Lumbar Region Research Articles

The Immediate Effect of Hanging Exercise and Muscle Cylinder Exercise on the Angle of Trunk Rotation in Adolescent Idiopathic Scoliosis

(1) Background: Semi-hanging and muscle cylinder exercises have been defined as scoliosis-specific corrective exercises. The aim of this study was to evaluate the immediate effect of muscle cylinder and semi-hanging exercises on the angle of trunk rotation in patients with adolescent idiopathic scoliosis (AIS). (2) Methods: Twenty-seven patients with AIS with a mean age of 18.6 years were retrospectively analyzed. The angle of trunk rotation (ATR) values were measured before and after performing semi-hanging and standing muscle cylinder exercises. Both exercises were performed for three to five respiratory cycles. The semi-hanging exercise was performed first, followed by the muscle cylinder exercise, in this order, in all participants. For statistical analysis, the Wilcoxon signed-rank test was used to analyze ATR changes after the exercises, and the Kruskal–Wallis test was used to compare ATR changes according to the main curve location. (3) Results: The thoracic, thoracolumbar and lumbar maximum ATR values were significantly increased after the semi-hanging exercise (p < 0.001) and decreased after the muscle cylinder exercise (p < 0.001). The ATR change was greater in the lumbar region than in the thoracic and thoracolumbar regions. (4) Conclusion: The results of this study of a small group of patients emphasized that one of the scoliosis-specific corrective exercises, the standing muscle cylinder exercise, improved ATR, while the other, the semi-hanging exercise, worsened ATR in patients with AIS. It is recommended that each scoliosis-specific corrective exercise be evaluated and redesigned to maximize the three-dimensional corrective effect, considering the biomechanics of the spine and the pathomechanics of scoliosis.

Identification of a Chondrocyte-Specific Enhancer in the Hoxc8 Gene.

Hox genes encode transcription factors whose roles in patterning animal body plans during embryonic development are well-documented. Multiple studies demonstrate that Hox genes continue to act in adult cells, in normal differentiation, in regenerative processes, and, with abnormal expression, in diverse types of cancers. However, surprisingly little is known about the regulatory mechanisms that govern Hox gene expression in specific cell types, as they differentiate during late embryonic development, and in the adult organism. The murine Hoxc8 gene determines the identity of multiple skeletal elements in the lower thoracic and lumbar region and continues to play a role in the proliferation and differentiation of cells in cartilage as the skeleton matures. This study was undertaken to identify regulatory elements in the Hoxc8 gene that control transcriptional activity, specifically in cartilage-producing chondrocytes. We report that an enhancer comprising two 416 and 224 bps long interacting DNA elements produces reporter gene activity when assayed on a heterologous transcriptional promoter in transgenic mice. This enhancer is distinct in spatial, temporal, and molecular regulation from previously identified regulatory sequences in the Hoxc8 gene that control its expression in early development. The identification of a tissue-specific Hox gene regulatory element now allows mechanistic investigations into Hox transcription factor expression and function in differentiating cell types and adult tissues and to specifically target these cells during repair processes and regeneration.

Primary Skeletal Muscle Diffuse Large B Cell Lymphoma in Lumbar Region – A Rare Occurrence

Diffuse large B cell lymphoma (DLBCL) is the most common type of non-Hodgkin lymphoma worldwide. Patients most often present with a rapidly growing tumour mass in single or multiple, nodal, or extranodal sites. Extranodal involvement is seen in up to 40% cases. Initial presentation as soft tissue lesion is rare. We report a case of extranodal DLBCL in an elderly male, presenting as a soft tissue mass in the left lumbar region, clinically suggestive of lipoma. The patient had no palpable lymphadenopathy. Complete blood counts were within normal limits. Initial ultrasonography was suggestive of abscess, possibly of tubercular origin. On fine needle aspiration cytology, features were of a malignant neoplasm; a lymphomatous process. Subsequent histopathological evaluation followed by IHC confirmed the diagnosis of DLBCL. Primary extranodal DLBCL involving the soft tissue is rare. Owing to its non- specific and unusual clinical presentation, accurate diagnosis may be delayed. Besides, imaging modalities are also diagnostically challenging due to a wide range of differentials, thereby emphasising the need for tissue diagnosis. Histopathological examination and immunohistochemistry are paramount in accurate diagnosis and tailoring treatment options.International Journal of Human and Health Sciences Vol. 08 No. 01 Jan’24 Page: 95-98

Exploring the Effectiveness of Transpedicular Fixation for Managing Thoracic and Lumbar Tuberculous Spine Disease

Background: Tuberculous spine disease, particularly in the thoracic and lumbar regions, poses a significant health challenge in Pakistan, necessitating effective surgical interventions. Transpedicular fixation has emerged as a promising treatment option, yet there is a paucity of comprehensive studies evaluating its efficacy within this demographic. Objective: The study aimed to systematically assess the effectiveness of transpedicular fixation for treating thoracic and lumbar tuberculous spine disease in Pakistan by analyzing preoperative conditions, surgical details, and postoperative outcomes. Methods: This retrospective cohort study involved 78 patients from the Neurosurgical Ward of Khyber Teaching Hospital, Peshawar, who underwent transpedicular fixation from January 2021 to December 2022. Demographics, preoperative clinical data, radiological findings, intraoperative details, and postoperative outcomes were collected. Statistical analysis was conducted using SPSS version 26, employing Chi-square and t-tests to evaluate outcome significance. Results: The patient cohort comprised 53.85% males, with a mean age of 36.3 years. The lumbar region was the most affected (45%), followed by the thoracic (38%) and thoracolumbar (17%). Postoperative outcomes indicated an improvement in radiological stability from 48.72% preoperatively to 73.08% postoperatively (p=0.001), a non-significant increase in complications (12.82% to 19.23%, p=0.231), and a slight rise in patient satisfaction (84.62% to 88.46%, p=0.453). Conclusion: Transpedicular fixation is effective in improving radiological stability and maintaining high patient satisfaction in the treatment of thoracic and lumbar tuberculous spine disease in Pakistan. The procedure's safety profile is acceptable, though the slight increase in postoperative complications warrants attention.

Literature Review: Efektivitas Elastic Therapeutic Taping (Ett) Terhadap Pengurangan Skala Nyeri Punggung Bawah Pada Kehamilan Trimester Iii

One of the physiological changes in pregnant women in the third trimester is the gradual musculoskeletal changes associated with the occurrence of low back pain due to increased body weight and changes in body posture. One of the new technologies in physical therapy is the use of elastic therapeutic bandages. This literature review aims to determine the effectiveness of elastic therapeutic taping (ett) against LBP in the third trimester of pregnancy. Of the 11 studies reviewed by the authors, it was shown that ETT support for low back pain relief was usually installed in the lumbar region 5 (L5) and sacrum (S1) with a band pattern I. ETT can be done 2 times a week and the ETT is replaced 3 days every 3 weeks for best results. optimally with a duration of 24-72 hours. ETT can reduce pain scores more significantly when combined with other therapies such as Paracetamol plus ETT, TENS plus ETT, ETT with oblique pelvic exercises, back exercises with ETT. The conclusion is that ETT can relieve low back pain and have a very real effect in reducing low back pain intensity in the last trimester of pregnancy.

Preoperative diagnosis and rotator cuff status impact functional internal rotation following reverse shoulder arthroplasty

PurposeThis study aimed to evaluate whether functional internal rotation (fIR) following reverse shoulder arthroplasty (RSA) differs based on diagnosis of either: primary osteoarthritis (OA) with intact rotator cuff, massive irreparable rotator cuff tear (MICT) or cuff tear arthropathy (CTA). MethodsA retrospective review was performed on RSAs performed by a single surgeon with the same implant over a five year period. Minimum two year follow-up was available in 235 patients; 139 (59.1%) were females, and the mean patient age was 72±8 years. Additional clinical evaluation included the simple shoulder value (SSV) and Constant score. Postoperative internal rotation was categorized as type I: hand to the buttock or hip, type II: to the lower lumbar region, or type III smooth motion to at least the upper lumber region. Type I was considered “non-functional” internal rotation and type II or III were fIR. . ResultsPreoperatively, internal rotation was classified as type I in 60 (25.5%) patients, type II in 114 (48.5%), and type III in 62 (26%). Postoperatively internal rotation was classified as type I in 70 (30%) patients, type II in 86 (36%), and type III in 79 (34%). Compared to preoperative status, fIR improved significantly in OA patients (p<0.001), with 49 (52.6%) classified as type II or III postoperatively. In CTA patients, there was no significant change (p=0.352). In patients with MICTs, there was significant loss in fIR postoperatively (p=0.003), with 25 (30.8%) patients deteriorating to type I after having either type II or III preoperatively, and only five (6.1%) patients improving to either type II or III. ConclusionsPatients who undergo RSA for primary OA have a better chance of postoperative fIR improvement. A decrease in fIR is common after RSA for MICTs.

Development of the Benefits of Using Manual SOP Therapy in Cases Low Back Pain at Causa Piriformis Syndrome

Low Back Pain at Causa Piriformis Syndrome is a musculoskeletal disorder that causes pain in the fifth lumbar and first sacral areas that radiates to the feet and legs due to an abnormal neuromuscular condition of the piriformis muscle or compression or irritation of the sciatic nerve running below through the muscles. muscle. Low back pain itself is something that is common in patients so patients seek medical help, whereas piriformis syndrome is a case that is difficult to diagnose. Electrodiagnostic consultants are often asked to differentiate between piriformis syndrome and radiculopathy. Low back pain at causa piriformis syndrome is caused by activities carried out in the wrong way and carried out repeatedly as well as a lack of education which results in pain in the back and radiating to the legs. This case study aims to find the benefits of physiotherapy intervention in the form of manual therapy such as stretching of the postural muscles, myofascial release, dynamic muscle adaptation, contract relax of the piriformis muscle, hip traction, and physiological movements in the lumbar region and the piriformis muscle. The research method used is a case study. The respondent used was a 48 year old patient who was a housewife who had retired from office work. This research was conducted 8 times for one month. Patients were evaluated using a visual analog scale (VAS). The results of using intervention in the form of manual therapy show a reduction in pain in low back pain at causa piriformis syndrome from a pressure pain scale of 8 to 3, movement pain from 8 to 2 and silent pain from 2 to 1. In conclusion, providing manual therapy intervention has benefits in Reduces pain in the lower back and piriformis syndrome muscle.

The Decline of Lumbar Artificial Disc Replacement.

Lower back pain associated with degenerative disc disease is a common occurrence, with many surgical treatments targeting the degenerated disc to relieve symptoms. Current surgical options for degenerative disc disease primarily consist of a discectomy followed by either spinal fusion or artificial disc replacement, with the former being increasingly more common in the lumbar region despite the risk of adjacent segment disease. Though artificial disc replacement aims to provide an increase in range of motion and decreases risk of adjacent segment disease, surgeons are increasingly opting for spinal fusion in the lumbar region. This review investigates underlying factors that may be contributing to this trend by assessing lumbar artificial disc replacement selection criteria, clinical outcomes, surgical technique, complications, revision burden, and overall cost. While these factors had some role in the physician's decision, ultimately the narrow selection criteria and lack of cost reimbursement by insurance has primarily led to the decline in lumbar artificial disc replacement.

Expect the unexpected–a rare case report of lumbar spinal eumycetoma

Mycetoma, a neglected disease found in tropical and subtropical countries, is a chronic granulomatous inflammatory disease affecting the subcutaneous tissue. The most common site of infection is the limbs, affecting around 80% of patients. Cases of cranial and spinal mycetomas are very rare. We are presenting an interesting case report of an intradural mycetoma in the lumbar region in an immunocompetent male with no discharging sinus. Notably, a 34-year-old man, presented with symptoms and signs suggestive of lumbar canal stenosis. On imaging with MRI (magnetic resonance imaging), an intradural lesion was observed at the L4-5 level of the lumbosacral spine. Given his history and imaging, an infective etiology, most probably tubercular, was suspected. He underwent L4-L5 laminectomy. During the procedure, pus was discovered extradurally, which was aspirated and analyzed. Upon opening the dura, grayish-black, moderately vascular, suckable grape-like black granules were observed. Sub-total excision of the lesion was performed, and a sample was sent for histopathology. The direct KOH smear showed septate fungal filaments. LPCB (lactophenol cotton blue) preparation revealed hyaline septate filaments with single-celled conidia and a truncated base, which was identified to be Pseudallescheria boydii. HPE (histopathological examination) report also concurred that the lesion was an eumycetoma. It is important to note that not all tumors in the lumbar canal are myxopapillary ependymomas, neurofibromas, metastatic bony lesions, or tuberculosis. There is a need to increase awareness and understanding of mycetoma, which would significantly improve disease management, particularly in the endemic areas.

Indications, Outcomes, Efficacy, and Complications of Percutaneous Sclerotherapy in the Management of Hemangiomas at Kenyatta National Hospital

Background The effective management of hemangiomas using percutaneous sclerotherapy optimizes desired clinical outcomes and minimizes the associated complications in affected patients. Intra-lesional sclerotherapy involves injecting a sclerosing agent (such as bleomycin and sodium tetradecyl sulfate) into a lesion or the interstitial space around the lesion, causing endothelial injury, thrombosis, inflammation, scarring, and shrinkage of the lesion. Extensive literature suggests that sclerotherapy has a role in the management of hemangiomas, as demonstrated by better health outcomes and improved quality of life among affected patients. Objectives To evaluate the indications, outcomes, efficacy, and complications of percutaneous intra-lesional sclerotherapy in the management of hemangiomas. Materials and methods The study was a prospective cross-sectional study, conducted at a level 6 National Referral Hospital Interventional Radiology Unit. Patients with hemangiomas referred for intralesional sclerotherapy were treated. Data including the indications of intra-lesional sclerotherapy, short-term outcomes, complications were collected, analyzed, and presented in percentages, graphs, pie charts, tables. Technical and clinical success rates were calculated. The efficacy of intralesional sclerotherapy was analyzed using chi-square test. Results A total of 20 patients with hemangiomas were treated. There were 11 females comprising 55% and 9 males comprising 45% with a male to female ratio of 1:1.2. The commonest indication for referral was pain (21.6%), followed by abnormal swelling (18.9%). Most lesions were located in the liver comprising 25%. Other locations included the hand, cheek, lower lip, lower extremities (calf, distal leg, foot, and thigh), lumbar region, posterior thoracic back region and abdomen mesenteric region. Majority of the patients had significant improvement of clinical symptoms with a p-value &lt;0.05. Similarly, there was a statistically significant reduction in the sizes of the lesions treated with a p-value of &lt;0.05. The technical success rate was 100% and the overall clinical success rate was 90%. Mild pain (10%), mild edema (10%) and skin discoloration (5%) were the commonest minor complications encountered, with no major complications. Conclusion Percutaneous intralesional sclerotherapy is a safe and efficacious treatment of hemangiomas with a high technical and clinical success rate. It should be considered as a first line of treatment for the hemangiomas.

Prediction of trunk muscle activation and spinal forces in adolescent idiopathic scoliosis during simulated trunk motion: A musculoskeletal modelling study

Due to lack of reference validation data, the common strategy in characterizing adolescent idiopathic scoliosis (AIS) by musculoskeletal modelling approach consists in adapting structure and parameters of validated body models of adult individuals with physiological alignments. Until now, only static postures have been replicated and investigated in AIS subjects. When aiming to simulate trunk motion, two critical factors need consideration: how distributing movement along the vertebral motion levels (lumbar spine rhythm), and if neglecting or accounting for the contribution of the stiffness of the motion segments (disc stiffness). The present study investigates the effect of three different lumbar spine rhythms and absence/presence of disc stiffness on trunk muscle imbalance in the lumbar region and on intervertebral lateral shear at different levels of the thoracolumbar/lumbar scoliotic curve, during simulated trunk motions in the three anatomical planes (flexion/extension, lateral bending, and axial rotation). A spine model with articulated ribcage previously developed in AnyBody software and adapted to replicate the spinal alignment in AIS subjects is employed. An existing dataset of 100 subjects with mild and moderate scoliosis is exploited. The results pointed out the significant impact of lumbar spine rhythm configuration and disc stiffness on changes in the evaluated outputs, as well as a relationship with scoliosis severity. Unfortunately, no optimal settings can be identified due to lack of reference validation data. According to that, extreme caution is recommended when aiming to adapt models of adult individuals with physiological alignments to adolescent subjects with scoliotic deformity.

Can Animals Predict that their Owner is Ill?

There are reports saying that dogs and cats can predict their owner illness. In this article, I am showing a case where the dog was barking a lot and wanted to bite the injury of the owner in the lumbar region in the back and discovered that it was a skin cancer. The conclusion of this study is to show that dogs and cats have the ability to predict their owner’s illness due to increase scent receptors compared to humans.

Effect of mild cortisol cosecretion on body composition and metabolic parameters in patients with primary hyperaldosteronism.

To investigate the effects of simultaneous cortisol cosecretion (CCS) on body composition in computed tomography(CT)-imaging and metabolic parameters in patients with primary aldosteronism (PA) with the objective of facilitating early detection. Retrospective cohort study. Forty-sevenpatients with PA and CCS confirmed by 1-mg dexamethasone suppression test (DST) with a cutoff of ≥1.8 µg/dL were compared with PA patients with excluded CCS(non-CCS, n = 47) matched by age and sex. Segmentation of the fat compartments and muscle area at the third lumbar region was performed on non-contrast-enhanced CT images with dedicated segmentation software. Additionally, liver, spleen, pancreas and muscle attenuation were compared between the two groups. Mean cortisol after DST was 1.2 µg/dL (33.1 nmol/L) in the non-CCS group and 3.2 µg/dL (88.3 nmol/L) in the CCS group with mild autonomous cortisol excess (MACE). No difference in total, visceral and subcutaneous fat volumes was observed between the CCS and non-CCS group (p = .7, .6 and .8, respectively). However, a multivariable regression analysis revealed a significant correlation between total serum cholesterol and results of serum cortisol after 1-mg DST (p = .026). Classification of the patients based on visible lesion on CT and PA-lateralization via adrenal venous samplingalso did not show any significant differences in body composition. MACE in PA patients does not translate into body composition changes on CT-imaging. Therefore, early detection of concurrent CCS in PA is currently only attainable through biochemical tests. Further investigation of the long-term clinical adverse effects of MACE in PA is necessary.

Lumbar Melanoma with Sentinel Lymph Nodes in Multiple Basins - Case Report and Review of the Literature.

Intreduction: Melanoma is an extremely aggressive form of skin neoplasia, an important stage in the diagnostic and treatment is identifying the dissemination at the lymphatic level. For a more accurate staging, the sentinel lymph node biopsy technique is performed, which in most of the time addresses one, respectively 2 locations, but cases with sentinel nodes in 3 lymphatic basins have rarely been described. Case report: We present a case of melanoma located in the right lumbar region, which from the point of view of histopathological features has a Breslow index of 4.2 mm, classified in the pT4b stage. After the CT evaluation was performed, it was decided that there is indication for performing the sentinel lymph node technique and excision with a margin of safety. Scintigraphy revealed that sentinel lymph nodes were identified in 3 different regions, respectively the right axilla and bilateral inguinal. Conclusions: Melanoma located on the trunk can present different lymphatic routes for the sentinel lymph nodes, unlike that on the limbs where certain patterns are present. Identifying these lymph nodes in cases like this involves a challenge both from a diagnostic and surgical point of view.

A Case Report on the Rare Presentation of Brucellosis-induced Spondylitis

Human brucellosis is a zoonosis with a global distribution that can affect several organs and tissues. The most frequent brucellosis consequence, osteoarticular arthritis, has been reported in 10-85% of patients. Arthritis (most common), bursitis, tenosynovitis, sacroiliitis, spondylitis, and osteomyelitis are among the range of bone and joint disorders. The age of the patient and the Brucella species involved both have an impact on the type of skeletal involvement. The most common and significant clinical type of osteoarticular involvement in adults with Brucella species infection is spondylitis. The diagnosis of spondylitis may be challenging, and it may be made more difficult by potentially fatal neurological or vascular problems. In most cases, spinal arthritis is the most common presentation which emerges a few weeks following the initial Brucella infection and can impact any segment of the spine (especially lumbar region). Unlike in this case, a 54-year-old male with a history of remittent fever presented with complications where uncommon complication of sacroiliac joints are involved. Managing the infection involves a combination of antibiotics and stabilising the affected joints. Nonetheless, the therapeutic process could extend over several months, and there's a possibility of infection recurrence if not treated appropriately

Percutaneous dual intervention in a child with Alagille syndrome –A case report.

Alagille syndrome(ALGS) is a rare autosomal dominant (AD) genetic disorder .ALGS involves multisystem which includes liver ,heart, skeleton, Eyes, kidneys with facial abnormalities. ALGS may involve a particular system like facial dysmorphism, cardiac defect or vertebral defect. Some individual may not have liver anomalies or typical features. We report a case of 9 year old male child with large ostium secundum ASD(16 mm) and branch pulmonary artery stenosis(LPA)diagnosed incidentally at 8 year of age. The child had facial dysmorphism (broad forehead, frontal bossing , triangular facies, hypertelorism, prominent ear and pointed chin, straight nose with bulbous tip. The mental development of the child was borderline. He also had butterfly vertebrae in thoracic and lumber region. He was treated successfully with ASD device closure for ASD and balloon pulmonary valvuloplasty for LPA stensis. Both the procedure was performed simultaneously without any complications. There is no curative management for the disorder so symptomatic management is the only treatment option.

Automatic 3D Lamina Curve Extraction from Freehand 3D Ultrasound Data using Sequential Localization Recurrent Convolutional Networks.

Freehand 3D ultrasound imaging is emerging as a promising modality for regular spine exams due to its non-invasiveness and affordability. The laminae landmarks play a critical role in depicting the 3D shape of the spine. However, the extraction of the 3D lamina curves from transverse ultrasound sequences presents a challenging task, primarily attributed to the presence of diverse contrast variations, imaging artifacts, the complex surface of vertebral bones, and the difficulties associated with probe manipulation. This paper proposes Sequential Localization Recurrent Convolutional Networks (SL-RCN), a novel deep learning model that takes the contextual relationships into account and embeds the transformation matrix feature as a 3D knowledge base to enhance accurate ultrasound sequence analysis. The assessment involved the analysis of 3D ultrasound sequences obtained from 10 healthy adult human participants, covering both the lumbar and thoracic regions. The performance of SL-RCN is evaluated through 7-fold cross-validation, employing the leave-one-participant-out strategy. The validity of the AI model training is assessed on test data from 3 participants. Normalized Discrete Fréchet Distance (NDFD) is employed as the main metric to evaluate the disparity of the extracted 3D lamina curves. In contrast to our previous 2D image analysis method, SL-RCN generates reduced left/right mean distance errors from 1.62/1.63mm to 1.41/1.40mm, and NDFDs from 0.5910/0.6389 to 0.4276/0.4567. The increase in the mean NDFD value from 7-fold cross-validation to the test-data experiment is less than 0.05. The experiments demonstrate the SL-RCN's capability in extracting accurate paired smooth lamina landmark curves.

A case report of subdiaphragmatic right kidney as a positional variant of cephalad renal ectopia

ABSTRACT Renal ectopia refers to the abnormal position of the kidney outside the renal fossa. It may be in sacral, lumbar, thoracic, or subdiaphragmatic regions, of which the latter is extremely rare and may be associated with congenital abnormalities. High renal ectopia is a rare disease that affects 1 in every 22 ectopic kidney occurrences. During the routine cadaveric dissection of a 50-year-old male, we observed an uncommon case of high ascent of the right kidney, up to the bare area of liver. The right kidney was normal in size and shape, and received a renal artery positioned obliquely, 3 mm below the origin of the left renal artery and its vein drained into the hepatic portion of the inferior venacava (IVC). Knowledge about the variations in the positions of the kidneys is very important as cephalad ectopic kidney may pose a challenge for surgical and interventional procedures.

Torsion of a Large Ovarian Dermoid Cyst in Third Trimester Pregnancy: A Case Report

Dermoid cysts are the most frequent ovarian tumours among women of reproductive age, constituting a notable 20% of all adult ovarian tumours. They are typically lined by stratified squamous epithelium and contain dermal and epidermal elements. During pregnancy, dermoid cysts are more likely to lead to infection, rupture and torsion. A 23-year-old multigravida (G2P1L1) female at 36 weeks of gestation presented with complaints of left lumbar pain persisting for one day, unrelieved by medication. Ultrasound (USG)revealed a multiloculated septated cystic lesion in the left lumbar region adjacent to the gravid uterus, just anteroinferior to the left kidney. Magnetic Resonance Imaging (MRI) showed a predominantly fat-density multiloculated cystic lesion with twisting of the pedicle. An emergency laparotomy was performed, and the left ovarian cyst was removed, revealing patchy discolored areas of gangrene, and a live healthy foetus was delivered. While torsion of an ovarian cyst is a well-known complication, its presentation during pregnancy is rare. Due to the variable symptoms of ovarian torsion, the clinical presentation can be quite confusing. Therefore, both the obstetrician and radiologist should have a lower threshold for clinical suspicion of torsion in pregnancy, enabling prompt diagnosis and management of such cases to prevent both maternal and foetal mortality.

Effect of Selected Yogic Asanas on Lumbar Spondylosis: A Systematic Review

Introduction: Lumbar spondylosis most commonly occurs at the L4- L5 and L5-S1 vertebral level. It’s prevalence has increased in recent years across the middle age groups. Non pharmacological and non-invasive interventions like Yogic Asanas are economical and effective in Lumbar spondylosis. Almost 266 million (3.63%) cases are observed per year worldwide, which is a major cause of morbidity. Degenerative changes in the intervertebral joints can start after 40 years of age which become more common around 45 years of age. Approximately 10% of the adult population suffers from symptomatic lumbar spondylosis, with women and men affected equally. Aim &amp; Objectives: To study and analyze the role of Yogic Asanas in the clinical management of lumbar spondylosis Materials and Methods: Screening of relevant material from the classical texts of Yoga. Systematic search of Pubmed, Google Scholar and other resources for published articles on Lumbar spondylosis and its management through Yoga and similar physical therapies. Discussion: A painful condition that puts stress on the muscles and bones of lumbar region is called lumbar spondylosis. In addition to limiting mobility, the medical condition additionally impacts quality of life. It may be caused by trauma, prolonged bike riding, poor sleeping habits, poor posture when sitting, and lack of physical activity. Numerous Yoga poses can help in lumbar spondylosis and offer particular therapeutic benefits for people with lumbar spondylosis. Conclusion: After a thorough review, reading and analyzing previous researches it can be concluded that physical, physiological, cognitive, and emotional levels are all affected by Yoga. Yogic Asanas are very much effective in improvement and strengthening the muscles of back, endurance and tone of whole back. Regular practice of Yoga poses stimulates many body parts, including the organs, muscles, joints, ligaments, vessels, and nerves. This is especially beneficial for treating lumbar spondylosis.