogenic content suggestive of pyonephrosis overlying a renal calculus, along with abdominal fluid collection. A confirmatory CT scan could not be performed due to the unavailability of imaging facilities. Exploratory laparotomy revealed purulent intra-peritoneal fluid and a necrotic right kidney, necessitating nephrectomy. The patient recovered well postoperatively. Beyond its surgical relevance, this case highlights the urgent need for increased awareness regarding early medical consultation and improved access to advanced diagnostic tools in rural areas. To the best of our knowledge, this is the first reported case of pediatric peritonitis due to ruptured pyonephrosis managed entirely in a rural African setting.

Abstract Introduction Longitudinally extensive transverse myelitis (LETM) in children raises concerns for serious underlying autoimmune conditions. Neuromyelitis optica spectrum disorder (NMOSD), often associated with anti-aquaporin-4 (AQP4) antibodies, can present with LETM and is increasingly recognised in paediatric populations. Juvenile systemic lupus erythematosus (jSLE) may manifest with central nervous system involvement, including myelitis. While NMOSD and SLE can occur independently, their coexistence—especially at initial presentation—is rare and diagnostically challenging. We report a paediatric case of LETM that led to the simultaneous diagnosis of NMOSD and jSLE, highlighting the importance of early recognition, comprehensive autoimmune evaluation and multidisciplinary collaboration. Case description An 8-year-old girl presented on Christmas evening with sudden bilateral leg numbness, difficulty standing, back pain, and urinary retention. Her history was otherwise unremarkable, aside from an innocuous fall 10 days earlier. Prior to admission, she developed thoracic and lumbar back pain and constipation over four days. Examination revealed lower limb weakness (power 4/5), brisk reflexes, abdominal tenderness, and a sensory level at T9/T10, but no rash, fever or optic neuritis on ophthalmic evaluation. She had thromboyctopaenia (platelet count nadir of 42) and lymphopenia. MRI scan of the spine showed long-segment spinal cord dilation suggestive of transverse myelitis. She was treated with 5 days of IV methylprednisolone, which led to partial and comparatively quick improvements in her mobility. She was discharged on a tapering course of prednisolone commencing at 40 mg with a plan to wean over the course of 5 weeks and twice daily intermittent catheterization. Three weeks later, she was readmitted with fever and signs suggestive of meningoencephalitis; her inflammatory markers were elevated, and she responded to antibiotics and antiviral therapy with all cultures (urine, blood, CSF) and CSF PCRs negative. Serum and CSF aquaporin-4 antibody positivity supported a diagnosis of NMOSD, while her ANA and dsDNA positivity indicated systemic lupus erythematosus (SLE). There was no evidence of other systemic involvement, and repeat MRI showed near complete resolution of inflammation. There were no significant neurological sequelae aside from ongoing twice daily CIC, gait was normal though running was still impaired. This child met criteria for SLE and NMOSD which can co-exist with lupus. Discussion This case underscores the importance of recognizing autoimmune overlaps in children presenting with transverse myelitis, particularly when associated with positive autoantibodies. Autoantibodies associated with SLE and Sjogrens have been associated with CNS AQP4 antibodies. In these patients NMOSD can precede or follow their rheumatological diagnosis. The coexistence of SLE and NMOSD influences management and prognosis, requiring a multidisciplinary approach to optimize outcomes and prevent future relapses or neurological sequelae. There was input from tertiary and quaternary neurology teams as well as rheumatology, neurology, urology and radiology teams. Discussions considered whether all features present at diagnosis could be explained by just one or the other diagnosis. It was felt that both were co-existing, and the NMOSD was distinct from neuropsychiatric SLE with the presence of LETM driven by AQP4 antibodies. She met SLICC and 2019 ACR criteria for SLE though mainly immunological and haematological domains (strongly positive ANA and dsDNA, thrombocytopaenia, leucopaenia and positive DCT). Given the associated risk of recurrent CNS inflammation with AQP4 antibodies present the aim was to prevent further flares and following discussions with a specialist neurologist in neuroinflammation alongside local rheumatology and neurology she was commenced on MMF as maintenance therapy. A longer weaning course of prednisolone was also prescribed. She still undergoes regular reviews and remains a positive and stoic character. Her physical function has recovered however her bladder residual volume is still significant to require CIC. She has recently had an admission for a urinary tract infection as a complication of this. Key learning points • Consider autoimmune rheumatological diseases in cases of NMOSD and vice versa - the overlap is documented and has consequences for prognosis and treatment. • Management of these complex cases is multi-disciplinary, treatment should be guided by all specialties involved and specialist advice sought as needed. • NMOSD associated with autoimmune disease is considered more severe with more frequent relapses and worse prognosis, our case highlights an example of early intervention where prompt treatment with IV steroids and early initiation of DMARD have so far provided rapid initial recovery and a period of relative stability. • Trasnverse myelitis can be one of the neurological presentations of jSLE, which can be clinically, radiologically and immunologically differentiated from coexisting NMOSD, which has implications on planning the treatment too. • Although reported in adults, coexistence of jSLE and NMOSD is exceedingly rare, limited to a handful of case reports.

Introduction:Chronic non-specific low back pain (CNSLBP) continues to pose a significant global health burden, often leading to persistent pain and functional limitations. Although conventional kinesiotherapy is a well-established approach in managing CNSLBP, the integration of Pilates a method emphasizing core stability, controlled movements, and neuromuscular re-education may offer additional therapeutic benefits. This pilot study aimed to assess the feasibility, safety, and preliminary clinical effects of combining Pilates-based exercises with conventional kinesiotherapy for individuals with CNSLBP.Materials and Methods:A single-group pre-post intervention design was employed. Thirty adults diagnosed with CNSLBP participated in an 8-week program integrating Pilates and kinesiotherapy. Feasibility metrics included recruitment rate, retention, session adherence, acceptability (participant feedback), and safety (adverse events). Clinical outcomes assessed pre- and post-intervention included pain intensity (visual analog scale), functional disability (Roland-Morris Disability Questionnaire), lumbar mobility (Modified-modified Schober’s Test), and lumbo-pelvic flexibility (V-Sit and reach test).Results:The study achieved a high recruitment rate (85.71%) and strong retention (86.67%). Mean adherence across 24 sessions was 75.64% (standard deviation = 21.72), with no adverse events reported. Participant feedback indicated moderate-to-high acceptability (mean score: 3.77 ± 0.85). Statistically significant improvements (P < 0.0001) were observed in all clinical outcome measures, including reductions in pain and disability and enhancements in lumbar mobility and flexibility.Conclusion:The integration of Pilates with conventional kinesiotherapy is both feasible and safe for individuals with CNSLBP, demonstrating promising preliminary improvements in pain, function, and mobility. These findings support the need for larger-scale randomized controlled trials to further investigate the efficacy and long-term outcomes of this combined intervention approach.

Platelet-rich plasma versus corticosteroids in facet joint syndrome: A controlled, randomized, double-blind study.

Low back pain is a common musculoskeletal disorder with a major socioeconomic impact. Understanding its association with spinopelvic alignment may enhance diagnosis and treatment by identifying key biomechanical factors linked to symptom severity. Objectives: To assess the relationship among spinopelvic parameters and low back pain severity. Methods: This retrospective study was conducted at Bahria International Hospital, Rawalpindi, Pakistan, including 150 patients. Full-spine standing X-rays were used to assess sagittal vertical axis, sacral slope, pelvic tilt, pelvic incidence, and lumbar lordosis using Surgimap® software. A visual analog scale was used to measure the severity of the pain, and Pearson correlation analysis was performed to determine associations between spinopelvic parameters and LBP severity. Results: Pelvic tilt showed a positive correlation with lumbar pain, which is significant (r=0.52, p&lt;0.001) and radicular pain (r=0.33, p=0.002). Sagittal vertical axis was also positively correlated with lumbar (r=0.47, p&lt;0.001) and radicular pain (r=0.38, p=0.001). A significant negative correlation of lumber lordosis was exhibited with both lumbar (r=-0.49, p&lt;0.001) and radicular pain (r=-0.41, p&lt;0.001). No significant correlation was found for PI or SS. Conclusions: Pelvic tilt and sagittal vertical axis positively correlate with low back pain severity, whereas lumbar lordosis exhibits a protective role. These findings emphasize the importance of spinopelvic alignment in low back pain pathophysiology.

ABSTRACTBertolotti syndrome is a lumbosacral anomaly that induces persistent lumbar pain. This case describes 3D navigation‐guided resection of an enlarged transverse process. Sufficient decompression provided pain relief refractory to noninvasive treatments. ODI and SF‐36 scales validated clinical efficacy, reflecting profound enhancement in the patient's functional and health‐related quality of life.Trial Registration: The publication project was approved by the Bioethics Committee of the Medical University of Łódź and conforms to the Declaration of Helsinki