Lumbar Part Research Articles

Effect of cryotherapy on the lumbar spine in elderly men with back pain

Whole-body cryotherapy (WBC) is a procedure which is more and more often successfully applied in medicine. Used in physiotherapy programs improves the efficiency of physiotherapeutic exercises applied in different aliments. The aim of the research was to determine the influence of WBC treatment on the improvement of spine activity in elderly men. The evaluation was based on subjects suffering from chronic lower back pain. The research was conducted on 96 male in the age of 65–75 years suffering from chronic pain in the lumbar spine, lasting >3 months. All the subjects performed physical exercises at a gym. Half of the examined patients performed only physical exercises while the second half of the group participated in WBC before performing the same exercises. The research evaluated the mobility of lumbar spine at all movement planes and examined the values of active potentials of erector spinae in the lumbar part of the spine. The group of men who participated in WBC showed significantly lower values of active potentials of erector spinae muscles in the lumbar part of the spine and a significant increase in the range of the lumbar spine mobility, in comparison to the group which did not use WBC.

Unilateral spinal anaesthesia in a patient with Osteogenesis Imperfecta with a lower leg fracture: a case report

Osteogenesis Imperfecta is a rare, genetically determined disease with several possible complications in anaesthesia. Anaesthesiologists therefore pay special attention to the treatment of patients suffering from Osteogenesis Imperfecta since they commonly suffer from a difficult airway and intraoperative positioning difficulties.We report here the case of unilateral spinal anaesthesia in a patient suffering from Osteogenesis Imperfecta type I. A 28-year-old patient diagnosed with Osteogenesis Imperfecta type I was admitted to the hospital due to lower leg fracture requiring surgical treatment. The patient had blue sclerae, triangular-shaped face, macroglossia, scoliosis of thoracic and lumbar parts of the spine, pectus carinatum and thrombocytopenia. Upon the correction of thrombocytopenia, unilateral spinal anaesthesia with hyperbaric levobupivacain was chosen in order to avoid possible complications typical for general anaesthesia. Consequently, unilateral spinal anaesthesia with a customized local anesthetic could be consdered as a safe anesthetic method for such patients.

고령자의 전동침대 사용 시 테이블 높이에 따른 상지와 체간의 근활성도 분석

PURPOSE: In recent years, senior friendly device is growing rapidly because of population aging The study was designed to investigate the effects of table height of electronic bed on upper extremity and trunk EMG in elderly. METHODS: Thirty right-handed elderly without history of neurological and musculoskeletal dysfunction were participated in this study. Three heights of the table (3/3 height, 2/3 height, and 1/3 height between top of the shoulder and olecranon) were provided. During the eating performance, surface electromyography (EMG) was used to measure muscle activity, and electrodes were attached to the deltoid middle fiber, serratus anterior, suprapinatus, upper trapezius, rhomboideus, cervical part of longissimus, thoracic part of longissimus, lumbar part of longissimus on right. One way ANOVA was conducted for the statistical analysis. RESULTS: There were significant differences in deltoid middle fiber, suprapinatus, upper trapezius, rhomboideus, lumbar part of longissimus in the 3 different height of table (p<.05). The deltoid middle fiber, suprapinatus, upper trapezius, and lumbar part of longissimus were significantly increased in higher table than lower table(p<.05). And the rhomboideus was significantly decreased in higher table than lower table(p<.05). CONCLUSION: This study demonstrates that different height of table affect upper extremity and trunk muscle activity. The table height of olecranon is the best for elderly.

Spinal Epidural Abscess: Common Symptoms of an Emergency Condition

Spinal epidural abscess (SEA) is a severe pyogenic infection of the epidural space that leads to devastating neurological deficits and may be fatal. SEA is usually located in the thoracic and lumbar parts of the vertebral column and injures the spine by direct compression or local ischemia. Spinal injury may be prevented if surgical and medical interventions are implemented early. The diagnosis is difficult, because clinical symptoms are not specific and can mimic many benign conditions. The classical triad of symptoms includes back pain, fever and neurological deterioration. The gold standard in the diagnostic evaluation is magnetic resonance imaging with gadolinium enhancement, which determines the location and extent of the abscess. Increased awareness of the disease is essential for rapid recognition and immediate implementation of treatment. Here we describe the case of a 26-year-old woman with SEA with fever, back pain in the thoracic region and delayed symptoms of a transverse spinal cord injury.

OP0221 Is Site of Back Pain Related to Location of Inflammatory Lesions on MRI in Patients with Chronic Back Pain?

BackgroundIt is unclear whether location of inflammatory lesions (presence of bone marrow edema (BME)) is linked to site of pain symptomsObjectivesTo evaluate if localisation of back pain, as indicated by...

AB0888 Distribution of active inflammatory lesions on magnetic resonance imaging of the the sacroiliac joints and the spine in patients with early axial spondyloarthritis –results of the esther trial at baseline

ObjectivesTo address the question whether active inflammation starts at specific sites of the sacroiliac joints (SI-joints) and/or the spine.MethodsWb-MRIs of 75 patients with early axial spondyloarhtritis (SpA) with a disease...

SAT0256 Osteophytosis is associated with low-grade spondylitis and disconnected from peripheral arthritis in mice immunized with human aggrecan G1 domain

BackgroundThe balance between inflammation-driven cartilage and bone erosion and new bone formation is set at different levels in rheumatoid arthritis and in ankylosing spondylitis (AS). Inflammation and tissue damage usually...

About Surgical Tactics in Damages of the Thoracic and Lumbar Parts of the Spine

In the overall structure of spinal injuries in adults vertebro-spinal injury ranges from 2.2% to 20.6%. When fractures of the spine are complicated by neurological disorders, most commonly lower thoracic and lumbar vertebrae - 39.2% and 48.5% are injured respectively. 45 patients with damage to the thoracic and lumbar spine, admitted to the neurosurgical department of RCSUMA. The main method of preparation of the combined graft is performed in the following manner: Bone graft is taken from the iliac crest and wings of the fibula of the patient, depending on the size of the vertebra. Next, the graft is cleaned of soft tissues and placed in a glass, which contains 3% of hydrogen peroxide, then in a second glass with a solution of broad-spectrum antibiotic for 5-10 minutes. To improve and strengthen support ability of bone graft, a hole is formed in the middle of the graft with the drill, which is then filled with bone cement. Bone cement is dissolved before use with a special solvent and liquid form is introduced with a syringe through the hole formed in the bone graft. The bone cement hardens within the bone hole and thereby enhances support ability of the transplant. To increase the coupling properties of the graft a few teeth are formed at its ends. The resulting clinical and neurological findings in these patients showed that after a comprehensive operative and conservative treatment 31 (68.9%) patients had positive neurological symptoms, increased sensitivity below the level of damage, and also the growth of the movement in the distal extremities was noted improvement of function of the pelvic organs in the form of urination. But despite undertaken complex therapeutic measures in 14 (31.1%) patients is not a marked improvement in neurological performance was not noted during treatment. The dynamics of neurological disorders after surgical treatment showed that in complicated injuries of the body of thoracic and lumbar vertebrae combined graft provides sufficient support ability of the spine and thus creates the conditions necessary to restore the function of damaged spinal cord and its elements

A case of hidroacanthoma simplex

We report a case of hidroacanthoma simplex with giant lesion that was found on the left lumbar part which was treated with surgical excision.

Comparison of Shoulder and Back Muscle Activation in Caregivers According to Various Handle Heights

[Purpose] This study aims to improve the safety for caregivers and avoid musculoskeletal diseases by examining the shoulder and trunk muscle activity depending on wheelchair handle height as the caregiver provides propulsion to a wheelchair for wheelchair-bound patients. [Subjects] The participants were caregivers who met the criteria for this study (n=30). [Methods] To determine the activity of the shoulder and trunk muscles of caregivers depending on the handle height, the muscle activity was measured as a wheelchair was being pushed under three height conditions. [Results] According to the study results, the deltoid middle fiber, serratus anterior muscle, rhomboid muscle, and erector spinalis of lumbar part showed significantly low muscle activity at a height that produced an elbow joint flexion angle of 30°. Caregivers are highly likely to develop musculoskeletal disease if the handle height is excessively low. In addition, the burden on the shoulder and back muscles can be reduced at heights that lead to flexion of 30°. [Conclusions] As a caregiver pushes a wheelchair, the handle height has a close relationship with the burden on the shoulder and back muscles. If the handle height is excessively low, the caregiver is highly likely to develop musculoskeletal disease.

Ultrasound assessment of selected peripheral nerves pathologies. Part II: Entrapment neuropathies of the lower limb.

Similarly to entrapment neuropathies of upper extremities, the ultrasound constitutes a valuable supplementation of diagnostic examinations performed in patients with suspicions of nerve entrapment syndromes of the lower limb. For many years, it was claimed that such pathologies were rare. This probably resulted from the lack of proper diagnostic tools (including high frequency ultrasound transducers) as well as the lack of sufficient knowledge in this area. In relation to the above, the symptoms of compression neuropathies were frequently interpreted as a manifestation of pathologies of the lumbar part of the spine or a other orthopedic disease (degenerative or overuse one). Consequently, many patients were treated ineffectively for many months and even, years which led to irreparable neurological changes and changes in the motor organ. Apart from a clinical examination, the diagnostics of entrapment neuropathies of lower limb is currently based on imaging tests (ultrasound, magnetic resonance) as well as functional assessments (electromyography). Magnetic resonance imaging is characterized by a relatively low resolution (as compared to ultrasound) which results in limited possibilities of morphological evaluation of the visualized pathology. Electromyography allows for the assessment of nerve function, but does not precisely determine the type and degree of change. This article presents examples of the most common entrapment neuropathies of the lower limb concerning the following nerves: sciatic, femoral, lateral femoral cutaneous, obturator, fibular and its branches, tibial and its branches as well as sural. The pathomorphological basis of the neuropathies as well as corresponding ultrasound images are presented in this paper. Attention has been drawn to echogenicity, degree of vascularization and bundle presentation of the trunk of a pathological peripheral nerve.

Analysis of Muscle Force-Velocity Parameter Changes in Elderly Women Resulting from Physical Activity—In Continuous Examinations

The aim of the paper was to evaluate changes in muscle force-velocity parameters (F-v) in elderly women subjected to physical exercise. The examinations encompassed 20 women, aged 62–71, who were students at the University of the Third Age in Wrocław. The evaluation of flexors and extensors of the knee joint, as well as flexors and extensors of the spine within the lumbar part, was performed under isokinetic conditions. The assessment was conducted three times: first, a preliminary evaluation; second, after four months of rehabilitation, which included march training and systemic exercises; third, was performed after another 12 months, during which the patients were subjected to various forms of individually selected physical activity. The examinations of muscles affecting the knee joint revealed that the results achieved in the second measurement, performed with load of 60°/s, revealed higher values than in the first examination and were similar or higher in the third examination. With a load of 180°/s, values achieved in the second measurement were higher than results from the first measurement and were mostly lower than registered in the measurement. The highest values of parameters F-v for flexors and extensors of the lumbar part of the spine were registered in third examination. The results were about 20% higher than achieved within measurements 1 and 2. The increase and maintenance of muscular fitness in elderly women is possible only if a load applied exceeds threshold values and is applied for a long time.

New non-invasive and patient-specific method allowing intradiscal pressure change measurement induced by lumbar conservative or surgical treatments

commonly prescribed as conservative treatment of low back pain. These devices could affect the distribution of loads among passive and active lumbar subsystems. However, with only one study in this field proposed by Nachemson et al (1983), their biomechanical action such as the reduction of the intradiscal pressure (IDP) remains unknown and controversial. The goal of this study was to investigate the IDP change induced by a rigid lumbar orthosis from a new non-invasive measurement method. Method.– From the comparison of two radiographs EOS (Biospace, Paris) with and without a lumbar orthosis, the displacements and rotations of each vertebra were calculated and implemented in a patient-specific finite element modelling. The IDP measurements along each lumbar disc were extracted with a precision of 2.5 Pa. Twenty patients were tested in standing or sitting posture with a semi-rigid lumbar orthosis Lordactiv (Ormihl-Danet, Villeurbanne) in two conditions: with or without a curved rigid lumbar part. Result.– A curved rigid lumbar part was necessary to obtain significant IDP distribution change along the anteroposterior direction. Interestingly, an IDP decrease appeared in somepatients until–50 Pa.However, the IDP change appeared very posture, disc level and patient-dependent ranging from –50 to +8 Pa. Discussion.– An IDP distribution change reveals a different load sharing between posterior elements and intervertebral discs whereas decompression only could be explained by a decrease muscle activity. Especially, the intradiscal elasticity (age-dependent) and the lumbar back adipose tissue thickness are the main variables correlated with the interindividual differences. Conclusion.– These results demonstrated that wearing a rigid lumbar orthosis can significantly influence the stress-strain values in diseased discs, provided that the patient is kept an sufficient elasticity.

Myelination disorders in the mechanism of hypogravity motor syndrome development

When modeling effects of hypogravitation by the method of hindlimb unloading in rats the area of cross-section in lumbar part of a spinal cord was found to reduce. The analysis of spinal cord slides showed that these changes are associated with a decrease in the area of white substance of a spinal cord. Data obtained are consistent with our previous observation of a decrease in expression of the genes encoding myelin proteins. Results of our researches give the good reasons to believe that miyelinization failure in CNS is one of the factors that underlie the development of hypogravitational motor syndrome.

Distribution of muscle fibers in skeletal muscles of the cheetah (Acinonyx jubatus)

We examine the muscle fiber population of skeletal muscles from whole body in the cheetah (Acinonyx jubatus). In the present experiments, we showed the characteristics of fiber composition in the cheetah by comparative studies among the cheetah, domestic cat, and the beagle dog. Fiber population was determined on muscle fibers stained with monoclonal antibody to each myosin heavy chain isoform. Histochemical analysis demonstrated that many muscles in the cheetah and domestic cat had a low percentage of Type I fibers and a high percentage of Type IIx fibers, while those in the beagle dog showed a high percentage of Type IIa. The hindlimb muscles in the cheetah had a higher percentage of Type II (Type IIa+IIx) fiber than the forelimb muscles. This fact suggests that the propulsive role of the hindlimb is greater than the forelimb in the cheetah. The longissimus in the cheetah had a high percentage of Type IIx fibers over a wide range from the thoracic to lumbar parts, while the population of muscle fibers in this muscle was different depending on the parts in the domestic cat and beagle dog. This indicates that the cheetah can produce a strong and quick extension of the spinal column and increase its stiffness during locomotion. Furthermore, we found the notable difference of muscle fiber type population between flexors and extensors of digits in the cheetah. The present experiments show the characteristics of muscle fibers in the cheetah, corresponded to its ability to perform high-speed running.

Does the afferent tubular segment in an orthotopic bladder substitution compromise ureteric antireflux properties? An experimental study in dogs

ObjectiveTo study the effects of a short ureter on renal function and histology in an orthotopic bladder substitution model using a long afferent limb, in a canine model. Materials and methodsThe study included nine adult mongrel dogs. A 40-cm segment of ileum was isolated, the distal half detubularized, configured into a U-shape and sutured to form a flat plate; this was then used to augment the bladder. The proximal half of the isolated ileum remained in continuity with the enterocystoplasty to form an isoperistaltic ileal ‘chimney’. The left ureter was divided at its lumbar part and anastomosed to the chimney using a refluxing end-to-side Nesbit technique. The contralateral ureter was divided at its lower end and then anastomosed directly to the augmented segment of the bladder in a similarly refluxing manner to act as a control. The assessment after surgery included biochemical studies, ascending cystography, intravenous urography (IVU) and radioisotope renography at 6weeks. The last two methods were repeated at intervals of 3 and 6months after surgery. Urine culture was obtained and both kidneys were examined histopathologically at 6months. ResultsThe biochemical values assessed in all dogs were comparable to those before surgery. The urine culture obtained from the augmented bladders showed significant bacterial growth in all dogs. IVU at all follow-up sample times showed a normal configuration of both kidneys. Ascending cystography showed reflux in four of nine dogs on the right and six on the left side. There was a progressive decrease in the mean selective renographic clearance values of each of the right and left kidneys at intervals of 6weeks, 3 and 6months. The mean percentage reduction of renographic clearance was significantly higher in the left kidneys at 6weeks and 3months. Histopathological examination showed evidence of interstitial nephritis in all nine dogs and pyelonephritis in four of the left kidneys, while none of the right kidneys showed evidence of inflammation. ConclusionAdequate peristalsis in a healthy long ureter is superior to the ileal segment substitution for protecting the kidney tissue against inflammation in the absence of an anatomical antireflux mechanism.

공기주입형 쿠션 베스트 개발

Abstract The development of modern transportation technology has required many people in spaces (such asvehicle seats, airports, and train stations) for long periods. The public seats provided in these places aremanufactured in a standard size; however, fatigue sets in if the seats are unsuitable for the person's physicalsize. For this reason, this study developed an air cushion vest that would enhance the comfort of vehicleseats. Passengers in vehicles, trains, airplanes, and buses were observed and surveyed to understand thedemand for seat comfort. Our analysis found that the greatest source of discomfort was involuntary noddingof the head while asleep and discomfort around the waist area. For this reason, the air cushion vest wasdesigned to support the head and the waist. The neck cushion of this vest was designed to strengthen headsupport to counter forward nodding because existing commercial neck cushions had no support for forwardnodding. For the waist cushion, at lumbar and below-lumbar parts were chosen as the key parts to besupported, the cushion was designed to contain air at those parts. To cover the embedded waist cushion, thevest was designed to be long. The closure was constructed with zippers from the neck to waistline, and withinvisible snaps from the waistline to the hemline so that the wearer could open them easily while seated. Asubjective comfort evaluation was conducted to verify the effectiveness of the developed vest. In the test,the developed cushions received a better evaluation than cushions currently available on the market. Thevolume of the vest could be adjusted by the inflow and outflow of air. It was proven that the vest waseffective in terms of comfort and portability. This shows that the developed vest could enhance passengercomfort while sitting on vehicle seats.Key words: Air cushion, Comfort, Neck support, Waist support; 공기주입 쿠션, 안락감, 머리 지지, 허리지지

КОМПЛЕКСНОЕ ЛЕЧЕНИЕ ПАЦИЕНТА С МНОЖЕСТВЕННЫМИ ПОРОКАМИ РАЗВИТИЯ ПОЗВОНОЧНИКА И СПИННОГО МОЗГА

Clinical case of the patient with the congenital deformation of thoracic and lumbar parts of the spine due to multiple congenital anomalies of vertebrae (disturbance of formation, fusion and segmentation), a terminale filum lipoma at the level of L5, tethered cord, rightside lower leg monoparesis. Multistage surgical treatment was performed: removing of intracanal deformity, correction and stabilization of the deformity at the thoracic and lumbar part of the spine. Patient was followed up during 2,5 years after the last step of the surgical operation. No evidence of recurrence or neurological deterioration were observed.

Possible thermoregulatory functions of the internal vertebral venous plexus in man and various other mammals: Evidence from comparative anatomical studies

Comparative anatomy was used to collect more evidence for a thermoregulatory function of the internal vertebral venous plexus (IVVP). The venous connections of the IVVP were studied and compared in various mammals in order to find evidence for the existence of climate related anatomical adaptations. Humans and vervet monkeys were chosen as representatives of mammals living in moderate climates, the IVVP of the dolphin was studied because this animal is always surrounded by cold water. The springbok was chosen as a representative of mammalian species living under very hot conditions. The present study was exclusively performed on post mortem material. After filling the venous system with latex the IVVP and its venous connections were dissected. It appeared that in the dolphin, veins from the trunk muscles were directly and exclusively connected to the IVVP in the absence of an azygos vein. In the vervet monkey and human specimens, veins originating in the muscles drained both into the caval veins and into the IVVP. In these mammals veins draining from brown fat areas were also connected to the IVVP. In the springbok, drainage of blood from the muscles was prevented to enter the IVVP by the presence of valves. In humans and vervet monkeys we found that the lumbar parts of the IVVP were connected to subcutaneous veins of the back. It was concluded that the anatomy of the IVVP and its connecting veins may serve to thermoregulate the spinal cord and that climate related anatomical adaptations were present in the species studied.

Effectiveness of diadynamic currents and transcutaneous electrical nerve stimulation in disc disease lumbar part of spine

Back pain has multi-factorial etiology and is modified by environmental influences, character of work, and individual predispositions. The aim of this study was to compare the efficiency of analgesic DD current therapy and TENS in low back discopathy. Eighty patients (age, 45-60 years) with diagnosed low back pain syndrome due to discopathy were subjected to therapy. In the first group (DD) of 40 people, DD current therapy was applied. In the second group (TENS) of 40 people, TENS was applied. The third group of 40 people was a control group in which a functional fitness test was performed for comparison purposes. The control group was in this case an equivalent to a norm. Before the beginning and on the completion of therapy in all patients, a pain level measurement and functional fitness test were performed. On the basis of research conducted it was stated that both therapies reduce pain level effectively. Obtained analyzed results conclude that both therapies applied have an analgesic effect. DD current and TENS therapies in low back discopathy have an analgesic impact and improve functional fitness. The applied therapies have a comparable impact on researched parameters.