Journal of Spine Practice (JSP)最新文献

{"title":"Consequences of Delayed Surgical Treatment of Traumatic Spinal Cord Injuries: Tertiary Centre Experience","authors":"A. AlHabeeb","doi":"10.18502/jsp.v1i1.9765","DOIUrl":"https://doi.org/10.18502/jsp.v1i1.9765","url":null,"abstract":"Introduction: Owing to its disabling consequences, spinal cord injury is devastating for both patients and their healthcare providers. There are many causes of spinal cord injury, the most common by far being motor vehicle accident (MVA). Unfortunately, in neglected injuries, many complications and poor outcomes could be encountered. This research aimed to assess the causes, consequences, and outcomes of neglected traumatic spinal cord injuries. \u0000Methodology: Out of the 750 cases reviewed between February 2016 and February 2021, 18 cases matched our inclusion criteria which was any Traumatic Spinal Cord Injury (TSCI) with neurological deficit requiring surgical intervention more than 14 days from the index trauma. The following variables were measured: patients’ demographics, injury, management, delay, complication, and hospital course characteristics. American Spinal Injury Association (ASIA) Impairment Scale scores were recorded at presentation and final follow-up. \u0000Result: Out of the 18 neglected TSCI patients, 72.2% were male. Patients’ mean age at the time of injury was 36.8 years, and 77.8% of them were from outside Riyadh. The mechanism of injury was MVA in all patients. Delay in referral to a tertiary hospital was the main cause accounting for 88.9%. The mean duration of neglect was 43 days. Improvement in ASIA score was found in two patients. Bedsores and DVT were found in 55.5% and 27.8%, respectively. Postoperatively, 77% of the patients were admitted to the ICU. Most patients (12) were unable to join a specialized spinal cord injury rehabilitation center postoperatively. \u0000Conclusion: Early referral of all traumatic spinal cord injury patients is highly encouraged to prevent short- and long-term complications.","PeriodicalId":199836,"journal":{"name":"Journal of Spine Practice (JSP)","volume":"65 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126632831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence of Deep Vein Thrombosis in Spine Surgery Patients at a Tertiary Care Hospital","authors":"Rakan S. Aldusari","doi":"10.18502/jsp.v1i1.9795","DOIUrl":"https://doi.org/10.18502/jsp.v1i1.9795","url":null,"abstract":"Introduction: The prevalence of deep venous thrombosis (DVT) and pulmonary embolisms (PE) has not been established accurately. Reported literature suggests an incidence rate of either DVT or PE ranging from 0.27% to as high as 60% in special cases. We aimed to discern the incidence rate in our local population post spinal surgery. \u0000Methodology: A retrospective chart review was conducted on 892 adult patients who were admitted to our center either electively or in an emergent manner between January 1, 2016 and January 1, 2019 at KAMC, Riyadh. The collected data included information on: demographics, diagnosis, complaint-to-surgery time, type of surgery, location, approach, functional status, days till max function for each patient, blood loss, smoking history, and type of trauma if it was a traumatic case. In addition, DVT/PE status of each patient with their previous or existing health conditions was also included. \u0000Result: Eight hundred patients met our inclusion criteria. Our sample was predominantly male at 422 patients (52.8%) with a mean age of 49.8 ± 18.83 years for both genders. The mean BMI was 28.9  ±  7.03 kg with the average weight being 75.9 ± 18.81 kg. Additionally, 422 (52.8%) participants were cardiac patients and 295 (36.9%) were diabetics. We had 30 (3.8%) instances of either DVT or PE out of the 800 patients, isolated cases of DVT being 18 cases (2.3%). The cervical region was found to be protective against DVT/PE (P = 0.0227). The length of stay was also significant for the development of DVT/PE (P < 0.0001). \u0000Conclusion: Our study is one of the largest conducted in our region, especially in spinal surgical patients. We found that the incidence for DVT/PE (3.8%) was consistent with the lower end of reported literature. We found significance especially in cervical operations being protective against the development of DVT/PE in comparison to other sites. Length of stay was also significant for the development of DVT/PE unlike the length of the operation itself. While we did not observe a significant difference between the prophylactic protocols for the development of DVT/PE in our patients, we had an overall low number of venous thromboembolic events, especially when comparing it to the reported literature.","PeriodicalId":199836,"journal":{"name":"Journal of Spine Practice (JSP)","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123720591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychological and Social Factors Contributing to Post-traumatic Growth After Spinal Cord Injury","authors":"Mohammed Alnamlah","doi":"10.18502/jsp.v1i1.9781","DOIUrl":"https://doi.org/10.18502/jsp.v1i1.9781","url":null,"abstract":"Introduction: Spinal cord injury (SCI) results in significant changes in a person's life; it has a tremendous psychological impact not only at the individual level but also on their caregiver. There is still little known about the positive psychological changes following SCI. The aim of this study was to determine the psychological and social factors affecting post-traumatic psychological growth after SCI. \u0000Methodology: This multi-center cross-sectional study was conducted on 66 patients with traumatic SCI between November 2020 and May 2021 using PWB-PTCQ, HADS, and social support scale. Data were analyzed using the SPSS program. \u0000Result: This study included 66 patients from multilabel territorial centers. The Mean ± SD of the patients’ age was 32.1 ± 14.5 years, and 34 (51.5%) of them were aged <32 years. Male patients were more dominant compared to their female counterparts; 48 (72.7%) versus 18 (27.3%), respectively. The most common type of injury was ASIA-A 24 (36.4%), and the most common nature of stress was financial 33 (53.2%). \u0000Conclusion: Anxiety and depression were less common among our patients with SCI, whereas there were high life stressors, and financial stress was the dominant type of stress among patients. The most affected dimension of PTG was a sense of mastery, whereas relationships and personal growth were the least affected among patients with SCI. Achieving PTG was significantly affected by depression, education level, and life stressors. There was a regression relation between PTG with depression and anxiety, thus PTG can predict depression and anxiety in patients with SCI.","PeriodicalId":199836,"journal":{"name":"Journal of Spine Practice (JSP)","volume":"77 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121775797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nonspecific Chronic Low Back Pain in Elderly Patients","authors":"Amal Mowafy","doi":"10.18502/jsp.v1i1.9793","DOIUrl":"https://doi.org/10.18502/jsp.v1i1.9793","url":null,"abstract":"Introduction: Low back pain is one of the most common causes of disabilities in old people often due to lumber degeneration (osteoarthritis) and spinal canal stenosis. In our study, we determine the prevalence and associated changes of low back pain that increase with age. \u0000Methodology: This observational cohort study was carried out from March 2019 to March 2021 at the El-Moussenin Center in Port Said. The study included 300 patients aged ≥65 years with a chronic nonspecific low back pain for at least six months, a Visual Analogue Scale (VAS) score of 3 and more, and an absence of spinal pathology such as infection, tumor, fracture, spondylolisthesis, or spinal degeneration of grade 2 and above. Patients were divided into two groups: (i) a study group including patients with a mean age of 75 years with nonspecific chronic LBP (n = 150) and (ii) an age- and sex-matched control group (n = 150) with no chronic low back pain using propensity score-matched analysis. All patients underwent whole spinal X-ray, lumbar MRI, CBC, and DXA. \u0000Result: We analyzed laboratory finding, radiological finding for global spinal parameter, and lumber degeneration body composition analysis using whole body dual energy X-ray absorptiometry. We found increase in red blood cell distribution width (it is an index of aging), it was higher in geriatric with CLBP (32) and in control (6.9) with a p-value < 0.001. Skeletal muscle mass index was 6.23 ± 0.92 in the studied group and 6.43 ± 1.02 in the control group with a p-value = 0.045. Increase in fat mass was noted in both the studied (32.17 ± 7.07) and the control (29.28 ± 7.48) groups with a p-value < 0.001. Moreover, those patients had lower lumbar lordosis, higher sagittal vertical axis regarding decrease in muscle mass in trunk and extremities. \u0000Conclusion: Red blood cell distribution width which is a sign of aging was high in geriatric group with CLBP. Moreover, geriatric CLBP is often associated with osteoporosis which affects the pain threshold and triggers CLBP due to age-related loss of skeletal muscle mass and spinal sagittal malalignment.","PeriodicalId":199836,"journal":{"name":"Journal of Spine Practice (JSP)","volume":"77 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125879919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rare Case of Lumbosacral Conjoint Root Diagnosed as Sequestered Disc by MRI: A Case Report","authors":"A. Awadallah","doi":"10.18502/jsp.v1i1.9799","DOIUrl":"https://doi.org/10.18502/jsp.v1i1.9799","url":null,"abstract":"Introduction: Conjoint nerve root is embryological nerve root abnormality mainly affecting lumbosacral region. The atypical roots present primarily as a bifid, conjoined structure originating from a wide area of the dura. The conjoint roots are highly liable to trauma due to their size and attachment to surrounding structures. The effects of compression and entrapment are augmented in the case of having stenosis of the lateral recesses where developmental changes and disc herniations deplete the available reserve space. Conjoined nerve roots are a relatively uncommon finding but are frequently left undiagnosed on preoperative imaging studies. Misinterpretation as sequestered disc can lead to devastating results especially during limited spine approach. \u0000Case Report: A 43-year-old male patient presented with low back pain gradually progressing over the last three years. Pain was radiating to his left leg associated with tingling sensation and a mild weakness in his left foot. Clinical examination revealed normal muscle bulk and tone. Strength was full bilaterally except the mild weakness 3/5 on toe dorsiflexion of the left foot. Deep tendon reflexes were 3+ at the left knee and ankle. Plantar responses were flexor. Sensation was intact, and there was no loss of sphincters control or bladder dysfunction. A standard plain lumbosacral MRI was performed. The patient was admitted for L5/S1 discectomy. Surgical intervention was recommended, during the surgery we recognized the huge conjoint root. Adhesiolysis and discectomy was done carefully without causing any serious neural injury to the conjoint root. Clinical surgical outcome was good. Pain and tingling sensation disappeared only paresthesia over the S1 dermatome. Postoperative course was uneventful, and the patient was discharged after his neurological improvement on day 7, post operation. However, the patient complained of recurrent pain on follow-up visit and continues being followed-up. \u0000Conclusion: The conjoined nerve root anomaly diagnosis is not easy and has several points of significance. If misdiagnosed, it could be incorrectly treated as a case for a herniated disc. Neurosurgeons should consider these anomalies in their differential diagnosis. Cases of conjoined nerve root anomaly may be wrongly managed and result in wrong level of surgery with a poor outcome. Researchers conclude that the correct diagnosis of root anomalies is vital for the patient, any misinterpretation could lead to catastrophic consequences.","PeriodicalId":199836,"journal":{"name":"Journal of Spine Practice (JSP)","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127396756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Pain Location and Extent Between Adults with Ankylosing Spondylitis-related Inflammatory versus Chronic Nonspecific Low Back Pain","authors":"Lolwah Alrashed Alhumaid","doi":"10.18502/jsp.v1i1.9777","DOIUrl":"https://doi.org/10.18502/jsp.v1i1.9777","url":null,"abstract":"Introduction: Pain among adults with ankylosing spondylitis-related inflammatory low back pain (AS-ILBP) is not well-characterized, and individuals with AS-ILBP are frequently misdiagnosed with chronic nonspecific low back pain (CNSLBP). This study digitally quantifies and compares the location and extent of pain between adults with AS-ILBP and those with CNSLBP and examines the relationship between the pain extent and functional, psychological, and condition-specific factors in those with AS-ILBP. \u0000Methodology: The location and extent of pain in adults with AS-ILBP (n = 27) or CNSLBP (n = 22) was quantified using a digital pain drawing analysis. Relationships between pain extent and perceived pain intensity and disability, pain-related cognitive factors (back beliefs, fear of movement, pain catastrophizing, pain coping, and self-efficacy), psychological distress, and AS-specific features were examined in those with AS-ILBP. \u0000Result: Pain extent in the dorsal region of the body was greater in those with AS-ILBP than in CNSLBP (P < 0.05). In AS-ILBP, the most prevalent pain location was the lumbar region (88.9%), followed by the buttock (70.4%); the frequencies of reported pain in these regions were similar between groups (P > 0.05). The AS-ILBP group more frequently reported pain in the thoracic (70.4%) and cervical (51.8%) regions (P < 0.05). In the AS-ILBP group, larger pain extent was moderately associated with negative back beliefs (rs = –0.44 to –0.41, P < 0.05) and lower self-efficacy (rs = –0.58 to –0.42, P < 0.05), but not with any of functional outcomes. Larger pain extent was associated with higher disease activity (P < 0.05). \u0000Conclusion: Adults with AS-ILBP perceive larger pain extent in spinal regions and the degree of pain extent is associated with negative back beliefs, lower self-efficacy, and higher disease activity. Pain drawings may assist in the differential diagnosis of CNSLBP and AS-ILBP. Further, they may aid psychological screening in adults with AS-ILBP.","PeriodicalId":199836,"journal":{"name":"Journal of Spine Practice (JSP)","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132766275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Upper Thoracic Spine Fractures Outcomes and Complications in King Abdul-Aziz Medical City, Riyadh","authors":"F. Konbaz","doi":"10.18502/jsp.v1i1.9776","DOIUrl":"https://doi.org/10.18502/jsp.v1i1.9776","url":null,"abstract":"Introduction: Upper thoracic spine fractures (T1-T6) are not uncommon. They are often high-energy injuries complicated by multiple life-threatening comorbidities. There is a controversial discussion in the literature regarding the treatment choices. Thoracic pedicle screw fixation has replaced all other fixation techniques for its success rate and safety. Despite the number of studies discussing upper thoracic spine fractures, data on literature reporting postoperative complications are deficient. The aim of the study was to assess, in a series of patients, the impact of traumatic upper thoracic fractures on sagittal alignment, the incidence of possible complications, and the effect of associated injuries. \u0000Methodology: This retrospective chart review study included all adult cases diagnosed as traumatic upper thoracic spine fractures in KAMC in Riyadh. Data were obtained from the computerized database. The information reviewed included fracture characteristics, associated injuries, pre- and postoperative neurological status and sagittal alignment, follow-up duration, and the presence of complications. \u0000Result: A total of 19 patients were included in the study. Of them, 17 (89.5%) were injured secondary to a motor vehicle accident. There were three patients with a fixation level crossing the CT junction, more blood loss and procedure time was noticed with these cases. There was a notable improvement in upper thoracic kyphosis by 9º when measuring pre- and postop fracture Cobb's angle. The mean preop angle was 28.98 and the mean postop was 20.76. Of all the 19 cases involved in the study, 3 patients had developed surgical site infection as a complication. No other complication was reviewed. \u0000Conclusion: It is well-known in the literature that the correction of kyphosis and the absence of residual deformity postoperatively are indicators of the success and safety of the procedure used. Our findings correspond to the literature discussion that the current practice in managing traumatic upper thoracic spine fracture in KAMC in Riyadh is relatively safe and effective. Yet, further studies are needed to elaborate more on the relationship between the presence of other injuries and patients’ factors and postoperative outcomes.","PeriodicalId":199836,"journal":{"name":"Journal of Spine Practice (JSP)","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128193524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experiences of Adults Living with Ankylosing Spondylitis-related Inflammatory Low Back Pain: A Qualitative Study","authors":"Lolwah Alrashed Alhumaid","doi":"10.18502/jsp.v1i1.9800","DOIUrl":"https://doi.org/10.18502/jsp.v1i1.9800","url":null,"abstract":"Introduction: Inflammatory low back pain (ILBP) is a key clinical symptom and a significant problem in ankylosing spondylitis (AS), its high socioeconomic costs are mainly attributed to disability. To the best of our knowledge, no study has specifically explored the ILBP experience in adults with AS. This study aimed to explore the experiences of ILBP from the perspective of adults with AS. \u0000Methodology: This study followed a qualitative descriptive design. Participants were recruited from rheumatology and physiotherapy outpatient clinics of two major hospitals in Dublin, and from AS patient support groups in Ireland. A total of 19 adults with AS-related inflammatory low back pain (AS-ILBP) (mean age 47.8 years [SD 11.2]) participated in semi-structured face-to-face interviews. All interviews were audio-recorded, transcribed verbatim, coded, and analyzed thematically. \u0000Result: Analysis of experiences revealed five themes: (i) experiences and perception surrounding diagnosis, (ii) perceived ILBP trajectories, (iii) impact of AS-ILBP, (iv) behavioral responses toward ILBP, and (v) experience with AS-ILBP treatments. Adults with AS-ILBP experienced a delay in diagnosis, in which ILBP was negatively perceived, and dysfunctional LBP beliefs and behaviors were reported. ILBP appeared to have a multidimensional nature and impact, with the greatest impact suggested on physical function and psychological health. Many individuals with AS held negative ILBP beliefs that drove dysfunctional behaviors. The primary received ILBP treatment was medication and to a lesser extent physiotherapy; both described treatments had limited effects. \u0000Conclusion: This study was the first to reveal the unique experience of ILBP from the perspective of adults with AS. AS-ILBP appear to have a varying course and a multidimensional associated factors that determine its trajectory. AS-ILBP was suggested to affect all aspects of individual's life. A bidirectional relationship between ILBP and the psychosocial factors was proposed; these factors were perceived as aggravators and consequences of ILBP. This study also points to the limitations of current AS-ILBP management, which were mainly biomedically oriented. Thus, healthcare providers are advised to incorporate a multidimensional pain screening with their routine physical assessments of adults with AS-ILBP. This could help in designing tailored individualized, effective AS-ILBP management programs.","PeriodicalId":199836,"journal":{"name":"Journal of Spine Practice (JSP)","volume":"290 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116402252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of Radiological and Morphological Grading Systems of Intervertebral Disc Degeneration","authors":"K. Krupa","doi":"10.18502/jsp.v1i1.9803","DOIUrl":"https://doi.org/10.18502/jsp.v1i1.9803","url":null,"abstract":"Introduction: Intervertebral disc (IVD) degeneration is considered to be one of the main pathophysiological causes of low back pain. Several grading systems have been developed for both morphological and radiological assessment. The aim of this study was to assess the morphological and radiological characteristics of IVD degeneration and validate popular radiological Pfirrmann scale against morphological Thompson grading system. \u0000Methodology: Full spinal columns (vertebrae L1-S1 and IVD between them) were harvested from cadavers through an anterior dissection. MRI scans of all samples were conducted. Then, all vertebral columns were cut in the midsagittal plane and assessed morphologically. \u0000Result: A total of 100 lumbar spine columns (446 IVDs) were included in the analysis of the degeneration grade. Morphologic Thompson scale graded the majority of discs as grade 2 and 3 (44.2% and 32.1%, respectively), followed by grade 4 (16.8%), grade 1 (5.8%), and grade 5 (1.1%). The Radiologic Pfirrmann grading system classified 44.2% of discs as grade 2, 32.1% as grade 3, 16.8% as grade 4, 5.8% as grade 1, and 1.1% as grade 5. The analysis on the effect of age on degeneration revealed significant, although moderate, positive correlation with both scales. Analysis of the agreement between scales showed weighted Cohen’s kappa equal to 0.61 (p < 0.001). Most of the disagreement occurred due to a 1-grade difference (91.5%), whereas only 8.5% due to a 2-grade difference. \u0000Conclusion: With the increase in the prevalence of IVD disease in the population, reliable grading systems of IVD degeneration are crucial for spine surgeons in their clinical assessment. While overall there is an agreement between both grading systems, clinicians should remain careful when using Pfirmann scale as the grades tend to deviate from the morphological assessment.","PeriodicalId":199836,"journal":{"name":"Journal of Spine Practice (JSP)","volume":"86 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126618958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Core Stabilization Exercise on the Lumbar Lordosis and Pelvic Inclination Among Chronic Nonspecific Low Back Pain Patients","authors":"Leo R Athinaraj Antony Soundararajan","doi":"10.18502/jsp.v1i1.9778","DOIUrl":"https://doi.org/10.18502/jsp.v1i1.9778","url":null,"abstract":"Introduction: Chronic low back pain (CLBP) is one of the most common musculoskeletal disorders and it is documented that >90% of the cases have no defined cause for pain, called nonspecific low back pain (NSLBP). Alteration in the joint position, abnormal posture, and impaired muscle recruitment may result in recurrent CLBP. Lumbar lordosis (LL) provides strength against the compressive forces of gravity and it also protects the posterior spinal ligament and acts as a shock absorber for vertical forces. Increased LL is considered as a reason for radiculopathy, facet pain, and postural pain. Spinal posture and pelvic position were analyzed and documented as altered in CLBP patients. Anatomically, the anterior and posterior tilt of the back and pelvis by the force of different muscles can alter the spinal curvature. Posterior pelvic tilt in a standing position can decrease the LL. The pelvic inclination is related to the lumbar curve, and both are related to the performance and length of the back and abdominal muscles. Therefore, in this study, we aimed to evaluate the effect of core stabilization exercise on pain intensity, functional disability, LL, and pelvic inclination in NSLBP. \u0000Methodology: A total of 63 patients aged between 20 and 60 years who met the selection criteria were included. All participants gave their written consent to participate in this study. Demographic data such as age, weight, height, and duration of the back pain were documented. Patients were asked to report their pain using the Visual Analogue Scale (VAS) and Disability in Roland Morris Disability Questionnaire (RMDQ). Exclusion criteria were participants with musculoskeletal disorders (osteoarthritis and rheumatoid arthritis) and a history of previous fractures and systemic diseases. DIERS Formetric 4D spine and posture analyzer were used to assess spinal alignment using the light-optical scanning method on the back of patient in standing position. Angle of LL: the angle formed by the apex of LL and the T12 and L5 spinous processes. Pelvic tilt is the orientation of the pelvis in respect to the thighbones and the rest of the body. Core stabilization exercises were given for 30 min, five days a week, for 12 sessions. Pre- and posttest values were documented and analyzed. \u0000Result: In this experimental study, we used Pearson’s correlation coefficient to find the correlation between LL and pelvic inclination angle and found a strong positive correlation (r = 0.76; P = 0.001). The study showed that core stabilization exercise for 12 weeks’ duration had statistically significant reduction in the pain intensity (p < 0.01), functional disability (p < 0.002), LL (p < 0.05), and pelvic inclination angle (p < 0.05) among patients with chronic NSLBP. \u0000Conclusion: From this research, we conclude that core stabilization exercises decrease the pain intensity, functional disability, LL, and pelvic inclination angle in patients with chronic NSLBP. Thus, evaluation of the lumbar curvat","PeriodicalId":199836,"journal":{"name":"Journal of Spine Practice (JSP)","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121598891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}