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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 -
The Journal of International Medical... Aug 2022Ewing sarcoma (ES) is a highly aggressive bone and soft tissue tumor that occurs mainly in young children and adolescents and is associated with primary and metastatic... (Review)
Review
Ewing sarcoma (ES) is a highly aggressive bone and soft tissue tumor that occurs mainly in young children and adolescents and is associated with primary and metastatic disease. Intramedullary ES (either primary or secondary) is rare, and the ideal management remains inconclusive. We herein report intramedullary and extramedullary metastatic ES in a single patient. A 46-year-old woman was referred to our outpatient clinic from the oncology clinic with progressive paraparesis and paresthesia for 1 week prior to presentation. She had developed left clavicular ES 2 years earlier for which surgery and chemoradiotherapy had been performed. At the present evaluation, she was diagnosed with intramedullary thoracic and lumbar extradural masses. Thoracic surgery was performed, and a biopsy of the lesion was obtained. The diagnosis of ES was confirmed histopathologically, and she underwent adjuvant chemotherapy. Her neurological status did not improve after surgery, and she underwent rehabilitation and physical therapy. The lumbar lesion resolved with chemotherapy. Metastasis of ES to the spinal cord, especially intramedullary lesions, is extremely rare, and there is no standard management guideline. However, surgical decompression and adjuvant chemotherapy are the main treatments in these cases.
Topics: Adolescent; Chemotherapy, Adjuvant; Child; Child, Preschool; Female; Humans; Lumbosacral Region; Middle Aged; Sarcoma, Ewing
PubMed: 35938475
DOI: 10.1177/03000605221108095 -
British Medical Journal (Clinical... May 1982
Topics: Constriction, Pathologic; Humans; Lumbosacral Region; Spinal Canal; Spinal Diseases
PubMed: 6805616
DOI: 10.1136/bmj.284.6329.1588-a -
Neurosurgical Review Apr 2023This meta-analysis compared the efficacy of oblique lumbar interbody fusion (OLIF) and minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) in the... (Meta-Analysis)
Meta-Analysis
Oblique lumbar interbody fusion versus minimally invasive transforaminal lumbar interbody fusion for the treatment of degenerative disease of the lumbar spine: a systematic review and meta-analysis.
This meta-analysis compared the efficacy of oblique lumbar interbody fusion (OLIF) and minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) in the treatment of lumbar degenerative diseases. A computer search for the published literature on OLIF and MIS-TLIF for the treatment of lumbar degenerative diseases in the PubMed, Web of Science, Embase, CINAHL, MEDLINE, Cochrane Library, and other databases was performed, from which 522 related articles were retrieved and 13 were finally included. Two reviewers independently extracted data from the included studies and analyzed them using RevMan 5.4. The quality of the studies was assessed using the Cochrane systematic analysis and the Newcastle-Ottawa scale. Meta-analysis showed that the blood loss [95% confidence intervals (CI) (- 121.01, - 54.56), [Formula: see text]], hospital stay [95% CI (- 1.98, - 0.85), [Formula: see text]], postoperative fusion rate [95%CI (1.04, 3.60), [Formula: see text]], postoperative disc height [95% CI (0.50, 3.63), [Formula: see text]], and postoperative foraminal height [95% CI (0.96, 4.13), [Formula: see text]] were all better in the OLIF group; however, the complication rates were significantly lower in the MIS-TLIF group [95% CI (1.01, 2.06), [Formula: see text]]. However, there were no significant differences between the two in terms of surgery time, patient satisfaction, or postoperative functional scores. The OLIF group had the advantages of lower blood loss, a shorter hospital stay, a higher postoperative fusion rate, and better recovery of the disc and foraminal heights, whereas MIS-TLIF had a relatively lower complication rate.
Topics: Humans; Lumbar Vertebrae; Minimally Invasive Surgical Procedures; Spinal Fusion; Patient Satisfaction; Lumbosacral Region; Treatment Outcome; Retrospective Studies
PubMed: 37119422
DOI: 10.1007/s10143-023-02009-0 -
Journal of Healthcare Engineering 2022Lumbopelvic kinematics has been observed to include different parameters and directly relate to the movement of the hip spine. In the current scenario, more than 65... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Lumbopelvic kinematics has been observed to include different parameters and directly relate to the movement of the hip spine. In the current scenario, more than 65 million people have been suffering from spinal pain, and 18% of adults experience chronic spinal pain.
METHODS
This systematic review and meta-analysis selected 9 studies for analysis via electronic databases like EMBASE, MEDLINE, Web of Science, Scopus, CINAHL, and Cochrane (CENTRAL). After collecting the data, the dataset has been systematically analyzed through statistical methodologies using RevMan and Stata.
RESULTS
Out of 116 studies initially scrutinized, nine were finally selected for the meta-analysis. When range of motion was studied via meta-analysis, it was noted that a considerable reduced movement was noted in the lumbar region of the spine when people were suffering from lower back pain in comparison to control group people. Hence, reduced lumbar range of motion, no difference in the angle of lordosis, and no significant difference in extension and rotation in people with lower back pain were found. However, variability was noted in people suffering from lower back pain for flexion and lateral flexion. A significant heterogeneity was found between the studies which lacked some details and standardization of the criteria which were used for defining patients with lower back pain or without them (control group). Results show that spinal pain is the main reason behind the limitation of lumbar range of motion. It is clear from the data set of mean and standard deviation, and this is clear to establish the relationship between the causes of pelvic and spinal pain. In flexion-based ROM, the mean difference was found to be -9.77 (95% CI: -21.86, 2.32). Similarly, for lateral flexion, the mean difference was found to be -5.58 (with 95% CI: -10.38, -0.79).
CONCLUSION
It can be concluded that spinal disease is too influential for people; thereby, it affects day-to-day life activities by creating painful and restricted movements. It is concluded that people suffering from lower back pain have reduced proprioception and range of movement in the lumbar region when compared to control groups with no lower back pain, which mainly focus on flexion and lateral flexion.
Topics: Adult; Biomechanical Phenomena; Humans; Low Back Pain; Lumbar Vertebrae; Lumbosacral Region; Range of Motion, Articular
PubMed: 35345658
DOI: 10.1155/2022/7369242 -
Journal of Healthcare Engineering 2022Unilateral knee extension restriction might change trunk alignment and increase mechanical load on the lumbar region during walking. We aimed to clarify lumbar region...
Unilateral knee extension restriction might change trunk alignment and increase mechanical load on the lumbar region during walking. We aimed to clarify lumbar region mechanical load during walking with restricted knee extension using a musculoskeletal model simulation. Seventeen healthy adult males were enrolled in this study. Participants walked 10 m at a comfortable velocity with and without restricted right knee extension of 15° and 30° using a knee brace. L4-5 joint moment, joint reaction force, and muscle forces around the lumbar region during walking were calculated for each condition. Peaks of kinetic data were compared among three gait conditions during 0%-30% and 50%-80% of the right gait cycle. Lumbar extension moment at early stance of the bilateral lower limbs was significantly increased in the 30° restricted condition ( ≤ 0.021). Muscle force of the multifidus showed peaks at stance phase of the contralateral side during walking, and the erector spinae showed force peaks at early stance of the bilateral lower limb. Muscle force of the multifidus and erector spinae increased with increasing degree of knee flexion ( ≤ 0.010), with a large effect size ( = 0.273-0.486). The joint force acting on L4-5 showed two peaks at early stance of the bilateral lower limbs during the walking cycle. The anterior and vertical joint force on L4-5 increased by 14.2%-36.5% and 10.0%-23.0% in walking with restricted knee extension, respectively ( ≤ 0.010), with a large effect size ( = 0.149-0.425). Restricted knee joint extension changed trunk alignment and increased the muscle force and the vertical and anterior joint force on the L4-5 joint during walking; this tendency became more obvious with increased restriction angle. Our results provide important information for therapists engaged in the rehabilitation of patients with knee contracture.
Topics: Adult; Biomechanical Phenomena; Gait; Humans; Knee Joint; Lower Extremity; Lumbosacral Region; Male
PubMed: 36046010
DOI: 10.1155/2022/1151753 -
Sensors (Basel, Switzerland) Feb 2022The lumbar spine plays a very important role in our load transfer and mobility. Vertebrae localization and segmentation are useful in detecting spinal deformities and...
The lumbar spine plays a very important role in our load transfer and mobility. Vertebrae localization and segmentation are useful in detecting spinal deformities and fractures. Understanding of automated medical imagery is of main importance to help doctors in handling the time-consuming manual or semi-manual diagnosis. Our paper presents the methods that will help clinicians to grade the severity of the disease with confidence, as the current manual diagnosis by different doctors has dissimilarity and variations in the analysis of diseases. In this paper we discuss the lumbar spine localization and segmentation which help for the analysis of lumbar spine deformities. The lumber spine is localized using YOLOv5 which is the fifth variant of the YOLO family. It is the fastest and the lightest object detector. Mean average precision (mAP) of 0.975 is achieved by YOLOv5. To diagnose the lumbar lordosis, we correlated the angles with region area that is computed from the YOLOv5 centroids and obtained 74.5% accuracy. Cropped images from YOLOv5 bounding boxes are passed through HED U-Net, which is a combination of segmentation and edge detection frameworks, to obtain the segmented vertebrae and its edges. Lumbar lordortic angles (LLAs) and lumbosacral angles (LSAs) are found after detecting the corners of vertebrae using a Harris corner detector with very small mean errors of 0.29° and 0.38°, respectively. This paper compares the different object detectors used to localize the vertebrae, the results of two methods used to diagnose the lumbar deformity, and the results with other researchers.
Topics: Deep Learning; Lumbar Vertebrae; Lumbosacral Region; Spine
PubMed: 35214448
DOI: 10.3390/s22041547 -
Sensors (Basel, Switzerland) Aug 2023The prevalence of musculoskeletal symptoms (MSS) like neck and back pain is high among open-surgery surgeons. Prolonged working in the same posture and unfavourable...
The prevalence of musculoskeletal symptoms (MSS) like neck and back pain is high among open-surgery surgeons. Prolonged working in the same posture and unfavourable postures are biomechanical risk factors for developing MSS. Ergonomic devices such as exoskeletons are possible solutions that can reduce muscle and joint load. To design effective exoskeletons for surgeons, one needs to quantify which neck and trunk postures are seen and how much support during actual surgery is required. Hence, this study aimed to establish the biomechanical profile of neck and trunk postures and neck and lumbar joint loads during open surgery (training). Eight surgical trainees volunteered to participate in this research. Neck and trunk segment orientations were recorded using an inertial measurement unit (IMU) system during open surgery (training). Neck and lumbar joint kinematics, joint moments and compression forces were computed using OpenSim modelling software and a musculoskeletal model. Histograms were used to illustrate the joint angle and load distribution of the neck and lumbar joints over time. During open surgery, the neck flexion angle was 71.6% of the total duration in the range of 10~40 degrees, and lumbar flexion was 68.9% of the duration in the range of 10~30 degrees. The normalized neck and lumbar flexion moments were 53.8% and 35.5% of the time in the range of 0.04~0.06 Nm/kg and 0.4~0.6 Nm/kg, respectively. Furthermore, the neck and lumbar compression forces were 32.9% and 38.2% of the time in the range of 2.0~2.5 N/kg and 15~20 N/kg, respectively. In contrast to exoskeletons used for heavy lifting tasks, exoskeletons designed for surgeons exhibit lower support torque requirements while additional degrees of freedom (DOF) are needed to accommodate combinations of neck and trunk postures.
Topics: Lumbar Vertebrae; Joints; Posture; Lumbosacral Region; Neck; Biomechanical Phenomena
PubMed: 37571757
DOI: 10.3390/s23156974 -
Systematic Reviews Oct 2021Numerous studies report changes in neuromuscular control in people with low back pain (LBP). However, the relationship between pain and altered neuromuscular control is...
BACKGROUND
Numerous studies report changes in neuromuscular control in people with low back pain (LBP). However, the relationship between pain and altered neuromuscular control is challenging to unravel given the heterogeneity that exists in clinical populations. One approach commonly adopted to overcome this issue is the use of experimental pain models, but it is currently unclear if the effects of experimental pain are consistent between studies. Therefore, this planned study will systematically evaluate and summarise the effect of experimentally induced pain in the lumbar region on neuromuscular control at sites both locally and remote to the low back.
METHODS
This protocol has been developed following the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). MEDLINE, EMBASE, CINAHL, ZETOC, Web of Science, and grey literature will be searched up to August 31, 2021. Screening processes (title/abstract and full-text), data extraction, and risk of bias assessment will be conducted by two independent reviewers. Studies investigating the effects of exogenous pain models delivered to the low back region on neuromuscular control in healthy individuals will be included. Muscle activity and body kinematics will be the outcomes of interest. The comparisons of interest will be between baseline or control conditions and the experimental pain condition, as well as between the experimental pain and post-pain conditions. Randomised crossover and non-randomised studies of interventions will be included and their risk of bias will be evaluated with the Cochrane Risk-of-Bias tool or with the Risk Of Bias In Non-randomised Studies of Interventions tool, respectively. A random-effect meta-analysis will be conducted for quantitative synthesis when clinical and methodological consistency is ensured. Quality of evidence will be evaluated using the Grading of Recommendations, Assessment, Development and Evaluation guidelines.
DISCUSSION
The current review will provide new insights to understand if and what neuromuscular adaptations are caused by pain experimentally induced in the lumbar region. Our findings will reveal which experimental pain model is able to better reproduce adaptations similar to those identified in people with low back pain, possibly contributing to improving our understanding of motor adaptation to low back pain in the long term.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO CRD42020220130.
Topics: Biomechanical Phenomena; Humans; Low Back Pain; Lumbosacral Region; Meta-Analysis as Topic; Review Literature as Topic; Systematic Reviews as Topic
PubMed: 34654481
DOI: 10.1186/s13643-021-01831-1 -
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