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Scientific Reports Feb 2021Pedicle subtraction osteotomy (PSO) is an invasive surgical technique allowing the restoration of a well-balanced sagittal profile, however, the risks of pseudarthrosis...
Pedicle subtraction osteotomy (PSO) is an invasive surgical technique allowing the restoration of a well-balanced sagittal profile, however, the risks of pseudarthrosis and instrumentation breakage are still high. Literature studied primary stability and posterior instrumentation loads, neglecting the load shared by the anterior column, which is fundamental to promote fusion early after surgery. The study aimed at quantifying the load-sharing occurring after PSO procedure across the ventral spinal structures and the posterior instrumentation, as affected by simple bilateral fixation alone, with interbody cages adjacent to PSO level and supplementary accessory rods. Lumbar spine segments were loaded in vitro under flexion-extension, lateral bending, and torsion using an established spine tester. Digital image correlation (DIC) and strain-gauge (SG) analyses measured, respectively, the full-field strain distribution on the ventral surface of the spine and the local strain on posterior primary rods. Ventral strains considerably decreased following PSO and instrumentation, confirming the effectiveness of posterior load-sharing. Supplemental accessory rods considerably reduced the posterior rod strains only with interbody cages, but the ventral strains were unaffected: this indicates that the load transfer across the osteotomy could be promoted, thus explaining the higher fusion rate with decreased rod fracture risk reported in clinical literature.
Topics: Biomechanical Phenomena; Biophysics; Female; Humans; Lordosis; Lumbar Vertebrae; Lumbosacral Region; Male; Middle Aged; Osteotomy; Pedicle Screws; Range of Motion, Articular; Spinal Fusion
PubMed: 33574504
DOI: 10.1038/s41598-021-83251-8 -
PM & R : the Journal of Injury,... Feb 2020It is assumed that the lumbar movement pattern observed during a clinical test is representative of the movement pattern used during a functional activity. Very little... (Observational Study)
Observational Study
BACKGROUND
It is assumed that the lumbar movement pattern observed during a clinical test is representative of the movement pattern used during a functional activity. Very little is known about how the lumbar movement pattern during a clinical test is associated with the lumbar movement pattern during a functional activity and how the lumbar movement pattern is associated with functional limitation.
OBJECTIVE
The purpose was to examine the lumbar movement pattern during a clinical test and a functional activity test in people with and people without low back pain (LBP), and the relationship of lumbar motion to LBP-related functional limitation.
DESIGN
Observational study.
PARTICIPANTS
16 back-healthy adults and 32 people with chronic LBP.
METHODS
Participants performed a standardized clinical test of forward bending and a functional activity test of picking up an object.
MAIN OUTCOME MEASUREMENTS
Maximal lumbar excursion and lumbar excursion at 0% to 50% and 50% to 100% of movement time were examined.
RESULTS
Significant associations were present between the two movement tests for both back-healthy people and people with LBP (r = 0.47-0.73). In people with LBP the amount of lumbar motion in the 0% to 50% of movement time interval for both tests was significantly associated with functional limitation (r = 0.43-0.62).
CONCLUSION
Lumbar movement patterns were similar between the two tests, and lumbar motion early in the movement of a functional test was related to self-report of functional limitation.
LEVEL OF EVIDENCE
III.
Topics: Adult; Biomechanical Phenomena; Female; Humans; Low Back Pain; Lumbar Vertebrae; Lumbosacral Region; Male; Movement; Range of Motion, Articular; Young Adult
PubMed: 31140705
DOI: 10.1002/pmrj.12197 -
Scientific Reports Apr 2018Surface electromyography (sEMG) studies have indicated that chronic low back pain (cLBP) involves altered electromyographic activity and morphological structure of the...
Surface electromyography (sEMG) studies have indicated that chronic low back pain (cLBP) involves altered electromyographic activity and morphological structure of the lumbar multifidus (LM) beyond pain perception; however, most studies have evaluated the superficial lumbar multifidus. It is difficult to record electromyography (EMG) signals from the deep multifidus (DM) to determine the neuromuscular activation patterns, making it difficult to determine the relationship between functional and structural changes in cLBP. We developed a novel method to record intramuscular EMG signals in the DM based on the sEMG system and fine-wire electrodes. We measured EMG signals of the DM in 24 cLBP patients and 26 pain-free healthy controls to identify changes in neuromuscular activation. We also used ultrasound to measure DM muscle thickness, cross-sectional area, and contraction activity to identify potential relationships between EMG activity and structural damage. cLBP patients had decreased average EMG and root mean square, but increased median frequency and mean power frequency. Average EMG was positively correlated with contractile activity, but not statistically correlated with noncontractile anatomical abnormalities. Our results suggest that cLBP alters the neuromuscular activation patterns and morphological structure of the contractile activity of the DM, providing insights into the mechanisms underlying pain perception.
Topics: Adult; Electrodes; Electromyography; Female; Humans; Low Back Pain; Lumbosacral Region; Male; Muscle Contraction; Muscle, Skeletal; Ultrasonography
PubMed: 29695727
DOI: 10.1038/s41598-018-24550-5 -
Applied Ergonomics Jul 2023This study aimed to analyze the position of the lumbopelvic region and lumbar muscle activity in the most common breastfeeding positions. We recorded the curvatures of...
This study aimed to analyze the position of the lumbopelvic region and lumbar muscle activity in the most common breastfeeding positions. We recorded the curvatures of the lumbar spine and pelvis by means of an electrogoniometer, and the muscle activation levels of the erector spinae with electromyography, in 34 women in erect standing and breastfeeding their children in several positions. Both side lying and clutch-hold positions showed a greater degree of lumbar spine flexion compared to standing. In all sitting postures it was observed that the pelvis was placed in retroversion when compared to standing and side lying. In muscle activity, it was observed that the activation intensity of the right erector in the right side-supported side lying position was significantly lower compared to the rest of breastfeeding postures and standing. Side lying may be a better position to avoid muscle fatigue.
Topics: Child; Humans; Female; Breast Feeding; Lumbosacral Region; Muscles; Posture; Electromyography; Lumbar Vertebrae; Biomechanical Phenomena; Muscle, Skeletal
PubMed: 37075644
DOI: 10.1016/j.apergo.2023.104029 -
Spine Aug 2020
Topics: Gene Expression; Humans; Lumbar Vertebrae; Lumbosacral Region; Paraspinal Muscles
PubMed: 32675621
DOI: 10.1097/BRS.0000000000003576 -
Journal of Orthopaedic Surgery and... Nov 2023Although oblique lumbar interbody fusion (OLIF) has produced good results for lumbar degenerative diseases (LDDs), its efficacy vis-a-vis posterior lumbar interbody... (Meta-Analysis)
Meta-Analysis
Comparison between oblique lumbar interbody fusion and posterior lumbar interbody fusion for the treatment of lumbar degenerative diseases: a systematic review and meta-analysis.
BACKGROUND
Although oblique lumbar interbody fusion (OLIF) has produced good results for lumbar degenerative diseases (LDDs), its efficacy vis-a-vis posterior lumbar interbody fusion (PLIF) remains controversial. This meta-analysis aimed to compare the clinical efficacy of OLIF and PLIF for the treatment of LDDs.
METHODS
A comprehensive assessment of the literature was conducted, and the quality of retrieved studies was assessed using the Newcastle-Ottawa Scale. Clinical parameters included the visual analog scale (VAS), and Oswestry Disability Index (ODI) for pain, disability, and functional levels. Statistical analysis related to operative time, intraoperative bleeding, length of hospital stay, lumbar lordosis angle, postoperative disc height, and complication rates was performed. The PROSPERO number for the present systematic review is CRD42023406695.
RESULTS
In total, 574 patients (287 for OLIF, 287 for PLIF) from eight studies were included. The combined mean postoperative difference in ODI and lumbar VAS scores was - 1.22 and - 0.43, respectively. In postoperative disc, height between OLIF and PLIF was 2.05. The combined advantage ratio of the total surgical complication rate and the mean difference in lumbar lordosis angle between OLIF and PLIF were 0.46 and 1.72, respectively. The combined mean difference in intraoperative blood loss and postoperative hospital stay between OLIF and PLIF was - 128.67 and - 2.32, respectively.
CONCLUSION
Both the OLIF and PLIF interventions showed good clinical efficacy for LDDs. However, OLIF demonstrated a superior advantage in terms of intraoperative bleeding, hospital stay, degree of postoperative disc height recovery, and postoperative complication rate.
Topics: Humans; Lordosis; Spinal Fusion; Lumbar Vertebrae; Treatment Outcome; Lumbosacral Region; Retrospective Studies
PubMed: 37950267
DOI: 10.1186/s13018-023-04312-4 -
American Journal of Biological... Apr 2022Despite the high frequency of segmentation anomalies in the human sacrum, their evolutionary and clinical implications remain controversial. Specifically,...
OBJECTIVES
Despite the high frequency of segmentation anomalies in the human sacrum, their evolutionary and clinical implications remain controversial. Specifically, inconsistencies involving the classification and counting methods obscure accurate assessment of lumbosacral transitional vertebrae. Therefore, we aim to establish more reliable morphological and morphometric methods for differentiating between sacralizations and lumbarizations in clinical and paleontological contexts.
MATERIALS AND METHODS
Using clinical CT data from 145 individuals aged 14-47 years, vertebral counts and the spatial relationship between the sacrum and adjoining bony structures were assessed, while the morphological variation of the sacrum was assessed using geometric morphometrics based on varied landmark configurations.
RESULTS
The prevalence of lumbosacral and sacrococcygeal segmentation anomalies was 40%. Lumbarizations and sacralizations were reliably distinguishable based on the spatial relationship between the iliac crest and the upward or downward trajectory of the linea terminalis on the sacrum. Different craniocaudal orientations of the alae relative to the corpus of the first sacral vertebra were also reflected in the geometric morphometric analyses. The fusion of the coccyx (32%) was frequently coupled with lumbarizations, suggesting that the six-element sacra more often incorporate the coccyx rather than the fifth lumbar vertebra.
CONCLUSIONS
Our approach allowed the consistent identification of segmentation anomalies even in isolated sacra. Additionally, our outcomes either suggest that homeotic border shifts often affect multiple spinal regions in a unidirectional way, or that sacrum length is highly conserved perhaps due to functional constraints. Our results elucidate the potential clinical, biomechanical, and evolutionary significance of lumbosacral transitional vertebrae.
Topics: Humans; Sacrum; Lumbar Vertebrae; Spinal Diseases; Lumbosacral Region; Ilium; Musculoskeletal Abnormalities
PubMed: 36787761
DOI: 10.1002/ajpa.24466 -
PeerJ 2022Workers who perform repetitive movements are exposed to many risk factors leading to the occurrence of lumbar back pain. The aim of the research was to answer the...
PURPOSE
Workers who perform repetitive movements are exposed to many risk factors leading to the occurrence of lumbar back pain. The aim of the research was to answer the question whether the ergonomic instruction conducted by a physiotherapist would change the tested range of motion of the segments of lumbar spine and the symmetry of the work of the torso and upper limbs muscles during work performed by foundry employees.
METHODS
The study included 12 foundry production line workers with musculoskeletal pain. The workstation was built in the laboratory that perfectly simulates work on the production line. The workers performed two activities from their daily work, i.e. transferring and moving a casting. They were then given ergonomic instruction by a physiotherapist and performed the assigned tasks again. During the activities, the electromyographic signal from five muscles was recorded in terms of symmetry of their work. The maximum angular ranges of the motor segments of the lumbar spine were measured using gyroscopes.
RESULTS
After the ergonomic instruction, the contralateral imbalance of muscle activity decreased statistically significantly during the first phase ( = 0.0004), second phase ( = 0.0002) and the third phase ( = 0.0069) of transferring the casting. While moving the casting , only erector spinae showed statistically significantly ( = 0.0131) more symmetrical work after the ergonomic instruction. During the transfer of the casting, statistically significantly lower values of the ranges of motion between the segments were obtained after carrying out the ergonomic instruction for the left ( = 0.0231) and right ( = 0.0032) lateral flexion. The ranges of movement between the segments differed statistically significantly for the flexion ( = 0.0117), extension ( = 0.0469) and left ( = 0.0031) and right lateral flexion movements ( = 0.0012).
CONCLUSION
Conducting ergonomic instruction consisting in teaching the correct performance of a movement task reduced the contralateral imbalance of muscle activity and changes the ranges of movement of L1-S1 segments. The task of optimizing the load on the musculoskeletal system, including the lumbar spine, should be carried out by means of appropriate ergonomic instruction and multi-pronged measures, including analysis of the health of employees, their working environment and physical activity outside the workplace. Electromyography and measurements of the range of movement of the lumbar spine appear to be good tools for the evaluation of workplace ergonomics.
Topics: Humans; Electromyography; Biomechanical Phenomena; Lumbar Vertebrae; Lumbosacral Region; Ergonomics
PubMed: 35321411
DOI: 10.7717/peerj.13072 -
Orthopaedic Surgery May 2013To study the methods for constructing a digitized three-dimensional (3D) model of a virtual lumbar region and its adjacent structures in order to assist anatomical study...
OBJECTIVE
To study the methods for constructing a digitized three-dimensional (3D) model of a virtual lumbar region and its adjacent structures in order to assist anatomical study and virtual surgery.
METHODS
Images of DSCF5375-p1 to DSCF5745-p1 were taken from the database of the digitized Virtual Chinese human of Southern Medical University in Guangzhou. This region encompasses the superior facet joint of L4 to the inferior edge of the intervertebral body of L5. The regions of interest were interactively segmented from the images utilizing Adobe Photoshop software. The images were further processed using format conversion and segmentation. Finally, a 3D model of the L4-5 region and its neighboring structures was reconstructed with the assistance of Mimics 10.01 software.
RESULTS
A digitized 3D model of this part of the virtual lumbar spine and its adjacent structures was reconstructed. This model allows all constructed structures to be displayed individually or jointly, moved or rotated arbitrarily, setting of different transparencies and convenient measurement of the diameters and angles of the reconstructed structures. The 3D model precisely displays the anatomical relationships between all structures and provides a reliable 3D model for a spinal endoscopic surgery simulation system.
CONCLUSION
Visualization of the digitized 3D reconstruction of the virtual lower lumbar region displays this region and its adjacent structures stereoscopically and in actuality, thus providing morphological data concerning anatomy, image diagnosis and virtual operations in this region.
Topics: China; Female; Humans; Imaging, Three-Dimensional; Lumbosacral Region; Orthopedic Procedures; Patient Simulation; Rotation; Software; User-Computer Interface; Visible Human Projects; Young Adult
PubMed: 23658049
DOI: 10.1111/os.12036 -
Medical Ultrasonography Feb 2018Patients with low back pain (LBP) frequently undergo various imaging studies in the pursuit of a more precise diagnosis. Ultrasound (US) has the advantage of being a... (Review)
Review
Patients with low back pain (LBP) frequently undergo various imaging studies in the pursuit of a more precise diagnosis. Ultrasound (US) has the advantage of being a widely available, multiplanar, fast and radiation-free diagnostic tool. Moreover, compared to most of the other imaging modalities, it is particularly efficient in the visualization and assessment of soft tissues. Consequently, the question about the possible diagnostic application of US in such a common pathology as LBP is very relevant to the clinical practice. For this reason, we performed a review of the literature on the diagnostic value of US in differentconditions that could cause LBP. We hereby discuss available studies on the diagnostic application of US in spinal canal stenosis and disc herniation (probably of historical significance only), as well as in the pathology of soft tissue structures like the lumbar and pelvic ligaments, muscles and entheses, the thoracolumbar fascia and the sacroiliac joints (maybe of greater importance nowadays). The evidence for the diagnostic value of US is not equivocal, though promising for some of the causative conditions, and clearly this area remains open to further research.
Topics: Back Muscles; Humans; Ligaments, Articular; Low Back Pain; Lumbosacral Region; Spinal Diseases; Ultrasonography
PubMed: 29400373
DOI: 10.11152/mu-1245