The relevance of high-intensity zones in degenerative disc disease

ConclusionsHIZ are likely a risk factor for discogenic LBP. However, its etiology and pathophysiology are not well understood. Some clinical studies suggest a link between its occurrence and LBP. However, the results are not consistent as a result of studies which are underpowered and based on heterogeneous study populations, lacking control groups, and without standardized imaging phenotypes. HIZ may be an important pain biomarker that should be further studied. With more modern MRI technology and a detailed classification system, future large-scale population studies will improve our knowledge on its role in the disc degeneration cascade and development of LBP.
Source: International Orthopaedics - Category: Orthopaedics Source Type: research

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In rare cases low back pain (LBP) may be caused by underlying serious pathology such as fracture, malignancy, cauda equina syndrome or spinal infection. The lack of evidence regarding either the clinical prevalence or population incidence of serious pathologies in the lumbar spine makes it difficult for clinicians to adequately assess a patient's risk of serious pathology.
Source: The Spine Journal - Category: Orthopaedics Authors: Source Type: research
En reiseglad 80-åring med ryggsmerter og vekttap. Tidsskr Nor Laegeforen. 2019 Sep 10;139(12): Authors: Leknesund SH, Finjord T, Jordal S Abstract BACKGROUND: This case report presents one of the first documented incidents of chronic Q-fever (C. burnetii) in Norway. A comprehensive workup resulted in an unexpected finding. CASE PRESENTATION: A Norwegian woman in her eighties presented to a district general hospital with lower back pain, decreased general condition and weight loss. Computer tomography (CT) revealed a large thoracic aortic aneurysm presumed to be of mycotic origin, and later ...
Source: Tidsskrift for den Norske Laegeforening - Category: General Medicine Authors: Tags: Tidsskr Nor Laegeforen Source Type: research
Study Design. Cross-sectional. Objective. We quantified fatty infiltration (FI) geography of the lumbar spine to identify whether demographics, temporal low back pain (LBP), and disability influence FI patterns. Summary of Background Data. Lumbar paravertebral muscle FI has been associated with age, sex, LBP, and disability; yet, FI accumulation patterns are inadequately described to optimize interventions. Methods. This cross-sectional study employed lumbar axial T1-weighted magnetic resonance imaging in 107 Southern-Chinese adults (54 females, 53 males). Single-slices at the vertebral inferior end-plate per lu...
Source: Spine - Category: Orthopaedics Tags: CLINICAL CASE SERIES Source Type: research
Conclusions The transforaminal endoscopic sequestrectomy can be safely implemented in a university hospital setting in selected patients with primary and recurrent lumbar disk herniations, and it leads to good clinical and radiologic results. However, learning curve, caseload, and residents' microsurgical training requirements clearly affect the implementation process. [...] Georg Thieme Verlag KG Stuttgart · New YorkArticle in Thieme eJournals: Table of contents  |  Abstract  |  Full text
Source: Journal of Neurological Surgery Part A: Central European Neurosurgery - Category: Neurosurgery Authors: Tags: Original Article Source Type: research
CONCLUSION: Compared with sham or no traction, lumbar traction exhibited significantly more pain reduction and functional improvements in the short term, but not in the long term. There is insufficient evidence to support the effect of lumbar traction on herniated disk size reduction. PMID: 31456418 [PubMed - as supplied by publisher]
Source: Clinical Rehabilitation - Category: Rehabilitation Authors: Tags: Clin Rehabil Source Type: research
Cauda equina syndrome (CES) is defined as the severe compression of the cauda equina resulting in loss of lower sacral nerve root function. There are no studies to date that demonstrate whether physical examination can accurately diagnose CES, therefore providers feel obligated to order magnetic resonance imaging (MRI) studies on patients reporting bowel or bladder dysfunction with associated low back pain to rule out a diagnosis of CES.
Source: The Spine Journal - Category: Orthopaedics Authors: Source Type: research
Conclusion: The case highlights the diagnostic challenges of co-existent OTB-ABC and the significant role of surgical management  via spinal reconstruction, stabilization and fusion after gross total tumour excision.Keywords: Osteoblastoma, aneurysmal bone cyst, lumbar vertebra, paediatric, instrumented fusion.
Source: African Health Sciences - Category: African Health Source Type: research
Conclusion. MCs were not found to be negatively associated with long-term pain, disability, or sick leave. Rather, the study found that LBP patients with MCs had significantly less disability and sick-leave at long-term follow-up. We encourage further studies to elucidate these findings. Level of Evidence: 2
Source: Spine - Category: Orthopaedics Tags: CLINICAL CASE SERIES Source Type: research
Study Design. A cross-sectional, retrospective cohort study. Objective. To examine the prevalence of the pedicle stress injury, spondylolysis in children and adolescents with low back pain. And secondly, to test the hypothesis that these pathologies are associated with lumbar lordosis angle. Summary of Background Data. The prevalence of the pedicle stress injury has not been investigated in children with low back pain. In recent studies, lumbar lordosis angle was associated with spondylolysis, on the other hand the pedicle stress injury was not investigated yet. Methods. In this retrospective study, 789 consecut...
Source: Spine - Category: Orthopaedics Tags: DIAGNOSTICS Source Type: research
ConclusionsThe present case is therefore a good example of overtreatment which may lead to delicate questions, investigating any possible mistakes in the diagnosis procedure as well as the role that defensive medicine is playing nowadays on medical procedures and the economic impact that all this can have on our healthcare system. In the end, we may ask ourselves: is “less” better or is “more” always “more?”
Source: Neurological Sciences - Category: Neurology Source Type: research
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