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Adar S, Apaydın O, Dündar U, Toktas H, Yesil H, Eroglu S, Eyvaz N. Comparison of the Effectiveness of Traditional Motorized Traction and Non-surgical Spinal Decompression Therapy Added to Conventional Physiotherapy for Treatment of Chronic Low Back Pain. Cureus 2024; 16:e69610. [PMID: 39318658 PMCID: PMC11420602 DOI: 10.7759/cureus.69610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/17/2024] [Indexed: 09/26/2024] Open
Abstract
BACKGROUND There are a limited number of studies comparing traditional motorized traction and non-surgical spinal decompression with other treatment options such as conventional motor traction in the treatment of low back pain caused by lumbar discopathy. This retrospective study aimed to compare the effectiveness of these treatments. METHODS The retrospective data of patients diagnosed with lumbar discopathy who underwent physical therapy in our clinic were reviewed. Demographic data, duration of their symptoms, physical examination findings, lumbosacral magnetic resonance imaging (MRI) reports, method and duration of treatment, and visual analog scale (VAS) and Oswestry Disability Index (ODI) results were recorded. RESULTS A total of 160 patients met the inclusion criteria. Their mean age was 44.6±12.4 (range 21-65) years, 57.5% (n=92) were female, and 42.5% (n=68) were male. There were no differences between the conventional physiotherapy, motorized traction, and spinal decompression groups in terms of age, duration of symptoms, and the number of sessions (p>0.05). In all three groups, the mean scores of VAS and ODI were significantly decreased in the pre-and post-treatment comparisons (p<0.005). The rates of change in VAS and ODI were higher in the traction group and spinal decompression group compared to the conventional treatment (p<0.005). CONCLUSION In patients with subacute and chronic lumbar discopathies, motorized traction and spinal decompression treatments added to conventional treatment were found to be more effective than conventional treatment alone. The results of spinal decompression and conventional motorized traction treatments appear to be similar.
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Affiliation(s)
- Sevda Adar
- Physical Medicine and Rehabilitation, Afyonkarahisar Health Sciences University, Afyonkarahisar, TUR
| | - Onurhan Apaydın
- Physical Medicine and Rehabilitation, Afyonkarahisar Health Sciences University, Afyonkarahisar, TUR
| | - Umit Dündar
- Physical Medicine and Rehabilitation, Afyonkarahisar Health Sciences University, Afyonkarahisar, TUR
| | - Hasan Toktas
- Physical Medicine and Rehabilitation, Afyonkarahisar Health Sciences University, Afyonkarahisar, TUR
| | - Hilal Yesil
- Physical Medicine and Rehabilitation, Afyonkarahisar Health Sciences University, Afyonkarahisar, TUR
| | - Selma Eroglu
- Physical Medicine and Rehabilitation, Afyonkarahisar Health Sciences University, Afyonkarahisar, TUR
| | - Nuran Eyvaz
- Physical Medicine and Rehabilitation, Afyonkarahisar Health Sciences University, Afyonkarahisar, TUR
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Miryutova NF, Badalov NG, Gameeva EV, Stepanova AM. [Effectiveness of spinal traction in degenerative spine diseases. (A literature review)]. VOPROSY KURORTOLOGII, FIZIOTERAPII, I LECHEBNOI FIZICHESKOI KULTURY 2024; 102:60-69. [PMID: 39248588 DOI: 10.17116/kurort202410104160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/10/2024]
Abstract
Back pain is one of the most urgent healthcare problems in many countries of the world. The high prevalence of the disease among persons of working age, the high disability indices and the high economic losses determine the relevance of this problem and its epidemiological and socio-economic significance. OBJECTIVE To analyze sources of scientific and technical literature and study materials of meta-analyses, systematic reviews on the issues of evaluation of the spinal traction effectiveness (dry and underwater, horizontal and vertical) in the treatment of patients with degenerative spine diseases. MATERIAL AND METHODS An analysis of 67 sources, including 54 periodical articles, 5 meta-analyses and 8 systematic reviews was conducted. The search depth was 20 years. RESULTS The ability of the spinal traction method to influence on the pain intensity, functional state, general improvement or return to work in patients with degenerative spine diseases has been identified. There has been a statistically significant regression of lumbar and radicular pain under the influence of «dry» horizontal tractions of the spine (13389 patients with degenerative spine diseases received them), including in combination with physiotherapy (vibration, impulse currents, laser therapy), and there has been an improvement in the motor function of the spine, a decrease in the disability rate in patients with herniated disks. These results were also obvious in short-term observation (up to 3 months after intervention). Underwater traction (5533 patients received it) had a positive impact on pain syndrome at rest and during activity, increased the activity of patients. All registered effects were related to short-term effect for up to 3 months after the intervention. CONCLUSION The evidence, based on the materials of meta-analyses and systematic reviews of medium and low quality, that «dry» and underwater spinal traction can be considered as a therapeutic tool for short-term (within 3 months) reducing pain and disability in patients with lumbar pain and lumbar radiculopathy, is presented.
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Affiliation(s)
- N F Miryutova
- Federal Scientific and Clinical Center of Medical Rehabilitation and Balneology of the Federal Medical-Biological Agency, Moscow, Russia
| | - N G Badalov
- Federal Scientific and Clinical Center of Medical Rehabilitation and Balneology of the Federal Medical-Biological Agency, Moscow, Russia
| | - E V Gameeva
- Federal Scientific and Clinical Center of Medical Rehabilitation and Balneology of the Federal Medical-Biological Agency, Moscow, Russia
| | - A M Stepanova
- Federal Scientific and Clinical Center of Medical Rehabilitation and Balneology of the Federal Medical-Biological Agency, Moscow, Russia
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Feng Y, Ma Y, Lai J, Wang C, Ma X, Liu J. Influence of rapid recovery nutritional support on functional recovery and hospitalization duration in patients undergoing minimally invasive lumbar surgery. Am J Transl Res 2023; 15:7023-7034. [PMID: 38186983 PMCID: PMC10767528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 09/24/2023] [Indexed: 01/09/2024]
Abstract
OBJECTIVE To examine the impact of a nutrition support model, specifically focused on rapid recovery, on postoperative recovery in patients with degenerative lumbar spinal stenosis who underwent minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF). METHODS A retrospective analysis was conducted, utilizing the medical records of 114 patients with degenerative lumbar spinal stenosis who underwent MIS-TLIF at the Affiliated Hospital of Gansu University of Chinese Medicine from February 2020 to October 2022. Among these patients, 63 individuals received a nutrition support model based on the concept of rapid recovery, comprising the observation group, while the remaining 51 patients received conventional postoperative support, forming the control group. The study compared the post-intervention lumbar function recovery, postoperative pain score, perioperative hospital stay, and patient satisfaction with nursing work between the two groups. RESULTS There was no statistically significant difference in the Japanese Orthopaedic Association (JOA) score and Oswestry Disability Index (ODI) at 6 months after the intervention between the two groups (P>0.05). Similarly, there was no statistically significant difference in the modified Barthel index and visual analog scale scores at 6 months after the intervention between the two groups (P>0.05). In terms of operation time and intraoperative blood loss, there was no statistically significant difference observed between the observation group and the control group (P>0.05). However, when compared to the control group, the observation group showed significant shorter hospital stay and time to ambulation after the intervention, leading to a decrease in treatment cost (P<0.01). Multivariate logistic regression analysis revealed that age, history of diabetes, nursing plan, operation time, and preoperative JOA score were identified as independent risk factors for prolonged hospital stay (P<0.05). CONCLUSION The nutrition support model, which is based on the concept of rapid recovery, has been found to have several benefits for patients with degenerative lumbar spinal stenosis undergoing MIS-TLIF. These benefits include reducing the hospital stay, treatment cost, and the time to ambulation. Additionally, logistic regression analysis has identified several independent risk factors that can affect the length of hospital stay. These risk factors include age, history of diabetes, nursing plan, operation time, and preoperative JOA score.
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Affiliation(s)
- Yiyun Feng
- Department of Spine Surgery, Elderly Orthopedics, Affiliated Hospital of Gansu University of Chinese MedicineNo. 732, Jiayu Pass West Road, Chengguan District, Lanzhou 730020, Gansu, China
| | - Yanan Ma
- Department of Spine Surgery, Elderly Orthopedics, Affiliated Hospital of Gansu University of Chinese MedicineNo. 732, Jiayu Pass West Road, Chengguan District, Lanzhou 730020, Gansu, China
| | - Jifang Lai
- Department of Joint Movement, Affiliated Hospital of Gansu University of Chinese MedicineNo. 732, Jiayu Pass West Road, Chengguan District, Lanzhou 730020, Gansu, China
| | - Chunyan Wang
- Department of Spine Surgery, Elderly Orthopedics, Affiliated Hospital of Gansu University of Chinese MedicineNo. 732, Jiayu Pass West Road, Chengguan District, Lanzhou 730020, Gansu, China
| | - Xiaoyan Ma
- Department of Spine Surgery, Elderly Orthopedics, Affiliated Hospital of Gansu University of Chinese MedicineNo. 732, Jiayu Pass West Road, Chengguan District, Lanzhou 730020, Gansu, China
| | - Jing Liu
- Department of Trauma Orthopedics, Pediatric Orthopedics, Emergency Surgery, Affiliated Hospital of Gansu University of Chinese MedicineNo. 732, Jiayu Pass West Road, Chengguan District, Lanzhou 730020, Gansu, China
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Ratajczak M, Waszak M, Śliwicka E, Wendt M, Skrypnik D, Zieliński J, Krutki P. In search of biomarkers for low back pain: can traction therapy effectiveness be prognosed by surface electromyography or blood parameters? Front Physiol 2023; 14:1290409. [PMID: 38143914 PMCID: PMC10739392 DOI: 10.3389/fphys.2023.1290409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 11/17/2023] [Indexed: 12/26/2023] Open
Abstract
Background: Lumbar traction therapy is a common method to reduce low back pain (LBP) but is not always effective. The search for biomarkers that would prognose the effectiveness of LBP management is one priority for improving patients' quality of life. Objectives: 1) To determine the phenotype of patients benefiting most from lumbar traction therapy. 2) To correlate systemic and electromyographic biomarkers with pain and pain-related disability. Methods: Data on muscle bioelectrical activity (surface electromyography [SEMG]) in the flexion-extension task, the concentrations of twelve systemic biochemical factors, LBP intensity (Visual Analog Scale), the Oswestry Disability Index, and the Roland-Morris Disability Questionnaire (RMDQ) were collected before and 72 h after 20 sessions of lumbar traction therapy. Patients were divided into responders and nonresponders based on the criterion of a 50% reduction in maximal pain. Results: The responders had lower maximal muscle bioactivity in the extension phase on the left side (p < 0.01) and higher flexion-extension ratios on both sides of the body in the SEMG (left: p < 0.05; right: p < 0.01), and higher adipsin, interleukin-2, interleukin-4, and interleukin-10 concentrations (p < 0.05) than nonresponders. Patients with higher interleukin-4 concentrations before therapy achieved greater reductions in maximal pain in the sitting position, bioelectrical muscle activity in flexion, and flexion-relaxation ratio on the left side of the body. Changes in adipsin and interleukin-4 concentrations correlated with changes in LBP intensity (r = 0.68; r = -0.77). Changes in stem cell growth factor and interleukin-17A correlated with changes in RMDQ (R = 0.53) and bioelectrical muscle activity in extension (left: R = -0.67; right: R = -0.76), respectively. Conclusion: Responders to traction therapy had SEMG indices of less favorable muscle activity in the flexion-extension task and elevated indices of inflammation before the study. For the first time, interleukin-4 was indicated as a potential biomarker for prognosing post-therapy changes in pain intensity and muscle activity.
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Affiliation(s)
- Marzena Ratajczak
- Department of Medical Biology, Poznan University of Physical Education, Poznan, Poland
| | - Małgorzata Waszak
- Department of Medical Biology, Poznan University of Physical Education, Poznan, Poland
| | - Ewa Śliwicka
- Department of Physiology and Biochemistry, Poznan University of Physical Education, Poznan, Poland
| | - Michał Wendt
- Department of Medical Biology, Poznan University of Physical Education, Poznan, Poland
| | - Damian Skrypnik
- Department of Treatment of Obesity, Metabolic Disorders and Clinical Dietetics, Poznan University of Medical Sciences, Poznan, Poland
| | - Jacek Zieliński
- Department of Athletics, Strength and Conditioning, Poznan University of Physical Education, Poznan, Poland
| | - Piotr Krutki
- Department of Medical Biology, Poznan University of Physical Education, Poznan, Poland
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Ratajczak M, Wendt M, Śliwicka E, Skrypnik D, Zieliński J, Kusy K, Krutki P, Waszak M. Subjective assessment and biochemical evaluation of traction therapy in women with chronic low back pain: does body mass index matter? A clinical study. BMC Musculoskelet Disord 2023; 24:196. [PMID: 36927409 PMCID: PMC10018835 DOI: 10.1186/s12891-023-06300-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 03/08/2023] [Indexed: 03/18/2023] Open
Abstract
BACKGROUND Apart from the positive effect of lumbar traction on structural changes within the spine in patients with low back pain, it is likely that therapeutic effects are correlated with pain biomarkers in the blood. Among them, systemic metabolic factors related to obesity may play an important role. This is the first study designed to examine the effectiveness of traction therapy in two experimental groups with considerably different BMI and to assess relationships between blood biomarkers and low back pain intensity. METHODS In the prospective clinical trial, women suffering from chronic low back pain were allocated into the normal-weight or obesity groups. Patients in both groups underwent twenty sessions of lumbar traction therapy (30 min a day, continuous mode with a force level of 25-30% of body weight). Before and after therapy subjective assessments of pain (VAS and PPT) were performed, and serum concentrations of aggrecan chondroitin sulfate 846 epitope (CS-846), neuropeptide Y, leptin, adipsin and growth and differentiation factor 15 (GDF-15) were determined. The data were statistically evaluated for 28 women. RESULTS After therapy, the maximal low back pain decreased in both groups, GDF-15 concentration was reduced in the normal-weight group and increased in the obesity group, and CS-846 concentration decreased in the obesity group. The sensation of PPT in the lumbar spine and mean concentrations of neuropeptide Y, leptin and adipsin did not change in both groups. However, the relationships of GDF-15, leptin, and adipsin concentrations with the perception of pain were revealed. CONCLUSION Distinct differences between the normal-weight and obesity groups pointed on the role of excessive adipose tissue in aggravating the inflammatory processes and in the development of low back pain. Adipsin, CS-846 and GDF-15 aspire to be the low back pain biomarkers in women with obesity, but there is a need for further research to answer whether they might be considered reliable biomarkers for the prognosis and monitoring of chronic low back treatment. TRIAL REGISTRATION NCT04507074, registered prospectively on July 6, 2020.
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Affiliation(s)
- Marzena Ratajczak
- Department of Biology and Anatomy, Poznan University of Physical Education, Królowej Jadwigi 27/39, 61-871, Poznan, Poland.
| | - Michał Wendt
- Department of Biology and Anatomy, Poznan University of Physical Education, Królowej Jadwigi 27/39, 61-871, Poznan, Poland
| | - Ewa Śliwicka
- Department of Physiology and Biochemistry, Poznan University of Physical Education, 61-871, Poznan, Poland
| | - Damian Skrypnik
- Department of Treatment of Obesity, Metabolic Disorders and Clinical Dietetics, Poznan University of Medical Sciences, 61-701, Poznan, Poland
| | - Jacek Zieliński
- Department of Athletics, Strength and Conditioning, Poznan University of Physical Education, 61-871, Poznan, Poland
| | - Krzysztof Kusy
- Department of Athletics, Strength and Conditioning, Poznan University of Physical Education, 61-871, Poznan, Poland
| | - Piotr Krutki
- Department of Biology and Anatomy, Poznan University of Physical Education, Królowej Jadwigi 27/39, 61-871, Poznan, Poland
| | - Małgorzata Waszak
- Department of Biology and Anatomy, Poznan University of Physical Education, Królowej Jadwigi 27/39, 61-871, Poznan, Poland
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Chen J, Qin Z, Zeng X, Zhong Y, Deng M, Lan B, Fan B. Applicative value of T2 mapping in evaluating lumbosacral nerve root injury induced by lumbosacral disc herniation. Acta Radiol 2022; 64:1526-1532. [PMID: 36171736 DOI: 10.1177/02841851221128377] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND To alleviate the damage caused by nerve root entrapment mediated by lumbosacral disc herniation (LDH), an imaging method that allows quantitative evaluation of the lumbosacral nerve injury is necessary. PURPOSE To investigate the diagnostic value of magnetic resonance (MR) T2 mapping in nerve root injury caused by LDH. MATERIAL AND METHODS A total of 70 patients with unilateral sciatic nerve pain and 35 healthy volunteers were divided into three groups: LDH with nerve root entrapment; LDH without nerve root entrapment; and 35 healthy volunteers. All participants underwent 3.0-T MR with T1-weighted (T1W) imaging, T2-weighted (T2W) imaging, and T2-mapping images. T2 was measured and observed with the left and right nerve roots of the L4-S1 segments in healthy volunteers; the differences between the three groups were compared. T2 and the relaxation rate of nerve root injury were analyzed. RESULTS T2 showed significant differences among the three groups (F = 89.494; P = 0.000), receiver operating characteristic curve revealed that the T2 relaxation threshold was 79 ms, the area under curve (AUC) area was 0.86, sensitivity was 0.77, and specificity was 0.74; the T2 relaxation rate was 1.06, the AUC area was 0.88, sensitivity was 0.74, and specificity was 0.85. CONCLUSION T2 mapping could quantitatively evaluate the nerve root injury with lumbar disc degeneration. Hence, it can be used for the clinical evaluation of nerve root entrapment caused by LDH.
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Affiliation(s)
- Jingcong Chen
- Department of Radiology, 598838Huizhou Municipal Central Hospital, Huizhou, PR China
| | - Ziliang Qin
- Interventional Room, 598838Huizhou Municipal Central Hospital, Huizhou, PR China
| | - Xiangling Zeng
- Department of Radiology, 598838Huizhou Municipal Central Hospital, Huizhou, PR China
| | - Yu Zhong
- Department of Radiology, 598838Huizhou Municipal Central Hospital, Huizhou, PR China
| | - Ming Deng
- Interventional Room, 598838Huizhou Municipal Central Hospital, Huizhou, PR China
| | - Bowen Lan
- Department of Radiology, 598838Huizhou Municipal Central Hospital, Huizhou, PR China
| | - Bing Fan
- Department of radiology, 159384Jiangxi Provincial People's Hospital, Nanchang, PR China
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Clinical Efficacy of Mechanical Traction as Physical Therapy for Lumbar Disc Herniation: A Meta-Analysis. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:5670303. [PMID: 35774300 PMCID: PMC9239808 DOI: 10.1155/2022/5670303] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 06/01/2022] [Accepted: 06/03/2022] [Indexed: 12/19/2022]
Abstract
Objective This study is aimed at exploring the clinical effect of mechanical traction on lumbar disc herniation (LDH). Methods Related literatures were retrieved from PubMed, Medline, Embase, CENTRAL, and CNKI databases. Inclusion of literature topic was comparison of mechanical traction and conventional physical therapy for lumbar disc herniation. Jadad scale was used to evaluate the quality of the included RCT studies. The Chi-square test was used for the heterogeneity test, and a random effect model was used with heterogeneity. Subgroup analysis and sensitivity analysis were used to explore the causes of heterogeneity. If there was no heterogeneity, the fixed effect model was used, and funnel plots were used to test publication bias. Results Visual analog scale (VAS) in the mechanical traction group was lower than that in the conventional physical therapy group (MD = −1.39 (95% CI (-1.81, -0.98)), Z = 6.56, and P < 0.00001). There was no heterogeneity among studies (Chi2 = 6.62, P = 0.25, and I2 = 24%) and no publication bias. Oswestry disability index (ODI) in the mechanical traction group was lower than that in the conventional physical therapy group (MD = −6.34 (95% CI (-10.28, -2.39)), Z = 3.15, and P = 0.002). There was no heterogeneity between studies (Chi2 = 6.27, P = 0.18, and I2 = 36%) and no publication bias. There was no significant difference in Schober test scores between the mechanical traction group and the conventional physical therapy group (MD = −0.40 (95% CI (-1.07, 0.28)), Z = 1.16, and P = 0.25). There was no heterogeneity among studies (Chi2 = 1.61, P = 0.66, and I2 = 0%) and no publication bias. Conclusion Mechanical traction can effectively relieve lumbar and leg pain and improve ODI in patients with lumbar disc herniation but has no significant effect on spinal motion. The therapeutic effect of mechanical traction was significantly better than that of conventional physical therapy. Lumbar traction can be used in conjunction with other traditional physical therapy.
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Liu C, Wang J, Hou B, Li Y, Morelli JN, Zhang P, Ran J, Li X. Diurnal Variation in Hydration of the Cervical Intervertebral Disc Assessed Using T2 Mapping of Magnetic Resonance Imaging. Korean J Radiol 2022; 23:638-648. [PMID: 35617994 PMCID: PMC9174496 DOI: 10.3348/kjr.2021.0950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 03/10/2022] [Accepted: 04/01/2022] [Indexed: 11/15/2022] Open
Abstract
Objective The study aimed to investigate the diurnal variation in cervical disc hydration and its relationship with cervical degeneration. Materials and Methods C3–C7 discs of 86 prospectively enrolled participants (37 males, 49 females; mean age ± standard deviation, 23.5 ± 2.5 years) were assessed using T2 mapping in the morning and evening. All discs were stratified by Miyazaki grade or C2–C7 Cobb angle and T2 values (T2). The degree of diurnal T2 variation (T2-DDV), defined as (morning T2 – evening T2)/morning T2 × 100%, was measured for the entire disc, annulus fibrosus (AF), nucleus pulposus (NP), and endplate zones. Results T2 of the entire disc decreased significantly after the daytime load (p < 0.001), with a T2-DDV of 13.3% for all discs and 16.0%, 12.2%, and 13.0% for healthy (grade I), mild degenerative (grade II), and advanced degenerative (grade III/IV) discs, respectively. T2 of regional NPs and AFs decreased significantly from morning to evening (p ≤ 0.049) except in the healthy anterior inner AF (p = 0.092). Compared with healthy discs, mild degenerative discs displayed lower T2 and T2-DDV in regional NPs (p < 0.001). Advanced degenerative discs showed higher T2-DDV in the anterior inner AF compared with healthy discs (p = 0.050). Significant diurnal T2 changes in the endplate zones were observed only in healthy discs (p = 0.013). Cervical discs in the low Cobb angle group showed higher T2-DDV in the anterior AFs and anterior NP and lower T2-DDV in the posterior AF than those in the high Cobb angle group (p ≤ 0.041). Conclusion This study characterized the diurnal variation in hydration of the cervical discs as assessed using T2 mapping and revealed early chemo-mechanical coupling dysfunction in degenerating discs. Cervical sagittal alignment on MRI can affect the diurnal stress patterns of the cervical discs. T2 mapping is sensitive to disc biomechanical dysfunction and offers translational potential from biomechanical research to clinical application.
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Affiliation(s)
- Chanyuan Liu
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jingyi Wang
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Bowen Hou
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yitong Li
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - John N Morelli
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Peisen Zhang
- Department of Rehabilitation Medicine, School of Medicine, Guangzhou First People's Hospital, South China University of Technology, Guangzhou, China
| | - Jun Ran
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaoming Li
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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Huang Y, Wang L, Zeng X, Chen J, Zhang Z, Jiang Y, Nie L, Cheng X, He B. Association of Paraspinal Muscle CSA and PDFF Measurements With Lumbar Intervertebral Disk Degeneration in Patients With Chronic Low Back Pain. Front Endocrinol (Lausanne) 2022; 13:792819. [PMID: 35721738 PMCID: PMC9204273 DOI: 10.3389/fendo.2022.792819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 04/21/2022] [Indexed: 12/01/2022] Open
Abstract
There is an interaction between the lumbar spine and paraspinal muscles, which may play a role in the development of intervertebral disc (IVD) degeneration and may affect CLBP. The study aims to assess the relationship between IVD degeneration and paraspinal muscle fat infiltration in CLBP patients by quantitative MR imaging, and to evaluate the influence of sex and age on CLBP muscle fat infiltration. Sixty CLBP patients (46.3 years ±17.0) and thirty-two healthy subjects (44.9 years ±17.6) were recruited for this study. 3.0 T MRI was used to perform the sagittal and axial T1, T2 of the lumbar spine, and axial paraspinal muscle IDEAL imaging at the L4/5 and L5/S1 levels. Proton density fat fraction (PDFF) of the multifidus and erector spinae at two IVD levels were measured. The Pfirrmann grades of IVD degeneration, Oswestry Disability Index (ODI), and Visual Analog Scale (VAS) were also evaluated. Compare the cross-sectional area (CSA) and PDFF of the paraspinal muscles between CLBP patients and healthy subjects, and analyze the relationship between the muscle PDFF and Pfirrmann grades, gender, and age of CLBP patients. Compared with healthy subjects, the CSA of the multifidus muscle in CLBP patients decreased (1320.2±188.1mm2vs. 1228.7±191.0 mm2, p<0.05) at the L4/5 level, the average PDFF increased, (7.7±2.6% vs. 14.79±5.3%, 8.8±4.2% vs. 16.03±5.3%, all p<0.05) at both L4/5 and L5/S1 levels. The PDFF of paraspinal muscles were correlated with adjacent IVD degeneration, ODI and VSA in CLBP patients (all p<0.05). After using age and body mass index (BMI) as control variables, significance was retained (all p<0.05). Multiple regression analysis revealed sex and age also were significantly associated with multifidus PDFF (all p < 0.05). This study confirmed that the CSA decreased and the PDFF increased of the paraspinal muscles in CLBP patients. It reveals a significant correlation between the PDFF of CLBP paraspinal muscles and the grade of IVD degeneration. Sex and age are also important factors influencing CLBP paraspinal muscle infiltration.
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Affiliation(s)
- Yilong Huang
- Department of Medical Imaging, the First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Ling Wang
- Department of Radiology, Beijing Jishuitan Hospital, Beijing, China
| | - Xiaomin Zeng
- Department of Medical Imaging, the First Affiliated Hospital of Kunming Medical University, Kunming, China
- GE Healthcare, Magnetic Resonance Field Application Team, Chengdu, China
| | - Jiaxin Chen
- Department of Medical Imaging, the First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Zhenguang Zhang
- Department of Medical Imaging, the First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Yuanming Jiang
- Department of Medical Imaging, the First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Lisha Nie
- GE Healthcare, Magnetic Resonance Research China, Beijing, China
| | - Xiaoguang Cheng
- Department of Radiology, Beijing Jishuitan Hospital, Beijing, China
- *Correspondence: Bo He, ; Xiaoguang Cheng,
| | - Bo He
- Department of Medical Imaging, the First Affiliated Hospital of Kunming Medical University, Kunming, China
- *Correspondence: Bo He, ; Xiaoguang Cheng,
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Choi E, Gil HY, Ju J, Han WK, Nahm FS, Lee PB. Effect of Nonsurgical Spinal Decompression on Intensity of Pain and Herniated Disc Volume in Subacute Lumbar Herniated Disc. Int J Clin Pract 2022; 2022:6343837. [PMID: 36263240 PMCID: PMC9553669 DOI: 10.1155/2022/6343837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 06/27/2022] [Accepted: 08/11/2022] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE Nonsurgical spinal decompression therapy (NSDT) is a conservative treatment for the lumbosacral herniated intervertebral disc (L-HIVD). This study aimed to evaluate the clinical effectiveness of the NSDT and change in disc volume through magnetic resonance imaging (MRI) in subacute L-HIVD. METHODS Sixty patients with subacute L-HIVD were randomized into either the decompression group (group D, n = 30) or the nondecompression group (group N, n = 30). In group D, NSDT was performed ten times in eight weeks. In group N, pseudodecompression therapy (no force) was performed with the same protocol. Lower back and lower leg pain intensities and functional improvements were measured by the visual analog scale and the Korean Oswestry Disability Index (K-ODI). The change in the lumbosacral disc herniation index (HI) was evaluated through a follow-up MRI three months after the therapy. RESULTS The lower leg pain intensity in group D was lower than that in group N at two months (p=0.028). Additionally, there were significantly lower K-ODI scores in group D at two and three months (p=0.023, 0.019) than in group N. The change in HI after the therapy was -27.6 ± 27.5 (%) in group D and -7.1 ± 24.9 (%) in group N, with a significant difference (p=0.017). Approximately 26.9% of patients in group D and no patients in group N showed over 50% reduction in HI (p=0.031). CONCLUSION NSDT may be a suitable treatment option for conservative treatment of subacute L-HIVD.
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Affiliation(s)
- Eunjoo Choi
- Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, 82 Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam 13620, Republic of Korea
| | - Ho Young Gil
- Department of Anesthesiology and Pain Medicine, Ajou University, School of Medicine, 164 World Cup-Ro, Yeongtong-Gu, Suwon 16499, Republic of Korea
| | - Jiyoun Ju
- Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, 82 Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam 13620, Republic of Korea
| | - Woong Ki Han
- Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, 82 Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam 13620, Republic of Korea
| | - Francis Sahngun Nahm
- Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, 82 Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam 13620, Republic of Korea
- Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, 101 Daehak-Ro, Jongno-Gu, Seoul 03080, Republic of Korea
| | - Pyung-Bok Lee
- Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, 82 Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam 13620, Republic of Korea
- Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, 101 Daehak-Ro, Jongno-Gu, Seoul 03080, Republic of Korea
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