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Revista Do Colegio Brasileiro de... 2021Lumbar and para-iliac hernias are rare and occur after removal of an iliac bone graft, nephrectomies, retroperitoneal aortic surgery, or after blunt trauma to the...
Lumbar and para-iliac hernias are rare and occur after removal of an iliac bone graft, nephrectomies, retroperitoneal aortic surgery, or after blunt trauma to the abdomen. The incidence of hernia after the removal of these grafts ranges from 0.5 to 10%. These hernias are a problem that surgeons will face, since bone grafts from the iliac crest are being used more routinely. The goal of this article was to report the technique to correct these complex hernias, using the technique of fixing the propylene mesh to the iliac bone and the result of this approach. In the period of 5 years, 165 patients were treated at the complex hernia service, 10 (6%) with hernia in the supra-iliac and lumbar region, managed with the technique of fixing the mesh to the iliac bone with correction of the failure. During the mean follow-up of 33 months (minimum of 2 and maximum of 48 months), there was no recurrence of the hernias.
Topics: Hernia; Herniorrhaphy; Humans; Ilium; Lumbosacral Region; Surgical Mesh
PubMed: 34133656
DOI: 10.1590/0100-6991e-20213029 -
Spine Aug 2020
Topics: Gene Expression; Humans; Lumbar Vertebrae; Lumbosacral Region; Paraspinal Muscles
PubMed: 32675621
DOI: 10.1097/BRS.0000000000003576 -
Sovremennye Tekhnologii V Meditsine 2021Lumbar spinal fusion is one of the most common operations in spinal surgery. For its implementation, anterolateral (pre-psoas) approach (oblique lumbar interbody fusion,... (Review)
Review
UNLABELLED
Lumbar spinal fusion is one of the most common operations in spinal surgery. For its implementation, anterolateral (pre-psoas) approach (oblique lumbar interbody fusion, OLIF) is now increasingly used due to its high efficacy and safety. However, there is still little information on the clinical and radiological results of using this technique. was to analyze the safety and efficacy of OLIF in the treatment of lumbar spine disorders as presented in the literature.
MATERIALS AND METHODS
The systematic electronic search was performed using the Ovid Medline, PubMed, and eLIBRARY.RU electronic databases. The following search key words were used: Oblique Lumbar Interbody Fusion, OLIF, Anterior to Psoas Lumbar Interbody Fusion, and ATP.
RESULTS
For the final analysis, 17 sources were selected; with a total of 2900 patients. Total complication rate was 13.9% (403 cases). The incidence of severe persistent complications was less than 1%. Based on the data obtained, we compared the clinical and radiological results of OLIF with other lumbar fusion methods.
CONCLUSION
OLIF is an effective, versatile, and minimally traumatic option for lumbar fusion with relatively few complications, which makes it superior to other retroperitoneal approaches. However, the OLIF technique is not completely free of complications associated with the ventral approach, and it cannot provide adequate decompression of the spinal canal in all cases. In addition, anterior approach surgery is still of limited use in cases of spinal deformities; adequate correction of deformity is achievable mainly in combination with posterior surgery.
Topics: Humans; Lumbar Vertebrae; Lumbosacral Region; Spinal Fusion
PubMed: 35265352
DOI: 10.17691/stm2021.13.5.09 -
PloS One 2021The vertebral endplate forms a structural boundary between intervertebral disc and the trabecular bone of the vertebral body. As a mechanical interface between the stiff...
The vertebral endplate forms a structural boundary between intervertebral disc and the trabecular bone of the vertebral body. As a mechanical interface between the stiff bone and resilient disc, the endplate is the weakest portion of the vertebral-disc complex and is predisposed to mechanical failure. However, the literature concerning the bone mineral density (BMD) distribution within the spinal endplate is comparatively sparse. The objective of this study is to investigate the three-dimensional (3D) distribution of computed tomography (CT) attenuation across the lumbosacral endplate measured in Hounsfield Units (HU). A total of 308 endplates from 28 cadaveric fresh-frozen lumbosacral spines were used in this study. Each spine was CT-scanned and the resulting DICOM data was used to obtain HU values of the bone endplate. Each individual endplate surface was subdivided into five clinically-relevant topographic zones. Attenuation was analyzed by spinal levels, sites (superior or inferior endplate) and endplate region. The highest HU values were found at the S1 endplate. Comparisons between the superior and inferior endplates showed the HU values in inferior endplates were significantly higher than those in the superior endplates within the same vertebra and the HU values in endplates cranial to the disc were significantly higher than those in the endplates caudal to the disc within the same disc. Attenuation in the peripheral region was significantly higher than in the central region by 32.5%. Regional comparison within the peripheral region showed the HU values in the posterior region were significantly higher than those in the anterior region and the HU values in the left region were significantly higher than those in the right region. This study provided detailed data on the regional HU distribution across the lumbosacral endplate, which can be useful to understand causes of some endplate lesions, such as fracture, and also to design interbody instrumentation.
Topics: Adult; Aged; Female; Humans; Intervertebral Disc; Lumbar Vertebrae; Lumbosacral Region; Male; Middle Aged; Spinal Fractures; Tomography, X-Ray Computed
PubMed: 34705863
DOI: 10.1371/journal.pone.0259001 -
International Journal of Molecular... Jul 2020Damage to the annulus fibrosus (AF), the outer region of the intervertebral disc (IVD), results in an undesirable condition that may accelerate IVD degeneration causing... (Review)
Review
Damage to the annulus fibrosus (AF), the outer region of the intervertebral disc (IVD), results in an undesirable condition that may accelerate IVD degeneration causing low back pain. Despite intense research interest, attempts to regenerate the IVD have failed so far and no effective strategy has translated into a successful clinical outcome. Of particular significance, the failure of strategies to repair the AF has been a major drawback in the regeneration of IVD and nucleus replacement. It is unlikely to secure regenerative mediators (cells, genes, and biomolecules) and artificial nucleus materials after injection with an unsealed AF, as IVD is exposed to significant load and large deformation during daily activities. The AF defects strongly change the mechanical properties of the IVD and activate catabolic routes that are responsible for accelerating IVD degeneration. Therefore, there is a strong need to develop effective therapeutic strategies to prevent or reconstruct AF damage to support operational IVD regenerative strategies and nucleus replacement. By the way of this review, repair and regenerative strategies for AF reconstruction, their current status, challenges ahead, and future outlooks were discussed.
Topics: Animals; Annulus Fibrosus; Humans; Intervertebral Disc; Intervertebral Disc Degeneration; Lumbosacral Region; Regeneration
PubMed: 32664453
DOI: 10.3390/ijms21144889 -
African Journal of Paediatric Surgery :... 2022In managing paediatric spinal deformities, the currently-in-use growth maturity assessment parameters (clinical or radiological) are based mostly on Caucasian...
BACKGROUND
In managing paediatric spinal deformities, the currently-in-use growth maturity assessment parameters (clinical or radiological) are based mostly on Caucasian populations. They may be adequate for general treatment planning but may not accurately predict the remaining growth potential. Some therapies (e.g. growing rod distractions or growth modulation surgeries) require more accurate predictions of remaining growth potential and race-specific values. Lumbar lordosis (LL) development ceases at spinal bone maturity. The age-of-cessation seems a more accurate predictor of remaining spinal bone growth potential, compared to currently-in-use growth maturity assessment parameters, but is rarely included in the growth maturity assessment parameters.
AIMS AND OBJECTIVES
As a predictor of remaining spinal growth potential, age-of-cessation of LL development (Race-specific of Black populations) was quantified.
MATERIALS AND METHODS
In archival normal lateral lumbosacral radiographs of patients of a tertiary hospital in South-East Nigeria, LL development across five age groups (Birth- 9, 10-15, 16-20, 21-25 and 26-30 years) was quantified with lumbosacral joint angle (LSJA) in 215 (110 males, 105 females), and lumbosacral angle (LSA) in 238 (119 males, 119 females). Data were analysed with IBM SPSS Statistics 23.0 (NY, USA). P ≤ 0.05 was considered statistically significant.
RESULTS
Both LSJA and LSA age groups' mean values progressively increased with age, and plateaued at 21-25 years range, with LSJA mean of 23.4 ± 1.3 years, and LSA mean 23.5 ± 1.3 years; the means difference was insignificant (P = 0.680).
CONCLUSION
With ageing, there is progressive increment, and later, cessation of LL. Age-of-cessation indirectly infers spinal-maturity-age, and could indirectly be an assessment parameter of spinal-maturity-status.
Topics: Adult; Child; Female; Humans; Lordosis; Lumbar Vertebrae; Lumbosacral Region; Male; Radiography; Retrospective Studies; Spinal Fusion; Young Adult
PubMed: 36018198
DOI: 10.4103/ajps.ajps_109_21 -
Sensors (Basel, Switzerland) Jun 2022Balance and posture are two topics that have been extensively studied, although with some conflicting findings. Therefore, the aim of this work is to analyze the...
Balance and posture are two topics that have been extensively studied, although with some conflicting findings. Therefore, the aim of this work is to analyze the relationship between the postural angles of the spine in the sagittal plane and the stable static balance. A cross-sectional study was conducted with children and adolescents from schools in northern Portugal in 2019. An online questionnaire was used to characterize the sample and analyze back pain. Spinal postural angle assessment (pelvic, lumbar, and thoracic) was performed using the Spinal Mouse, while stabilometry assessment was performed using Namrol Podoprint. Statistical significance was set as α = 0.05. The results showed that girls have better balance variables. There is a weak correlation between the anthropometric variables with stabilometry variables and the postural angles. This correlation is mostly negative, except for the thoracic spine with anthropometric variables and the lumbar spine with BMI. The results showed that postural angles of the spine are poor predictors of the stabilometric variables. Concerning back pain, increasing the postural angle of the thoracic spine increases the odds ratio of manifestation of back pain by 3%.
Topics: Adolescent; Animals; Back Pain; Cross-Sectional Studies; Humans; Lumbosacral Region; Mice; Postural Balance; Posture; Spine
PubMed: 35808468
DOI: 10.3390/s22134973 -
Folia Morphologica 2022The sympathetic chain serves to distribute visceral efferents and afferents over the entire body. The sympathetic chain courses from the base of the skull to the coccyx...
The sympathetic chain serves to distribute visceral efferents and afferents over the entire body. The sympathetic chain courses from the base of the skull to the coccyx and sends branches to distribute along spinal nerves and a number of visceral nerves that distribute to cardiac muscle, smooth muscle and glands. During dissection of the posterior abdominal wall, we identified a rare variation of the sympathetic chain. In this subject, the sympathetic chain failed to send grey rami to the L2-4 spinal nerves and terminated by joining the S1 anterior ramus. Such a variation has only been reported once in the literature in 1895. We provide both schematic and photographic documentation of this variation and propose a number of possible circuits whereby visceral axons can reach their target despite these anatomical barriers.
Topics: Spinal Nerves; Lumbosacral Region; Axons
PubMed: 34545560
DOI: 10.5603/FM.a2021.0089 -
JPMA. the Journal of the Pakistan... Mar 2022To systematically review the role of low-intensity pulsed ultrasound on lumbar spondylolysis.
OBJECTIVE
To systematically review the role of low-intensity pulsed ultrasound on lumbar spondylolysis.
METHODS
Literature search was conducted on PubMed, Embase, CINAHL, Web of Science, PEDro and Scopus databases to identify relevant studies published between 2010 and 2020 by using medical subject headings and applying Booleans, such as low-intensity pulsed ultrasound OR interventional ultrasound AND lumbar spine OR lumbar region AND spondylolysis OR stress fracture. Unpublished studies were hand-searched in the journals, abstracts of conferences were reviewed, and citation index was used for searching experts in the field and then contacting them for information. Studies included were the ones that had at least one of the following outcomes: bone union rate, treatment period to bone union and time to return to previous activities.
RESULTS
Of the 243 studies identified, 228(94%) were full text articles and only 2(0.8%) studies were critically appraised for qualitative synthesis based on bone union rate, treatment period to bone union, and time to return to previous activities.
CONCLUSIONS
Low-intensity pulsed ultrasound was found to be effective for bone union and a useful therapy for quick return to playing sports in patients with lumbar spondylolysis.
Topics: Hand; Humans; Lumbosacral Region; Spondylolysis; Ultrasonic Therapy; Ultrasonic Waves
PubMed: 35320236
DOI: 10.47391/JPMA.3320 -
Journal of Biomechanics Aug 2023Lumbar joint compression forces have been linked to the development of chronic low back pain, which is specially present in occupational environments. Offline...
Lumbar joint compression forces have been linked to the development of chronic low back pain, which is specially present in occupational environments. Offline methodologies for lumbosacral joint compression force estimation are not commonly integrated in occupational or medical applications due to the highly time-consuming and complex post-processing procedures. Hence, applications such as real-time adjustment of assistive devices (i.e., back-support exoskeletons) for optimal modulation of compression forces remains unfeasible. Here, we present a real-time electromyography (EMG)-driven musculoskeletal model, capable of estimating accurate lumbosacral joint moments and plausible compression forces. Ten participants performed box-lifting tasks (5 and 15 kg) with and without the Laevo Flex back-support exoskeleton using squat and stoop lifting techniques. Lumbosacral kinematics and EMGs from abdominal and thoracolumbar muscles were used to drive, in real-time, subject-specific EMG-driven models, and estimate lumbosacral joint moments and compression forces. Real-time EMG-model derived moments showed high correlations (R = 0.76 - 0.83) and estimation errors below 30% with respect to reference inverse dynamic moments. Compared to unassisted lifting conditions, exoskeleton liftings showed mean lumbosacral joint moments and compression forces reductions of 11.9 - 18.7 Nm (6 - 12% of peak moment) and 300 - 450 N (5 - 10%), respectively. Our modelling framework was capable of estimating in real-time, valid lumbosacral joint moments and compression forces in line with in vivo experimental data, as well as detecting the biomechanical effects of a passive back-support exoskeleton. Our presented technology may lead to a new class of bio-protective robots in which personalized assistance profiles are provided based on subject-specific musculoskeletal variables.
Topics: Humans; Electromyography; Lifting; Exoskeleton Device; Lumbosacral Region; Biomechanical Phenomena; Abdominal Muscles
PubMed: 37499430
DOI: 10.1016/j.jbiomech.2023.111727