Lumbar spine abnormalities in patients with obstructive sleep apnoea

Treatment method selection for sleep quality due to lumbar DISC herniation: Early surgery or others?; A single center clinical trial

BACKGROUND/AIM

Sleep deprivation may lead to individual and social insufficiency associated with many physiological and psychological pathologies. This study is reported to investigate sleep quality and the relationship between treatment modalities of lumbar disc herniation, which is the most common cause of chronic lower back pain and sciatica.

MATERIALS AND METHODS

This present study was conducted on 249 cases with chronic lower back pain and sciatica caused by a single- level lumbar disc herniation diagnosed after lumbar MRI (Magnetic Resonance Imaging) between June 2017 and September 2019. Cases were divided into three groups according to the treatment modalities: early surgical treatment (n:80), extended conservative treatment (n:142), and medical treatment only (n:27). VAS (Visual Analog Scale) and PSQI (Pittsburgh Sleep Quality Index) data before the treatment and 6 months after the treatment were statistically analyzed.

RESULTS

It was determined that post-treatment VAS and PSQI scores were significantly reduced in all cases, regardless of the differences in treatment modalities (p < 0.05). In the early surgical treatment group, VAS score was improved by 69% and PSQI score was improved by 63.8%. These values were 28.5% and 38.6% in the extended conservative treatment. However, VAS score was increased by 27% in the patients who received only medical treatment. Statistical analysis of the treatment modalities showed that early surgical treatment was superior to the other treatment modalities (p < 0.05).

CONCLUSIONS

It was determined that early surgical treatment of lumbar disc herniation was superior to other treatment methods in terms of maintaining the sleep quality impairments associated with deterioration in sleep quality.

Bone mineral density alteration in obstructive sleep apnea by derived computed tomography screening

The association between obstructive sleep apnea (OSA) and bone mineral density (BMD) is poorly elucidated and has contradictory findings. Abdominal computed tomography (CT) for other indications can provide a valuable opportunity for osteoporosis screening. Thus, we retrospectively explored the association between OSA and BMD by examining abdominal CT vertebrae images for a multitude of conditions and indications. We included 315 subjects (174 with OSA and 141 without OSA) who performed at least two CT scans (under similar settings). Both groups had a similar duration between the first and second CT scans of 3.6 years. BMD decreased in those with OSA and increased age. A multivariate linear regression indicated that OSA is associated with BMD alterations after controlling for age, gender, and cardiovascular diseases. Here, we report that OSA is associated with BMD alterations. Further studies are required to untangle the complex affect of OSA on BMD and the possible clinical implications of vertebra-depressed or femoral neck fractures.