Sample records for characterize lumbar muscle

  1. [Relationship between lumbosacral multifidus muscle and lumbar disc herniation]. (United States)

    Chen, Wei-ye; Wang, Kuan; Yuan, Wei-an; Zhan, Hong-sheng


    As a common disease in clinical, the treatment of lumbar disc herniation (LDH) focused on local intervertebral disc, such as surgery and other interventional therapy treatment, but postoperative complications and recurrence rate has been a difficult problem in the field of profession. With the development of spine biomechanics and anatomy, researches on lumbar herniation also increased. Researchers discovered that the incidence and prognosis of LDH were inseparable with local muscle and soft tissue. As the deep paraspinal muscles, multifidus muscle plays an important role to make lumbar stability. Its abnormal function could reduce the stable of lumbar spine, and the chronic lumbar disease could also lead to multifidus muscle atrophy.

  2. The effects of gluteus muscle strengthening exercise and lumbar stabilization exercise on lumbar muscle strength and balance in chronic low back pain patients. (United States)

    Jeong, Ui-Cheol; Sim, Jae-Heon; Kim, Cheol-Yong; Hwang-Bo, Gak; Nam, Chan-Woo


    [Purpose] The aim of this study was to examine the effects of exercise to strengthen the muscles of the hip together with lumbar segmental stabilization exercise on the lumbar disability index, lumbar muscle strength, and balance. [Subjects and Methods] This study randomly and equally assigned 40 participants who provided written consent to participate in this study to a lumbar segmental stabilization exercise plus exercise to strengthen the muscles of the gluteus group (SMG + LES group) and a lumbar segmental stabilization exercise group. [Results] Each evaluation item showed a statistically significant effect. [Conclusion] Clinical application of exercise in this study showed that lumbar segmental stabilization exercise plus exercise to strengthen the muscles of the gluteus resulted in a greater decrease in low back pain disability index and increase in lumbar muscle strength and balance ability than lumbar segmental stabilization exercise in chronic low back pain patients receiving the exercise treatments during the same period.

  3. Effect of Electroacupuncture Combined with Tuina on Lumbar Muscle Tone in Patients with Acute Lumbar Sprain

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    Fan Yuan-zhi; Wu Yao-chi


    Objective: To observe the clinical effect of electroacupuncture (EA) combined with tuina on acute lumbar sprain and lumbar muscle tone before and after treatment. Methods: A total of 130 acute lumbar sprain cases were randomly allocated into an observation group and a control group, 65 in each group. Cases in the observation group were treated with EA combined with tuina, whereas cases in the control group were treated with Diclofenac Sodium Dual Release Enteric-coated capsules. The muscle tones in two groups were tested before and after treatment. Results: The recovery rate and overall response rate in the observation group were 66.2% and 93.8% respectively, versus 56.9% and 87.7% in the control group, showing no between-group statistical significances (P>0.05). After treatment, the force-displacement area under curve (AUC) in both groups showed a significance difference (P Conclusion: Both EA combined with tuina and aforementioned oral medication have remarkable effects for acute lumbar sprain, and the former can better improve the lumbar muscle tone in patients with acute lumbar sprain.

  4. Comparison of electromyographic activities of lumbar iliocostalis and lumbar multifidus muscles during stabilization exercises in prone, quadruped, and sitting positions


    Kelly, Marie; Jacobs, Dee; Wooten, Mary E.; Edeer, Ayse Ozcan


    [Purpose] The purposes of this study were: 1) describe a hierarchy of electromyographic activity production, using percentage maximum voluntary contraction of lumbar iliocostalis and lumbar multifidus muscles during prone, quadruped and sitting exercises; and 2) identify optimal recruitment exercises for both lumbar iliocostalis as a global multi-segmental stabilizer and lumbar multifidus as a segmental stabilizer. [Subjects] Twelve healthy volunteers (six male and six female) aged 24 to 45 p...

  5. Enhanced muscle activity during lumbar extension exercise with pelvic stabilization. (United States)

    Lee, Ho-Seong


    The purpose of this study was to investigate whether pelvic stabilization affects multifidus (MF) and iliocostalis lumborum (IL) muscle activities during dynamic extension exercise. Nine males (age, 25.1±6.3 yr; height, 176.6±2.4 cm; body mass, 74.9±6.7 kg) performed an isometric lumbar extension strength test and dynamic exercise in an upright seated position with or without pelvic stabilization. The electromyography and muscle strength of the MF and IL muscles were measured when the subjects performed the isometric lumbar extension strength test at the trunk angle 110°, 146°, and 182°. In addition, the trunk extensor muscle activities were measured using 50% muscle strength of maximum isometric strength during a dynamic trunk extension exercise. The MF and IL muscle activities were significantly higher at 110°, 146°, and 182° with pelvic stabilization than that without pelvic stabilization during the isometric lumbar extension strength test (Plumbar extension exercise with pelvic stabilization may be more effective for MF and IL muscle activity compared to that without pelvic stabilization.

  6. MRI of lumbar trunk muscles in patients with Parkinson's disease and camptocormia. (United States)

    Margraf, N G; Rohr, A; Granert, O; Hampel, J; Drews, A; Deuschl, G


    Camptocormia in Parkinson's disease (PD) is an axial postural disorder usually accompanied by histopathological changes in the paravertebral muscles of unknown etiology. The diagnostic potential of magnetic resonance imaging (MRI) of back muscles in camptocormia has not been systematically assessed. Our objective was to characterize pathological muscle changes with MRI and to develop radiological criteria for camptocormia. The criteria edema, swelling and fatty degeneration in 20 idiopathic PD patients with camptocormia were assessed using MRI (T1w and short tau inversion recovery (STIR) sequences) of the lumbar trunk muscles and compared with 20 group-matched PD patients without camptocormia. Edema and fatty degeneration of the paravertebral muscles were significantly more frequent in camptocormia. Edema correlated negatively and fatty degeneration positively with the duration of camptocormia and not PD. Swelling of the paravertebral muscles, edema and swelling of the quadratus lumborum muscle and rare edema of the psoas muscle were only found in camptocormia patients. In this case-control study the defined MRI criteria distinguish the group of PD patients with camptocormia versus those without. Our findings suggest dynamic changes in the MRI signals over time in the paravertebral muscles: edema and swelling are found initially, followed by fatty atrophic degeneration 2-3 years after the beginning of camptocormia. Muscle MRI qualifies as a tool for categorizing phases of camptocormia as acute or chronic, with potential consequences for therapeutic approaches. The involvement of muscles beyond an isolated impairment of the paravertebral muscles implies a more systemic view with a deregulation of lumbar trunk muscles.

  7. Lumbar multifidus muscle changes in unilateral lumbar disc herniation using magnetic resonance imaging

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    Altinkaya, Naime [Baskent University Medical School, Department of Radiology, Adana (Turkey); Cekinmez, Melih [Baskent University Medical School Adana, Department of Neurosurgery, Adana (Turkey)


    To assess multifidus muscle asymmetry using the cross-sectional area (CSA) and perpendicular distance of the multifidus muscle to the lamina (MLD) measurements in patients with nerve compression due to lumbosacral disc hernia. In total, 122 patients who underwent microdiscectomy for unilateral radiculopathy caused by disc herniation, diagnosed by magnetic resonance imaging (MRI), were evaluated retrospectively. Posterolateral or foraminal disc herniation at only one disc level, the L3-4, L4-L5, or L5-S1 region, was confirmed using MRI. Subjects were divided by symptom duration: 1-30 days, (group A), 31-90 days (group B), and > 90 days (group C). There were 48 cases in group A, 26 in group B, and 48 in group C. In groups A, B, and C, the median MLD differed significantly between the diseased and normal sides (P < 0.05). The MLD increased on the diseased side with symptom duration by lumbar disc herniation. The diseased side MLD was 5.1, 6.7, and 7.6 mm in groups A, B, and C, respectively (P < 0.05). The cut-off values for the MLD measurements were 5.3 mm (sensitivity = 62.3 %, specificity = 55.5 %; P < 0.05). In groups A, B, and C, the median CSA of the multifidus muscle was not significantly different between the diseased and the normal side (P > 0.05). The MLD measurement correlated significantly with multifidus asymmetry in patients with lumbar disc herniation. (orig.)

  8. Is Abdominal Muscle Activity Different from Lumbar Muscle Activity during Four-Point Kneeling?


    Soraya Pirouzi; Farahnaz Emami; Shohreh Taghizadeh; Ali Ghanbari


    Background: Stabilization exercises can improve the performance of trunk and back muscles, which are effective in the prevention and treatment of low back pain. The four-point kneeling exercise is one of the most common types of stabilization exercises. This quasi-experimental study aimed to evaluate and compare the level of activation between abdominal and lumbar muscles in the different stages of the four-point kneeling exercise. Methods: The present study was conducted on 30 healthy wom...

  9. Trunk muscle response to various protocols of lumbar traction. (United States)

    Cholewicki, Jacek; Lee, Angela S; Reeves, N Peter; Calle, Elizabeth A


    The purpose of this study was to compare trunk muscle activity, spinal decompression force, and trunk flexibility resulting from various protocols of spinal traction. Four experiments explored the effects of (1) sinusoidal, triangular, square, and continuous distraction-force waveforms, (2) 0, 10, 20, and 30 degrees of pull angle, (3) superimposed low, medium and high frequency force oscillations, and (4) sham traction. Nineteen healthy subjects volunteered for this study. Surface EMG was recorded during traction and later used in a biomechanical model to estimate spine decompression force. Trunk flexibility was measured before and after each treatment. There were no differences in muscle activity between any of the experimental conditions except the thoracic erector spinae muscle, which had lower EMG during continuous compared to sinusoidal distraction-force waveform (p=0.02). Thoracic and lumbar erector spinae muscles were significantly less active during sham than real traction (p=0.01 and p=0.04, respectively). The estimated L4-L5 spine compression force was 25N. Trunk flexibility decreased after each experimental session (p=0.01), and there were no differences between sessions. Our results suggest that the trunk muscle activity is minimal and point toward fluid exchange in the disc as one of the key biomechanical effects of spinal traction.

  10. Optical characterization of muscle (United States)

    Oliveira, Luís; Lage, Armindo; Pais Clemente, Manuel; Tuchin, Valery V.


    Optical characterization and internal structure of biological tissues is highly important for biomedical optics. In particular for optical clearing processes, such information is of vital importance to understand the mechanisms involved through the variation of the refractive indices of tissue components. The skeletal muscle presents a fibrous structure with an internal arrangement of muscle fiber cords surrounded by interstitial fluid that is responsible for strong light scattering. To determine the refractive index of muscle components we have used a simple method of measuring tissue mass and refractive index during dehydration. After performing measurements for natural and ten dehydration states of the muscle samples, we have determined the dependence between the refractive index of the muscle and its water content. Also, we have joined our measurements with some values reported in literature to perform some calculations that have permitted to determine the refractive index of the dried muscle fibers and their corresponding volume percentage inside the natural muscle.

  11. Imaging Characterization Lumbar Disk Hernia in Operated patients.

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    Enrique Hernández Padrón


    Full Text Available Background: The details of lumbar disk hernia are specifically described in imaging studies, which leads to very specific diagnosis contributing to its appropriate treatment. Objective: To characterize through imaging studies the lumbar disk hernia in operated patients. Methods: Descriptive observational, correlational, retrospective study of a series of cases, carried out in the University Hospital “Dr. Gustavo Aldereguía Lima” of Cienfuegos, from 2000 to 2005, including all the patients who required imaging studies for a suspect of lumbar disk hernia, who received surgical treatment in that institution. The available imaging means were used: spine simple radiography in lumbar area, myelography and computerized axial tomography. Results: Males were more affected by lumbar disk hernia. The most common sings observed through spine simple radiography in lumbar area were: decrease of the intervertebral space and arthrosic changes in the vertebral bodies. Myelography was performed in six patients and three of them were positive. The most common kind of hernia according with their localization was the lateral, and according with the amount of herniated material, the protruded hernia. The most affected spaces were: L5- S1 and L4-L5. The patients of the third and fourth decade of life were the most affected, with a prevalence of the protruded hernia in the L5-S1 y L4 -L5 spaces. Conclusions: The imaging studies contributed to a correct characterization of lumbar disk hernia.

  12. Effect of extensor muscle activation on the response to lumbar posteroanterior forces. (United States)

    Lee, M; Esler, M A; Mildren, J; Herbert, R


    The purpose of this study was to examine the responses of normal subjects to the application of cyclical lumbar posteroanterior forces which simulated a manipulative therapy technique known as mobilization. The specific aim was to determine whether increases in spinal extensor muscle activity could modify the stiffness of lumbar posteroanterior movements. The lumbar posteroanterior stiffness was measured in eleven asymptomatic subjects in the prone position, both in the relaxed condition and during maximal voluntary isometric muscle contractions. The electromyographic activity of lumbar extensor muscles was measured in the relaxed and maximal contraction conditions during the application of mobilization. The posteroanterior stiffness was found to be significantly greater during maximum activation of the extensor muscles. The results indicate that muscle activity can significantly alter lumbar posteroanterior stiffness. Clinicians often apply posteroanterior forces over a spinous process of a vertebra to assess the resistance to movement. Information about the degree and nature of perceived resistance to posteroanterior movement is used to help make a diagnosis and select treatment techniques. This study has shown that increased activity of the spinal extensor muscles can increase the stiffness of lumbar posteroanterior movements, compared with the case where the subject is relaxed. When interpreting the posteroanterior responses of patients, clinicians should be aware that spinal extensor mucle activity can influence resistance to posteroanterior movement.

  13. Effects of pelvic stabilization on lumbar muscle activity during dynamic exercise. (United States)

    San Juan, Jun G; Yaggie, James A; Levy, Susan S; Mooney, Vert; Udermann, Brian E; Mayer, John M


    Many commonly utilized low-back exercise devices offer mechanisms to stabilize the pelvis and to isolate the lumbar spine, but the value of these mechanisms remains unclear. The purpose of this study was to examine the effect of pelvic stabilization on the activity of the lumbar and hip extensor muscles during dynamic back extension exercise. Fifteen volunteers in good general health performed dynamic extension exercise in a seated upright position on a lumbar extension machine with and without pelvic stabilization. During exercise, surface electromyographic activity of the lumbar multifidus and biceps femoris was recorded. The activity of the multifidus was 51% greater during the stabilized condition, whereas there was no difference in the activity of the biceps femoris between conditions. This study demonstrates that pelvic stabilization enhances lumbar muscle recruitment during dynamic exercise on machines. Exercise specialists can use these data when designing exercise programs to develop low back strength.

  14. Sarcomere length organization as a design for cooperative function amongst all lumbar spine muscles. (United States)

    Zwambag, Derek P; Ricketts, T Alexander; Brown, Stephen H M


    The functional design of spine muscles in part dictates their role in moving, loading, and stabilizing the lumbar spine. There have been numerous studies that have examined the isolated properties of these individual muscles. Understanding how these muscles interact and work together, necessary for the prediction of muscle function, spine loading, and stability, is lacking. The objective of this study was to measure sarcomere lengths of lumbar muscles in a neutral cadaveric position and predict the sarcomere operating ranges of these muscles throughout full ranges of spine movements. Sarcomere lengths of seven lumbar muscles in each of seven cadaveric donors were measured using laser diffraction. Using published anatomical coordinate data, superior muscle attachment sites were rotated about each intervertebral joint and the total change in muscle length was used to predict sarcomere length operating ranges. The extensor muscles had short sarcomere lengths in a neutral spine posture and there were no statistically significant differences between extensor muscles. The quadratus lumborum was the only muscle with sarcomere lengths that were optimal for force production in a neutral spine position, and the psoas muscles had the longest lengths in this position. During modeled flexion the extensor, quadratus lumborum, and intertransversarii muscles lengthened so that all muscles operated in the approximate same location on the descending limb of the force-length relationship. The intrinsic properties of lumbar muscles are designed to complement each other. The extensor muscles are all designed to produce maximum force in a mid-flexed posture, and all muscles are designed to operate at similar locations of the force-length relationship at full spine flexion.

  15. The influence of muscle forces on the stress distribution in the lumbar spine

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    Wong, C; Rasmussen, J; Simonsen, Erik B.;


    Introduction: Previous studies of bone stresses in the human lumbar spine have relied on simplified models when modeling the spinal musculature, even though muscle forces are likely major contributors to the stresses in the vertebral bones. Detailed musculoskeletal spine models have recently become...... available and show good correlation with experimental findings. A combined inverse dynamics and finite element analysis study was conducted in the lumbar spine to investigate the effects of muscle forces on a detailed musculoskeletal finite element model of the 4th lumbar vertebral body. Materials...... and Methodology: The muscle forces were computed with a detailed and validated inverse dynamics musculoskeletal spine model in a lifting situation, and were then applied to an orthotropic finite element model of the 4th lumbar vertebra. The results were compared with those from a simplified load case without...

  16. Impact of lumbar spine posture on thoracic spine motion and muscle activation patterns. (United States)

    Nairn, Brian C; Drake, Janessa D M


    Complex motion during standing is typical in daily living and requires movement of both the thoracic and lumbar spine; however, the effects of lumbar spine posture on thoracic spine motion patterns remain unclear. Thirteen males moved to six positions involving different lumbar (neutral and flexed) and thoracic (flexed and twisted) posture combinations. The thoracic spine was partitioned into three segments and the range of motion from each posture was calculated. Electromyographical data were collected from eight muscles bilaterally. Results showed that with a flexed lumbar spine, the lower-thoracic region had 14.83 ° and 15.6 1 ° more flexion than the upper- and mid-thoracic regions, respectively. A flexed lumbar spine significantly reduced the mid-thoracic axial twist angle by 5.21 ° compared to maximum twist in the mid-thoracic region. Functional differences emerged across muscles, as low back musculature was greatest in maintaining flexed lumbar postures, while thoracic erector spinae and abdominals showed bilateral differences with greater activations to the ipsilateral side. Combined postures have been previously identified as potential injury modulators and bilateral muscle patterns can have an effect on loading pathways. Overall, changes in thoracic motion were modified by lumbar spine posture, highlighting the importance of considering a multi-segmented approach when analyzing trunk motion.

  17. Is Abdominal Muscle Activity Different from Lumbar Muscle Activity during Four-Point Kneeling?

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    Soraya Pirouzi


    Full Text Available Background: Stabilization exercises can improve the performance of trunk and back muscles, which are effective in the prevention and treatment of low back pain. The four-point kneeling exercise is one of the most common types of stabilization exercises. This quasi-experimental study aimed to evaluate and compare the level of activation between abdominal and lumbar muscles in the different stages of the four-point kneeling exercise. Methods: The present study was conducted on 30 healthy women between 20 and 30 years old. Muscle activity was recorded bilaterally from transversus abdominis, internal oblique, and multifidus muscles with an electromyography (EMG device during the different stages of the four-point kneeling exercise. All the collected EMG data were normalized to the percentage of maximum voluntary isometric contraction. The repeated measures ANOVA and paired t-test were used for the statistical analysis of the data. Results: A comparison between mean muscle activation in right arm extension and left leg extension showed that left internal oblique and left transverse abdominis muscles produced greater activation during left leg extension (P<0.05. The comparison of mean muscle activation between right arm extension and the bird-dog position showed that, except for the right internal oblique, all the muscles produced higher activation in the bird-dog stage (P<0.05. In comparison to the bird-dog stage, the left multifidus showed high activation during left leg extension (P<0.05. Conclusion: The results of this study showed that the activity of all the above-mentioned muscles during quadruped exercise can provide stability, coordination, and smoothness of movements.

  18. Disorders of paravertebral lumbar muscles: from pathology to cross-sectional imaging

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    Bierry, Guillaume; Kremer, Stephane; Abu Eid, Maher; Bogorin, Adriana; Dietemann, Jean-Louis [University Hospital, Hautepierre Hospital, Department of Radiology 2, Strasbourg (France); Kellner, Frauke [Inselspital Bern, Department of Radiology, Berne (Switzerland)


    Paravertebral lumbar muscles are important for spine stabilization and mobility. They may be abnormal in several disorders that may be associated with pain or functional impairment. Special attention should be paid to the paravertebral muscles during imaging, so that a possible muscular disease is not overlooked, especially in patients with low back pain. This article reviews such imaging abnormalities. (orig.)

  19. Spinal muscles can create compressive follower loads in the lumbar spine in a neutral standing posture. (United States)

    Han, Kap-Soo; Rohlmann, Antonius; Yang, Seok-Jo; Kim, Byeong Sam; Lim, Tae-Hong


    The ligamentous spinal column buckles under compressive loads of even less than 100N. Experimental results showed that under the follower load constraint, the ligamentous lumbar spine can sustain large compressive loads without buckling, while at the same time maintaining its flexibility reasonably well. The purpose of this study was to investigate the feasibility of follower loads produced by spinal muscles in the lumbar spine in a quiet standing posture. A three-dimensional static model of the lumbar spine incorporating 232 back muscles was developed and utilized to perform the optimization analysis in order to find the muscle forces, and compressive follower loads (CFLs) along optimum follower load paths (FLPs). The effect of increasing external loads on CFLs was also investigated. An optimum solution was found which is feasible for muscle forces producing minimum CFLs along the FLP located 11 mm posterior to the curve connecting the geometrical centers of the vertebral bodies. Activation of 30 muscles was found to create CFLs with zero joint moments in all intervertebral joints. CFLs increased with increasing external loads including FLP deviations from the optimum location. Our results demonstrate that spinal muscles can create CFLs in the lumbar spine in a neutral standing posture in vivo to sustain stability. Therefore, its application in experimental and numerical studies concerning loading conditions seems to be suitable for the attainment of realistic results.

  20. The effects of deep abdominal muscle strengthening exercises on respiratory function and lumbar stability. (United States)

    Kim, Eunyoung; Lee, Hanyong


    [Purpose] The purpose of this study was to examine the effects of deep abdominal muscle strengthening exercises on respiratory function and lumbar stability. [Subjects] From among 120 male and female students, 22 whose thoraxes opened no more than 5 cm during inspiration and expiration and whose forced expiratory flow rates were around 300 m/L were recruited. The subjects were randomly divided into an experimental group of eleven, who performed deep abdominal muscle strengthening exercises, and a control group of eleven, who received no particular intervention. [Methods] The subjects were instructed to perform normal breathing in the hook-lying position. They were then directed to hold their breath for ten seconds at the end of inspiration. Ten repetitions of this breathing comprised a set of respiratory training, and a total of five sets were performed by the subjects. [Results] Deep abdominal muscle training was effective at enhancing respiratory function and lumbar stabilization. [Conclusion] The clinical application of deep abdominal muscle strengthening exercises along with lumbar stabilization exercises should be effective for lower back pain patients in need of lumbar stabilization.

  1. Psoas muscle and lumbar spine stability : a concept uniting existing controversies - Critical review and hypothesis

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    Penning, L


    Psoas muscle (PM) function with regard to the lumbar spine (LS) is disputed. Electromyographic studies attribute to the PM a possible role as stabilizer. Anatomical textbooks describe the PM as an LS flexor, but not a stabilizer. According to more recent anatomical studies, the PM does not act on th

  2. CT and MRI Determination of Intermuscular Space within Lumbar Paraspinal Muscles at Different Intervertebral Disc Levels.

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    Xuefei Deng

    Full Text Available Recognition of the intermuscular spaces within lumbar paraspinal muscles is critically important for using the paramedian muscle-splitting approach to the lumbar spine. As such, it is important to determine the intermuscular spaces within the lumbar paraspinal muscles by utilizing modern medical imaging such as computed tomography (CT and magnetic resonance imaging (MRI.A total of 30 adult cadavers were studied by sectional anatomic dissection, and 60 patients were examined using CT (16 slices, 3-mm thickness, 3-mm intersection gap, n = 30 and MRI (3.0T, T2-WI, 5-mm thickness, 1-mm intersection gap, n = 30. The distances between the midline and the superficial points of the intermuscular spaces at different intervertebral disc levels were measured.Based on study of our cadavers, the mean distances from the midline to the intermuscular space between multifidus and longissimus, from intervertebral disc levels L1-L2 to L5-S1, were 0.9, 1.1, 1.7, 3.0, and 3.5 cm, respectively. Compared with the upper levels (L1-L3, the superficial location at the lower level (L4-S1 is more laterally to the midline (P<0.05. The intermuscular space between sacrospinalis and quadratus lumborum, and that between longissimus and iliocostalis did not exist at L4-S1. The intermuscular spaces in patients also varied at different levels of the lumbar spine showing a low discontinuous density in CT and a high signal in MRI. There were no significant differences between the observations in cadavers and those made using CT and MRI.The intermuscular spaces within the paraspinal muscles vary at different intervertebral disc levels. Preoperative CT and MRI can facilitate selection of the muscle-splitting approach to the lumbar spine. This paper demonstrates the efficacy of medical imaging techniques in surgical planning.

  3. CT and MRI Determination of Intermuscular Space within Lumbar Paraspinal Muscles at Different Intervertebral Disc Levels (United States)

    Wang, Shidong; Zhang, Yu; Han, Hui; Zheng, Dengquan; Ding, Zihai; Wong, Kelvin K. L.


    Background Recognition of the intermuscular spaces within lumbar paraspinal muscles is critically important for using the paramedian muscle-splitting approach to the lumbar spine. As such, it is important to determine the intermuscular spaces within the lumbar paraspinal muscles by utilizing modern medical imaging such as computed tomography (CT) and magnetic resonance imaging (MRI). Methods A total of 30 adult cadavers were studied by sectional anatomic dissection, and 60 patients were examined using CT (16 slices, 3-mm thickness, 3-mm intersection gap, n = 30) and MRI (3.0T, T2-WI, 5-mm thickness, 1-mm intersection gap, n = 30). The distances between the midline and the superficial points of the intermuscular spaces at different intervertebral disc levels were measured. Results Based on study of our cadavers, the mean distances from the midline to the intermuscular space between multifidus and longissimus, from intervertebral disc levels L1–L2 to L5–S1, were 0.9, 1.1, 1.7, 3.0, and 3.5 cm, respectively. Compared with the upper levels (L1–L3), the superficial location at the lower level (L4–S1) is more laterally to the midline (Pquadratus lumborum, and that between longissimus and iliocostalis did not exist at L4–S1. The intermuscular spaces in patients also varied at different levels of the lumbar spine showing a low discontinuous density in CT and a high signal in MRI. There were no significant differences between the observations in cadavers and those made using CT and MRI. Conclusion The intermuscular spaces within the paraspinal muscles vary at different intervertebral disc levels. Preoperative CT and MRI can facilitate selection of the muscle-splitting approach to the lumbar spine. This paper demonstrates the efficacy of medical imaging techniques in surgical planning. PMID:26458269

  4. Seizure-induced muscle force can caused lumbar spine fracture

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    Mehlhorn, A T; Strohm, P C; Hausschildt, O;


    Patients suffering form epilepsy have an increased risk for fractures. Beside fractures caused by fall or accident muscles forces alone generated during tonic-clonic seizure can result in severe musculoskeletal injury. Contractions of strong paraspinal muscles can lead to compression fracture of ...

  5. Operative access to kidney without damage of lumbar and intercostal muscles, vessels and nerves

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    Anatoliy Zalewsky


    Full Text Available The purpose of the study is a search of operative access to the kidney with less surgical trauma and associated complications. Specific research tasks included experiment on the dead bodies of people to develop operative access to the kidney without the transversal section of muscles and damage of intercostal and lumbar vessels and nerves. The research also studied the parameters of access using the Sozon-Yaroshevich method (1954 to estimate his appropriateness in surgical practice.Operative access to the kidney with the longitudinal section of latissimus dorsi muscle and the XII rib is anatomically justified and possesses parameters which are sufficient for the successful conducting of operations on a kidney and upper departments of the urine excretion system. The suggested operative access to the kidney eliminates the damage of intercostal and lumbar muscles, vessels and nerves. Application of this operative access method to the kidney in treatment of urology patients decreases time of their treatment and eliminates relaxation of abdominal muscles and development of postoperative lumbar hernia.

  6. Atrophy of sacrospinal muscle groups in patients with chronic, diffusely radiating lumbar back pain

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    Laasonen, E.M.


    After surgery necessitated by lumbar back pain syndromes, radiolucency verified by CT may appear in the sacrospinal muscle group on the operate side. This radiolucency represents muscular atrophy and is in its most severe form a result of the replacement of muscle tissue with adipose tissue. Such muscular atrophy appeared in the present series in 31 out of all 156 patients (19.9%) and in 29 out of 94 patients operated on because of radiating lumbar back pain (30.9%). The radiological appearance, extent, and HU values of this muscular atrophy are presented in detail. Only weak correlations with the multitude of clinical symptoms and signs were found in this retrospective study. The effects of irreversible muscular atrophy on the indications for surgery and physiotherapy are discussed.

  7. Weakness of unilateral lower limb’s proximal muscle; diabetic amyotrophy coexisting with lumbar discopathy: Case report and review of the literature

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    Emine Eda Kurt


    Full Text Available Diabetic amyotrophy is a relatively infrequent complication of diabetes mellitus is most often characterized by weakness of unilateral lower limb and pain. Clinical differentiation from lumbar disc herniation may be difficult. ıt was hereby presented; 64 year old male patient who has 15 year old history of diabetes mellitus and lumbar discopathy previously diagnosed. He had weakness of unilateral lower limb and pain. Patient was admitted right thigh pain and weakness of proximal lower limb muscle. The physical examination, magnetic resonance imaging and electromyographic examination of the patient was consistent with the diagnosis of diabetic amyotrophy. When diabetic amyotrophy and lumbar disc herniaton coexist as a pain source, which disease responsible from pain should be detected well and treatments should be arrenged according to responsible disease. Thus, unnecessary surgeries can be avoided.

  8. EMG Activity of Selected Trunk and Hip Muscles During a Squat Lift: Effect of Varying the Lumbar Posture (United States)


    Analysis of the electromyographic (EMG) signal of a muscle group during lifting can provide insight into the force developed by that muscle (Anderrson, 1977...Jonsson, 1985). Myoelectric activity of a muscle has been found to vary linearly with the tension developed, in similar activities and non-fatigue...the lumbar spine in a kyphotic position would result in a significant increase in the amount of myoelectric activity seen in the hip extensor muscles

  9. Trunk strength and lumbar paraspinal muscle activity during isometric exercise in chronic low-back pain patients and controls. (United States)

    Cassisi, J E; Robinson, M E; O'Conner, P; MacMillan, M


    The purpose of this study was to describe trunk strength and lumbar paraspinal muscle activity across five angles of flexion during isometric exercise and rest in chronic low-back pain patients and control subjects. High muscle tension as measured by surface integrated electromyography is predicted by a muscle spasm model, and low muscle tension is predicted by a muscle deficiency model. Prior lumbar surgery had no affect on peak torque or maximum surface integrated electromyography data. Both groups produced greater torque and less surface integrated electromyography in more flexed positions. Chronic low-back pain patients exhibited lower peak torque and lower maximum surface integrated electromyography bilaterally during isometric extension effort across all angles. A muscle deficiency model of chronic low back pain was supported by these data and a muscle spasm model was not supported. Discriminant analyses indicated that monitoring maximum surface integrated electromyography of lumbar muscles during isometric effort facilitates classification of chronic low-back pain patients. Future directions are discussed in terms of applying psychophysiologic methods to pain rehabilitation.

  10. How does back muscle strength change after posterior lumbar interbody fusion? (United States)

    Lee, Chong-Suh; Kang, Kyung-Chung; Chung, Sung-Soo; Park, Won-Hah; Shin, Won-Ju; Seo, Yong-Gon


    OBJECTIVE There is a lack of evidence of how back muscle strength changes after lumbar fusion surgery and how exercise influences these changes. The aim of this study was to evaluate changes in back muscle strength after posterior lumbar interbody fusion (PLIF) and to measure the effects of a postoperative exercise program on muscle strength and physical and mental health outcomes. METHODS This prospective study enrolled 59 women (mean age 58 years) who underwent PLIF at 1 or 2 spinal levels. To assess the effects of a supervised lumbar stabilization exercise (LSE), the authors allocated the patients to an LSE (n = 26) or a control (n = 33) group. The patients in the LSE group performed the LSEs between 3 and 6 months postoperatively. Back extensor strength, visual analog scale (VAS) scores in back pain, and physical component summary (PCS) and mental component summary (MCS) scores on the 36-Item Short Form Health Survey were determined for the both groups. RESULTS Mean strength of the back muscles tended to slightly decrease by 7.5% from preoperatively to 3 months after PLIF (p = 0.145), but it significantly increased thereafter and was sustained until the last follow-up (38.1%, p strength was similar in the LSE and control groups preoperatively, but it increased significantly more in the LSE group (64.2%) than in the control group (21.7%) at the last follow-up 12 months after PLIF (p = 0.012). At the last follow-up, decreases in back pain VAS scores were more significant among LSE group patients, who had a pain reduction on average of 58.2%, than among control group patients (reduction of 26.1%) (p = 0.013). The patients in the LSE group also had greater improvement in both PCS (39.9% improvement) and MCS (20.7% improvement) scores than the patients in the control group (improvement of 18.0% and 1.1%, p = 0.042 and p = 0.035, respectively). CONCLUSIONS After PLIF, strength in back muscles decreased until 3 months postoperatively but significantly increased after

  11. Idiopathic and normal lateral lumbar curves: muscle effects interpreted by 12th rib length asymmetry with pathomechanic implications for lumbar idiopathic scoliosis

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    Theodoros B. Grivas


    Full Text Available Abstract Background The historical view of scoliosis as a primary rotation deformity led to debate about the pathomechanic role of paravertebral muscles; particularly multifidus, thought by some to be scoliogenic, counteracting, uncertain, or unimportant. Here, we address lateral lumbar curves (LLC and suggest a pathomechanic role for quadrates lumborum, (QL in the light of a new finding, namely of 12th rib bilateral length asymmetry associated with idiopathic and small non-scoliosis LLC. Methods Group 1: The postero-anterior spinal radiographs of 14 children (girls 9, boys 5 aged 9–18, median age 13 years, with right lumbar idiopathic scoliosis (IS and right LLC less that 10°, were studied. The mean Cobb angle was 12° (range 5–22°. Group 2: In 28 children (girls 17, boys 11 with straight spines, postero-anterior spinal radiographs were evaluated similarly to the children with the LLC, aged 8–17, median age 13 years. The ratio of the right/left 12th rib lengths and it’s reliability was calculated. The difference of the ratio between the two groups was tested; and the correlation between the ratio and the Cobb angle estimated. Statistical analysis was done using the SPSS package. Results The ratio’s reliability study showed intra-observer +/−0,036 and the inter-observer error +/−0,042 respectively in terms of 95 % confidence limit of the error of measurements. The 12th rib was longer on the side of the curve convexity in 12 children with LLC and equal in two patients with lumbar scoliosis. The 12th rib ratios of the children with lumbar curve were statistically significantly greater than in those with straight spines. The correlation of the 12th rib ratio with Cobb angle was statistically significant. The 12th thoracic vertebrae show no axial rotation (or minimal in the LLC and no rotation in the straight spine group. Conclusions It is not possible, at present, to determine whether the 12th convex rib lengthening is

  12. The effects of stabilization exercise on pain, functional disability and muscle endurance in patients suspectedto lumbar segmental instability

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    Y. Javadian


    Full Text Available AbstractIntroduction: Lumbar segmental instability is one of the subgroups of non specific chronic low back pain and it seems that 30-40% of patients with LBP suffer from lumbar segmental instability. Pain intensity, functional disability and reduced muscle endurance are common in such patients. The aim of this study was to evaluate the effects of stabilization exercise on pain, functional disability and muscle endurance in patients suspected to lumbar segmental instability Material & methods: Following ethical approval, a randomized clinical trial was carried out on 30 patients suspected to lumbar segmental instability ranging from 18-45 years old. They were randomly divided into two groups; the first group underwent routine exercise only while the second group performed routine exercise plus stabilization training for 8 weeks. Outcome measure included pain intensity, functional disability, and flexion and extension range of motion and flexor, extensor and side support muscle endurance which were evaluated before and after treatment. Data were analyzed using paired t test and independent t test.Results: Muscle endurance and flexion range of motion increased in both groups although the increase was higher in stabilization training group (p=0.00. Pain intensity and functional disability significantly decreased in both groups (p=0.00, but decreasing of pain intensity and functional disability were more in stabilization training group (p=0.00. Conclusion: Stabilization training is more effective than routine exercise in improvement of pain intensity, functional disability, muscle endurance and range of motion in patients suspected to lumbar segmental instability. J Mazand Univ Med Sci 2008; 18(65: 63-73 (Persian

  13. The Application of Parallel Robotics to Investigate the Effect of Lumbar Bracing on Trunk Muscle Activity

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    Gregory N. Kawchuk


    Full Text Available Lumbar bracing is prescribed frequently for disability caused by low back pain; however, investigations into this practice demonstrate a range of patient outcomes. This inconsistency may arise from the practice of employing voluntary, single-axis trunk movements when investigating braces. Alternatively, this study employed a parallel robot to create a standardised, multi-axis testing environment. Surface electromyographic (sEMG data were collected from the trunk of 24 asymptomatic participants, who were seated on the robot, tilted to 15°, then circumducted while attempting to maintain an upright posture. Multiple trials were performed for three randomised conditions: non-braced, soft-material brace and stiff-material brace. As expected, the sEMG activity was significantly reduced in the majority of muscle responses (201/240. Unexpectedly, a paradoxical increase in the sEMG activity was observed in 39/240 responses. While lumbar bracing reduces the sEMG activity on average, these data suggest the existence of an infrequent paradoxical response that may provide a possible explanation for the discordant results observed in previous bracing investigations.

  14. Characterization of radiographic features of consecutive lumbar spondylolisthesis (United States)

    Sun, Yapeng; Wang, Hui; Yang, Dalong; Zhang, Nan; Yang, Sidong; Zhang, Wei; Ding, Wenyuan


    Abstract Radiographic features of consecutive lumbar spondylolisthesis were retrospectively analyzed in a total of 17 patients treated for this condition at the Third Hospital of Hebei Medical University from June 2005 to March 2012. To investigate the radiographic features, pelvic compensatory mechanisms, and possible underlying etiologies of consecutive lumbar spondylolisthesis. To the best of our knowledge, there is no previous report concerning the characteristics of consecutive lumbar spondylolisthesis. The Taillard index and the lumbar lordosis (LL), pelvic incidence (PI), sacrum slope (SS), and pelvic tilt (PT) were determined on lateral X-ray images, and the angular displacement was analyzed on flexion–extension X-ray images. Correlation between LL and various pelvic parameters and correlation between Taillard index and angular displacement were assessed by Pearson correlation analysis. A total of 20 cases of isthmic spondylolisthesis and 14 of degenerative spondylolisthesis were retrospectively studied in 17 patients. The Taillard index and the angular displacement in the lower vertebrae were both larger than those in the upper vertebrae. Statistical analysis revealed that LL was correlated with PI and PT, whereas PI was correlated with PT and SS. However, no correlation was identified between Taillard index and angular displacement. In consecutive lumbar spondylolisthesis, the degree of vertebral slip and the angular displacement of the lower vertebrae were both greater than those of the upper vertebrae, indicating that the compensatory mechanism of the pelvis plays an important role in maintaining sagittal balance. PMID:27861359

  15. Changes in the flexion relaxation response induced by lumbar muscle fatigue

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    Cantin Vincent


    Full Text Available Abstract Background The flexion relaxation phenomenon (FRP is an interesting model to study the modulation of lumbar stability. Previous investigations have explored the effect of load, angular velocity and posture on this particular response. However, the influence of muscular fatigue on FRP parameters has not been thoroughly examined. The objective of the study is to identify the effect of erector spinae (ES muscle fatigue and spine loading on myoelectric silence onset and cessation in healthy individuals during a flexion-extension task. Methods Twenty healthy subjects participated in this study and performed blocks of 3 complete trunk flexions under 4 different experimental conditions: no fatigue/no load (1, no fatigue/load (2, fatigue/no load(3, and fatigue/load (4. Fatigue was induced according to the Sorenson protocol, and electromyographic (EMG power spectral analysis confirmed that muscular fatigue was adequate in each subject. Trunk and pelvis angles and surface EMG of the ES L2 and L5 were recorded during a flexion-extension task. Trunk flexion angle corresponding to the onset and cessation of myoelectric silence was then compared across the different experimental conditions using 2 × 2 repeated-measures ANOVA. Results Onset of myoelectric silence during the flexion motion appeared earlier after the fatigue task. Additionally, the cessation of myoelectric silence was observed later during the extension after the fatigue task. Statistical analysis also yielded a main effect of load, indicating a persistence of ES myoelectric activity in flexion during the load condition. Conclusion The results of this study suggest that the presence of fatigue of the ES muscles modifies the FRP. Superficial back muscle fatigue seems to induce a shift in load-sharing towards passive stabilizing structures. The loss of muscle contribution together with or without laxity in the viscoelastic tissues may have a substantial impact on post fatigue stability.

  16. Does lumbar paraspinal muscle fatty degeneration correlate with aerobic index and Oswestry disability index?

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    Mark L Prasarn


    Full Text Available Background: We sought to analyze whether the amount of paraspinal fatty degeneration correlates with a patient′s physical fitness, and to determine if these findings on lumbar magnetic resonance imaging (MRI scans can help predict functional outcomes. Methods: A retrospective review was performed on 172 patients . Inclusion criteria involved being seen by a spine surgeon for low back pain, having aerobic index (AI, body mass index (BMI, Oswestry disability index (ODI, and body fat percentage measured recently, and having had a recent lumbar MRI scan. The percentage of fatty muscle degeneration was graded by three reviewers using T2-weighted axial images at L3 and L5 using a newly proposed system that was validated independently. The system is graded as follows: Grade 1: 0-24%, Grade 2: 25-49%,
Grade 3: 50-74%, and
Grade 4: 75-100%. An independent t-test was used for comparisons. Results: The average AI was 34.87, and the cohort was divided into two groups: above-average AI (89 patients and below-average AI (83 patients. For all paraspinal fat measurements and body fat percentage, the difference between the above- and below-average AI groups was statistically significant (P < 0.05, with the least amount of paraspinal fatty degeneration and body fat in the greater AI group. Weight alone and BMI were not found to be significantly different between those with above-average AI when compared to those with below-average AI (P = 0.491 and P = 0.122, respectively. There was a trend for lower ODI scores in the above-average AI group (41.9 vs 46.1, but this did not reach statistical significance between the two groups (P = 0.075. For all patients it was shown that there was significantly less paraspinal fat at the L3 level as compared to L5 (P < 0.001. Conclusions: We were able to show that patients with a higher AI have lower body fat percentages and lower amounts of fatty degeneration in their lumbar paraspinal musculature. The amount of

  17. Imaging Characterization Lumbar Disk Hernia in Operated patients. Caracterización por imaginología de la hernia discal lumbar en pacientes operados.


    Félix Dueñas Ros; Enrique Hernández Padrón


    Background: The details of lumbar disk hernia are specifically described in imaging studies, which leads to very specific diagnosis contributing to its appropriate treatment. Objective: To characterize through imaging studies the lumbar disk hernia in operated patients. Methods: Descriptive observational, correlational, retrospective study of a series of cases, carried out in the University Hospital “Dr. Gu...

  18. The biomechanical effects of variation in the maximum forces exerted by trunk muscles on the joint forces and moments in the lumbar spine: a finite element analysis. (United States)

    Kim, K; Lee, S K; Kim, Y H


    The weakening of trunk muscles is known to be related to a reduction of the stabilization function provided by the muscles to the lumbar spine; therefore, strengthening deep muscles might reduce the possibility of injury and pain in the lumbar spine. In this study, the effect of variation in maximum forces of trunk muscles on the joint forces and moments in the lumbar spine was investigated. Accordingly, a three-dimensional finite element model of the lumbar spine that included the trunk muscles was used in this study. The variation in maximum forces of specific muscle groups was then modelled, and joint compressive and shear forces, as well as resultant joint moments, which were presumed to be related to spinal stabilization from a mechanical viewpoint, were analysed. The increase in resultant joint moments occurred owing to decrease in maximum forces of the multifidus, interspinales, intertransversarii, rotatores, iliocostalis, longissimus, psoas, and quadratus lumborum. In addition, joint shear forces and resultant joint moments were reduced as the maximum forces of deep muscles were increased. These results from finite element analysis indicate that the variation in maximum forces exerted by trunk muscles could affect the joint forces and joint moments in the lumbar spine.

  19. Influence of lumbar muscle fatigue on trunk adaptations during sudden external perturbations

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    Jacques Abboud


    Full Text Available IntroductionWhen the spine is subjected to perturbations, neuromuscular responses such as reflex muscle contractions contribute to the overall balance control and spinal stabilization mechanisms. These responses are influenced by muscle fatigue, which has been shown to trigger changes in muscle recruitment patterns. Neuromuscular adaptations, e.g. attenuation of reflex activation and/or postural oscillations following repeated unexpected external perturbations, have also been described. However, the characterization of these adaptations still remains unclear. Using high-density electromyography (EMG may help understand how the nervous system chooses to deal with an unknown perturbation in different physiological and/or mechanical perturbation environments. AimTo characterize trunk neuromuscular adaptations following repeated sudden external perturbations after a back muscle fatigue task using high-density EMG.MethodsTwenty-five healthy participants experienced a series of 15 sudden external perturbations before and after back muscle fatigue. Erector spinae muscle activity was recorded using high-density EMG. Trunk kinematics during perturbation trials were collected using a 3-D motion analysis system. A two-way repeated measure ANOVA was conducted to assess 1 the adaptation effect across trials, 2 the fatigue effect, and 3 the interaction effect (fatigue x adaptation for the baseline activity, the reflex latency, the reflex peak and trunk kinematic variables (flexion angle, velocity and time to peak velocity. Muscle activity spatial distribution before and following the fatigue task was also compared using t-tests for dependent samples. ResultsAn attenuation of muscle reflex peak was observed across perturbation trials before the fatigue task, but not after. The spatial distribution of muscle activity was significantly higher before the fatigue task compared to post-fatigue trials. Baseline activity showed a trend to higher values after muscle

  20. [Case of painful muscle spasm induced by thoracic vertebral fracture: successful treatment with lumbar sympathetic ganglia block]. (United States)

    Shimizu, Fumitaka; Kawai, Motoharu; Koga, Michiaki; Ogasawara, Jun-ichi; Negoro, Kiyoshi; Kanda, Takashi


    We report a 70-year-old man, who developed painful involuntary muscle contraction of the left leg after the lumbar discectomy, which exacerbated after a vertebral fracture of Th12. This involuntary movement was accompanied with the abnormal position of left leg simulating triple flexion response, and was induced by active or passive movement of his left knee and foot joints. Several drugs including benzodiazepines and dantrolene were ineffective, although treatment with baclofen or carbamazepine was effective. These findings suggest that hyperexcitability of the anterior horn cells following the disturbance of spinal inhibitory interneurons was involved. Electophysiological studies suggested the disturbance of left lumber nerve roots. The spinal root blocks from L3 to S1 were performed, after which the painful involuntary muscle spasm was resolved. The lumbar sympathetic ganglia block was also effective; suggesting that abnormal afferent neuronal input to spinal cord was caused by the nerve root trauma which triggered the formation of secondary abnormal network in the spine. Lumbar sympathetic ganglia block should be recommended to a therapeutic option for the refractory painful muscle spasm of the leg.

  1. MRI-determined lumbar muscle morphometry in man and sheep: potential biomechanical implications for ovine model to human spine translation. (United States)

    Valentin, Stephanie; Licka, Theresia F; Elliott, James


    The sheep is a commonly used animal model for human lumbar spine surgery, but only in vitro investigations comparing the human and ovine spine exist. Spinal musculature has previously not been compared between man and sheep. This additional knowledge could further indicate to what extent these species are biomechanically similar. Therefore, the purpose of the study was to investigate spinal muscle morphometric properties using magnetic resonance imaging (MRI) in different age groups of healthy human participants and sheep in vivo. Healthy human participants (n = 24) and sheep (n = 17) of different age groups underwent T1-weighted MRI of the lumbar spine. Regions of interest of the muscles erector spinae (ES), multifidus (M) and psoas (PS) were identified. The ratio of flexor to extensor volume, ratio of M to ES volume, and muscle fat relative to an area of intermuscular fat were calculated. Sheep M to ES ratio was significantly smaller than in the human participants (sheep 0.16 ± 0.02; human 0.37 ± 0.05; P sheep 0.43 ± 0.05; P = 0.06). Age did not influence any muscle ratio outcome. Sheep had significantly greater extensor muscle fat compared with the human participants (M left human 40.64%, sheep 53.81%; M right human 39.17%, sheep 51.33%; ES left human 40.86%, sheep 51.29%; ES right human 35.93%, sheep 44.38%; all median values; all P sheep 33.67%; PS right human 32.78%, sheep 30.09%; P sheep and human lumbar spine muscles may indicate dissimilar biomechanical and functional demands, which is an important consideration when translating to human surgical models.

  2. Biomechanical effects of sitting with adjustable ischial and lumbar support on occupational low back pain: evaluation of sitting load and back muscle activity

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    Lin Fang


    Full Text Available Abstract Background Compared to standing posture, sitting decreases lumbar lordosis, increases low back muscle activity, disc pressure, and pressure on the ischium, which are associated with occupational LBP. A sitting device that reduces spinal load and low back muscle activities may help increase sitting comfort and reduce LBP risk. The objective of this study is to investigate the biomechanical effect of sitting with a reduced ischial support and an enhanced lumbar support (Off-Loading on load, interface pressure and muscle activities. Methods A laboratory test in low back pain (LBP and asymptomatic subjects was designed to test the biomechanical effect of using the Off-Loading sitting posture. The load and interface pressure on seat and the backrest, and back muscle activities associated with usual and this Off-Loading posture were recorded and compared between the two postures. Results Compared with Normal (sitting upright with full support of the seat and flat backrest posture, sitting in Off-Loading posture significantly shifted the center of the force and the peak pressure on the seat anteriorly towards the thighs. It also significantly decreased the contact area on the seat and increased that on the backrest. It decreased the lumbar muscle activities significantly. These effects are similar in individuals with and without LBP. Conclusion Sitting with reduced ischial support and enhanced lumbar support resulted in reduced sitting load on the lumbar spine and reduced the lumbar muscular activity, which may potentially reduce sitting-related LBP.

  3. The effect of experimental low back pain on lumbar muscle activity in people with a history of clinical low back pain: a muscle functional MRI study. (United States)

    Danneels, Lieven; Cagnie, Barbara; D'hooge, Roseline; De Deene, Yves; Crombez, Geert; Vanderstraeten, Guy; Parlevliet, Thierry; Van Oosterwijck, Jessica


    In people with a history of low back pain (LBP), structural and functional alterations have been observed at several peripheral and central levels of the sensorimotor pathway. These existing alterations might interact with the way the sensorimotor system responds to pain. We examined this assumption by evaluating the lumbar motor responses to experimental nociceptive input of 15 participants during remission of unilateral recurrent LBP. Quantitative T2 images (muscle functional MRI) were taken bilaterally of multifidus, erector spinae, and psoas at several segmental levels (L3 upper and L4 upper and lower endplate) and during several conditions: 1) at rest, 2) upon trunk-extension exercise without pain, and 3) upon trunk-extension exercise with experimental induced pain at the clinical pain-side (1.5-ml intramuscular hypertonic saline injections in erector spinae). Following experimental pain induction, muscle activity levels similarly reduced for all three muscles, on both painful and nonpainful sides, and at multiple segmental levels (P = 0.038). Pain intensity and localization from experimental LBP were similar as during recalled clinical LBP episodes. In conclusion, unilateral and unisegmental experimental LBP exerts a generalized and widespread decrease in lumbar muscle activity during remission of recurrent LBP. This muscle response is consistent with previous observed patterns in healthy people subjected to the same experimental pain paradigm. It is striking that similar inhibitory patterns in response to pain could be observed, despite the presence of preexisting alterations in the lumbar musculature during remission of recurrent LBP. These results suggest that motor output can modify along the course of recurrent LBP.

  4. The Role of Lumbar Sympathetic Nerves in Regulation of Blood Flow to Skeletal Muscle during Anaphylactic Hypotension in Anesthetized Rats.

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    Jie Song

    Full Text Available During hypovolemic shock, skeletal muscle blood flow could be redistributed to vital organs via vasoconstriction in part evoked by activation of the innervating sympathetic nerve activity. However, it is not well known whether this mechanism operates during anaphylactic shock. We determined the femoral artery blood flow (FBF and lumbar sympathetic nerve activity (LSNA mainly regulating the hindquater muscle blood flow during anaphylactic hypotension in anesthetized rats. Anesthetized Sprague-Dawley rats were randomly allocated to the following groups (n = 7/group: (1 non-sensitized, (2 anaphylaxis, (3 anaphylaxis-lumbar sympathectomy (LS and (4 anaphylaxis-sinoaortic denervation (SAD groups. Anaphylaxis was induced by an intravenous injection of the ovalbumin antigen to the sensitized rats. The systemic arterial pressure (SAP, heart rate (HR, central venous pressure (CVP, FBF and LSNA were continuously measured. In the anaphylaxis group, LSNA and HR increased, while SAP and FBF decreased after antigen injection. In the anaphylaxis-SAD group, LSNA did not significantly change during the early phase, but the responses of SAP and FBF were similar to those in the anaphylaxis group. In the anaphylaxis-LS group, both FBF and SAP decreased similarly to the anaphylaxis group during anaphylactic hypotension. These results indicated that LSNA increased via baroreceptor reflex, but this sympathoexcitation or LS did not affect antigen-induced decreases in FBF or SAP. Lumbar sympathetic nerves are not involved in regulation of the blood flow to the hindlimb or systemic blood pressure during anaphylactic hypotension in anesthetized rats.

  5. Effect of the different ages and visual display terminal use on repositioning and lumbar muscle activity during continuous sitting. (United States)

    Yoo, Won-Gyu


    [Purpose] The purpose of this study was to investigate the effect of different ages and visual display terminal (VDT) use on repositioning and lumbar muscle activity during continuous sitting. [Subjects] Thirteen males two groups: 7 males in their 20s, 6 males in their 40s participated in this study. [Methods] The two groups watched a lecture in a seated position under different conditions. L4 paraspinal muscle activity was recorded using a surface electromyography system. Repositioning was assessed using a video camera and Tekscan system. [Results] The repositioning times decreased significantly in the order to without a VDT in males in their 20s and 40s > with a VDT in males in their 20s > with a VDT in males in their 40s. The L4 paraspinal muscle activity significantly increased in order to without a VDT in males in their 20s and 40s < with a VDT in males in their 20s < with a VDT in males in their 40s. [Conclusion] The results of this study suggest that the number of repositioning movements during continuous sitting could affect lumbar muscle activity and could be an important factor for prevention of low back pain.

  6. Effect of spinal decompression on the lumbar muscle activity and disk height in patients with herniated intervertebral disk (United States)

    Kang, Jeong-Il; Jeong, Dae-Keun; Choi, Hyun


    [Purpose] This study was conducted to clarify the difference in therapeutic effects between traction and decompression therapies, and their clinical therapeutic significance. [Subjects and Methods] The subjects were 31 patients aged 35 to 50 years who had unilateral or bilateral lumbar and radicular leg pain. An intervention program was implemented in 31 patients with lumbar herniated intervertebral disks. For the experimental group, 15 subjects were randomly selected to receive decompression therapy and trunk stabilization exercise. For the control group, 16 subjects were randomly selected to receive traction therapy and trunk stabilization exercise. [Results] Activities of the rectus abdominis, transverse abdominis, and external oblique muscles increased significantly in both groups. However, the activity of the erector spine muscle decreased, which was the only significant change in muscle activity among those of the other muscles in both groups. The disk herniation index in the experimental group decreased significantly in comparison with that in the control group, and the difference in the change in disk herniation index between the groups was significant. [Conclusion] Decompression therapy was demonstrated to be more effective clinically than conventional traction therapy as an intervention method for disk disease. PMID:27942133

  7. Lumbar and abdominal muscle activity during walking in subjects with chronic low back pain: Support of the “guarding” hypothesis?

    NARCIS (Netherlands)

    Hulst, van der M.; Vollenbroek-Hutten, M.M.R.; Rietman, J.S.; Hermens, H.J.


    It has been hypothesized that changes in trunk muscle activity in chronic low back pain (CLBP) reflect an underlying “guarding” mechanism, which will manifest itself as increased superficial abdominal – and lumbar muscle activity. During a functional task like walking, it may be further provoked at

  8. Pace bowlers in cricket with history of lumbar stress fracture have increased risk of lower limb muscle strains, particularly calf strains

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    John Orchard


    Full Text Available John Orchard1, Patrick Farhart2, Alex Kountouris3, Trefor James3, Marc Portus31School of Public Health, University of Sydney, Australia; 2Punjab Kings XI team, Indian Premier League, India; 3Cricket Australia, Melbourne, AustraliaObjective: To assess whether a history of lumbar stress fracture in pace bowlers in cricket is a risk factor for lower limb muscle strains.Methods: This was a prospective cohort risk factor study, conducted using injury data from contracted first class pace bowlers in Australia during seasons 1998–1999 to 2008–2009 inclusive. There were 205 pace bowlers, 33 of whom suffered a lumbar stress fracture when playing first class cricket. Risk ratios ([RR] with 95% confidence intervals[CI] were calculated to compare the seasonal incidence of various injuries between bowlers with a prior history of lumbar stress fracture and those with no history of lumbar stress fracture.Results: Risk of calf strain was strongly associated with prior lumbar stress fracture injury history (RR = 4.1; 95% CI: 2.4–7.1. Risks of both hamstring strain (RR = 1.5; 95% CI: 1.03–2.1 and quadriceps strain (RR = 2.0; 95% CI: 1.1–3.5 were somewhat associated with history of lumbar stress fracture. Risk of groin strain was not associated with history of lumbar stress fracture (RR = 0.7; 95% CI: 0.4–1.1. Other injuries showed little association with prior lumbar stress fracture, although knee cartilage injuries were more likely in the non-stress fracture group.Conclusion: Bony hypertrophy associated with lumbar stress fracture healing may lead to subsequent lumbar nerve root impingement, making lower limb muscle strains more likely to occur. Confounders may be responsible for some of the findings. In particular, bowling speed is likely to be independently correlated with risk of lumbar stress fracture and risk of muscle strain. However, as the relationship between lumbar stress fracture history and calf strain was very strong, and that there is a

  9. Influence of overall nursing intervention and lumbar and abdominal mus-cle strength training on lumbar vertebral function of patients with lumbar intervertebral disc protrusion%整体护理干预腰腹肌肌力训练对腰椎间盘突出症患者腰椎功能的影响

    Institute of Scientific and Technical Information of China (English)

    丛培彦; 张灵芝; 于丽


    Objective To assess the influence of overall nursing intervention and lumbar and abdominal muscle strength training on the lumbar vertebral function of patients with lumbar intervertebral disc protrusion. Methods Seventy-six patients with lumbar intervertebral disc protrusion treated in our hospital from May 2013 to December 2014 were ran-domly divided into the control group and the observation group. The control group was given simple lumbar and ab-dominal muscle strength training, and the observation group was given additional overall nursing intervention on the ba-sis of lumbar and abdominal muscle strength training. The changes of lumbar vertebral function scores and the patient satisfaction rates of the two groups were compared. Results Before nursing training, the two groups were not signifi-cantly different in the lumbar vertebral function score (P>0.05); after nursing training, the observation group was sig-nificantly higher than the control group in the lumbar vertebral function score, with statistically significant difference(P0.05);护理训练后观察组腰椎功能评分明显高于对照组,差异具有统计学意义(孕<0.05)。观察组患者的满意度明显高于对照组,差异具有统计学意义(孕<0.05)。结论整体护理干预腰腹肌肌力训练能有效提高患者对疾病的认知程度,使患者积极配合治疗,效果显著,患者满意度高,值得临床推广应用。

  10. The role of the psoas and iliacus muscles for stability and movement of the lumbar spine, pelvis and hip. (United States)

    Andersson, E; Oddsson, L; Grundström, H; Thorstensson, A


    The activation patterns of the psoas and iliacus muscles were investigated in 7 healthy adult subjects (4 men and 3 women) during a variety of motor tasks in standing, sitting and lying. Myoelectric activity was recorded simultaneously from the 2 muscles using thin wire electrodes inserted under guidance of high-resolution ultrasound. In general, both muscles were coactivated, albeit to different relative levels, particularly when hip flexor torque was required. Selective activation of the iliacus could, however, be seen to stabilize the pelvis in contralateral hip extension during standing. Psoas was found to be selectively involved in sitting with a straight back and in contralateral loading situations requiring stabilization of the spine in the frontal plane. During training exercises from a supine position, such as sit-ups, the contribution of the psoas and iliacus muscles could be varied by changing the range of motion as well as the position and support for the legs. Thus, the 2 anatomically different muscles of the iliopsoas complex were shown to have individual and task-specific activation patterns depending on the particular demands for stability and movement at the lumbar spine, pelvis and hip.

  11. Somatotopic organization of lumbar muscle-innervating neurons in the ventral horn of the rat spinal cord. (United States)

    Takahashi, Yuzuru; Ohtori, Seiji; Takahashi, Kazuhisa


    The ventral horn of the rat spinal cord was investigated with respect to the somatotopic organization of the motor neurons that innervate the lumbar muscles. Neurotracer 1,1'-dioctadecyl-3,3,3',3'-tetramethylindocarbocyanine perchlorate (DiI) was applied to specific sites in lumbar muscles. Spinal cord segments at L1 through L4 levels were cut into 40-mum serial transverse sections. Labeled neurons were located in the ventromedial nucleus (VM) and lateromedial nucleus (LM) nuclei of Rexed's lamina IX. Motor neurons innervating the m. interspinales lumborum and m. multifidus were without exception present in the VM, whereas all motor neurons innervating the m. rectus abdominis were present in the LM. Forty percent of motor neurons innervating the m. quadratus lumborum were present in the VM and the other 60% were in the LM. Although most of the motor neurons innervating the m. psoas major were present in the LM, a few labeled neurons existed in the VM. These results suggest that the border zone demarcating the areas of innervation of the dorsal and ventral rami of spinal nerves crosses the m. quadratus lumborum.

  12. The Relationship of Lumbar Multifidus Muscle Morphology to Previous, Current, and Future Low Back Pain

    DEFF Research Database (Denmark)

    Hebert, Jeffrey J; Kjær, Per; Fritz, Julie M;


    Study Design. Population based prospective cohort study.Objective. We explored the cross-sectional relationships between lumbar multifidus (LM) intramuscular adipose tissue (IMAT) infiltration and LBP at three successive time points and investigated the role of IMAT in predicting the occurrence o...

  13. Can a fatigue test of the isolated lumbar extensor muscles of untrained young men predict strength progression in a resistance exercise program?

    NARCIS (Netherlands)

    Helmhout, P.; Staal, B.; Dijk, J. van; Harts, C.; Bertina, F.; Bie, R. de


    AIM: The aim of this exploratory study was to investigate the predictive value of a fatigue test of the lumbar extensor muscles for training progression in a group of 28 healthy but predominantly sedentary male students, in an 8-week resistance exercise program. METHODS: A three-phased fatigue test

  14. Estimation of lumbar spinal loading and trunk muscle forces during asymmetric lifting tasks: application of whole-body musculoskeletal modelling in OpenSim. (United States)

    Kim, Hyun-Kyung; Zhang, Yanxin


    Large spinal compressive force combined with axial torsional shear force during asymmetric lifting tasks is highly associated with lower back injury (LBI). The aim of this study was to estimate lumbar spinal loading and muscle forces during symmetric lifting (SL) and asymmetric lifting (AL) tasks using a whole-body musculoskeletal modelling approach. Thirteen healthy males lifted loads of 7 and 12 kg under two lifting conditions (SL and AL). Kinematic data and ground reaction force data were collected and then processed by a whole-body musculoskeletal model. The results show AL produced a significantly higher peak lateral shear force as well as greater peak force of psoas major, quadratus lumborum, multifidus, iliocostalis lumborum pars lumborum, longissimus thoracis pars lumborum and external oblique than SL. The greater lateral shear forces combined with higher muscle force and asymmetrical muscle contractions may have the biomechanical mechanism responsible for the increased risk of LBI during AL. Practitioner Summary: Estimating lumbar spinal loading and muscle forces during free-dynamic asymmetric lifting tasks with a whole-body musculoskeletal modelling in OpenSim is the core value of this research. The results show that certain muscle groups are fundamentally responsible for asymmetric movement, thereby producing high lumbar spinal loading and muscle forces, which may increase risks of LBI during asymmetric lifting tasks.

  15. Influence of lumbar spine rhythms and intra-abdominal pressure on spinal loads and trunk muscle forces during upper body inclination. (United States)

    Arshad, Rizwan; Zander, Thomas; Dreischarf, Marcel; Schmidt, Hendrik


    Improved knowledge on spinal loads and trunk muscle forces may clarify the mechanical causes of various spinal diseases and has the potential to improve the current treatment options. Using an inverse dynamic musculoskeletal model, this sensitivity analysis was aimed to investigate the influence of lumbar spine rhythms and intra-abdominal pressure on the compressive and shear forces in L4-L5 disc and the trunk muscle forces during upper body inclination. Based on in vivo data, three different spine rhythms (SRs) were used along with alternative settings (with/without) of intra-abdominal pressure (IAP). Compressive and shear forces in L4-L5 disc as well as trunk muscle forces were predicted by inverse static simulations from standing upright to 55° of intermediate trunk inclination. Alternate model settings of intra-abdominal pressure and different spine rhythms resulted in significant variation of compression (763 N) and shear forces (195 N) in the L4-L5 disc and in global (454 N) and local (156 N) trunk muscle forces at maximum flexed position. During upper body inclination, the compression forces at L4-L5 disc were mostly released by IAP and increased for larger intervertebral rotation in a lumbar spine rhythm. This study demonstrated that with various possible assumptions of lumbar spine rhythm and intra-abdominal pressure, variation in predicted loads and muscles forces increase with larger flexion. It is therefore, essential to adapt these model parameters for accurate prediction of spinal loads and trunk muscle forces.

  16. Activity Pattern of the Erector Spinae Muscles During Two Lumbar Strengthening Exercises Patrón de activación del músculo erector spinae en dos ejercicios de fortalecimiento lumbar




    The flexion-relaxation-phenomenon is the specific response of the erector spinae muscles, in free-pain subjects, during forward bending from upright standing. The contraction intensity of the erector spinae has been studied during trunk exercises on the roman chair, which has brought about significant information in order to graduate lumbar training intensity. To our knowl...

  17. Effect of Individual Strengthening Exercises for Anterior Pelvic Tilt Muscles on Back Pain, Pelvic Angle, and Lumbar ROMs of a LBP Patient with Flat Back. (United States)

    Yoo, Won-Gyu


    [Purpose] The purpose of this paper is to report the effect of individual strengthening exercises for the anterior pelvic tilt muscles on back pain, pelvic tilt angle, and lumbar ROM of a low back pain (LBP) patient with flat back. [Subject] A 37 year-old male, who complained of LBP pain at L3-5 levels with flat back, participated. [Methods] He performed the individual strengthening exercises for anterior pelvic tilt muscles (erector spinae,iliopsoas, rectus femoris). [Results] Pelvic tilt angles of the right and left sides were recovered to normal ranges. His lumbar ROMs increased, and low back pain decreased. [Conclusion] We suggest that individual resistance exercises are a necessary approach for effective and fast strengthening of pelvic anterior tilt muscles in LBP with flat back.

  18. Lumbar paraspinal muscle morphometry and its correlations with demographic and radiological factors in adult isthmic spondylolisthesis: a retrospective review of 120 surgically managed cases. (United States)

    Thakar, Sumit; Sivaraju, Laxminadh; Aryan, Saritha; Mohan, Dilip; Sai Kiran, Narayanam Anantha; Hegde, Alangar S


    OBJECTIVE The objective of this study was to assess the cross-sectional areas (CSAs) of lumbar paraspinal muscles in adults with isthmic spondylolisthesis (IS), to compare them with those in the normative population, and to evaluate their correlations with demographic factors and MRI changes in various spinal elements. METHODS The authors conducted a retrospective study of patients who had undergone posterior lumbar interbody fusion for IS, and 2 of the authors acting as independent observers calculated the CSAs of various lumbar paraspinal muscles (psoas, erector spinae [ES], multifidus [MF]) on preoperative axial T2-weighted MR images from the L-3 to L-5 vertebral levels and computed the CSAs as ratios with respect to the corresponding vertebral body areas. These values were then compared with those in an age- and sex-matched normative population and were analyzed with respect to age, sex, duration of symptoms, grade of listhesis, and various MRI changes at the level of the listhesis (pedicle signal change, disc degeneration, and facetal arthropathy). RESULTS Compared with values in normative controls, the mean CSA value for the ES muscle was significantly higher in the study cohort of 120 patients (p = 0.002), whereas that for the MF muscle was significantly lower (p = 0.009), and more so in the patients with PSC (p = 0.002). Magnetic resonance imaging signal change in the pedicle was seen in half of the patients, all of whom demonstrated a Type 2 change. Of the variables tested in a multivariate analysis, age independently predicted lower area values for all 3 muscles (p ≤ 0.001), whereas female sex predicted a lower mean psoas area value (p < 0.001). None of the other variables significantly predicted any of the muscle area values. A decrease in the mean MF muscle area value alone was associated with a significantly increased likelihood of a PSC (p = 0.039). CONCLUSIONS Compared with normative controls, patients with IS suffer selective atrophy of their MF

  19. Pace bowlers in cricket with history of lumbar stress fracture have increased risk of lower limb muscle strains, particularly calf strains


    John Orchard; Patrick Farhart; Alex Kountouris; et al.


    John Orchard1, Patrick Farhart2, Alex Kountouris3, Trefor James3, Marc Portus31School of Public Health, University of Sydney, Australia; 2Punjab Kings XI team, Indian Premier League, India; 3Cricket Australia, Melbourne, AustraliaObjective: To assess whether a history of lumbar stress fracture in pace bowlers in cricket is a risk factor for lower limb muscle strains.Methods: This was a prospective cohort risk factor study, conducted using injury data from contracted first class pace bowlers i...

  20. Lumbar back muscle activity of helicopter pilots and whole-body vibration. (United States)

    de Oliveira, C G; Simpson, D M; Nadal, J


    Several studies have attributed the prevalence of low back pain (LBP) in helicopter pilots mainly to poor posture in-flight and whole-body vibration, with the latter hypothesis particularly related to a cyclic response of the erector spine (ES) muscle to vibration. This work aims to determine if helicopter vibration and the pilot's normal posture during flight have significant effects on the electromyogram (EMG) of the ES muscle. The bilateral surface EMG of the ES muscle at the L3 level was collected in 10 young pilots before and during a short flight in UH-50 helicopters. The vibration was monitored by a triaxial accelerometer fixed to the pilots' seat. Prior to the flight, the EMG was recorded for relaxed seated and standing postures with 0 degrees (P0) and 35 degrees (P35) of trunk flexion. The effect of the posture during the flight was tested by comparing left and right EMG (normalized with respect to P35). The in-flight muscle stress was evaluated by histograms of EMG activity, and compared to P0 values. Only one pilot in ten showed significant (pvibration and the EMG over cycles of vibration, and no consistent causal effect was found. The pilots' posture did not show significant asymmetric muscular activity, and low EMG levels were observed during most of the duration of the flight. The results do not provide evidence that LBP in helicopter pilots is caused by ES muscle stress in the conditions studied.

  1. 腰椎退行性疾病椎旁肌的渐进变化%Change of paravertebral muscle in patients with lumbar degenerative disease

    Institute of Scientific and Technical Information of China (English)

    乔培柳; 塔依尔·阿不都哈德尔


    BACKGROUND:Lumbar paravertebral muscles play an important role for lumbar spinal stability. Increasing studies emphasize on the change of paravertebral muscles in patients with lumbar degenerative disease and therefore have important clinical significance for the rehabilitation training of paravertebral muscle in patients with lumbar degenerative disease. OBJECTIVE:To review the research progress of the change of paravertebral muscle in patients with lumbar degenerative disease and to look into the future development prospects. METHODS:A computer-based online search of PubMed and WANFANG DATA between 1986 and 2014 was performed with the key words“lumbar vertebra, paravertebral muscle, psoas major, multifidus muscle, cross sectional area, muscle atrophy, fatty infiltration, muscle biopsy, MRI, electromyography”in English and Chinese, respectively. The clinical and experimental studies addressing the changes of paravertebral muscle in patients with lumbar degenerative disease were included. According to the inclusion and exclusion criteria, 48 literatures were included into the final analysis, 8 Chinese and 40 English. RESULTS AND CONCLUSION:The change of paravertebral muscle in patients with lumbar degenerative disease includes muscle atrophy and fatty infiltration. The changes of paravertebral muscles are often detected with B-ultrasound, CT, MRI, EMG and muscle biopsy. Due to the differences of sample size, age and study method, there are different results, even conflicting. So some limitations of sample size, age and study method are needed to obtain accurate results. In addition, further studies wil focus on the verification of which nerve specifical y dominants lumbar paravertebral muscles.%背景:腰部椎旁肌对于腰椎稳定具有重要作用,关于腰椎退行性疾病患者椎旁肌改变的研究越来越多,此类研究对于腰椎椎旁肌康复训练具有重要临床意义。  目的:综述腰椎退行性疾病椎旁肌变化的

  2. Activity Pattern of the Erector Spinae Muscles During Two Lumbar Strengthening Exercises Patrón de activación del músculo erector spinae en dos ejercicios de fortalecimiento lumbar

    Directory of Open Access Journals (Sweden)

    D. Sánchez


    Full Text Available


    The flexion-relaxation-phenomenon is the specific response of the erector spinae muscles, in free-pain subjects, during forward bending from upright standing. The contraction intensity of the erector spinae has been studied during trunk exercises on the roman chair, which has brought about significant information in order to graduate lumbar training intensity. To our knowledge, no study determined the pattern of erector spinae activity in the course of movement at the roman-chair exercises. The EMG of the right erector spinae and the angular displacement of the dorso-lumbar spine were symultaneously recorded during the time-course of flexion-extension exercises at upright standing and roman chair (n=20, M: 21.4 years, 64.5Kg and  168.4cm, the muscles activation were compared between the two exercises and different patterns were observed. The flexion-relaxation–phenomenon was  observed during flexion form upright standing but not  during exercises at the roman chair, the maximum amplitude of flexion was significantly less (p ≤ 0.05 and progresive decrease in ES activity occurred when the trunk flexed by maximum. Avoiding maximum range of flexion during trunk exercises is recommended since, as a rule during lumbar training, it may prevent from spine injury.
    KEY WORDS: Erector spinae, flexion-relaxation phenomenon, roman-chair exercises, lumbar-strengthening-exercises, lumbar motion.


    El fenómeno de flexión-relajación, disminución brusca y espontánea de la actividad del músculo erector spinae durante la flexión, es la respuesta específica de este músculo en personas sanas. Se ha estudiado la intensidad de contracción del ES durante ejercicios en el banco romano con el objeto de graduar la intensidad del entrenamiento de la musculatura lumbar, pero se desconoce si el

  3. A study on the Efficacy of Muscle Energy Technique as compared to Conventional Therapy on Lumbar Spine Range of Motion in Chronic Low Back Pain of Sacroiliac Origin

    Directory of Open Access Journals (Sweden)

    Supreet Bindra


    Full Text Available Sacroiliac joint dysfunction is a term often used to describe pain in and around the region of the joint that is presumed to be due to biomechanical disorders of the joint. Despite of high incidence, the contribution of sacroiliac joint to low back pain has been a matter of controversy. Physical therapists routinely assess spinal range of motion in patients with low back pain and believe that spinal range of motion and disability are closely linked. The present study was aimed to determine the relative efficacy of Muscle Energy Technique as compared to Conventional Therapy on lumbar spine range of motion in chronic low back pain of Sacroiliac origin. It was found that the subjects who were treated with Muscle Energy Technique showed greater improvements in lumbar spine range of motion as compared to Conventional Therapy Group. As far as reduction in pain and disability are concerned both the groups showed almost similar results. The study concluded that sacroiliac joint dysfunction affects lumbar spine range of motion and is a significant contributor to chronic low back pain.

  4. Association between history and physical examination factors and change in lumbar multifidus muscle thickness after spinal manipulation in patients with low back pain. (United States)

    Koppenhaver, Shane L; Fritz, Julie M; Hebert, Jeffrey J; Kawchuk, Greg N; Parent, Eric C; Gill, Norman W; Childs, John D; Teyhen, Deydre S


    Understanding the clinical characteristics of patients with low back pain (LBP) who display improved lumbar multifidus (LM) muscle function after spinal manipulative therapy (SMT) may provide insight into a potentially synergistic interaction between SMT and exercise. Therefore, the purpose of this study was to identify the baseline historical and physical examination factors associated with increased contracted LM muscle thickness one week after SMT. Eighty-one participants with LBP underwent a baseline physical examination and ultrasound imaging assessment of the LM muscle during submaximal contraction before and one week after SMT. The relationship between baseline examination variables and 1-week change in contracted LM thickness was assessed using correlation analysis and hierarchical multiple linear regression. Four variables best predicted the magnitude of increases in contracted LM muscle thickness after SMT. When combined, these variables suggest that patients with LBP, (1) that are fairly acute, (2) have at least a moderately good prognosis without focal and irritable symptoms, and (3) exhibit signs of spinal instability, may be the best candidates for a combined SMT and lumbar stabilization exercise (LSE) treatment approach.

  5. Activation of Neck and Low-Back Muscles Is Reduced with the Use of a Neck Balance System Together with a Lumbar Support in Urban Drivers.

    Directory of Open Access Journals (Sweden)

    Federica Menotti

    Full Text Available Driving is associated with high activation of low-back and neck muscles due to the sitting position and perturbations imposed by the vehicle. The aim of this study was to investigate the use of a neck balance system together with a lumbar support on the activation of low-back and neck muscles during driving. Twelve healthy male subjects (age 32±6.71 years were asked to drive in two conditions: 1 with devices; 2 without devices. During vehicle accelerations and decelerations root mean square (RMS of surface electromyography (sEMG was recorded from the erector spinae, semispinalis capitis and sternocleidomastoid muscles and expressed as a percentage of maximal voluntary contraction (MVC. The pitch of the head was obtained by means of an inertial sensor placed on the subjects' head. A visual analog scale (VAS was used to assess the level of perceived comfort. RMS of the low back muscles was lower with than without devices during both acceleration and deceleration of the vehicle (1.40±0.93% vs 29 2.32±1.90% and 1.88±1.45% vs 2.91±2.33%, respectively, while RMS of neck extensor muscles was reduced only during acceleration (5.18±1.96% vs 5.91±2.16%. There were no differences between the two conditions in RMS of neck flexor muscles, the pitch of the head and the VAS score. The use of these two ergonomic devices is therefore effective in reducing the activation of low-back and neck muscles during driving with no changes in the level of perceived comfort, which is likely due to rebalancing weight on the neck and giving a neutral position to lumbar segments.

  6. Comparison of degree of postoperative muscle damage between MIS-TLIF- and PLIF treatment for single-level degenerative lumbar disease

    Directory of Open Access Journals (Sweden)

    Liang ZHOU


    Full Text Available Objective To compare the postoperative muscle damage after either posterior lumbar interbody fusion (PLIF or minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF with the aid of X-Tube system in patients with singlelevel degenerative lumbar spinal disease. Methods The clinical data of 52 patients (males 28, females 24, aged 54.3±7.8 years with single-level degenerative lumbar spinal disease undergoing MIS-TLIF assisted by the X-Tube system from Oct 2010 to Sep 2011 was analyzed retrospectively. The operative time, intraoperative blood loss, postoperative drainage volume, postoperative bedtime, and serum creatine kinase (CK level 1 day before surgery and 1, 3 and 5 days after surgery were recorded and compared with those of 38 patients (males 20, females 18, aged 51.6±8.6 years with the same disease undergoing conventional open PLIF during the corresponding period. The back pain visual analogue score (VAS, Oswestry disability index (ODI score and imaging examination were performed before operation, after operation and during follow-up duration for each patient. Results There was no significant difference in the gender, age, clinical diagnosis, lesion location, preoperative CK level, VAS and ODI scores between the two groups (P>0.05. The operative time was longer in MIS-TLIF group than in PLIF group (P0.05. Radiological followup observation revealed good fusion 6 months after operation in all the patients. Conclusion The X-Tube-assisted MIS-TLIF has several advantages over conventional open PLIF, such as less intraoperative blood loss, milder muscle damage, and lighter back pain. DOI: 10.11855/j.issn.0577-7402.2013.12.04

  7. Muscle activity characterization by laser Doppler Myography (United States)

    Scalise, Lorenzo; Casaccia, Sara; Marchionni, Paolo; Ercoli, Ilaria; Primo Tomasini, Enrico


    Electromiography (EMG) is the gold-standard technique used for the evaluation of muscle activity. This technique is used in biomechanics, sport medicine, neurology and rehabilitation therapy and it provides the electrical activity produced by skeletal muscles. Among the parameters measured with EMG, two very important quantities are: signal amplitude and duration of muscle contraction, muscle fatigue and maximum muscle power. Recently, a new measurement procedure, named Laser Doppler Myography (LDMi), for the non contact assessment of muscle activity has been proposed to measure the vibro-mechanical behaviour of the muscle. The aim of this study is to present the LDMi technique and to evaluate its capacity to measure some characteristic features proper of the muscle. In this paper LDMi is compared with standard superficial EMG (sEMG) requiring the application of sensors on the skin of each patient. sEMG and LDMi signals have been simultaneously acquired and processed to test correlations. Three parameters has been analyzed to compare these techniques: Muscle activation timing, signal amplitude and muscle fatigue. LDMi appears to be a reliable and promising measurement technique allowing the measurements without contact with the patient skin.

  8. Third-Degree Hindpaw Burn Injury Induced Apoptosis of Lumbar Spinal Cord Ventral Horn Motor Neurons and Sciatic Nerve and Muscle Atrophy in Rats

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    Sheng-Hua Wu


    Full Text Available Background. Severe burns result in hypercatabolic state and concomitant muscle atrophy that persists for several months, thereby limiting patient recovery. However, the effects of burns on the corresponding spinal dermatome remain unknown. This study aimed to investigate whether burns induce apoptosis of spinal cord ventral horn motor neurons (VHMNs and consequently cause skeletal muscle wasting. Methods. Third-degree hindpaw burn injury with 1% total body surface area (TBSA rats were euthanized 4 and 8 weeks after burn injury. The apoptosis profiles in the ventral horns of the lumbar spinal cords, sciatic nerves, and gastrocnemius muscles were examined. The Schwann cells in the sciatic nerve were marked with S100. The gastrocnemius muscles were harvested to measure the denervation atrophy. Result. The VHMNs apoptosis in the spinal cord was observed after inducing third-degree burns in the hindpaw. The S100 and TUNEL double-positive cells in the sciatic nerve increased significantly after the burn injury. Gastrocnemius muscle apoptosis and denervation atrophy area increased significantly after the burn injury. Conclusion. Local hindpaw burn induces apoptosis in VHMNs and Schwann cells in sciatic nerve, which causes corresponding gastrocnemius muscle denervation atrophy. Our results provided an animal model to evaluate burn-induced muscle wasting, and elucidate the underlying mechanisms.

  9. The lumbar cord location of the motoneurons innervating psoas and iliacus muscles: a single and double labeling study in the female Syrian golden hamster. (United States)

    Gerrits, P O; Boers, J; Holstege, G


    The spinal cord location of the motoneurons innervating the psoas and iliacus muscles was determined in the golden hamster. The results of single and double labeling studies, using the retrograde tracers horseradish peroxidase (HRP) and cholera toxin B-subunit (CTB), showed that both psoas and iliacus motoneurons were present ventrolaterally in the ventral horn in the caudal L1 to rostral L5 lumbar spinal segments with their motoneurons intermingled in one cell group. Further retrograde tracing studies demonstrated abdominal muscle motoneurons ventrolaterally in the ventral horn of the L1 and upper L2 segments. Double labeling experiments revealed that at these levels (caudal L1 and rostral L2), the abdominal muscle motoneurons were located dorsomedial to the psoas and iliacus motoneurons.

  10. Characterization of DTI Indices in the Cervical, Thoracic, and Lumbar Spinal Cord in Healthy Humans

    Directory of Open Access Journals (Sweden)

    Rachael L. Bosma


    Full Text Available The aim of this study was to characterize in vivo measurements of diffusion along the length of the entire healthy spinal cord and to compare DTI indices, including fractional anisotropy (FA and mean diffusivity (MD, between cord regions. The objective is to determine whether or not there are significant differences in DTI indices along the cord that must be considered for future applications of characterizing the effects of injury or disease. A cardiac gated, single-shot EPI sequence was used to acquire diffusion-weighted images of the cervical, thoracic, and lumbar regions of the spinal cord in nine neurologically intact subjects (19 to 22 years. For each cord section, FA versus MD values were plotted, and a k-means clustering method was applied to partition the data according to tissue properties. FA and MD values from both white matter (average FA=0.69, average MD=0.93 × 10−3 mm2/s and grey matter (average FA=0.44, average MD=1.8 × 10−3 mm2/s were relatively consistent along the length of the cord.

  11. Effects of selective exercise for the deep abdominal muscles and lumbar stabilization exercise on the thickness of the transversus abdominis and postural maintenance (United States)

    Lee, Jung-seok; Kim, Tae-ho; Kim, Da-yeon; Shim, Jae-ho; Lim, Jin-yong


    [Purpose] The purpose of this study was to examine the effects of selective exercise for the deep abdominal muscles (SEDA) and lumbar stabilization exercise (LSE) on the thickness of the transversus abdominis and postural maintenance on an unstable base of support. [Subjects and Methods] The subjects of this study were 20 male and 10 female adults in their 20s without lumbar pain. They were equally and randomly assigned to a SEDA group and a LSE group. The thickness of the transversus abdominis was measured using ultrasound imaging during rest and drawing-in. The thickness of the transversus abdominis was measured when subjects raised their right and left legs while lying on a Swiss ball. [Results] Initially, there were no differences between the two groups. After the intervention, significant differences were observed in all parameters. A significant interaction between group and period was not found for any parameters. [Conclusion] In conclusion, both SEDA and LSE thickened the transversus abdominis, which is a deep abdominal muscle, thereby adjusting posture, and stabilizing the trunk. These exercises increased the thickness of the deep abdominal muscles. They are important exercises for improving the stability of athletes or patients who need postural adjustment. PMID:25729169

  12. Effect of spinal decompression on the lumbar muscle activity and disk height in patients with herniated intervertebral disk


    Kang, Jeong-il; Jeong, Dae-Keun; Choi, Hyun


    [Purpose] This study was conducted to clarify the difference in therapeutic effects between traction and decompression therapies, and their clinical therapeutic significance. [Subjects and Methods] The subjects were 31 patients aged 35 to 50 years who had unilateral or bilateral lumbar and radicular leg pain. An intervention program was implemented in 31 patients with lumbar herniated intervertebral disks. For the experimental group, 15 subjects were randomly selected to receive decompression...

  13. Mechanical Characterization of the Human Lumbar Intervertebral Disc Subjected to Impact Loading Conditions (United States)

    Jamison, David, IV

    Low back pain is a large and costly problem in the United States. Several working populations, such as miners, construction workers, forklift operators, and military personnel, have an increased risk and prevalence of low back pain compared to the general population. This is due to exposure to repeated, transient impact shocks, particularly while operating vehicles or other machinery. These shocks typically do not cause acute injury, but rather lead to pain and injury over time. The major focus in low back pain is often the intervertebral disc, due to its role as the major primary load-bearing component along the spinal column. The formation of a reliable standard for human lumbar disc exposure to repeated transient shock could potentially reduce injury risk for these working populations. The objective of this project, therefore, is to characterize the mechanical response of the lumbar intervertebral disc subjected to sub-traumatic impact loading conditions using both cadaveric and computational models, and to investigate the possible implications of this type of loading environment for low back pain. Axial, compressive impact loading events on Naval high speed boats were simulated in the laboratory and applied to human cadaveric specimen. Disc stiffness was higher and hysteresis was lower than quasi-static loading conditions. This indicates a shift in mechanical response when the disc is under impact loads and this behavior could be contributing to long-term back pain. Interstitial fluid loss and disc height changes were shown to affect disc impact mechanics in a creep study. Neutral zone increased, while energy dissipation and low-strain region stiffness decreased. This suggests that the disc has greater clinical instability during impact loading with progressive creep and fluid loss, indicating that time of day should be considered for working populations subjected to impact loads. A finite element model was developed and validated against cadaver specimen

  14. Physiological characterization of human muscle acetylcholine receptors from ALS patients (United States)

    Palma, Eleonora; Inghilleri, Maurizio; Conti, Luca; Deflorio, Cristina; Frasca, Vittorio; Manteca, Alessia; Pichiorri, Floriana; Roseti, Cristina; Torchia, Gregorio; Limatola, Cristina; Grassi, Francesca; Miledi, Ricardo


    Amyotrophic lateral sclerosis (ALS) is characterized by progressive degeneration of motor neurons leading to muscle paralysis. Research in transgenic mice suggests that the muscle actively contributes to the disease onset, but such studies are difficult to pursue in humans and in vitro models would represent a good starting point. In this work we show that tiny amounts of muscle from ALS or from control denervated muscle, obtained by needle biopsy, are amenable to functional characterization by two different technical approaches: “microtransplantation” of muscle membranes into Xenopus oocytes and culture of myogenic satellite cells. Acetylcholine (ACh)-evoked currents and unitary events were characterized in oocytes and multinucleated myotubes. We found that ALS acetylcholine receptors (AChRs) retain their native physiological characteristics, being activated by ACh and nicotine and blocked by α-bungarotoxin (α-BuTX), d-tubocurarine (dTC), and galantamine. The reversal potential of ACh-evoked currents and the unitary channel behavior were also typical of normal muscle AChRs. Interestingly, in oocytes injected with muscle membranes derived from ALS patients, the AChRs showed a significant decrease in ACh affinity, compared with denervated controls. Finally, riluzole, the only drug currently used against ALS, reduced, in a dose-dependent manner, the ACh-evoked currents, indicating that its action remains to be fully characterized. The two methods described here will be important tools for elucidating the role of muscle in ALS pathogenesis and for developing drugs to counter the effects of this disease. PMID:22128328

  15. Characterization of the Muscle Electrical Properties in Low Back Pain Patients by Electrical Impedance Myography


    Congo Tak-Shing Ching; Yueh-Chi Chen; Li-Hua Lu; Hsieh, Peiyuan F; Chin-Sung Hsiao; Tai-Ping Sun; Hsiu-Li Shieh; Kang-Ming Chang


    OBJECTIVES: This study aims to investigate the electrical properties of lumbar paraspinal muscles (LPM) of patients with acute lower back pain (LBP) and to study a new approach, namely Electrical Impedance Myography (EIM), for reliable, low-cost, non-invasive, and real-time assessment of muscle-strained acute LBP. DESIGN: Patients with muscle-strained acute LBP (n = 30) are compared to a healthy reference group (n = 30). Electrical properties of LPM are studied. BACKGROUND: EIM is a novel tec...

  16. The effect of parameters of equilibrium-based 3-D biomechanical models on extracted muscle synergies during isometric lumbar exertion. (United States)

    Eskandari, A H; Sedaghat-Nejad, E; Rashedi, E; Sedighi, A; Arjmand, N; Parnianpour, M


    A hallmark of more advanced models is their higher details of trunk muscles represented by a larger number of muscles. The question is if in reality we control these muscles individually as independent agents or we control groups of them called "synergy". To address this, we employed a 3-D biomechanical model of the spine with 18 trunk muscles that satisfied equilibrium conditions at L4/5, with different cost functions. The solutions of several 2-D and 3-D tasks were arranged in a data matrix and the synergies were computed by using non-negative matrix factorization (NMF) algorithms. Variance accounted for (VAF) was used to evaluate the number of synergies that emerged by the analysis, which were used to reconstruct the original muscle activations. It was showed that four and six muscle synergies were adequate to reconstruct the input data of 2-D and 3-D torque space analysis. The synergies were different by choosing alternative cost functions as expected. The constraints affected the extracted muscle synergies, particularly muscles that participated in more than one functional tasks were influenced substantially. The compositions of extracted muscle synergies were in agreement with experimental studies on healthy participants. The following computational methods show that the synergies can reduce the complexity of load distributions and allow reduced dimensional space to be used in clinical settings.

  17. Isolation, characterization, and molecular regulation of muscle stem cells

    Directory of Open Access Journals (Sweden)

    So-ichiro eFukada


    Full Text Available keletal muscle has great regenerative capacity which is dependent on muscle stem cells, also known as satellite cells. A loss of satellite cells and/or their function impairs skeletal muscle regeneration and leads to a loss of skeletal muscle power; therefore, the molecular mechanisms for maintaining satellite cells in a quiescent and undifferentiated state are of great interest in skeletal muscle biology. Many studies have demonstrated proteins expressed by satellite cells, including Pax7, M-cadherin, Cxcr4, syndecan3/4, and c-met. To further characterize satellite cells, we established a method to directly isolate satellite cells using a monoclonal antibody, SM/C-2.6. Using SM/C-2.6 and microarrays, we measured the genes expressed in quiescent satellite cells and demonstrated that Hesr3 may complement Hesr1 in generating quiescent satellite cells. Although Hesr1- or Hesr3-single knockout mice show a normal skeletal muscle phenotype, including satellite cells, Hesr1/Hesr3-double knockout mice show a gradual decrease in the number of satellite cells and increase in regenerative defects dependent on satellite cell numbers. We also observed that a mouse’s genetic background affects the regenerative capacity of its skeletal muscle and have established a line of DBA/2-background mdx mice that has a much more severe phenotype than the frequently used C57BL/10-mdx mice. The phenotype of DBA/2-mdx mice also seems to depend on the function of satellite cells. In this review, we summarize the methodology of direct isolation, characterization, and molecular regulation of satellite cells based on our results. The relationship between the regenerative capacity of satellite cells and progression of muscular disorders is also summarized. In the last part, we discuss application of the accumulating scientific information on satellite cells to treatment of patients with muscular disorders.

  18. Comparación entre la respuesta de la actividad muscular lumbar en plataforma vibratoria y en ejercicio clásico de squat isométrico en 30º y 60º. (A comparison of the lumbar muscle activity responsein 30º and 60º isometric squat between whole-body vibration and a classic exercise.

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    Alejandro Santos-Lozano


    Full Text Available Whole-body vibration (WBV has improved as a variety of exercises, so it is necessary know muscles responses to the vibration stimulus.The aim of this work was to study and to compare the change in muscle activation in the lumbar area and lower body between the whole-body vibration exercise and classic strength exercises in isometric squat.23 subjects were exposed to six different loads in one of each exercise mode: vibration or classic strength. Both exercises were performed at 30º and 60º semi-squat position. Muscle activity of the lower body and lumbar area was measured using surface electromyography activity (EMG.The results showed that the response of lumbar area in WBV was lower than in the classic strength exercise at the same value of lower body sEMG. Lumbar sEMG was highest for the classic exercise. Moreover, during 30º squat sEMG was higher than during 60ºsquat.ResumenEl aumento del uso de la plataforma vibratoria como forma de realizar ejercicio conlleva la necesidad de conocer las respuestas musculares al estímulo de la misma.El objetivo de este trabajo ha sido estudiar y comparar la respuesta de la activación muscular de la zona lumbar y del tren inferior en el trabajo de plataforma vibratoria con el trabajo clásico de fuerza en un squat isométrico.23 sujetos fueron sometidos a 6 condiciones de vibración y a 6 de un trabajo clásico de pesas. Se analizó la sEMG del tren inferior y de la zona lumbar en un trabajo isométrico de un squat con flexión de 30º y 60º de rodilla.Los resultados muestran que para un mismo valor de sEMG del tren inferior, los valores de sEMG de la zona lumbar son menores en el ejercicio vibratorio. Existiendo en el trabajo de pesas una mayor exigencia en la zona lumbar. Además, con una flexión de 30º la activación muscular es mayor en todas las condiciones. (p

  19. 颈、腰肌训练的效果研究%Effects of muscle training on improving neck/lumbar functions

    Institute of Scientific and Technical Information of China (English)

    邓略; 王全; 卫晓阳; 王海霞; 李宝辉; 金朝; 马月欣; 成海平; 耿喜臣


    ,保持颈、腰运动功能.训练计划对于改善颈、腰损伤的效果还需进一步研究.%Objective To provide measure for preventing and rehabilitating neck and lumbar injury in fighter pilots by 6-wk program of neck and psoas muscle isometric training cooperated with healing setting-up exercises.Methods Six male healthy volunteers were trained in isometric contractions twice a week for 6 weeks by using self-designed Neck and Psoas Muscle Isometric Training Cooperated Equipment.During training,subjects seated and kept the same posture as in flight.They performed 2 sets of neck and lumbar extension exercises with 60% maximal voluntary contraction (MVC) strength for 10 times.Subjects also completed healing setting-up exercises before equipment training.They were also asked to perform additional healing setting-up exercises by themselves at least twice a week.The setting-up exercises included:relax in prone posture,prone posture stretching,prostrate straight on back,sit-up,and standing stretching.The pre-and posttraining tests consisted of the isometric MVC strength in neck extension,neck left lateral flexion (Ltflx) and right lateral flexion (Rtflx),lumbar extension,10 s maximal strength impulse and 90 s maximal strength total impulse in neck/lumbar extension test,electromyography in impulse test,spine active range-of-motion (ROM) in flexion and extension,Ltflx and Rtflx,left and right rotation.The software package SPSS 18.0 was applied for paired t-test.Results Compared with those before training,post-training neck isometric MVC in extension and Ltflx improved significantly (t=4.140,3.125,P<0.05).Lumbar extension isometric MVC mean value increased 10%.10 s maximal strength impulse and 90 s maximal strength total impulse in neck and lumbar extension increased significantly (t=2.631-3.202,P<0.05).ROM in neck extension,lumbar flexion and left rotation improved significantly (t=4.011-6.343,P<0.01).In SEMG,median frequency in 90 s neck extension and

  20. Sternoclavicular joint septic arthritis following paraspinal muscle abscess and septic lumbar spondylodiscitis with epidural abscess in a patient with diabetes: a case report

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    Shioya Nobuki


    Full Text Available Abstract Background Septic arthritis of the sternoclavicular joint (SCJ is extremely rare, and usually appears to result from hematogenous spread. Predisposing factors include immunocompromising diseases such as diabetes. Case presentation A 61-year-old man with poorly controlled diabetes mellitus presented to our emergency department with low back pain, high fever, and a painful mass over his left SCJ. He had received two epidural blocks over the past 2 weeks for severe back and leg pain secondary to lumbar disc herniation. He did not complain of weakness or sensory changes of his lower limbs, and his bladder and bowel function were normal. He had no history of shoulder injection, subclavian vein catheterization, intravenous drug abuse, or focal infection including tooth decay. CT showed an abscess of the left SCJ, with extension into the mediastinum and sternocleidomastoid muscle, and left paraspinal muscle swelling at the level of L2. MRI showed spondylodiscitis of L3-L4 with a contiguous extradural abscess. Staphylococcus aureus was isolated from cultures of aspirated pus from his SCJ, and from his urine and blood. The SCJ abscess was incised and drained, and appropriate intravenous antibiotic therapy was administered. Two weeks after admission, the purulent discharge from the left SCJ had completely stopped, and the wound showed improvement. He was transferred to another ward for treatment of the ongoing back pain. Conclusion Diabetic patients with S. aureus bacteremia may be at risk of severe musculoskeletal infections via hematogenous spread.

  1. [Lumbar hernia]. (United States)

    Teiblum, Sandra Sofie; Hjørne, Flemming Pii; Bisgaard, Thue


    Lumbar hernia is a rare condition. Lumbar hernia should be considered a rare differential diagnosis to unexplained back pain. Symptoms are scarce and diffuse and can vary with the size and content of the hernia. As there is a 25% risk of incarceration, operation is indicated even in asymptomatic hernias. We report a case of lumbar hernia in a woman with a slow growing mass in the lumbar region. She presented with pain and a computed tomography confirmed the diagnosis. She underwent open surgery and fully recovered with recurrence within the first half year.

  2. Lateral Lumbar Interbody Fusion (United States)

    Hughes, Alexander; Girardi, Federico; Sama, Andrew; Lebl, Darren; Cammisa, Frank


    The lateral lumbar interbody fusion (LLIF) is a relatively new technique that allows the surgeon to access the intervertebral space from a direct lateral approach either anterior to or through the psoas muscle. This approach provides an alternative to anterior lumbar interbody fusion with instrumentation, posterior lumbar interbody fusion, and transforaminal lumbar interbody fusion for anterior column support. LLIF is minimally invasive, safe, better structural support from the apophyseal ring, potential for coronal plane deformity correction, and indirect decompression, which have has made this technique popular. LLIF is currently being utilized for a variety of pathologies including but not limited to adult de novo lumbar scoliosis, central and foraminal stenosis, spondylolisthesis, and adjacent segment degeneration. Although early clinical outcomes have been good, the potential for significant neurological and vascular vertebral endplate complications exists. Nevertheless, LLIF is a promising technique with the potential to more effectively treat complex adult de novo scoliosis and achieve predictable fusion while avoiding the complications of traditional anterior surgery and posterior interbody techniques. PMID:26713134

  3. Characterization of focal muscle compression under impact loading (United States)

    Butler, B. J.; Sory, D. R.; Nguyen, T.-T. N.; Proud, W. G.; Williams, A.; Brown, K. A.


    In modern wars over 70% of combat wounds are to the extremities. These injuries are characterized by disruption and contamination of the limb soft tissue envelope. The extent of this tissue trauma and contamination determine the outcome of the extremity injury. In military injury, common post-traumatic complications at amputation sites include heterotopic ossification (formation of bone in soft tissue), and severe soft tissue and bone infections. We are currently developing a model of soft tissue injury that recreates pathologies observed in combat injuries. Here we present characterization of a controlled focal compression of the rabbit flexor carpi ulnaris (FCU) muscle group. The FCU was previously identified as a suitable site for studying impact injury because its muscle belly can easily be mobilized from the underlying bone without disturbing anatomical alignment in the limb. We show how macroscopic changes in tissue organization, as visualized using optical microscopy, can be correlated with data from temporally resolved traces of loading conditions.

  4. Optical characterization and composition of abdominal wall muscle from rat (United States)

    Oliveira, Luís; Lage, Armindo; Pais Clemente, M.; Tuchin, Valery


    Complete optical characterization of biological tissue is desirable to develop clinical methods using optical technologies. Particularly, to develop optical clearing methods in biological tissues, it is necessary to know the composition of the tissue, the percentage of each constituent and corresponding refractive indexes. To obtain such information for rat muscle, we used a simple method to characterize tissue constituents for both content percentage and refractive index. The study consisted on measuring mass with a precision weighting scale and the refractive index with an Abbe refractometer during tissue dehydration. With the collected data, we used a theoretical model to calculate the refractive index and percentage for both interstitial fluid and solid part of the rat muscle. The results obtained are in good agreement with data published by other authors, and were considered of vital information for the optical clearing studies that we planned to perform.

  5. Correlations between the cross-sectional area and moment arm length of the erector spinae muscle and the thickness of the psoas major muscle as measured by MRI and the body mass index in lumbar degenerative kyphosis patients

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    Lee, Hyun; Lee, Sang Jin; Lee, Sang Ho [Busan Wooridul Hospital, Busan (Korea, Republic of)


    Lumbar degenerative kyphosis (LDK) is a subgroup of the flatback syndrome, which is a condition caused by spinal degeneration. LDK is reported to be the most frequent cause of lumbar spine deformity in the farming districts of the 'oriental' countries. We investigated the relationship between the cross-sectional area (CSA) and the moment arm length (MAL) of the erector spinae muscle and the thickness of the psoas major muscle (PT) and the body mass index (BMI) by performing statistical analysis, and we tried to show the crucial role of these variables for diagnosing LDK. From July 2004 to April 2005, we retrospectively reviewed 17 LDK patients who had undergone anterior lumbar interbody fusion (ALIF) with posterior stabilization. We measured both the CSA and MAL on the transverse cross-sectional MR image of the trunk at the fourth to fifth vertebrae (L4/5). The MAL was defined as the anterior-posterior distance between the center of the erector spinae muscle and that of the vertebral body. A comparative study was undertaken between the LDK group and the matched (according to age and gender) control group with regard to the CSA, MAL, PT and BMI. The 17 LDK patients were all females [age: 62.5 {+-} 4.93 years, height: 157 {+-} 6.19 cm, weight: 55.59 {+-} 4.7 kg, and BMI: 22.58 {+-} 2.08 kg/m{sup 2}]. The control group patients were all female [age: 63.6 {+-} 2.27 years, height: 156 {+-} 5.05 cm, weight: 59.65 {+-} 7.39 kg and BMI: 24.38 {+-} 2.94 kg/m{sup 2}]. Spearman's rho indicated a positive association between the CSA and BMI (rho = 0.49, {rho} = 0.046), between the MAL and BMI (rho = 0.808, {rho} = 0.000) and between the CSA and PT (rho = 0.566, {rho} = 0.018) in the LDK patients. In terms of the CSA versus MAL, there was a positive association in both groups (rho = 0.67, {rho} = 0.000, MAL = 0.023CSA + 5.454 in the LDK group; rho = 0.564, {rho} 0.018, MAL = 0.02CSA + 5.832 in the control group with using linear regression analysis). Independent

  6. Clinical anatomy and 3D virtual reconstruction of the lumbar plexus with respect to lumbar surgery

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    Ding Zi-hai


    Full Text Available Abstract Background Exposure of the anterior or lateral lumbar via the retroperitoneal approach easily causes injuries to the lumbar plexus. Lumbar plexus injuries which occur during anterior or transpsoas lumbar spine exposure and placement of instruments have been reported. This study aims is to provide more anatomical data and surgical landmarks in operations concerning the lumbar plexus in order to prevent lumbar plexus injuries and to increase the possibility of safety in anterior approach lumbar surgery. Methods To study the applied anatomy related to the lumbar plexus of fifteen formaldehyde-preserved cadavers, Five sets of Virtual Human (VH data set were prepared and used in the study. Three-dimensional (3D computerized reconstructions of the lumbar plexus and their adjacent structures were conducted from the VH female data set. Results The order of lumbar nerves is regular. From the anterior view, lumbar plexus nerves are arranged from medial at L5 to lateral at L2. From the lateral view, lumbar nerves are arranged from ventral at L2 to dorsal at L5. The angle of each nerve root exiting outward to the corresponding intervertebral foramen increases from L1 to L5. The lumbar plexus nerves are observed to be in close contact with transverse processes (TP. All parts of the lumbar plexus were located by sectional anatomy in the dorsal third of the psoas muscle. Thus, access to the psoas major muscle at the ventral 2/3 region can safely prevent nerve injuries. 3D reconstruction of the lumbar plexus based on VCH data can clearly show the relationships between the lumbar plexus and the blood vessels, vertebral body, kidney, and psoas muscle. Conclusion The psoas muscle can be considered as a surgical landmark since incision at the ventral 2/3 of the region can prevent lumbar plexus injuries for procedures requiring exposure of the lateral anterior of the lumbar. The transverse process can be considered as a landmark and reference in surgical

  7. Appropriately placed surface EMG electrodes reflect deep muscle activity (psoas, quadratus lumborum, abdominal wall) in the lumbar spine. (United States)

    McGill, S; Juker, D; Kropf, P


    This study tested the possibility of obtaining the activity of deeper muscles in the torso-specifically psoas, quadratus lumborum, external oblique, internal oblique and transverse abdominis, using surface myoelectric electrodes. It was hypothesized that: (1) surface electrodes adequately represent the amplitude of deep muscles (specifically psoas, quadratus lumborum, external oblique, internal oblique, transverse abdominis); (2) a single surface electrode location would best represent the activation profiles of each deep muscle over a broad variety of tasks. We assumed that prediction of activation within 10% of maximum voluntary contraction (RMS difference between the surface and intramuscular channels), over the time history of the signal, was reasonable and acceptable to assist clinical interpretation of muscle activation amplitude, and ultimately for modeled estimates of muscle force. Surface electrodes were applied and intramuscular electrodes were inserted on the left side of the body in five men and three women who then performed a wide variety of flexor tasks (bent knee and straight leg situps and leg raises, curl ups), extensor tasks (including lifting barbells up to 70 kg), lateral bending tasks (standing lateral bend and horizontal lying side support), twisting tasks (standing and sitting), and internal/external hip rotation. Using the criteria of RMS difference and the coefficient of determination (R2) to compare surface with intramuscular myoelectric signals, the results indicated that selected surface electrodes adequately represent the amplitude of deep muscles-always within 15% RMS difference, or less with the exception of psoas where differences up to 20% were observed but only in certain maximum voluntary contraction efforts. It appears reasonable for spine modelers, and particularly clinicians, to assume well selected surface electrode locations provide a representation of these deeper muscles-as long as they recognize the magnitude of error for


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    Ville Leinonen


    Full Text Available Impaired motor and sensory functions have been associated with low back pain (LBP. This includes disturbances in a wide range of sensorimotor control e.g. sensory dysfunctions, impaired postural responses and psychomotor control. However, the physiological mechanisms, clinical relevance and characteristics of these findings in different spinal pathologies require further clarification. The purposes of this study were to investigate postural control, lumbar muscle function, movement perception and associations between these findings in healthy volunteers (n=35, patients with lumbar disc herniation (n=20 and lumbar spinal stenosis (LSS, n=26. Paraspinal muscle responses for sudden upper limb loading and muscle activation during flexion-extension movement and the lumbar endurance test were measured by surface electromyography (EMG. Postural stability was measured on a force platform during two- and one-footed standing. Lumbar movement perception was assessed in a motorised trunk rotation unit in the seated position. In addition, measurements of motor-(MEP and somatosensory evoked potentials (SEP and needle EMG examination of lumbar multifidus muscles were performed in the LSS patients. Clinical and questionnaire data were also recorded. A short latency paraspinal muscle response (~50 ms for sudden upper limb loading was observed. The latency of the response was shortened by expectation (p=0.017. The response latency for unexpected loading was similar in healthy persons and disc herniation patients but the latency was not shortened by expectation in the patients (p = 0.014. Also impaired postural control (p < 0.05 and lumbar movement perception (p = 0.012 were observed in disc herniation patients. The impaired lumbar movement perception (p=0.054 and anticipatory muscle activation (p = 0.043 tended to be restored after successful surgery but postural control had still not recovered after 3 months of follow-up. The majority of LSS patients were unable

  9. The preventive and therapeutic effects of Crawling movement for lumbar muscle strain%爬行运动对腰肌劳损防治作用的生理学分析

    Institute of Scientific and Technical Information of China (English)

    杨威; 黄元汛


    爬行运动是近几年的新兴运动,由于其简单易行、不受时间地点的影响,而且疗效显著,因而逐渐受到大众的喜爱。本文详细介绍了爬行运动的标准动作要领,并从生理学角度较深入的分析了腰肌劳损的成因和爬行运动对腰肌劳损防治作用的机理。并从生理学角度印证了爬行运动对腰肌劳损的预防和治疗作用具有明显的针对性,是切实可行的,能够作为腰肌劳损患者和易患人群的治疗和保健运动。%Crawling movement is emerging sports in recent years, due to its simplicity, not affected by time and place, and the curative effect is distinct, so popular with the public gradually. The article introduces the crawling motion standard behavioral essentials, and from the Angle of physiology more in-depth analysis of the cause of the strain of lumbar muscles and crawling motion mechanism of the effect on prevention and control of strain of lumbar muscles. And confirms the crawling movement from the Angle of physiological role in the prevention and treatment of strain of lumbar muscles have obvious pertinence, is feasible, and can be used as a strain of lumbar muscles of patients and treatment and health care movement of people.

  10. Imaging study of paravertebral muscle degeneration in degenerative lumbar instability%退变性腰椎不稳椎旁肌退变的影像学研究

    Institute of Scientific and Technical Information of China (English)

    郭旭朝; 张旭; 丁文元; 杨大龙; 马雷; 谢东晓; 王辉; 王海莹; 路宽


    目的 以MRI为评估手段,对比在退变性腰椎不稳患者和正常人两组人群中椎旁肌(多裂肌、竖脊肌、腰大肌)的改变,观察椎旁肌退变情况并分析椎旁肌退变与退变性腰椎不稳腰椎曲度的关系.方法 选取2011年12月至2013年7月60例退变性腰椎不稳患者为研究对象(退变组),以同期进行健康体检、无腰椎不稳者60例为对照组;两组间性别、年龄、体重指数相匹配.应用ImageJ软件测量两组MRI T2WI上L4~S1椎间盘水平两侧椎旁肌横截面积和脂肪浸润百分比,同时测量腰椎正侧位X线上两组患者的腰椎生理曲度以腰椎前凸角表示,所测数据应用两独立样本t检验进行统计学分析.结果 退变组患者多裂肌横截面积及脂肪浸润百分比在L4~L5、L5~S1水平与对照组相比差异有统计学意义(t=2.768、6.216,P<0.05).两组间竖脊肌脂肪浸润百分比差异有统计学意义(t=5.862,P<0.01).两组间竖脊肌横截面积、腰大肌退变程度(脂肪浸润百分比、肌肉横截面积)无统计学意义.退变组与对照组患者腰椎前凸角分别为(43.9±15.6)°和(39.3±14.2)°,两组间差异有统计学意义(P<0.05).结论 退变性腰椎不稳患者与对照组相比多裂肌、竖脊肌存在退变,且多裂肌退变明显;椎旁肌各肌群退变程度不一致与退变性腰椎不稳腰椎生理前凸角增大相关.%Objectives To compare the paravertebral muscle (such as multifidus,erector spinae,psoas muscle) changes between the patients with degenerative lumbar instability and normal person by MRI and to observe the degeneration of paravertebral muscles.To analyze the relationship between paravertebral muscle degeneration and lumbar curvature of degenerative lumbar instability.Methods Sixty patients with degenerative lumbar instability were retrospectively enrolled from December 2011 to July 2013 as degeneration group,meanwhile 60 health persons with no degenerative lumbar

  11. 椎旁肌横截面积变化可导致退行性腰椎滑脱%Alterations in cross-sectional area of paraspinal muscle induce degenerative lumbar spondylolisthesis

    Institute of Scientific and Technical Information of China (English)

    朱康; 孙根文; 乔培柳; 塔依尔•阿不都哈德尔


    背景:近年来,关节突关节形态在退变性腰椎滑脱症发病中所起的作用是讨论的焦点,但多集中于关节角及骨关节炎 CT 表现的研究。有研究表明椎旁肌横截面积的变化被认为可能是退行性腰椎滑脱的病理学诊断的重要标志,但既往的研究由于样本量偏小、研究对象的年龄较小以及测量等诸多问题限制了其结论的准确性。  目的:观察退变性腰椎滑脱两侧椎旁肌的MRI影像学变化。  方法:采用回顾性研究方法,选取退行性腰椎滑脱的患者80例作为腰椎滑脱组,选取健康者80例作为对照组。应用Image J软件测量两组MRI T2加权像上L 3-5椎体下终板水平两侧竖脊肌和腰大肌的横截面积,并计算相关数据的比值。  结果与结论:与对照组相比,腰椎滑脱组同侧并同水平椎旁肌的横截面积比值增高(P0.05)。结果说明,椎旁肌横截面积的变化可导致退行性腰椎滑脱,可考虑其作为退行性腰椎滑脱的诊断标准。%BACKGROUND:Recently, the effects of lumbar facet joint morphology on the onset of degenerative lumbar spondylolisthesis have been a discussion point. However, the discussion mainly concerned CT manifestations of joint angle and osteoarthritis. Studies have shown that the changes in cross-sectional area of paraspinal muscle were considered as the essential marker for the pathological diagnosis of degenerative lumbar spondylolisthesis. However, previous studies limited the accuracy of the conclusion due to smal sample size, young age, and measurement. OBJECTIVE:To observe changes in MRI images of bilateral paraspinal muscles after degenerative lumbar spondylolisthesis. METHODS:This study adopted the method of retrospective study, selected 80 cases of degenerative lumbar spondylolisthesis as lumbar spondylolisthesis group, and 80 healthy persons as control group. Image J software was utilized to measure cross

  12. Effects of 30 d-6°Head-down Bed Rest on Lumbar Spine and Lumbar Paraspinal Muscles%30d-6°头低位卧床对腰椎和椎旁肌肉面积的影响

    Institute of Scientific and Technical Information of China (English)

    冯金升; 李勇枝; 郭立国; 石宏志; 李奕兴; 金真; 王健


    Objective To study the changes of entire lumbar spinal height,the lordotic angle,the midsagittal area between adjacent lumbar vertebral bodies and the cross-sectional area of lumbar paraspinal muscles following 30 d-6°head-down bed rest (HDBR.Methods A 30 d-6°HDBR experiment was proposed to simulate weightlessness effects.Fourteen healthy male subjects volunteered to participate in the experiment.All subjects underwent magnetic resonance imaging (MRI)test in supine psoas-relaxed position before and after HDBR.Midsagittal views were used to measure the entire lumbar spinal height,the midsagittal area between adjacent lumbar vertebral bodies and lordotic angle.Axial MR image at the level of the L4-L5 disc was used to determine cross-sectional area of lumbar paraspinal muscles.Results After 30 d-6°HDBR,the entire lumbar spinal height of subjects was higher and the midsagittal areas of subjects were larger than those measured before HDBR (P < 0.01).The cross-sectional area of lumbar paraspinal muscles reduced significantly (P < 0.01).The lordotic angle of subjects did not change significantly.Conclusion Thirty days of HDBR at-6°can affect lumbar spinal stability and function and then result in the changes in lumbar spinal biomechanics.%目的 观察30 d-6°头低位卧床实验后志愿者腰椎高度、腰椎间隙中矢状位面积、腰椎前凸角度以及椎旁肌肉横切面积的变化.方法 14名健康男性参加30 d卧床模拟失重实验.于卧床前1天、卧床第30天分别进行腰椎核磁检测,同时测量人体腰椎高度、腰椎间隙中矢状位面积、腰椎前凸角度以及椎旁肌肉横切面积.结果 30 d卧床实验后志愿者腰椎高度增加(P<0.01)、腰椎间隙中矢状位面积增大(P<0.01),椎旁肌肉横切面积减少(P<0.01),而腰椎前凸角度变化不明显.结论 30 d-6°头低位卧床模拟失重对人体腰椎稳定性和功能有影响,从而导致人体腰椎的生物力学变化.

  13. Genomic signatures characterize leukocyte infiltration in myositis muscles

    Directory of Open Access Journals (Sweden)

    Zhu Wei


    Full Text Available Abstract Background Leukocyte infiltration plays an important role in the pathogenesis and progression of myositis, and is highly associated with disease severity. Currently, there is a lack of: efficacious therapies for myositis; understanding of the molecular features important for disease pathogenesis; and potential molecular biomarkers for characterizing inflammatory myopathies to aid in clinical development. Methods In this study, we developed a simple model and predicted that 1 leukocyte-specific transcripts (including both protein-coding transcripts and microRNAs should be coherently overexpressed in myositis muscle and 2 the level of over-expression of these transcripts should be correlated with leukocyte infiltration. We applied this model to assess immune cell infiltration in myositis by examining mRNA and microRNA (miRNA expression profiles in muscle biopsies from 31 myositis patients and 5 normal controls. Results Several gene signatures, including a leukocyte index, type 1 interferon (IFN, MHC class I, and immunoglobulin signature, were developed to characterize myositis patients at the molecular level. The leukocyte index, consisting of genes predominantly associated with immune function, displayed strong concordance with pathological assessment of immune cell infiltration. This leukocyte index was subsequently utilized to differentiate transcriptional changes due to leukocyte infiltration from other alterations in myositis muscle. Results from this differentiation revealed biologically relevant differences in the relationship between the type 1 IFN pathway, miR-146a, and leukocyte infiltration within various myositis subtypes. Conclusions Results indicate that a likely interaction between miR-146a expression and the type 1 IFN pathway is confounded by the level of leukocyte infiltration into muscle tissue. Although the role of miR-146a in myositis remains uncertain, our results highlight the potential benefit of deconvoluting the

  14. Effects of thrust amplitude and duration of high velocity low amplitude spinal manipulation on lumbar muscle spindle responses to vertebral position and movement (United States)

    Cao, Dong-Yuan; Reed, William R.; Long, Cynthia R.; Kawchuk, Gregory N.; Pickar, Joel G.


    OBJECTIVE Mechanical characteristics of high velocity low amplitude spinal manipulations (HVLA-SM) can be variable. Sustained changes in peripheral neuronal signaling due to altered load transmission to a sensory receptor’s local mechanical environment are often considered a mechanism contributing to the therapeutic effects of spinal manipulation. The purpose of this study was to determine whether an HVLA-SM’s thrust amplitude or duration altered neural responsiveness of lumbar muscle spindles to either vertebral movement or position. METHODS Anesthetized cats (n=112) received L6 HVLA-SMs delivered to the spinous process. Cats were divided into 6 cohorts depending upon the peak thrust force (25%, 55%, 85% body weight) or thrust displacement (1, 2, 3mm) they received. Cats in each cohort received 8 thrust durations (0–250ms). Afferent discharge from 112 spindles was recorded in response to ramp and hold vertebral movement before and after the manipulation. Changes in mean instantaneous frequency (MIF) during the baseline period preceding the ramps (ΔMIFresting), during ramp movements (ΔMIFmovement), and with the vertebra held in the new position (ΔMIFposition) were compared. RESULTS Thrust duration had a small but statistically significant effect on ΔMIFresting at all six thrust amplitudes compared to control (0ms thrust duration). The lowest amplitude thrust displacement (1mm) increased ΔMIFresting at all thrust durations. For all the other thrust displacements and forces, the direction of change in ΔMIFresting was not consistent and the pattern of change was not systematically related to thrust duration. Regardless of thrust force, displacement, or duration, ΔMIFmovement and ΔMIFposition were not significantly different from control. Conclusion Relatively low amplitude thrust displacements applied during an HVLA-SM produced sustained increases in the resting discharge of paraspinal muscle spindles regardless of the duration over which the thrust was

  15. A study on the positive influence of Core muscle training on the lumbar disc herniation%核心肌群训练对腰椎间盘突出症的改善作用

    Institute of Scientific and Technical Information of China (English)

    曹犇; 尹德雷; 薛晋智


    To investigate the value of Core muscle training for the treatment of lumbar disc herniation. For 120 pa- tient with lumbar disc herniation had spent 5 months on core muscle training. In order to comparison and analysis of the affected part by combining spiral CT with MRI angiography technique. The results showed that the patients in the experimental group improved significantly more than the physiological curve of the reference group ( p 〈 0. 05) , The experimental group patients with whist pain and thigh numbness is greatly improved than the reference group [ p 〈 0. 01 ). The experimental conclusioned that through core muscle training can improve lumbar disc sur- rounding ligament tension, eliminating muscle adhesion , stabilization of the lumbar spine and other positive effects. It has important clinical value for the prevention and treatment of lumbar disc herniation.%探讨核心肌群训练在腰椎间盘突出症治疗中的价值。对120名腰椎间盘突出症患者进行了5个月的核心肌群训练。结合螺旋CT、MRI造影技术对患处进行分析对比。结果表明实验组患者生理曲线改善程度显著高于参照组(P〈0.05),实验组患者腰部疼痛感大腿麻木感较参照组有较大明显改善(P〈0.01)。实验结论:通过核心肌群训练能够明显改善腰椎间盘周围韧带驹牵张力消除肌肉粘连稳定腰椎等积极作用,对预防和治疗腰椎间盘突出症,防止再次复发具有重要的临床价值。

  16. Quantitative ultrasound tissue characterization in shoulder and thigh muscles – a new approach

    DEFF Research Database (Denmark)

    Nielsen, P.K.; Jensen, B.R.; Darvann, Tron Andre;


    the method for characterization of ultrasound images of the supraspinatus muscle, and the vastus lateralis muscle. Methods: Computerized texture analyses employing first-order and higher-order grey-scale statistics were developed to objectively characterize ultrasound images of m. supraspinatus and m. vastus...... lateralis from 9 healthy participants. Results: The mean grey-scale intensity was higher in the vastus lateralis muscle ( p ...) was higher in the vastus lateralis ( p vastus lateralis: 0.092 mm(-2) and for m. supraspinatus: 0.016 mm(-2)). Conclusion: The higher intensity and the higher number of blobs in the vastus lateralis muscle indicates that the thigh muscle contained more non...

  17. Characterization of human carbonic anhydrase III from skeletal muscle. (United States)

    Carter, N; Jeffery, S; Shiels, A; Edwards, Y; Tipler, T; Hopkinson, D A


    A third form of human carbonic anhydrase (CA III), found at high concentrations in skeletal muscle, has been purified and characterized. This isozyme shows relatively poor hydratase and esterase activities compared to the red cell isozymes, CA I and CA II, but is similar to these isozymes in subunit structure (monomer) and molecular size (28,000). CA III is liable to posttranslational modification by thiol group interaction. Monomeric secondary isozymes, sensitive to beta-mercaptoethanol, are found in both crude and purified material and can be generated in vitro by the addition of thiol reagents. Active dimeric isozymes, generated apparently by the formation of intermolecular disulfide bridges, also occur but account for only a small proportion of the total protein and appear only when the concentration of CA III is particularly high.

  18. 背部阳经透刺治疗慢性腰肌劳损30例%30 Cases of Chronic Lumbar Muscle Strain Treated with Penetration Needling at Yang Meridians of Back

    Institute of Scientific and Technical Information of China (English)

    孙远征; 曾婷婷; 尚莉莉


    目的:通过对背部阳经透刺法治疗慢性腰肌劳损的疗效观测,从而找到一种新的治疗方法。方法:选取30例符合慢性腰肌劳损诊断标准的患者,取腰背部痛点的督脉穴和相应足太阳膀胱经第一侧线背俞穴从上而下采用沿皮循经透刺法针刺直至不痛处为止,再配合电针治疗,治疗30天。观察治疗后临床疗效及治疗前后McGill量表评分。结果:30例患者治愈率为23.3%,有效率为93.3%。经过治疗前后的对比,McGill疼痛问卷中VAS、疼痛指数、PPI各值均出现明显的变化( P<0.01)。结论:在慢性腰肌劳损治疗方面,背部阳经透方法确实有一定效果,显著地缓解了病患的腰痛。%Objective:To observe the effect of penetration needling at Yang meridians of back on chronic lum-bar muscle strain , seeking new ideas for clinical acupuncture treatment for chronic lumbar muscle strain , broad-ening the new field of penetration needling method .Methods:Select thirty patients according to chronic lumbar muscle strain diagnostic code .Take the back pain point of Dumai point and the corresponding levels on the back-shu points on the first line of the Bladder Meridian by penetration needling along the skin from up -to-down until it was not sore , then combine with electroacupuncture for thirty days .Observe the clinical McGill score and effect after treatment .Results:The effective rate was 93 .3%and the curative rate was 23 .3%in all the patients.The pain index,VAS,PPI had significant differences after the treatment (P<0.01).Conclusion:Penetration needling at Yang meridians of back has a curative effect on chronic lumbar muscle strain, which can also release the osphyalgia .

  19. A musculoskeletal model for the lumbar spine. (United States)

    Christophy, Miguel; Faruk Senan, Nur Adila; Lotz, Jeffrey C; O'Reilly, Oliver M


    A new musculoskeletal model for the lumbar spine is described in this paper. This model features a rigid pelvis and sacrum, the five lumbar vertebrae, and a rigid torso consisting of a lumped thoracic spine and ribcage. The motion of the individual lumbar vertebrae was defined as a fraction of the net lumbar movement about the three rotational degrees of freedom: flexion-extension lateral bending, and axial rotation. Additionally, the eight main muscle groups of the lumbar spine were incorporated using 238 muscle fascicles with prescriptions for the parameters in the Hill-type muscle models obtained with the help of an extensive literature survey. The features of the model include the abilities to predict joint reactions, muscle forces, and muscle activation patterns. To illustrate the capabilities of the model and validate its physiological similarity, the model's predictions for the moment arms of the muscles are shown for a range of flexion-extension motions of the lower back. The model uses the OpenSim platform and is freely available on to other spinal researchers interested in analyzing the kinematics of the spine. The model can also be integrated with existing OpenSim models to build more comprehensive models of the human body.

  20. Characterization of muscle contraction with second harmonic generation microscopy (United States)

    Prent, Nicole

    correlations. The characteristic correlation coefficients and amplitudes were obtained for each case, allowing for the characterization of the synchronization of sarcomere movement during muscle contraction. These investigations constitute the basis for studying the structure and physiology of muscle cell contractions with polarization SHG microscopy. Live dynamic imaging of myocytes is applicable for contractility research, drug discovery, and as a diagnostic tool for monitoring muscular diseases.

  1. Observation of Efifcacy of Acupuncture Combined with Xinli Orthopedic Sprays in Treatment of Lumbar Muscle Strain%针灸配合新力正骨喷雾剂治疗腰肌劳损的疗效观察

    Institute of Scientific and Technical Information of China (English)



    目的:观察针灸配合新力正骨喷雾剂治疗腰肌劳损的临床疗效。方法:腰肌劳损患者70例,随机分为两组,对照组35例,治疗组35例。对照组患者采用针灸治疗法,治疗组患者在对照组治疗基础上加用新力正骨喷雾剂。结果:治疗组患者腰部疼痛评分VAS评分较对照组显著降低(P<0.05),背部肌肉耐力较对照组显著提高(P<0.05),临床总有效率也显著高于对照组(P<0.05)。结论:新力正骨喷雾剂能有效缓解腰肌劳损所致腰部疼痛,提高肌肉耐力,与传统针灸联合应用疗效更显著。%Objective:To observe the clinical efifcacy of acupuncture combined with Xinli orthopedic sprays in treatment of lumbar muscle strain. Methods:70 cases diagnosed with lumbar muscle strain were randomly divided into two groups. 35 patients in control group were given acupuncture. The treatment group were given additional Xinli orthopedic sprays Results:The VAS scores of treatment patients were signiifcantly lower than that of the control group(P<0.05), the back muscle endurance of the treatment group was signiifcantly increased than the control group(P<0.05), the clinical total effective rate was also signiifcantly higher than that of control group(P<0.05). Conclusion:Xinli orthopedic sprays could effectively relieve back pain caused by lumbar muscle strain, improve muscle endurance and was more pronounced combined with traditional acupuncture.

  2. Lumbar spine CT scan (United States)

    CAT scan - lumbar spine; Computed axial tomography scan - lumbar spine; Computed tomography scan - lumbar spine; CT - lower back ... your breath for short periods of time. The scan should take only 10 to 15 minutes.

  3. Experimental biomechanics study on the relationship of psoas major muscles and lumbar spine movements%腰大肌与腰椎运动力学关系动物实验研究

    Institute of Scientific and Technical Information of China (English)

    韦以宗; 田新宇; 王慧敏; 谢冰


    目的 探讨恒河猴(活体)腰大肌对腰椎运动生物力学的关系.方法 取恒河猴4只,动态X线片观察分别在正常状态下、切断一侧腰大肌、切断双侧腰大肌;分别做正、侧位数码照像.在正位DR照片上,进行椎体旋转级评价;在侧位DR照片上,腰曲运用应用数学几何学弓形面积计算法,计算出腰曲的弓形面积.利用统计学软件,分析恒河猴在正常状态下、一侧腰大肌切断后和两侧腰大肌切断后分别于坐位、站立位、跨步的椎体旋转角度和腰曲弓形面积.结果 在坐位、站立位、跨步3种不同的状态下,相比于正常腰大肌正常状态,一侧腰大肌切断后,椎体旋转级数和腰曲的弓形面积测量都有显著性差异;而在双侧腰大肌切断后,椎体旋转级数和腰曲的弓形面积测量变化,相比于术前,并无显著差异.结论 腰大肌是腰椎运动和维持腰曲的主要肌肉,在生物力学上,是维持腰椎力学平衡的前方二维动力.%Objective To explore the function ofpsoas major muscles on lumbar spine movements in biomechanics of Rhesus. Methods Four Rhesus were studied in our study. The dynamic AP and lateral digital X-ray views of Rhesus were conducted in three different status, including normal status, one side psoas major resection and bilateral psoas major resection. Vertebral rotations of the spine were evaluated in AP views.The segment areas of lumbar curvatures were calculated in lateral views in applied mathematics geometry. The parameters of vertebral rotational degrees and segment areas of lumbar curvatures were analyzed in three different positions: sitting, standing and stepping in statistics. Results For measurements of both the vertebral rotational degrees and segment areas of lumbar curvatures, there were significant differences between normal status and one side psoas major resection, but there were no significant differences between normal status and bilateral psoas major

  4. HHF35, a muscle-actin-specific monoclonal antibody. I. Immunocytochemical and biochemical characterization. (United States)

    Tsukada, T; Tippens, D; Gordon, D; Ross, R; Gown, A M


    A monoclonal antibody to muscle cell actin isotypes was produced and characterized. Immunocytochemical analysis of methanol-Carnoy's-fixed, paraffin-embedded human tissue revealed that this antibody, termed HHF35, reacts with skeletal muscle cells, cardiac muscle cells, smooth muscle cells, pericytes, and myoepithelial cells, but is nonreactive with endothelial, epithelial, neural, or connective tissue cells. When assayed by indirect immunofluorescence, HHF35 reacts with microfilament bundles from various cultured mammalian smooth muscle cells, but does not react with cultured human dermal fibroblasts or various epithelial tumor cell lines. In one-dimensional gel electrophoresis immunoblot experiments this antibody detects a 42-kd polypeptide from tissue extracts of uterus, ileum, aorta, diaphragm, and heart and extract from smooth muscle cells. The antibody also reacts with a comigrating 42-kd band of highly purified rabbit skeletal muscle actin. HHF35 is nonreactive on immunoblots of extracts from all tested nonmuscle cell extracts. Immunoelectrophoresis followed by immunoblotting performed in the presence of urea and reducing agents reveals recognition of the alpha isoelectrophoretic variant of actin from skeletal, cardiac, and smooth muscle sources and of the gamma variant from smooth muscle sources. Because HHF35 reacts with virtually all muscle cells, it will be useful as a marker for muscle and muscle-derived cells.

  5. Characterization of muscle stretching and damage using polarization-sensitive optical coherence tomography (PS-OCT) (United States)

    Chen, Dongsheng; Zeng, Nan; Liu, Celong; Ma, Hui


    In this paper, we study muscle elastic drawing and damage using our lab's polarization-sensitive optical coherence tomography (PS-OCT) instrument and polarization sensitive Monte Carlo program. First, we acquire two-dimensional PS-OCT images of elastically drawn and injured muscle, injury processes including dehydration and hydrolysis, we extract some characteristics from experimental results including extinction coefficient, integral reflectivity and birefringence and so on, which will change during muscle is being elastically drawn or injured. In order to further understand and evaluate the degree of muscle elastic drawing or damage according to the measurements parameters mentioned above, we do some corresponding simulations using our lab's Monte Carlo program, which is based on a sphere cylinder birefringence model and can simulate complicated tissue containing anisotropic microstructures and various polarization imaging and measurement systems. For muscle elastic drawing, we find that integral reflectivity sometimes increases and decreases as muscle's elastic drawing continues, and through simulation we are unable to find the relationship between extinction coefficients and muscle elastic drawing. As for muscle damage, we simulate two processes: dehydration and hydrolysis. We find that as dehydration deepens, the birefringence of muscle is increasing but getting slowly and the integral reflectivity is decreasing, and as hydrolysis deepens, the birefringence decreases and the integral reflectivity decreases almost linearly. Through the analysis above, we demonstrate the validity of those parameters to characterize muscle elasticity and fiber structure and explain its potential for assessment of muscle damage.

  6. 早期腰背肌功能锻炼对腰椎术后功能恢复临床分析%Analysis of early lumbodorsal back muscle functional exercise after lumbar spine postoperative functional recovery

    Institute of Scientific and Technical Information of China (English)

    曾冠楠; 徐玉生; 李星晨; 金伟林; 王培松


    目的 探讨合理的腰背肌功能锻炼对腰椎术后并发腰背肌痉挛性疼痛疗效.方法 对52例LDH患者进行分组,手术方式及内置物均相同,观察组27例,术后早期采取系统的腰背肌功能锻炼;对照组25例,术后单纯应用药物营养支持治疗.结果 观察组与对照组患者术后,腰痛、双下肢麻木、酸沉症状均较术前明显好转,其中通过合理规范的康复支持治疗,观察组总体疗效优于对照组(P<0.05).结论 早期系统的腰背肌功能锻炼可明显改善LDH术后腰背部疼痛症状,对腰背肌衰弱综合征及腰椎不稳有明显的预防作用.%Objective To explore whether it has a significant effect on back muscle spasm pain and waist weakness when taking reasonable back muscle exercise on lumbar postoperative.Methods Totally 52 patients with LDH were admitted to our department the same surgical approach and implant.The observation group 27 patients to take the systematic back muscle exercise,supply of drug treatment ;The control group 25 patients had simple drug treatment and nutritional supportment,take a rest then adopt the exercise after two month.Results After surgery,patients of the observation group and the control both have low back pain,lower limbs numbness.The symptoms are markedly improved comparing with the preoperative feature.The effect of the observation group which taking reasonable rehabilitative support therapy was better than that of the control group (P < 0.05).Conclusion The early systematic back muscle exercise can significantly improve lower back pain and other symptoms of the LDH postoperative has a significant preventive effect on low back muscle debilitating syndrome and lumbar instability.

  7. Dissociation of skeletal muscle for flow cytometric characterization of immune cells in macaques. (United States)

    Liang, Frank; Ploquin, Aurélie; Hernández, José DelaO; Fausther-Bovendo, Hugues; Lindgren, Gustaf; Stanley, Daphne; Martinez, Aiala Salvador; Brenchley, Jason M; Koup, Richard A; Loré, Karin; Sullivan, Nancy J


    The majority of vaccines and several treatments are administered by intramuscular injection. The aim is to engage and activate immune cells, although they are rare in normal skeletal muscle. The phenotype and function of resident as well as infiltrating immune cells in the muscle after injection are largely unknown. While methods for obtaining and characterizing murine muscle cell suspensions have been reported, protocols for nonhuman primates (NHPs) have not been well defined. NHPs comprise important in vivo models for studies of immune cell function due to their high degree of resemblance with humans. In this study, we developed and systematically compared methods to collect vaccine-injected muscle tissue to be processed into single cell suspensions for flow cytometric characterization of immune cells. We found that muscle tissue processed by mechanical disruption alone resulted in significantly lower immune cell yields compared to enzymatic digestion using Liberase. Dendritic cell subsets, monocytes, macrophages, neutrophils, B cells, T cells and NK cells were readily detected in the muscle by the classic human markers. The methods for obtaining skeletal muscle cell suspension established here offer opportunities to increase the understanding of immune responses in the muscle, and provide a basis for defining immediate post-injection vaccine responses in primates.

  8. Women boxing athletes' EMG of upper limbs and lumbar muscles in the training of air striking of straight punch%女子拳击运动员上肢和腰部肌肉力量训练的肌电分析

    Institute of Scientific and Technical Information of China (English)

    张日辉; 康志新


    目的:利用肌电指标分析拳击运动员上肢和腰部肌肉力量训练效果.方法:用Mega公司的ME6000肌电图仪记录分析10名女子拳击运动员上臂肱二头肌(主动肌)与肱三头肌(拮抗肌)、前臂屈肌(主动肌)与伸肌(拮抗肌)和腰部肌群的运动诱发肌电,规定运动为手持2.5 kg的哑铃负荷进行直拳空击运动直至局部肌肉力竭.结果:直拳空击运动至局部肌肉力竭过程中,上肢拮抗肌的中位频率(MF)下降幅度和速度大于相对应的主动肌,且从肌群作功来看,主动肌作功百分比较拮抗肌大.其中9名普通运动员腰肌的肌电频率(MF)均值较1名指定样本世界冠军的下降缓慢,而且其作功百分比都较小.结论:通过对普通女子拳击运动员上肢和腰部肌群肌电指标测试与世界冠军的比较分析,提示本研究中所测普通拳击运动员拮抗肌和腰部肌肉力量训练不足,有待加强该部肌肉的力量训练.%Objective: To study training effect of upper limbs and lumbar muscles in the proceed of air striking of straight punch by analyzing boxing athletes' changes of electromyogram(EMG). Methods: We measured EMG of ten women boxing athletes' upper arm biceps ( contractor muscle), upper arm triceps(antagonistic muscle), forearm flexor muscle(contractor muscle), forearm extensor muscle(antagonistic muscle), and lumbar muscles by ME6000(Mega Electronics Ltd. ). The stipulated exercise was to do air striking of straight punch with loads of 2.5 kg of dumbbell in the hand until exhausted. Results: In the proceed of exercise-induce exhausted, the descend magnitude and speed of median frequency(MF) in upper limb antagonistic muscle exceeded to contracting muscle, moreover, the work percentage showed that contractor have done a larger percentage of work than antagonistic muscle. Comparel with world champion's EMG, the majority of ordinary athletes' lumbar muscles MF revealed non- drop tendency, and the work percentage

  9. Minimally invasive procedures on the lumbar spine (United States)

    Skovrlj, Branko; Gilligan, Jeffrey; Cutler, Holt S; Qureshi, Sheeraz A


    Degenerative disease of the lumbar spine is a common and increasingly prevalent condition that is often implicated as the primary reason for chronic low back pain and the leading cause of disability in the western world. Surgical management of lumbar degenerative disease has historically been approached by way of open surgical procedures aimed at decompressing and/or stabilizing the lumbar spine. Advances in technology and surgical instrumentation have led to minimally invasive surgical techniques being developed and increasingly used in the treatment of lumbar degenerative disease. Compared to the traditional open spine surgery, minimally invasive techniques require smaller incisions and decrease approach-related morbidity by avoiding muscle crush injury by self-retaining retractors, preventing the disruption of tendon attachment sites of important muscles at the spinous processes, using known anatomic neurovascular and muscle planes, and minimizing collateral soft-tissue injury by limiting the width of the surgical corridor. The theoretical benefits of minimally invasive surgery over traditional open surgery include reduced blood loss, decreased postoperative pain and narcotics use, shorter hospital length of stay, faster recover and quicker return to work and normal activity. This paper describes the different minimally invasive techniques that are currently available for the treatment of degenerative disease of the lumbar spine. PMID:25610845

  10. Methods for dynamic characterization of the major muscles activating the lower limb joints in cycling motion

    Directory of Open Access Journals (Sweden)

    Navit Roth


    Full Text Available The functional activation, through electrical stimulation, of the lower limb consisting of several deficient muscles requires well-patterned and coordinated activation of these muscles. This study presents a method for characterizing the parameters of the major muscle groups controlling the ankle and knee joints in cycling motion, the latter having particular significance in the rehabilitation of locomotion. To lower mechanical indeterminacy in the joints the system is reduced by grouping the muscles acting in synergism. The joint torques were calculated by inverse dynamics methods from cycling motion data, including kinematics and foot/pedal reaction loads (forces, moments. The mechanical indeterminacy was resolved by applying optimization criteria and the individual muscle torques were parceled-out from the joint torques. System identification of the individual muscles, part of which being bi-articular, in this non-isometric condition was performed from the relationship between the evaluated force and the measured EMG of each the muscles, using both first and second order linear transfer functions. Feasibility of the presented method was demonstrated through the computation of the coefficients of the muscles involved and validating the results on the experimental data obtained from one subject.

  11. Acquired lumbar spinal stenosis. (United States)

    Deasy, JoAnn


    Lumbar spinal stenosis is the most frequent reason for spinal surgery in patients over age 65 years. In this condition, narrowing of the lumbar spinal canal and nerve root canals leads to painful, debilitating compression of spinal nerves and blood vessels. As the population ages, an increasing number of patients will be diagnosed and treated for lumbar spinal stenosis by primary care providers. This article reviews the pathophysiology, diagnosis, and management of lumbar spinal stenosis in adults over age 50 years.

  12. Congenital Lumbar Hernia

    Directory of Open Access Journals (Sweden)

    Sanjay Sharma


    Full Text Available Lumbar hernia is a rare hernia. It constitutes less than one percent of all abdominal hernias. It can becongenital or acquired. Acquired can occur either spontaneously or after surgery or trauma. Only 300cases of lumbar hernia are reported till date. We report a case of congenital lumbar hernia in one month oldmale baby

  13. Lumbar gibbus in storage diseases and bone dysplasias

    Energy Technology Data Exchange (ETDEWEB)

    Levin, T.L. [Department of Radiology, Division of Pediatric Radiology, Columbia-Presbyterian Medical Center, Babies and Children`s Hospital of New York, NY (United States); Berdon, W.E. [Department of Radiology, Division of Pediatric Radiology, Columbia-Presbyterian Medical Center, Babies and Children`s Hospital of New York, NY (United States); Lachman, R.S. [International Skeletal Dysplasia Registry, Los Angeles, CA (United States); Anyane-Yeboa, K. [Department of Pediatrics, Columbia-Presbyterian Medical Center, Babies and Children`s Hospital of New York, NY (United States); Ruzal-Shapiro, C. [Department of Radiology, Division of Pediatric Radiology, Columbia-Presbyterian Medical Center, Babies and Children`s Hospital of New York, NY (United States); Roye, D.P. Jr. [Department of Orthopedic Surgery, Columbia-Presbyterian Medical Center, Babies and Children`s Hospital of New York, NY (United States)


    Objective. The objective of this study was to review the problem of lumbar gibbus in children with storage diseases and bone dysplasias utilizing plain films and MR imaging. Materials and methods. Clinical histories and radiographic images in five patients with storage diseases [four mucopolysaccharidosis (MPS) and one mucolipidosis] and two with achondroplasia were reviewed. The International Skeletal Dysplasia Registry (Los Angeles, Calif.), surveyed for all patients with lumbar gibbus and skeletal dysplasias, provided 12 additional cases. Results. All patients had localized gibbus of the upper lumbar spine, characterized by anterior wedging and posterior displacement of the vertebrae at the apex of the curve, producing a beaked appearance. The curve, exaggerated in the sitting or standing position, was most severe in the two patients with MPS-IV (one of whom died). Both developed severe neurologic signs and symptoms requiring surgical intervention. In four patients, MR images demonstrated the apex of the curve to be at or below the conus. Two patients demonstrated anterior herniation of the intervertebral discs at the apex of the curve, though the signal intensity of the intervertebral discs was normal. Conclusion. Lumbar gibbus has important neurologic and orthopedic implications, and is most severe in patients with MPS. The etiology of the gibbus with vertebral beaking is multifactorial and includes poor truncal muscle tone, weight-bearing forces, growth disturbance and anterior disc herniation. The curve is generally at or below the conus. Neurologic complications are unusual, although orthopedic problems can arise. Due to their longer survival, patients with achondroplasia or Morquio`s disease are more vulnerable to eventual gibbus-related musculoskeletal complications. (orig.). With 6 figs., 2 tabs.

  14. PhaseⅢ Clinical Trial of Qingxian Zhitong Plaster in Treating Strain of Lumbar Muscles%卿仙止痛膏治疗腰肌劳损的Ⅲ期临床疗效观察

    Institute of Scientific and Technical Information of China (English)

    鲁齐林; 沈霖; 杨艳萍; 帅波; 徐晓娟; 李成刚; 马秀才


    Objective:To evaluate the effectiveness and safety of Qingxian Zhitong Plaster in treating strain of lumbar muscles (syndrome of wind-damp and blood stasis). Methods: A randomized, double-blinded, placebo-controlled design was used. Sixty-four patients with strain of lumbar muscles were randomly divided into the treatment group (treated with Qingxian Zhitong Plaster) and the control group (treated with placebo). All the patients were treated with 2 plasters once and changed the dressing every 24h. The treatment for both groups continued for 7 days. All patients' clinical symptoms and signs, index of safety,including vital sign, routine test for blood, urine, and stool, ALT, AST, BUN, Cr, ECG, and adverse events were observed. ResultS;The result showed that the effective rate was 76. 60% in the treatment group while 37.50% in the placebo group, and there was statistical difference between the two groups (P<0. 05). In the treatment group, the scores of pain and heavy feeling were decreased obviously (P< 0. 001). The scores of soreness and weakness of waist and knees, and the difficulty in turning were also decreased obviously compared with control group after treatment (P < 0. 05). Conclusion:Qingxian Zhitong Plaster is effective and safe for the treatment of strain of lumbar muscles.%目的:评价卿仙止痛膏治疗腰肌劳损(风湿瘀阻兼瘀血阻络)临床症状的有效性及安全性.方法:采用随机、双盲、安慰剂平行对照的方法将64例腰肌劳损患者随机分为卿仙止痛膏治疗组(治疗组)和安慰剂对照组(对照组),将膏药贴于患处,24h换药1次,每次2贴,7d后观察患者治疗前后的临床症状、体征的变化,检测安全性指标:生命体征、血尿便常规、肝肾功能、心电图、不良反应.结果:治疗组总有效率为76.60%,对照组总有效率37.5%,治疗组疗效明显优于对照组(P<0.05);并且治疗组治疗后的疼痛、重着积分较对照组治疗后明显下降(P<0.001),

  15. Curative Effects of Auricular Plaster Therapy Combined with Electroacupuncture on Lumbar Muscle Strain%耳穴贴压配合电针治疗腰肌劳损的疗效观察

    Institute of Scientific and Technical Information of China (English)

    黄志勇; 陈家凤; 黄臻; 高燕


    Objective:To investigate the auricular plaster therapy for enhancing the clinically curative effect of electroacupuncture treatment on lumbar muscle strain.Methods:90 lumbar muscle strain patients were randomly divided into an observation group ( auricular plaster therapy with electroacupuncture ) and a control group ( electroacupuncture) ,and each group had 45 cases.The observation group was treated with auricular plaster therapy combined with electroacupuncture, and the control group was treated with electroacupuncture.Observe the efficacy and SF-MPQ before and after treatment.Results:The total effective rate of the observation group and the control group was 93.33% and 77.78%,and there was a significant difference between two groups (P0.05).Compared with those before treatment, after treatment in two groups PRI feelling,PRI emotion, PRI total score,VAS,PPI score were significantly decreased (P<0.05), and the observation group decreased more significantly than the control group (P<0.05).Conclusion:Auricular plaster therapy can enhance the clinically curative effect of electroacupuncture on lumbar muscle strain,and it is a safe and effective method,which is worth clinical popularization and application.%目的:探讨耳穴贴压能否增强电针治疗腰肌劳损的临床疗效。方法:90例腰肌劳损患者随机分成观察组和对照组,每组各45例。观察组采用耳穴配合电针治疗,对照组采用电针治疗,观察两组的临床疗效及SF-MPQ评分的变化。结果:观察组和对照组的总有效率分别为93.33%和77.78%,两组比较有显著性差异( P<0.05)。治疗前两组患者PRI感觉、PRI情感、PRI总分、VAS、PPI共5个项目评分差异无统计学意义( P>0.05);与治疗前相比,治疗后两组患者PRI感觉、PRI情感、PRI总分、VAS及PPI评分均显著下降(P<0.05),而观察组下降更为显著(P<0.05)。结论:耳穴贴压疗法能增

  16. Characterization of muscle architecture in children and adults using magnetic resonance elastography and ultrasound techniques. (United States)

    Debernard, Laëtitia; Robert, Ludovic; Charleux, Fabrice; Bensamoun, Sabine F


    The purpose of this study is to characterize the muscle architecture of children and adults using magnetic resonance elastography and ultrasound techniques. Five children (8-12 yr) and seven adults (24-58 yr) underwent both tests on the vastus medialis muscle at relaxed and contracted (10% and 20% of MVC) states. Longitudinal ultrasonic images were performed in the same area as the phase image showing the shear wave's propagation. Two geometrical parameters were defined: the wave angle (α(_MRE)) corresponding to the shear wave propagation and the fascicule angle (α(_US)) tracking the path of fascicles. Moreover, shear modulus was measured at different localizations within the muscle and in the subcutaneous adipose tissue. The association of both techniques demonstrates that the shear wave propagation follows the muscle fascicles path, reflecting the internal muscle architecture. At rest, ultrasound images revealed waves propagating parallel to the children fascicle while adults showed oblique waves corresponding to already oriented (α(_US)=15.4±2.54°) muscle fascicles. In contraction, the waves' propagation were in an oblique direction for children (α(_US_10%MVC)=10.6±2.27°, α(_US_20%MVC)=10.2±2.29°) as well as adults (α(_US_10%MVC)=15.4±2.54°, α(_US_20%MVC)=17.2±2.44°). A stiffness variation (1 kPa) was found between the upper and lower parts of the adult VM muscle and a lower stiffness (1.85±0.17 kPa) was measured in the subcutaneous adipose tissue. This study demonstrates the feasibility of the MRE technique to provide geometrical insights from the children and adults muscles and to characterize different physiological media.

  17. Changes of the fat/water ratio in the erector trunci muscle in patients with lumbar disc herniation: a comparative study with {sup 1}H-MRS; Veraenderungen des Fett/Wasser-Quotienten im Musculus erector trunci bei Patienten mit lumbalem Bandscheibenvorfall: eine vergleichende {sup 1}H-MRS Studie

    Energy Technology Data Exchange (ETDEWEB)

    Schilling, A.M.; Heidenreich, J.O.; Graessmann, A.; Wolf, K.J. [Klinik und Poliklinik fuer Radiologie und Nuklearmedizin, Universitaetsklinikum Benjamin Franklin, Freie Univ. Berlin (Germany); Schulte, T.; Stendel, R.; Brock, M. [Klinik und Poliklinik fuer Neurochirurgie, Universitaetsklinikum Benjamin Franklin, Freie Univ. Berlin (Germany)


    Purpose: To evaluate whether metabolic changes of the erector trunci muscle in patients with lumbar disc herniation can be detected with proton magnetic resonance spectroscopy ({sup 1}H-MRS). Materials and Methods: In 10 patients with lumbar disc herniation and 16 healthy volunteers, proton spectra were obtained from the erector trunci muscle and analyzed for fat-water ratio. The axial images were evaluated for the degree of atrophy of the erector trunci muscle. The muscular tissue was histopathologically examined in 2 patients. Results: The examination was well tolerated by all patients and volunteers and all acquired spectra could be analyzed. Patients with lumbar disc herniation have a significantly increased fat-water ratio of 0.19 compared to 0.09 in the control group, with a p-value of 0.003. This result correlates well with the bioptical findings of increased intracellular lipid deposits and lipomatous transformation of the muscle parenchyma. Conclusion: {sup 1}H-MRS is a useful method to detect metabolic changes in lumbar back musculature and, as a non-invasive technique, might play a role in monitoring exercise in lumbar disc herniation. It can be expected that muscle regeneration will be shown as precisely as muscle degeneration. This hypothesis, however, remains to be proven. (orig.) [German] Ziel: Ziel der Untersuchung war es zu pruefen, ob man mit der Protonen-Magnetresonanz-Spektroskopie ({sup 1}H-MRS) Veraenderungen des Fett/Wasser-Quotienten im M. erector trunci bei Patienten mit lumbalem Bandscheibenvorfall nachweisen kann. Material und Methoden: Bei 10 Patienten mit lumbalem Bandscheibenvorfall und 16 gesunden Probanden wurden im M. erector trunci Protonenspektren generiert und hinsichtlich des Fett/Wasser-Verhaeltnisses analysiert. Die axialen Untersuchungen wurden hinsichtlich des Atrophiegrades des M. erector trunci beurteilt. Bei 2/10 Patienten wurde Muskelgewebe histopathologisch aufgearbeitet. Ergebnisse: Die Untersuchung wurde von allen

  18. Lumbar hernia: surgical anatomy, embryology, and technique of repair. (United States)

    Stamatiou, Dimitrios; Skandalakis, John E; Skandalakis, Lee J; Mirilas, Petros


    Lumbar hernia is the protrusion of intraperitoneal or extraperitoneal contents through a defect of the posterolateral abdominal wall. Barbette was the first, in 1672, to suggest the existence of lumbar hernias. The first case was reported by Garangeot in 1731. Petit and Grynfeltt delineated the boundaries of the inferior and superior lumbar triangles in 1783 and 1866, respectively. These two anatomical sites account for about 95 per cent of lumbar hernias. Approximately 20 per cent of lumbar hernias are congenital. The rest are either primarily or secondarily acquired. The most common cause of primarily acquired lumbar hernias is increased intra-abdominal pressure. Secondarily acquired lumbar hernias are associated with prior surgical incisions, trauma, and abscess formation. During embryologic development, weakening of the area of the aponeuroses of the layered abdominal muscles that derive from somitic mesoderm, which invades the somatopleure, may potentially lead to lumbar hernias. Repair of lumbar hernias should be performed as early as possible to avoid incarceration and strangulation. The classic repair technique uses the open approach, where closure of the defect is performed either directly or using prosthetic mesh. The laparoscopic approach, either transabdominal or extraperitoneal, is an alternative.

  19. Identification and Characterization of Adult Porcine Muscle Stem Cells

    NARCIS (Netherlands)

    Wilschut, K.J.


    In the past decade, tissue-specific stem cell research has been emerging. Stem cells are characterized by a long-term expansion and a broad developmental potential in vitro. Pre-clinical studies appear promising, but still many limitations have to be overcome before broad therapeutic use of stem cel

  20. Immune-Mediated Muscle Diseases of the Horse. (United States)

    Durward-Akhurst, S A; Valberg, S J


    In horses, immune-mediated muscle disorders can arise from an overzealous immune response to concurrent infections or potentially from an inherent immune response to host muscle antigens. Streptococcus equi ss. equi infection or vaccination can result in infarctive purpura hemorrhagica (IPH) in which vascular deposition of IgA-streptococcal M protein complexes produces ischemia and complete focal infarction of skeletal muscle and internal organs. In Quarter Horse-related breeds with immune-mediated myositis, an apparent abnormal immune response to muscle antigens results in upregulation of major histocompatibility complex class (MHC) I and II on muscle cell membranes, lymphocytic infiltration of lumbar and gluteal myofibers, and subsequent gross muscle atrophy. Rarely, an inflammatory event results in myositis with subsequent systemic calcinosis characterized by a pathognomonic hyperphosphatemia and high fatality rate. This review presents an overview of these immune-mediated myopathies and highlights clinical and pathological features as well as the suspected pathophysiology.

  1. Characterization of adipocytes derived from fibro/adipogenic progenitors resident in human skeletal muscle (United States)

    Arrighi, N; Moratal, C; Clément, N; Giorgetti-Peraldi, S; Peraldi, P; Loubat, A; Kurzenne, J-Y; Dani, C; Chopard, A; Dechesne, C A


    A population of fibro/adipogenic but non-myogenic progenitors located between skeletal muscle fibers was recently discovered. The aim of this study was to determine the extent to which these progenitors differentiate into fully functional adipocytes. The characterization of muscle progenitor-derived adipocytes is a central issue in understanding muscle homeostasis. They are considered as being the cellular origin of intermuscular adipose tissue that develops in several pathophysiological situations. Here fibro/adipogenic progenitors were isolated from a panel of 15 human muscle biopsies on the basis of the specific cell-surface immunophenotype CD15+/PDGFRα+CD56−. This allowed investigations of their differentiation into adipocytes and the cellular functions of terminally differentiated adipocytes. Adipogenic differentiation was found to be regulated by the same effectors as those regulating differentiation of progenitors derived from white subcutaneous adipose tissue. Similarly, basic adipocyte functions, such as triglyceride synthesis and lipolysis occurred at levels similar to those observed with subcutaneous adipose tissue progenitor-derived adipocytes. However, muscle progenitor-derived adipocytes were found to be insensitive to insulin-induced glucose uptake, in association with the impairment of phosphorylation of key insulin-signaling effectors. Our findings indicate that muscle adipogenic progenitors give rise to bona fide white adipocytes that have the unexpected feature of being insulin-resistant. PMID:25906156

  2. Analysis of ultrasound pulse-echo images for characterization of muscle disease (United States)

    Leeman, Sidney; Heckmatt, John Z.


    This study aims to extract quantifiable indices characterizing ultrasound propagation and scattering in skeletal muscle, from data acquired using a real-time linear array scanner in a paediatric muscle clinic, in order to establish early diagnosis of Duchenne muscular dystrophy in young children, as well as to chart the progressive severity of the disease. Approximately 40 patients with gait disorders, aged between 1 and 11 years, were scanned with a real-time linear array ultrasound scanner, at 5 MHz. A control group consisted of approximately 50 boys, in the same age range, with no evidence or history of muscle disease. Results show that ultrasound quantitative methods can provide a tight clustering of normal data, and also provide a basis for charting the degree of change in diseased muscle. The most significant (quantitative) parameters derive from the frequency of the attenuation and the muscle echogenicity. The approach provides a discrimination method that is more sensitive than visual assessment of the corresponding image by even an experienced observer. There are also indications that the need for traumatic muscle biopsy may be obviated in some cases.

  3. Mechanical and histological characterization of the abdominal muscle. A previous step to modelling hernia surgery. (United States)

    Hernández, B; Peña, E; Pascual, G; Rodríguez, M; Calvo, B; Doblaré, M; Bellón, J M


    The aims of this study are to experimentally characterize the passive elastic behaviour of the rabbit abdominal wall and to develop a mechanical constitutive law which accurately reproduces the obtained experimental results. For this purpose, tissue samples from New Zealand White rabbits 2150±50 (g) were mechanically tested in vitro. Mechanical tests, consisting of uniaxial loading on tissue samples oriented along the craneo-caudal and the perpendicular directions, respectively, revealed the anisotropic non-linear mechanical behaviour of the abdominal tissues. Experiments were performed considering the composite muscle (including external oblique-EO, internal oblique-IO and transverse abdominis-TA muscle layers), as well as separated muscle layers (i.e., external oblique, and the bilayer formed by internal oblique and transverse abdominis). Both the EO muscle layer and the IO-TA bilayer demonstrated a stiffer behaviour along the transversal direction to muscle fibres than along the longitudinal one. The fibre arrangement was measured by means of a histological study which confirmed that collagen fibres are mainly responsible for the passive mechanical strength and stiffness. Furthermore, the degree of anisotropy of the abdominal composite muscle turned out to be less pronounced than those obtained while studying the EO and IO-TA separately. Moreover, a phenomenological constitutive law was used to capture the measured experimental curves. A Levenberg-Marquardt optimization algorithm was used to fit the model constants to reproduce the experimental curves.

  4. Identification and Characterization of the Dermal Panniculus Carnosus Muscle Stem Cells

    Directory of Open Access Journals (Sweden)

    Neia Naldaiz-Gastesi


    Full Text Available The dermal Panniculus carnosus (PC muscle is important for wound contraction in lower mammals and represents an interesting model of muscle regeneration due to its high cell turnover. The resident satellite cells (the bona fide muscle stem cells remain poorly characterized. Here we analyzed PC satellite cells with regard to developmental origin and purported function. Lineage tracing shows that they originate in Myf5+, Pax3/Pax7+ cell populations. Skin and muscle wounding increased PC myofiber turnover, with the satellite cell progeny being involved in muscle regeneration but with no detectable contribution to the wound-bed myofibroblasts. Since hematopoietic stem cells fuse to PC myofibers in the absence of injury, we also studied the contribution of bone marrow-derived cells to the PC satellite cell compartment, demonstrating that cells of donor origin are capable of repopulating the PC muscle stem cell niche after irradiation and bone marrow transplantation but may not fully acquire the relevant myogenic commitment.

  5. The lumbar cord location of the motoneurons innervating psoas and iliacus muscles : a single and double labeling study in the female Syrian golden hamster

    NARCIS (Netherlands)

    Gerrits, PO; Boers, J; Holstege, G


    The spinal cord location of the motoneurons innervating the psoas and iliacus muscles was determined in the golden hamster. The results of single and double labeling studies, using the retrograde tracers horseradish peroxidase (HRP) and cholera toxin B-subunit (CTB), showed that both psoas and iliac

  6. The Lumbar Cord Location Of The Motoneurons Innervating Psoas And Iliacus Muscles; A Single And Double Labeling Study In The Female Syrian Golden Hamster

    NARCIS (Netherlands)

    Gerrits, Peter O.; Boers, José; Holstege, Gert


    The spinal cord location of the motoneurons innervating the psoas and iliacus muscles was determined in the golden hamster. The results of single and double labeling studies, using the retrograde tracers horseradish peroxidase (HRP) and cholera toxin B-subunit (CTB), showed that both psoas and iliac

  7. Clinical Observation of the Treatment of Lumbar Muscle Fasciitis with Wax Therapy Combining Sling Exercise Therapy%蜡疗联合悬吊运动疗法治疗腰肌筋膜炎临床观察

    Institute of Scientific and Technical Information of China (English)

    李丽; 董雯雯


    Objective:To observe the clinical efifcacy of the treatment of lumbar muscle fasciitis with wax therapy combining sling exercise therapy.Methods:87 cases of lumbar myofascitis were randomly divided into a wax therapy group,a sling exercise therapy group and a combined therapy group,29 cases in each group. The wax therapy group was treated with the parafifn therapy—a physical therapy,the sling exercise therapy group was treated by sling exercise therapy,and the combined therapy group using the above two methods.3 groups all treated once a day,5 times a week,20 times for 1 course.The curative effects were evaluated respectively before treatment and 1 course after treatment by visual analogue scale(VAS)and Oswestry Disability Index(ODI). Results:The waist pain in the 3 groups was obviously relieved after treatment,the difference being statistically significant(P < 0.05);The VAS score and ODI score of the combined therapy group were better than those of the other two groups,the difference being statistically signiifcant(P<0.05).Conclusion:The wax therapy combining sling exercise therapy has a signiifcant clinical efifcacy in the treatment of lumbar muscle fasciitis.%目的:观察蜡疗联合悬吊运动疗法治疗腰肌筋膜炎的临床疗效。方法:将87例腰肌筋膜炎患者随机分成蜡疗组、悬吊组和综合疗法组,每组29例。蜡疗组采用物理疗法中的石蜡疗法,悬吊组采用悬吊运动疗法,综合疗法组采用上述两种方法结合治疗。治疗时间均每日1次,每周5次,20次为1个疗程。分别于治疗前、治疗1个疗程后采用视觉模拟评分法(VAS)和Oswestry功能障碍指数(ODI)对患者疗效进行评定。结果:3组患者治疗前后比较,腰部疼痛均明显减轻,差异有统计学意义(P<0.05);3组间进行比较,综合疗法组VAS评分和ODI评分优于蜡疗组和悬吊组,差异有统计学意义(P<0.05)。结论:蜡疗联合悬吊运动疗法治疗

  8. An animal model for human masseter muscle: histochemical characterization of mouse, rat, rabbit, cat, dog, pig, and cow masseter muscle

    DEFF Research Database (Denmark)

    Tuxen, A; Kirkeby, S


    .4, type IM fibers react moderately, and type II fibers react strongly. Rat and mouse masseter muscles contained type II fibers only, as did some rabbit masseter muscles, whereas other rabbit masseter muscles possessed equal amounts of type I and II fibers. Cat and dog masseter muscles possessed both type...

  9. Curative Effect Observation of Acupuncture and Moxibustion in Treatment of Muscle Strain of the Iliac and Lumbar%针灸治疗髂腰肌拉伤的疗效观察

    Institute of Scientific and Technical Information of China (English)

    薛建凯; 余忠诚; 李建平


    Objective To investigate the clinical effect of acupuncture and moxibustion in the treatment of the injury of the muscle strain of the iliac and lumbar muscles.Methods Select 60 cases in our hospital of the iliopsoas muscle sprain patients,lots were randomly divided into treatment group (acupuncture iliopsoas and local Ashi points)of 30 patients and the control group (acupuncture local Ashi points)in 30 cases of curative effect observation.Results After 1 months of follow-up within and between groups after 12 days of treatment and treatment group two patients,the VAS score had significant difference ( <0.05);two patients suffering from hip activity also significantly difference ( <0.05).Conclusion Combined acupuncture needling iliopsoas puncturing Ashi point of iliopsoas muscle strain has obvious therapeutic effect,and its curative effect is superior to that of simple acupuncture Ashi point.%目的:探讨针灸治疗髂腰肌拉伤的临床疗效。方法选取60例我院收治的髂腰肌拉伤患者,抽签方式随机分为治疗组(斜刺髂腰肌及局部阿是穴)30例和对照组(斜刺局部阿是穴)30例进行疗效观察。结果两组患者治疗12d后及治疗结束后1个月随访组内、组间比较,VAS评分存在显著性差异(<0.05);两组患者患髋活动度亦存在显著性差异(<0.05)。结论针灸斜刺髂腰肌结合斜刺阿是穴对髂腰肌拉伤具有明显的治疗效果,且其疗效优于单纯斜刺阿是穴。

  10. Estudo comparativo do trofismo do multífido na artrodese lombar aberta versus minimamente invasiva Estudio comparativo de trofismo del multífido en la artrodesis lumbar abierta versus la mínimamente invasiva Comparative study of tropism of the multifidus muscle in open lumbar arthrodesis versus minimally invasive arthrodesis

    Directory of Open Access Journals (Sweden)

    Cristiano Magalhaes Menezes


    Full Text Available OBJETIVO: Determinar se a abordagem MIS para artrodese lombar em um nível reduz as alterações estruturais do multífido, tais como a diminuição de sua área de secção transversa e a degeneração gordurosa patológica, quando comparada a uma abordagem convencional aberta. MÉTODOS: Entre Janeiro de 2007 e Janeiro de 2010, foram avaliados 27 pacientes submetidos a procedimento cirúrgico de artrodese aberta e MIS. Realizou-se RNM no pós-operatório, no intervalo entre 12 e 36 meses após a cirurgia, com vizualizacao do músculo multífido para seu estudo. RESULTADOS: Todos os pacientes foram operados num nível de artrodese através da técnica aberta e MIS. CONCLUSÃO: Não foram encontradas diferenças significativas referentes às variáveis sexo e idade com a área e trofismo do multífido em ambos os lados.OBJETIVO: Determinar si un enfoque de MIS, para la artrodesis lumbar en un nivel, reduce los cambios estructurales en el multífido, como la reducción de su área de sección transversal y la patología de la degeneración grasa, en comparación con un enfoque abierto convencional. MÉTODOS: Entre enero de 2007 y enero de 2010, se evaluaron 27 pacientes sometidos a procedimiento quirúrgico de artrodesis abierta y MIS. Se realizó RNM en el posoperatorio, entre 12 y 36 meses después de la cirugía, con la visualización del músculo multífido para su estudio. RESULTADOS: Todos los pacientes fueron operados en un nivel de artrodesis con la técnica abierta y MIS. CONCLUSIÓN: No se encontraron diferencias significativas respecto a las variables de sexo y edad, con el área y el trofismo del multífido en ambos lados.OBJECTIVE: Determine if the minimally invasive surgery (MIS approach for lumbar fusion in a determined level can reduce structural changes in the multifidus muscle, such as decrease their cross-sectional area and pathologic fatty degeneration, compared to a conventional open approach. METHODS: Between January 2007 and

  11. Primary Intraosseous Smooth Muscle Tumor of Uncertain Malignant Potential: Original Report and Molecular Characterization (United States)

    Kropp, Lauren; Siegal, Gene P.; Frampton, Garrett M.; Rodriguez, Michael G.; McKee, Svetlana; Conry, Robert M.


    We report the first case of primary intraosseous smooth muscle tumor of uncertain malignant potential (STUMP) which is analogous to borderline malignant uterine smooth muscle tumors so designated. The tumor presented in the femur of an otherwise healthy 30-year-old woman. Over a 3-year period, the patient underwent 11 biopsies or resections and 2 cytologic procedures. Multiple pathologists reviewed the histologic material including musculoskeletal pathologists but could not reach a definitive diagnosis. However, metastases eventually developed and were rapidly progressive and responsive to gemcitabine and docetaxel. Molecular characterization and ultrastructural analysis was consistent with smooth muscle origin, and amplification of unmutated chromosome 12p and 12q segments appears to be the major genomic driver of this tumor. Primary intraosseous STUMP is thought to be genetically related to leiomyosarcoma of bone, but likely representing an earlier stage of carcinogenesis. Wide excision and aggressive follow-up is warranted for this potentially life-threatening neoplasm. PMID:27994831

  12. Ultrasonic tissue characterization of the upper trapezius muscle in patients with myofascial pain syndrome. (United States)

    Turo, Diego; Otto, Paul; Shah, Jay P; Heimur, Juliana; Gebreab, Tadesse; Armstrong, Katherine; Gerber, Lynn H; Sikdar, Siddhartha


    Myofascial trigger points (MTrPs) are palpable, tender nodules in skeletal muscle that produce symptomatic referred pain when palpated. MTrPs are characteristic findings in myofascial pain syndrome (MPS). The role of MTrPs in the pathophysiology of MPS is unknown. Objective characterization and quantitative measurement of the properties of MTrPs can improve their localization and diagnosis, as well as lead to clinical outcome measures. MTrPs associated with soft tissue neck pain are often found in the upper trapezius muscle. We have previously demonstrated that MTrPs can be visualized using ultrasound imaging. The goal of this study was to evaluate whether texture-based image analysis can differentiate structural heterogeneity of symptomatic MTrPs and normal muscle.

  13. Validação de escala de contração da musculatura paravertebral ao estímulo da punção lombar Validación de escala de contracción de la musculatura paravertebral al estímulo de la punción lumbar Validation of a scale for the assessment of paravertebral muscle contraction during lumbar puncture

    Directory of Open Access Journals (Sweden)

    Tiago Gayer de Alencar


    evaluación de los efectos de la infiltración con anestésico local en futuros trabajos. MÉTODO: Participaron del estudio 31 observadores, de 2 Centros de Enseñanza y Entrenamiento (CEE-SBA, 12 del CEE-SBA 1 y 19 del CEE-SBA 2. Ocho participantes eran Médicos en Especialización (ME de primer año, 6 de segundo año y 17 eran Instructores. A los evaluadores fueron mostradas 23 películas, repetidas en 3 muestras, según la secuencia aleatoria generada electrónicamente. Las películas contenían estímulo de la piel con agujas de Quincke 25, 27 y 29G durante punciones lumbares y simulaciones de punciones (toque de puntas de jeringas. Los pacientes autorizaron la filmación y utilización. Los movimientos de la musculatura paravertebral fueron cuantificados por los evaluadores, en la siguiente escala: 0 - ausencia de contracción visible; 1 - contracción leve, sin desplazamiento evidente de la columna; 2 - contracción, con movimentación moderada de la columna vertebral; 3 - contracción de la musculatura con movimentación que impide la progresión de la aguja. Para cálculo de los contajes de cada película, se consideraron las modas de las tres muestras. Se testó la consistencia interna por el coeficiente alfa de Cronbach y la concordancia entre los múltiples observadores por el coeficiente alfa de Krippendorff. RESULTADOS: El coeficiente alfa de Cronbach fue 0,98. La mediana (cuartil inferior; superior de los coeficientes alfa de Krippendorff fue 0,81 (0,78; 0,84. CONCLUSIONES: La escala presentó un buen desempeño en lo que se refiere a la concordancia entre múltiples observadores, pudiendo ser utilizada para cuantificar la contracción de la musculatura paravertebral durante las punciones lumbares.BACKGROUND AND OBJECTIVES: This study aimed at validating a scale to quantify the intensity of paravertebral muscle contraction during lumbar punctures, to be used in further studies on the effects of local anesthetic infiltration. METHODS: This study involved 31

  14. Traumatic lumbar hernia: can't afford to miss. (United States)

    Saboo, Sachin S; Khurana, Bharti; Desai, Naman; Juan, Yu-Hsiang; Landman, Wendy; Sodickson, Aaron; Gates, Jonathan


    We describe the radiological and surgical correlation of an uncommon case of a traumatic lumbar hernia in a 22-year-old man presenting to the emergency department following a motor vehicle accident. Computed tomography (CT) of the abdomen revealed a right-sided traumatic inferior lumbar hernia containing a small amount of fat through the posterior lateral internal oblique muscle with hematoma in the subcutaneous fat and adjacent abdominal wall musculature, which was repaired surgically via primary closure on emergent basis. The purpose of this article is to emphasize the importance of diagnosing traumatic lumbar hernia on CT and need for urgent repair to avoid potential complications of bowel incarceration and strangulation.


    Institute of Scientific and Technical Information of China (English)

    WANG Zhan-hui


    @@ Lumbar strain refers to the long-term accumulated mild injuries due to improper posture and overload in soft tissues, such as in lumbar sacral muscle, ligament and fascia. It happens generally at young age, is the common disorder in clinic and leads to quite inconvenience and pain in the life of patient. The author adopted medicinal injection with procaine and Vit. B1 on Tingyaoxue (挺腰穴) to treat 54 cases of lumbar strain and has achieved the remarkable effects. The report is presented as follows.

  16. Recombinant human bone morphogenetic protein 2-induced heterotopic ossification of the retroperitoneum, psoas muscle, pelvis and abdominal wall following lumbar spinal fusion

    Energy Technology Data Exchange (ETDEWEB)

    Shah, Raj K. [The George Washington University School of Medicine, Washington, DC (United States); Moncayo, Valeria M.; Pierre-Jerome, Claude; Terk, Michael R. [Emory University School of Medicine, Radiology Department, Musculoskeletal Division, Atlanta, GA (United States); Smitson, Robert D. [Emory University School of Medicine, Atlanta, GA (United States)


    A 45-year-old man presented with vertebral collapse at L5 as an initial manifestation of multiple myeloma and underwent spinal fusion surgery using recombinant human bone morphogenetic protein-2 (rhBMP-2). Subsequent computed tomography (CT) scans and X-rays revealed heterotopic ossification of the left psoas muscle, pelvis, and anterior abdominal wall. While the occurrence of heterotopic ossification has previously been reported when rhBMP-2 has been used for spinal fusion surgery, this case demonstrates that it can occur to a much greater degree than previously seen. (orig.)

  17. Evaluation of the lumbar multifidus in rowers during spinal stabilization exercise

    Directory of Open Access Journals (Sweden)

    Joseani Ceccato


    Full Text Available Lumbar stabilization is important in high performance rowing due to the high incidence of low back pain. The purpose of this study was to evaluate the lumbar stabilizers muscles performance during an exercise of spinal segmental stabilization and in lumbar multifidus muscle thickness in rowing athletes trained and untrained for this exercise. Nine rowers trained with lumbar stabilization (TLS and eight rowers without training (CON participated in the study. Lumbar stabilization performance and multifidus muscle thickness were measured during a maximal voluntary isometric contraction. Lumbar stabilization performance was higher (p=0.015 in the TLS (mean 18.38 ± 8.00 mmHg compared to the CON (9.31 ± 4.91 mmHg group. Muscle thickness variation was higher (p=0.023 in the TLS (6.92% ± 3.98 compared to the CON (2.81% ± 1.40 group. Lumbar stabilization training is an efficient clinical tool to strengthen lumbar muscles and may help to prevent low back pain in rowers.

  18. Laparoscopic lumbar hernia repair. (United States)

    Madan, Atul K; Ternovits, Craig A; Speck, Karen E; Pritchard, F Elizabeth; Tichansky, David S


    Lumbar hernias are rare clinical entities that often pose a challenge for repair. Because of the surrounding anatomy, adequate surgical herniorraphy is often difficult. Minimally invasive surgery has become an option for these hernias. Herein, we describe two patients with lumbar hernias (one with a recurrent traumatic hernia and one with an incisional hernia). Both of these hernias were successfully repaired laparoscopically.

  19. Characterization of cyclic AMP accumulation in cultured human corpus cavernosum smooth muscle cells. (United States)

    Palmer, L S; Valcic, M; Melman, A; Giraldi, A; Wagner, G; Christ, G J


    Intracavernous pharmacotherapy relies heavily on the use of vasoactive agents which act by increasing intracellular cAMP levels in human corpus cavernosum smooth muscle. Yet little is known about the cAMP generating system in this tissue, and how it may affect observed patient variability. Thus, the goal of these studies was to better characterize the biochemistry of cAMP formation in human corpus cavernosum smooth muscle, and thus provide more insight into the mechanisms of corporal smooth muscle relaxation in vivo. We studied both receptor and nonreceptor mediated increases in cAMP formation in short-term cultures of human corpus cavernosum smooth muscle cells. Both isoproterenol (ISO) and prostaglandin E1 (PGE1) produced concentration-dependent increases in cAMP, but histamine, serotonin and vasoactive intestinal polypeptide did not. Forskolin, a relatively specific activator of adenylate cyclase, was also a potent stimulant of cAMP formation in these cells. Moreover, there was a direct correlation between the degree of forskolin-induced cAMP accumulation in cultured corporal smooth muscle cells and the magnitude of the forskolin-induced relaxation response of precontracted isolated corporal smooth muscle strips. Prostaglandin E1 and ISO concentration response curves (CRCs) were then assayed in the absence and presence of subthreshold forskolin (0.1 microM.). In the presence of forskolin, the calculated maximal PGE1-induced cAMP accumulation (Emax) was significantly greater than that elicited by PGE1 alone, ISO alone, or ISO + forskolin (p protocol was used to demonstrate that both 80:20 and 70:30 FMRs (but not 95:5 or 90:10), were associated with significantly greater cAMP Emax values than that observed for PGE1 alone (p < or = 0.01). These data provide direct evidence that the degree of cAMP formation in cultured corporal smooth muscle cells is strongly correlated with the magnitude of relaxation of isolated corporal smooth muscle strips. In addition, since

  20. Characterization of B cells in muscle-specific kinase antibody myasthenia gravis


    Guptill, Jeffrey T.; Yi, John S.; Sanders, Donald B.; Guidon, Amanda C.; Juel, Vern C; Massey, Janice M.; Howard, James F.; Scuderi, Flavia; Bartoccioni, Emanuela; Evoli, Amelia; Kent J Weinhold


    Objective: To characterize B-cell subsets in patients with muscle-specific tyrosine kinase (MuSK) myasthenia gravis (MG). Methods: In accordance with Human Immunology Project Consortium guidelines, we performed polychromatic flow cytometry and ELISA assays in peripheral blood samples from 18 patients with MuSK MG and 9 healthy controls. To complement a B-cell phenotype assay that evaluated maturational subsets, we measured B10 cell percentages, plasma B cell–activating factor (BAFF) levels, a...

  1. 退变性腰椎侧凸两侧椎旁肌的影像学差异及其临床意义%Radiological comparison of bilateral paravertebral muscles in degenerative lumbar scoliosis and its potential importance

    Institute of Scientific and Technical Information of China (English)

    谢冬晓; 丁文元; 申勇; 张英泽; 杨大龙; 孙亚澎; 徐佳欣; 张峰


    具有潜在的临床意义.%Objectives To investigate the radiological change of bilateral paravertebral muscles in degenerative lumbar scoliosis (DLS) and analyze its clinical significance.Methods As a retrospective study,66 patients with DLS and 66 patients with lumbar spinal stenosis were retrospectively enrolled from April 2004 to August 2011 as scoliosis group and lumbar spinal stenosis group,meanwhile 66 health persons with no lumbar spinal stenosis were selected as control group.No significant differences were found in the gender,age and body mass index among the three groups.The cross-sectional area(CSA) and percentage of fat infiltration area (FIA) of the bilateral paravertebral muscles at the L1-S1 levels were measured using T2-weighted axial MRI and Image J software.The measured data were analyzed with a paired t-test.Results In the DLS with bilateral symptom group,the mean percentage of FIA of the multifidus muscle on the convex side were 18% ±4%,21% ±4%,27% ±4%,34% ±6%,42% ± 10% and on the concave side were 25% ±8%,30% ±7%,35% ±7%,40% ± 10%,44% ±8% at L1-2,L2-3,L3-4,L4-5 and L5-S1 levels,which showed significant differences between the convex side and the concave side (t =7.95,9.30,5.35,2.78,2.38,P <0.05) ;the mean percentage of FIA of the longissimus muscle on the convex side were 25% ±9%,28% ±8% and on the concave side were 27% ± 9%,31% ± 9% at L3-4,L4-5 levels,which showed significant differences between the convex side and the concave side(t =2.52,3.48,P < 0.05).There were no significant differences in the CSA of both muscles between the concave and convex sides (P > 0.05).In the DLS with unilateral symptom group,the mean percentage of FIA of the multifidus muscle on the convex side were 18% ±5%,23% ±5%,29% ±5%,34% ±6%,42% ±9% and on the concave side were 23% ±6%,30% ±7%,36% ±7%,41% ± 10%,45% ± 8% at L1-2,L2-3,L3-4,L4-5 and L5-S1 levels,which showed significant

  2. Characterization of the equine skeletal muscle transcriptome identifies novel functional responses to exercise training.

    LENUS (Irish Health Repository)

    McGivney, Beatrice A


    BACKGROUND: Digital gene expression profiling was used to characterize the assembly of genes expressed in equine skeletal muscle and to identify the subset of genes that were differentially expressed following a ten-month period of exercise training. The study cohort comprised seven Thoroughbred racehorses from a single training yard. Skeletal muscle biopsies were collected at rest from the gluteus medius at two time points: T(1) - untrained, (9 +\\/- 0.5 months old) and T(2) - trained (20 +\\/- 0.7 months old). RESULTS: The most abundant mRNA transcripts in the muscle transcriptome were those involved in muscle contraction, aerobic respiration and mitochondrial function. A previously unreported over-representation of genes related to RNA processing, the stress response and proteolysis was observed. Following training 92 tags were differentially expressed of which 74 were annotated. Sixteen genes showed increased expression, including the mitochondrial genes ACADVL, MRPS21 and SLC25A29 encoded by the nuclear genome. Among the 58 genes with decreased expression, MSTN, a negative regulator of muscle growth, had the greatest decrease.Functional analysis of all expressed genes using FatiScan revealed an asymmetric distribution of 482 Gene Ontology (GO) groups and 18 KEGG pathways. Functional groups displaying highly significant (P < 0.0001) increased expression included mitochondrion, oxidative phosphorylation and fatty acid metabolism while functional groups with decreased expression were mainly associated with structural genes and included the sarcoplasm, laminin complex and cytoskeleton. CONCLUSION: Exercise training in Thoroughbred racehorses results in coordinate changes in the gene expression of functional groups of genes related to metabolism, oxidative phosphorylation and muscle structure.

  3. Clinical study on shoot fire therapy combined with massage therapy in the treatment of lumbar muscle strain%拍火疗法配合推拿治疗腰肌劳损临床研究

    Institute of Scientific and Technical Information of China (English)



    目的 观察研究拍火疗法配合推拿治疗腰肌劳损的临床疗效和机制.方法 将400例患者随机分为采用拍火疗法配合推拿治疗的治疗组(200例)和采用中药熏蒸配合推拿治疗的对照组(200例),治疗2个疗程后进行疗效观察,6个月后随访,最后比较两组临床疗效.结果 治疗组治愈率为54.5%(109/200),显效率为26.5%(53/200),愈显率为81.0%;对照组治愈率为48.5%(97/200),显效率为15.5%(31/200),愈显率为64.0%.治疗组愈显率与对照组比较,差异有统计学意义(P < 0.05),治疗组疗效明显优于对照组.结论 拍火疗法配合推拿治疗腰肌劳损简廉易行,具有良好的治疗效果和特色.%Objective To observe the therapeutic efficacy and mechanism of shoot fire therapy combined with massage therapy in the treatment of lumbar muscle strain. Methods 400 patients were randomly divided into the treatment group which was given shot fire therapy combined with massage therapy and the control group which was given herbal steaming therapy combined with massage therapy, each group had 200 cases. Treatment efficacy of two groups were observed after 2 courses of treatment and follow-up were performed 6 months after treatment, and then the therapeutic efficacies of the two groups were compared and analyzed. Results In the treatment group, the cure rate was 54.5% (109/200), marked improvement rate wa.s 26.5% (53/200) and good improvement rate was 81.0%; in the control group, the cure rate was 48.5% (97/200), marked improvement rate was 15.5% (31/200) and good improvement rate was 64.0%. The good improvement rate of the treatment group was significantly better than that of the control group (P <0.05). Conclusion Combined therapy of shoot fire therapy and massage therapy is easy and inexpensive in the treatment of lumbar muscle strain and the treatment also has good therapeutic effect and unique features.

  4. 大叶碎米荠胶囊治疗腰肌劳损76例临床观察%Clinical observation on Cardamine Macrophylla Willd.Capsule in the treatment of 76 patients with lumbar muscle strain

    Institute of Scientific and Technical Information of China (English)

    周凯; 李东辉; 刘江舟; 周效思


    Objective: To study curative effect of Cardamine Macrophylla Willd. Capsule in the treatment of lumbar muscle strain. Methods: 147 patients who met the full diagnostic criteria were divided into treatment group (76 cases) and control group (71 cases). The treatment group were treated with Cardamine Macrophylla Willd. Capsule per os, while the control group were treated with Western medicine Piroxicam Tablets per os. The comprehensive curative effects of the two groups were summarized after 15 days. Results: The total effective rate of the treatment group was 93.42%, and that of the control group was 74.65%, the curative effect was found to be better in the treatment group than that in the control group (P<0.05). Conclusion: The curative effect in the treatment group treated with Cardamine Macrophylla Willd. Capsule (per os) was significantly better than that in the control group treated with Piroxicam Tablets (per os).%目的:观察大叶碎米荠(Cardamine macrophylla Willd.)治疗腰肌劳损的临床疗效.方法:将我院符合诊断标准的腰肌劳损147例患者分为治疗组(76例)和对照组(71例),治疗组以口服大叶碎米荠胶囊治疗,对照组予口服吡罗昔康治疗.15 d后对两组综合疗效进行比较.结果:治疗组总有效率为93.42%,对照组为74.65%,两组总有效率比较差异有统计学意义(P<0.05).结论:口服大叶碎米荠治疗腰肌劳损的疗效明显,优于吡罗昔康对照组.

  5. Characterization of vascular smooth muscle cell phenotype in long-term culture. (United States)

    Absher, M; Woodcock-Mitchell, J; Mitchell, J; Baldor, L; Low, R; Warshaw, D


    Studies of bovine carotid artery smooth muscle cells, during long-term in vitro subcultivation (up to 100 population doublings), have revealed phenotypic heterogeneity among cells, as characterized by differences in proliferative behavior, cell morphology, and contractile-cytoskeletal protein profiles. In vivo, smooth muscle cells were spindle-shaped and expressed desmin and alpha-smooth muscle actin (50% of total actin) as their predominant cytoskeletal and contractile proteins. Within 24 h of culture, vimentin rather than desmin was the predominant intermediate filament protein, with little change in alpha-actin content. Upon initial subcultivation, all cells were flattened and fibroblastic in appearance with a concomitant fivefold reduction in alpha-actin content, whereas the beta and gamma nonmuscle actins predominated. In three out of four cell lines studied, fluctuations in proliferative activity were observed during the life span of the culture. These spontaneous fluctuations in proliferation were accompanied by coordinated changes in morphology and contractile-cytoskeletal protein profiles. During periods of enhanced proliferation a significant proportion of cells reverted to their original spindle-shaped morphology with a simultaneous increase in alpha-actin content (20 to 30% of total actin). These results suggest that in long-term culture smooth muscle cells undergo spontaneous modulations in cell phenotype and may serve as a useful model for studying the regulation of intracellular protein expression.

  6. Low back pain characterized by muscle resistance and occupational factors associated with nursing

    Directory of Open Access Journals (Sweden)

    Rafael de Souza Petersen


    Full Text Available OBJECTIVE: to identify the occupational factors associated with low back pain using a surveillance tool and to characterize the low back pain by the resistance of the extensor muscles of the vertebral column among nursing professionals at an Intensive Care Unit.METHODS: Cross-sectional study. The workers answered a questionnaire about occupational factors and participated in a resistance test of the extensor muscles of the vertebral column. Associations were established through Student's T-test or Mann-Whitney's U-test and correlations using Pearson's test.RESULTS: Out of 48 participants, 32 (67% suffered from low pain. For the resistance test, the subjects suffering from low back pain endured less time in comparison with asymptomatic subjects, but without significant differences (p=0.147. The duration of the pain episode showed a significant negative correlation (p=0.016 with the results of the resistance test though. The main factors identified as causes of low back pain were biomechanical and postural elements, conditions of the muscle structure and physical and organizational conditions.CONCLUSIONS: the main occupational factors associated with the low back pain were the posture and the characteristics of the physical and organizational conditions. In addition, the extensor muscles of the column showed a trend towards lesser resistance for workers in pain. This evidence is important when considering prevention and treatment strategies.

  7. 优秀柔道运动员腰肌劳损的康复性体能训练研究%Study on Rehabilitation of Physical Training of Elite Judo Player with Lumbar Muscle Strain

    Institute of Scientific and Technical Information of China (English)



    Rehabilitation physical training is a new direction of research and practice of physical training, at the same time it has a relatively rapid development, provides the solution and good method for injury prevention and injury recovery of athlete. Cheng is a key Judo player in Chinese Team, his waist had discomfort in 2012 October,had Pain after high intensity training and it led to a diagnosis:Lumbar muscle strain. Based on the facts, This study uses is kinetic muscle strength test, body composition and Function check to evaluate the body function of Cheng, and to develop targeted rehabilitation physical training program. After 3 stages of 25 weeks rehabilitation physical training, physical fitness level of Cheng had been greatly improved, and the injury of players got good recovery, it help Cheng to achieve good performance in the 12 National Games.%康复性体能训练是体能训练领域较新的研究和实践方向,同时发展也较为迅速,它为运动员的损伤预防和伤病恢复提供了很好的解决方向和方法。程**,中国柔道队队员,2012年10月,腰部出现不适,大强度训练后出现疼痛,后经诊断为腰肌劳损。基于此,研究运用等速肌力测试、体成份测试和功能检查等方法对程**的身体功能情况进行系统的阶段性的评估,并根据腰部损伤情况制定针对性的康复体能训练计划。经过3个阶段25周的康复性体能训练后,程**腰肌劳损的伤病得到了很好的恢复,并且体能水平得到了较大程度的提高,这为其在12届全国运动会上取得冠军的比赛成绩打下了坚实的基础。

  8. Characterizing rapid-onset vasodilation to single muscle contractions in the human leg. (United States)

    Credeur, Daniel P; Holwerda, Seth W; Restaino, Robert M; King, Phillip M; Crutcher, Kiera L; Laughlin, M Harold; Padilla, Jaume; Fadel, Paul J


    Rapid-onset vasodilation (ROV) following single muscle contractions has been examined in the forearm of humans, but has not yet been characterized in the leg. Given known vascular differences between the arm and leg, we sought to characterize ROV following single muscle contractions in the leg. Sixteen healthy men performed random ordered single contractions at 5, 10, 20, 40, and 60% of their maximum voluntary contraction (MVC) using isometric knee extension made with the leg above and below heart level, and these were compared with single isometric contractions of the forearm (handgrip). Single thigh cuff compressions (300 mmHg) were utilized to estimate the mechanical contribution to leg ROV. Continuous blood flow was determined by duplex-Doppler ultrasound and blood pressure via finger photoplethysmography (Finometer). Single isometric knee extensor contractions produced intensity-dependent increases in peak leg vascular conductance that were significantly greater than the forearm in both the above- and below-heart level positions (e.g., above heart level: leg 20% MVC, +138 ± 28% vs. arm 20% MVC, +89 ± 17%; P contractions in the leg. Collectively, these data demonstrate the presence of a rapid and robust vasodilation to single muscle contractions in the leg that is largely independent of mechanical factors, thus establishing the leg as a viable model to study ROV in humans.

  9. Lumbar stenosis: clinical case

    Directory of Open Access Journals (Sweden)

    Pedro Sá


    Full Text Available Lumbar stenosis is an increasingly common pathological condition that is becoming more frequent with increasing mean life expectancy, with high costs for society. It has many causes, among which degenerative, neoplastic and traumatic causes stand out. Most of the patients respond well to conservative therapy. Surgical treatment is reserved for patients who present symptoms after implementation of conservative measures. Here, a case of severe stenosis of the lumbar spine at several levels, in a female patient with pathological and surgical antecedents in the lumbar spine, is presented. The patient underwent two different decompression techniques within the same operation.

  10. Comparison of Paraspinal Muscle Injury Between Open Discectomy and Microendoscopic Discectomy for Lumbar Disc Herniation%椎间盘镜与椎板开窗手术治疗腰椎间盘突出症对椎旁肌损伤的比较

    Institute of Scientific and Technical Information of China (English)

    汤朝晖; 杨维权; 孙荣华; 植致敏; 朱海云; 卫杰; 刘大雄


    目的 比较椎板开窗(OLD)与经椎间盘镜(MED)治疗腰椎间盘突出症对椎旁肌的损伤.方法对60例单节段腰椎间盘突出症,30例采用OLD(OLD组),30例采用MED(MED组),术中不同时间段切取受牵拉的椎旁肌标本,切片观察肌肉的病理改变和透射电镜观察超微结构改变,并对术前和术后1个月椎旁肌的肌电图(EMG)和MRI检查进行比较.结果光镜下,两组肌肉损伤无明显差异,电镜下,OLD组肌肉损伤明显比MED组严重,肌原纤维紊乱、断裂、溶解,线粒体和内质网肿胀、空泡状;EMG显示OLD组椎旁肌收缩动作电位波幅降低,出现多相电位,MED组手术前后无明显差异.MRI检查,在同一平面比较手术前后椎旁肌横截面积,OLD组椎旁肌明显萎缩,MED组手术前后椎旁肌面积无显著差异.结论OLD对椎旁肌损伤明显比MED严重,而且术后椎旁肌恢复较慢.MED对肌肉损伤轻,对于腰椎间盘突出症术后的恢复具有优势.%Objective To compare the damage on the paraspinal muscle in open lumbar discectomy (OLD) and microendoscopic discec-tomy (MED) for lumbar disc herniation. Methods Sixty cases of single lumbar disc hemiation, 30 patients by OLD, 30 cases by MED, the paraspinal muscle specimens harvested at different times in surgery, muscle pathological changes were observed by light microscope and transmission electron microscopy. Preoperative and postoperative 1 month, the electromyography (EMG) and magnetic resonance imaging (MRI) examination of paraspinal muscle were evaluated. Results In the light microscope, the two groups had no significant difference in muscle damage, in the electron microscope, OLD group paraspinal muscle injury was significantly more serious than MED group, my-ofibril disorder, fracture, mitochondria and endoplasmic reticulum swelling observed in OLD group. EMC examination revealed that in OLD group the paraspinal muscle motor unit potential (MUP) amplitude decreased, the average time was

  11. Endoscopic anatomy and features of lumbar discectomy by Destandau technique

    Directory of Open Access Journals (Sweden)

    Keyvan Mostofi


    Full Text Available Minimally invasive spine surgery prevents alteration of paraspinal muscles and avoids traditional open surgery, so in the majority of cases, recovery is much quicker and patients have less back pain after surgery. The authors describe an endoscopic approach to lumbar disc herniation by the Destandau's method originated in Bordeaux. Destandau designed ENDOSPINE for discectomy will be inserted, and the procedure will continue using endoscopy. The Endoscopic approach to lumbar disc herniation by Destandau's method offers a convenient access to lumbar disc herniation with less complications and negligible morbidity. It gives maximum exposure to the disc space with maximal angles and minimal cutaneous incision. Contrary to other minimally invasive approaches, the visual field in discectomy by Destandau technique is broad and depending on the workability of ENDOSPINE an adequate access to lumbar disc herniation is possible.

  12. Jogging gait kinetics following fatiguing lumbar paraspinal exercise. (United States)

    Hart, Joseph M; Kerrigan, D Casey; Fritz, Julie M; Saliba, Ethan N; Gansneder, Bruce; Ingersoll, Christopher D


    A relationship exists between lumbar paraspinal muscle fatigue and quadriceps muscle activation. The objective of this study was to determine whether hip and knee joint moments during jogging changed following paraspinal fatiguing exercise. Fifty total subjects (25 with self-reported history of low back pain) performed fatiguing, isometric lumbar extension exercise until a shift in EMG median frequency corresponding to a mild level of muscle fatigue was observed. We compared 3-dimensional external joint moments of the hip and knee during jogging before and after lumbar paraspinal fatigue using a 10-camera motion analysis system. Reduced external knee flexion, knee adduction, knee internal rotation and hip external rotation moments and increased external knee extension moments resulted from repetitive lumbar paraspinal fatiguing exercise. Persons with a self-reported history of LBP had larger knee flexion moments than controls during jogging. Neuromuscular changes in the lower extremity occur while resisting knee and hip joint moments following isolated lumbar paraspinal exercise. Persons with a history of LBP seem to rely more heavily on quadriceps activity while jogging.

  13. Characterization of MR-1, a Novel Myofibrillogenesis Regulator in Human Muscle

    Institute of Scientific and Technical Information of China (English)

    Tian-Bo LI; Xiu-Hua LIU; Shuang FENG; Yang HU; Wei-Xi YANG; Yue HAN; Yi-Guang WANG; Li-Min GONG


    The actin-myosin contractile apparatus consists of several thick filament and thin filament proteins.Specific regulatory mechanisms are involved in this highly ordered process.In this paper,we reported the identification and characterization of a novel myofibrillogenesis regulator,MR-l.The MR-lgene was cloned from human skeletal muscle cDNA library by using a strategy that involves EST data base searching,PCR and RACE.The MR-l gene is located on human chromosome 2q35 and encodes a 142 aa protein.Northern blot revealed that the mRNA level of MR-1 was highest in the skeletal muscle and certain level of MR-1 expression was also observed in heart,liver and kidney.Immunohistochemical assay confirmed that the MR-l protein existed in human myocardial myofibrils.It was found by yeast two-hybrid screening and confirmed by in vitro binding assay that MR-1 could interact with sarcomeric proteins,such as myosin regulatory light chain,myomesin 1 and β-enolase.These studies suggested that MR-I might play a regulatory role in the muscle cell and it was worth investigating further.


    Directory of Open Access Journals (Sweden)

    Sangeeta Wazir


    Full Text Available Background: Lumbar backache is a very common problem nowadays. Sacralisation of lumbar vertebrae is one of the cause for that. During routine osteology teaching a sacrum with incomplete attached lumbar 5 vertebrae is seen. Observation: Incompletely fused L 5 vertebrae with sacrum is seen. The bodies of the vertebrae are fused but the transverse process of left side is completely fused with the ala of sacrum.But on the right side is incompletely fused. Conclusion: The person is usually asymptomatic or may present with symptoms which include spinal or radicular pain, disc degeneration, L4/L5 disc prolapse, lumbar scoliosis and lumbar extradural defects. In transitional lumbosacral segmentation, it was observed that the lumbosacral intervertebral disc is significantly narrowed. The incidence of disc herniation is found to be higher and can occur even at young ages. There was also relationship established between transitional vertebrae and the degree of slippage in spondylolytic spondylolisthesis. In addition, this anomaly has known implications in the field of disc surgery.

  15. Incarcerated inferior lumbar (Petit's) hernia. (United States)

    Astarcioğlu, H; Sökmen, S; Atila, K; Karademir, S


    Petit's hernia is an uncommon abdominal wall defect in the inferior lumbar triangle. Colonic incarceration through the inferior lumbar triangle, which causes mechanical obstructive symptoms, necessitates particular diagnostic and management strategy. We present a rare case of inferior lumbar hernia, leading to mechanical bowel obstruction, successfully treated with prosthetic mesh reinforcement repair.

  16. Characterization of proteins in the muscle of limanda yokohamae from the masan bay, Korea (United States)

    Kim, Soo Woon; Kim, Sam Moon; Lee, Dong Kun; Moon, Hyo Bang; Choi, Hee Gu; Kang, Chang Keun; Choe, Eun Sang


    Increasing industrial development in the Masan Bay area of Korea over the past decades increased the risk for the survival of marine organisms in the bay area by the deterioration of the water quality. Since living organisms have the ability to adapt contamination-associated stimuli by the alteration of gene expression, changes in proteins can be used as an important criterion for assessing the levels of environmental conditions. In this study, therefore, alterations of the expression of proteins in the muscle of Limanda yokohamae from Dukdong and Dotsum in the bay area were surveyed and characterized as compared with Haegumgang, which served as a control site. The results demonstrated that the twenty spots detected from Dukdong and Dotsum were similar to each other. Fifteen proteins were found to be predicted or undefined proteins, while five proteins were identified as heavy polypeptide 11 of myosin, apolipoprotein A-I, fibroblast growth factor 17b precursor, G protein-coupled receptor kinase 1 b and bonnie and clyde. These data suggest that local fish in the bay area have dysfunction in muscle physiology including contraction, lipid metabolism, proliferation and differentiation and nervous system.

  17. Characterization of Post-Translational Modifications to Calsequestrins of Cardiac and Skeletal Muscle

    Directory of Open Access Journals (Sweden)

    Kevin M. Lewis


    Full Text Available Calsequestrin is glycosylated and phosphorylated during its transit to its final destination in the junctional sarcoplasmic reticulum. To determine the significance and universal profile of these post-translational modifications to mammalian calsequestrin, we characterized, via mass spectrometry, the glycosylation and phosphorylation of skeletal muscle calsequestrin from cattle (B. taurus, lab mice (M. musculus and lab rats (R. norvegicus and cardiac muscle calsequestrin from cattle, lab rats and humans. On average, glycosylation of skeletal calsequestrin consisted of two N-acetylglucosamines and one mannose (GlcNAc2Man1, while cardiac calsequestrin had five additional mannoses (GlcNAc2Man6. Skeletal calsequestrin was not phosphorylated, while the C-terminal tails of cardiac calsequestrin contained between zero to two phosphoryls, indicating that phosphorylation of cardiac calsequestrin may be heterogeneous in vivo. Static light scattering experiments showed that the Ca2+-dependent polymerization capabilities of native bovine skeletal calsequestrin are enhanced, relative to the non-glycosylated, recombinant isoform, which our crystallographic studies suggest may be due to glycosylation providing a dynamic “guiderail”-like scaffold for calsequestrin polymerization. Glycosylation likely increases a polymerization/depolymerization response to changing Ca2+ concentrations, and proper glycosylation, in turn, guarantees both effective Ca2+ storage/buffering of the sarcoplasmic reticulum and localization of calsequestrin (Casq at its target site.

  18. Characterizing upper limb muscle volume and strength in older adults: a comparison with young adults. (United States)

    Vidt, Meghan E; Daly, Melissa; Miller, Michael E; Davis, Cralen C; Marsh, Anthony P; Saul, Katherine R


    Aging is associated with the loss of muscle volume (MV) and force leading to difficulties with activities of daily living. However, the relationship between upper limb MV and joint strength has not been characterized for older adults. Quantifying this relationship may help our understanding of the functional declines of the upper limb that older adults experience. Our objective was to assess the relationship between upper limb MV and maximal isometric joint moment-generating capacity (IJM) in a single cohort of healthy older adults (age ≥ 65 years) for 6 major functional groups (32 muscles). MV was determined from MRI for 18 participants (75.1±4.3 years). IJM at the shoulder (abduction/adduction), elbow (flexion/extension), and wrist (flexion/extension) was measured. MV and IJM measurements were compared to previous reports for young adults (28.6±4.5 years). On average older adults had 16.5% less total upper limb MV compared to young adults. Additionally, older adult wrist extensors composed a significantly increased percentage of upper limb MV. Older adult IJM was reduced across all joints, with significant differences for shoulder abductors (pIJM was accounted for by MV changes (p≤0.027), compared to 81.0% in young adults. We conclude that for older adults, MV and IJM are, on average, reduced but the significant linear relationship between MV and IJM is maintained. These results suggest that older adult MV and IJM cannot be simply scaled from young adults.

  19. Human skeletal muscle behavior in vivo: Finite element implementation, experiment, and passive mechanical characterization. (United States)

    Clemen, Christof B; Benderoth, Günther E K; Schmidt, Andreas; Hübner, Frank; Vogl, Thomas J; Silber, Gerhard


    In this study, useful methods for active human skeletal muscle material parameter determination are provided. First, a straightforward approach to the implementation of a transversely isotropic hyperelastic continuum mechanical material model in an invariant formulation is presented. This procedure is found to be feasible even if the strain energy is formulated in terms of invariants other than those predetermined by the software's requirements. Next, an appropriate experimental setup for the observation of activation-dependent material behavior, corresponding data acquisition, and evaluation is given. Geometry reconstruction based on magnetic resonance imaging of different deformation states is used to generate realistic, subject-specific finite element models of the upper arm. Using the deterministic SIMPLEX optimization strategy, a convenient quasi-static passive-elastic material characterization is pursued; the results of this approach used to characterize the behavior of human biceps in vivo indicate the feasibility of the illustrated methods to identify active material parameters comprising multiple loading modes. A comparison of a contact simulation incorporating the optimized parameters to a reconstructed deformed geometry of an indented upper arm shows the validity of the obtained results regarding deformation scenarios perpendicular to the effective direction of the nonactivated biceps. However, for a valid, activatable, general-purpose material characterization, the material model needs some modifications as well as a multicriteria optimization of the force-displacement data for different loading modes.

  20. Lumbar hernia: a diagnostic dilemma. (United States)

    Ahmed, Syed Tausif; Ranjan, Rajeeva; Saha, Subhendu Bikas; Singh, Balbodh


    Lumbar hernia is one of the rare cases that most surgeons are not exposed to. Hence the diagnosis can be easily missed. This leads to delay in the treatment causing increased morbidity. We report a case of lumbar hernia in a middle-aged woman. It was misdiagnosed as lipoma by another surgeon. It was a case of primary acquired lumbar hernia in the superior lumbar triangle. Clinical and MRI findings were correlated to reach the diagnosis. We also highlight the types, the process of diagnosis and the surgical repair of lumbar hernias. We wish to alert our fellow surgeons to keep the differential diagnosis of the lumbar hernia in mind before diagnosing any lumbar swelling as lipoma.

  1. Variant lumbar pedicle

    Energy Technology Data Exchange (ETDEWEB)

    Whelan, M.A.; Feldman, F.


    Three cases of aplastic and/or hypoplastic lumbar pedicle are presented and discussed. The importance of plain films, especially the 45/sup 0/ posterior oblique, for making the diagnosis is emphasized. The incidence and embryology of abnormalities of the pedicle are reviewed and the radiological features used to differentiate these congenital abnormalities from neoplasm and trauma are described.

  2. Epidurography in lumbar spondylolisthesis

    Energy Technology Data Exchange (ETDEWEB)

    Johansen, J.G.; Hauge, O.


    Seventeen patients with lytic lumbar spondylolisthesis (Meyerding grade I-II) and radicular symptoms were examined by epidurography in addition to radiculomyelography before surgical treatment. Epidurography is considered more suitble than radiculomyelogrphy for assessing this condition because narrowing of the epidural space and compression of the nerve roots, due to osteofibrous changes at the lysis, are more consistently demonstrated.

  3. Characterization of hemorrhages in the tenderloins of slaughter pigs

    DEFF Research Database (Denmark)

    Dich-Jørgensen, Kristine; McEvoy, Fintan; Larsen, Helle Daugaard;


    Muscle hemorrhages are regularly observed in especially the tip of the tenderloin muscles of slaughter pigs. In order to characterize the hemorrhages, a macro- and microscopic examination of tenderloins with (n = 5) and without (n = 4) hemorrhages and the associated vertebral column was carried out....... Furthermore, all columns were radiographed and two were CT scanned. Histologically, the muscle hemorrhages contained cells from bone marrow and growth line cartilage. Ventral epiphysiolysis in either the cranial or caudal epiphysis of the first lumbar vertebrae (L1) in 8 out of the 9 vertebral columns...... was present. In the 5 cases with tenderloin hemorrhage, similar hemorrhage with growth line cartilage was found within the fracture of the epiphysis. The hemorrhages develop secondarily to epiphysiolysis in the lumbar vertebrae, where the tenderloin attaches to the spine. The lesions probably develop around...

  4. 运动行针法治疗急性腰扭伤65例%Treatment of 65 cases of acute lumbar sprain with active exercise and needle manipulation

    Institute of Scientific and Technical Information of China (English)



    @@ Acute lumbar sprain is a common symptom in acupuncture and moxibustion department. It is acute laceration induced by over traction of soft tissues,such as lumbar muscle, fascia and ligament due to external exertions. Lumbar pain is typical in clinic.The pain is drastic, persistent, with fixed location and combined with limited motor function.

  5. Skeletal muscle characterization of Japanese quail line selectively bred for lower body weight as an avian model of delayed muscle growth with hypoplasia. (United States)

    Choi, Young Min; Suh, Yeunsu; Shin, Sangsu; Lee, Kichoon


    This study was designed to extensively characterize the skeletal muscle development in the low weight (LW) quail selected from random bred control (RBC) Japanese quail in order to provide a new avian model of impaired and delayed growth in physically normal animals. The LW line had smaller embryo and body weights than the RBC line in all age groups (Pgrowth with prolonged expression of Pax7 and lower expression levels of MyoD, Myf-5, and myogenin (Pgrowth in the LW line is accompanied by higher levels of myogenin expression at 42 d (Pcharacterized avian model for future identification of the responsible genes and for studying mechanisms of hypoplasia and delayed muscle growth.

  6. Laparoscopic repair of a lumbar hernia: report of a case and extensive review of the literature. (United States)

    Suarez, Sebastian; Hernandez, Juan D


    Lumbar hernias are a protrusion of intra-abdominal contents through a weakness or rupture in the posterior abdominal wall. They are considered to be a rare entity with approximately 300 cases reported in the literature since it was first described by Barbette in 1672. Petit described the inferior lumbar triangle in 1783 and Grynfeltt described the superior lumbar triangle in 1866; both are anatomical boundaries where 95% of lumbar hernias occur, whereas the other 5% are considered to be diffuse. Twenty percent of lumbar hernias are congenital and the other 80% are acquired; the acquired lumbar hernias can be further classified into either primary (spontaneous) or secondary. The typical presentation of lumbar hernias is a patient with a protruding semispherical bulge in the back with a slow growth. However, they may present with an incarcerated or strangulated bowel, so it is recommended that all lumbar hernias must be repaired as soon as they are diagnosed. The "gold standard" for diagnosing a lumbar hernia is a CT scan, because it is able to delineate muscular and fascial layers, detect a defect in one or more of these layers, evaluate the presence of herniated contents, differentiate muscle atrophy from a real hernia, and serve as a useful tool in the differential diagnosis, such as tumors. Recent studies have demonstrated the advantages of a laparoscopic repair instead of the classic open approach as the ideal treatment option for lumbar hernias. We report a case of a spontaneous lumbar hernia initially diagnosed as a lipoma and corrected with the open approach, but after relapsing 2 years later it was corrected using a laparoscopic approach. It is followed by an extensive review of lumbar hernias literature regarding history, anatomy, and surgical techniques.

  7. A fibroblast-associated antigen: Characterization in fibroblasts and immunoreactivity in smooth muscle differentiated stromal cells

    DEFF Research Database (Denmark)

    Rønnov-Jessen, Lone; Celis, Julio E.; van Deurs, Bo


    Fibroblasts with smooth muscle differentiation are frequently derived from human breast tissue. Immunofluorescence cytochemistry of a fibroblast-associated antigen recognized by a monoclonal antibody (MAb), 1B10, was analyzed with a view to discriminating smooth muscle differentiated fibroblasts...... from vascular smooth muscle cells. The antigen was detected on the cell surface and in cathepsin D-positive and acridine orange-accumulating vesicular compartments of fibroblasts. Ultrastructurally, the antigen was revealed in coated pits and in endosomal and lysosomal structures. 1B10 recognized three...... immunoreactivity was specific to fibroblasts and smooth muscle differentiated fibroblasts within the context of vascular smooth muscle cells....

  8. Lumbar facet syndromes. (United States)

    Beresford, Zach M; Kendall, Richard W; Willick, Stuart E


    Low back pain is a common presenting complaint to sports medicine providers. The lumbar spine is a complex anatomic structure with multiple potential pain generators. Epidemiologic studies have shown that the intervertebral disc is the most common pain generator in all patients with low back pain. The facet joints may account for 15%-40% of low back pain. It can be challenging at times to establish a firm diagnosis of facet pain. Facet pain can have different presentations, and pain emanating from other lumbopelvic structures can present similarly as facet joint pain. This article reviews the anatomy and biomechanics of the lumbar facet joints, presenting symptoms and physical examination findings seen with facet pain. We also will discuss diagnostic and treatment paradigms that are helpful to the clinician treating low back pain in athletes.

  9. Congenital Lumbar Hernia with Lumbocostovertebral Syndrome: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Ketan Vagholkar


    Full Text Available Introduction. Congenital lumbar hernia is one of the rare types of hernias. Anomalies of the ribs, spine, and muscles which constitute the lumbocostovertebral syndrome in association with congenital lumbar hernia make it the rarest of entities. In addition, a multitude of other organ systems may be involved. Case Report. A case of congenital lumbar hernia associated with lumbocostovertebral syndrome is presented in view of its rarity and diagnostic and therapeutic challenges. Discussion. Anatomical background of congenital lumbar hernia associated with various other anomalies especially of the musculoskeletal structures is discussed. All cases of congenital lumbar hernia should be investigated for other congenital anomalies. Both open and laparoscopic approaches have been described for surgical treatment. Conclusion. Open surgical intervention is the mainstay of treatment taking into consideration the technical challenges posed by distorted anatomy due to the associated congenital anomalies.

  10. Lumbar-sacral dysplasias

    Energy Technology Data Exchange (ETDEWEB)

    Schumacher, M.; Thron, A.


    By means of some selected examples, the myelographic and CT characteristics are presentated of different lumbar-sacral dysplasias. The advantage of the different methods of examination (CT, CT myelography and myelography) and the improved presentation of pathological-anatomical details by means of a combination of these methods in the diagnosis of hyperplasia of the filum terminale, diastematomyelia, tethered conus, intracorporal and anterior sacral meningocele have been shown.

  11. Electrodiagnosis of lumbar radiculopathy. (United States)

    Barr, Karen


    The evaluation of patients with suspected lumbar radiculopathy is one of the most common reasons patients are referred for electrodiagnostic testing. The utility of this study depends on the expertise of the physician who plans, performs, and completes the study. This article reviews the strengths and weaknesses of electrodiagnosis to make this diagnosis, as well as the clinical reasoning of appropriate study planning. The current use of electrodiagnostic testing to determine prognosis and treatment outcomes is also discussed.

  12. Bilateral congenital lumbar hernias in a patient with central core disease--A case report. (United States)

    Lazier, Joanna; Mah, Jean K; Nikolic, Ana; Wei, Xing-Chang; Samedi, Veronica; Fajardo, Carlos; Brindle, Mary; Perrier, Renee; Thomas, Mary Ann


    Congenital lumbar hernias are rare malformations caused by defects in the development of the posterior abdominal wall. A known association exists with lumbocostovertebral syndrome; however other associated anomalies, including one case with arthrogryposis, have been previously reported. We present an infant girl with bilateral congenital lumbar hernias, multiple joint contractures, decreased muscle bulk and symptoms of malignant hyperthermia. Molecular testing revealed an R4861C mutation in the ryanodine receptor 1 (RYR1) gene, known to be associated with central core disease. This is the first reported case of the co-occurrence of congenital lumbar hernias and central core disease. We hypothesize that ryanodine receptor 1 mutations may interrupt muscle differentiation and development. Further, this case suggests an expansion of the ryanodine receptor 1-related myopathy phenotype to include congenital lumbar hernias.

  13. Computed tomographic evaluation of lumbar spinal structures during traction. (United States)

    Sari, Hidayet; Akarirmak, Ulkü; Karacan, Ilhan; Akman, Haluk


    In the previous studies, it is reported that traction diminishes the compressive load on intervertebral discs, reduces herniation, stretches lumbar spinal muscle and ligaments, decreases muscle spasm, and widens intervertebral foramina. The aim of this study was to evaluate the effects of horizontal motorized static traction on spinal anatomic structures (herniated area, spinal canal area, intervertebral disc heights, neural foraminal diameter, and m.psoas diameter) by quantitative measures in patients with lumbar disc herniation (LDH). At the same time the effect of traction in different localizations (median and posterolateral herniation) and at different levels (L4-L5 and L5-S1) was assessed. Thirty two patients with acute LDH participated in the study. A special traction system was used to apply horizontally-motorized static lumbar traction. Before and during traction a CT- scan was made to observe the changes in the area of spinal canal and herniated disc material, in the width of neural foramina, intervertebral disc heights, and in the thickness of psoas muscle. During traction, the area of protruded disc area, and the thickness of psoas muscle decreased 24.5% (p = 0.0001), and 5.7% (p = 0.0001), respectively. The area of the spinal canal and the width of the neural foramen increased 21.6% (p = 0.0001) and 26.7% (p = 0.0001), respectively. The anterior intervertebral disc height remained unchanged with traction however the posterior intervertebral disc height was significantly expanded. This study is the first to evaluated in detail and quantitatively the effect of motorized horizontal lumbar spinal traction on spinal structures and herniated area. According to detailed measures it was concluded that during traction of individuals with acute LDH there was a reduction of the size of the herniation, increased space within the spinal canal, widening of the neural foramina, and decreased thickness of the psoas muscle.

  14. A simple and rapid method to characterize lipid fate in skeletal muscle


    Massart, Julie; Juleen R Zierath; Chibalin, Alexander V.


    Background Elevated fatty acids contribute to the development of type 2 diabetes and affect skeletal muscle insulin sensitivity. Since elevated intramuscular lipids and insulin resistance is strongly correlated, aberrant lipid storage or lipid intermediates may be involved in diabetes pathogenesis. The aim of this study was to develop a method to determine the dynamic metabolic fate of lipids in primary human skeletal muscle cells and in intact mouse skeletal muscle. We report a simple and fa...

  15. Molecular characterization of muscle-parasitizing didymozoid from a chub mackerel, Scomber japonicus. (United States)

    Abe, Niichiro; Okamoto, Mitsuru


    Didymozoids found in the muscles of marine fish are almost always damaged because they are usually found after being sliced. Therefore, identifying muscle-parasitizing didymozoids is difficult because of the difficulty in collecting non-damaged worms and observing their organs as key points for morphological identification. Moreover, muscle-parasitizing didymozoids are not easily found because they parasitize at the trunk muscles. Therefore, muscle-parasitizing didymozoid classification has not progressed because there are few opportunities to detect them. Our recent report was the first to describe the usefulness of sequencing analysis for discrimination among muscle-parasitizing didymozoids. Recently, we found a didymozoid in the trunk muscle of a chub mackerel Scomber japonicus. The present study genetically compares the present isolate with other muscle-parasitizing didymozoids. The present isolate differs markedly from the previously unidentified didymozoid from an Atlantic mackerel S. scombrus by phylogenetic analysis of 18S rDNA. It also differs from other muscle-parasitizing didymozoids from other host species based on phylogenetic analyses of 18S, 28S rDNAs, and coxI loci. These results suggest that sequencing analysis is useful for the discrimination of muscle-parasitizing didymozoids. Combining the present data with earlier data for sequencing analysis, muscle-parasitizing didymozoids from seven marine fish species were classified as seven species. We proposed appellations for six distinct muscle-parasitizing didymozoids for future analysis: sweetlips fish type from Diagramma pictum and Plectorhinchus cinctus, red sea bream type from Pagrus major, flying fish type from Cypselurus heterurus, Atlantic mackerel type from Scomber scombrus, chub mackerel type from S. japonicus, and purple rockcod type from Epinephelus cyanopodus.

  16. Characterizing the Peano fluidic muscle and the effects of its geometry properties on its behavior (United States)

    Veale, Allan Joshua; Xie, Sheng Quan; Anderson, Iain Alexander


    In this work, we explore the basic static and dynamic behavior of a hydraulically actuated Peano muscle and how its geometry affects key static and dynamic performance metrics. The Peano muscle, or pouch motor is a fluid powered artificial muscle. Similar to McKibben pneumatic artificial muscles (PAMs), it has the ability to generate the high forces of biological muscles with the low threshold pressure of pleated PAMs, but in a slim, easily distributed form. We found that Peano muscles have similar characteristics to other PAMs, but produce lower free-strains. A test rig capable of measuring high-speed flow rates with a Venturi tube revealed that their efficiency peaks at about 40% during highly dynamic movements. Peano muscles with more tubes and of a greater size do not move faster. Also, their muscle tubes should have an aspect ratio of at least 1:3 and channel width greater than 20% to maximize performance. These findings suggest that finite element modeling be used to optimize more complex Peano muscle geometries.

  17. Multi-wavelength Characterization of Exoplanet Host Stars with the MUSCLES Treasury Survey (United States)

    France, Kevin; Youngblood, Allison; Parke Loyd, R. O.; Schneider, Christian


    High-energy photons (X-ray to NUV) from exoplanet host stars regulate the atmospheric temperature profiles and photochemistry on orbiting planets, influencing the long-term stability of planetary atmospheres and the production of potential “biomarker” gases. However, relatively few observational and theoretical constraints exist on the high-energy irradiance from typical (i.e., weakly active) M and K dwarf exoplanet host stars. In this talk, I will describe results from a panchromatic survey (Chandra/XMM/Hubble/ground) of M and K dwarf exoplanet hosts. The MUSCLES Treasury Survey (Measurements of the Ultraviolet Spectral Characteristics of Low-mass Exoplanetary Systems) combines UV, X-ray, and optical observations with reconstructed Lyman-alpha and EUV (100-900 Ang) radiation to create 5 Angstrom to 5 micron stellar irradiance spectra that are available as a High-Level Science Product on STScI/MAST. I will discuss how we use multi-wavelength observations to study possible abiotic production of the suggested biomarkers O2 and O3, develop scaling relations to infer the high-energy particle fluxes from these stars based on solar UV flare/particle flux measurements, calibrate visible-wavelength proxies for the high-energy irradiance, and characterize the UV variability and flare frequency of “optically inactive” M dwarfs.

  18. Development and characterization of self-healing carbon fabric/ionomer composite through stitched polymeric artificial muscle (United States)

    Gabriel, Mark Joseph

    Typical cracks in composite materials are hard to detect, because they may be very small or occur inside the material. This study investigates the development and characterization of carbon fiber and an ionomer, self-healing, laminate composite, enhanced with stitched artificial muscle elements. Although the carbon fiber is used as a structural reinforcement, the carbon fiber can also act as a resistive heating element in order to activate the healing elements in a Close-Then-Heal (CTH) approach. However in this study, hot air in an oven was used to activate the, SurlynRTM 8940, self-healing matrix. Artificial muscle was prepared from commercial fishing line to stitch reinforce the carbon laminate composite in the Z plane. Holes were drilled into the final composite and the muscle was stitched into the composite for active reinforcement. Differential scanning calorimetry was used to characterize the matrix and fishing line properties. The resulting smart composite was subjected to low velocity impact tests and consequential damage before healing in an oven, followed by three point bending flexure tests. Cracks in the carbon fiber reinforcement formed more easily than expected after impact because the holes were drilled to facilitate the muscle stitching. The matrix material could heal, but the reinforcement carbon could not. Several equipment issues and failures limited the amount of samples that could be created to continue testing with new parameters.

  19. Lumbar hernia treated with lightweight partially absorbable mesh: report of a case. (United States)

    Yamaguchi, Shohei; Tsutsumi, Norifumi; Kusumoto, Eiji; Endo, Kazuya; Ikejiri, Koji; Yamashita, Yo-ichi; Uchiyama, Hideaki; Saeki, Hiroshi; Oki, Eiji; Kawanaka, Hirofumi; Morita, Masaru; Ikeda, Tetsuo; Maehara, Yoshihiko


    Superior lumbar hernia, also known as Grynfeltt-Lesshaft hernia, is an uncommon abdominal wall defect. We report a case of superior lumbar hernia, which was successfully treated with a lightweight partially absorbable mesh. A 73-year-old man visited our department with complaints of lumbar pain and a feeling of pressure associated with a right lumbar mass. A CT scan of the abdomen demonstrated a defect in the aponeurosis of the transversus abdominis muscle and a protrusion of the small intestine through the defect. The diagnosis of a right superior lumbar hernia was made. The lumbar hernia was surgically treated with a lightweight large-pore polypropylene mesh containing an absorbable component consisting of poliglecaprone (ULTRAPRO Plug). The patient had no evidence of recurrence after 4 years of follow-up without any sense of discomfort. This is the first case report of a lumbar hernia treated with a lightweight partially absorbable mesh. This partially absorbable mesh can be considered to be suitable for the treatment of a lumbar hernia.

  20. Isolation and characterization of satellite cells from rat head branchiomeric muscles

    NARCIS (Netherlands)

    Carvajal Monroy, P.L.; Yablonka-Reuveni, Z.; Grefte, Sander; Kuijpers-Jagtman, Anne Marie; Wagener, F.A.D.T.G.; Hoff, Von den J.W.


    This protocol describes the isolation of satellite cells from branchiomeric head muscles of a 9 week-old rat. The muscles originate from different branchial arches. Subsequently, the satellite cells are cultured on a spot coating of millimeter size to study their differentiation. This approach avoid

  1. Pulmonary edema following lumbar puncture

    Directory of Open Access Journals (Sweden)

    Gupta D


    Full Text Available In a boy of 17 years with disseminated tuberculosis, sudden onset of pulmonary edema following lumbar puncture is described. Possible pat ho-mechanisms have been discussed. The link bet-ween the lumbar puncture and the development of pulmonary edema is not casual.

  2. Neuromuscular disorders associated with static lumbar flexion: a feline model. (United States)

    Solomonow, M; Zhou, B; Baratta, R V; Zhu, M; Lu, Y


    Static flexion of the lumbar spine with constant load applied to the viscoelastic structures for 20 minutes and for 50 minutes resulted in development of spasms and inhibition in the multifidus muscles (e.g., deep erector spinae) and in creep of the supraspinous ligament in the feline model. The development of spasms and inhibition was not dependent on load magnitude. It is suggested that occupational and sports activities which require prolonged static lumbar flexion within the physiological range can cause a "sprain"-like injury to the ligaments, which in turn reflexively induce spasms and inhibition in some erector spinae muscles. Such disorder may take a long time to recover, in the order of days to weeks, depending on the level of creep developed in the tissues.

  3. Comparison of selective electromyographic activity of the superficial lumbar multifidus between prone trunk extension and four-point kneeling arm and leg lift exercises


    Kim, Jun-Seok; Kang, Min-Hyeok; Jang, Jun-Hyeok; Oh, Jae-Seop


    [Purpose] This study examined the selective electromyographic activity of the lumbar paraspinal muscles in healthy male and female subjects in the prone trunk extension (PTE) and four-point kneeling arm and leg lift (FPKAL) exercises to determine the most beneficial exercise for selective activation of the lumbar multifidus (LM). [Subjects and Methods] Twenty healthy male and female subjects participated in this study. Surface electromyographic data were collected from the left-side lumbar er...

  4. Application of CT guided ozone therapy in the treatment of lumbar disc herniation complicated with acute muscle fiber%CT引导臭氧治疗椎间盘突出合并急性肌纤维炎的临床应用

    Institute of Scientific and Technical Information of China (English)

    彭浩; 彭丽静; 胡效坤; 李子祥


    目的:探讨CT引导臭氧( O3)消融术治疗椎间盘突出症合并急性肌纤维炎的适应症、消融方法,并判断其疗效。方法112例椎间盘突出症合并急性肌纤维炎行CT引导下O3消融治疗,其中颈椎间盘11例,腰椎间盘101例。结果本组病例随访1~12月。近期疗效急性疼痛消失65例,疼痛级别降低1~2级47例,有效率100%。远期疗效明显82例,有效26例,无效4例,总有效率达96.4%。无出现明显的并发症。结论 CT引导O3消融术治疗椎间盘突出症合并急性肌纤维炎效果明显,操作简便,定位准确,严格掌握适应症及消融方法对提高短期疗效及长期疗效有着重要的意义。%Objective To investigate the indications and ablation methods of CT guided ozone therapy in the treatment of lum -bar disc herniation with acute muscle fiber , and to judge the curative effect .Methods CT guided ozone therapy was performed in 112 patients with lumbar disc herniation complicated with acute muscle fiber .Among them , 11 cases of cervical intervertebral disc and 101 cases of lumbar intervertebral disc were treated .Results The patients were followed up for 1~12 months.The recent efficacy of acute pain disappeared in 65 cases, the pain level of 47 cases lower to 1~2, the effective rate was 100%.Long term curative effect was obvious in 82 cases, effective in 26 cases, ineffective in 4 cases, the total effective rate was 96.4%.There were no obvious complications .Conclusion CT guided ozone treatment of intervertebral disc herniation with acute muscle inflam -mation effect obviously has the advantages of simple operation , accurate positioning .Strictly grasping the indications and ablation method has important significance has important significanle in impruving the short -term and lorg-oerm curative effect .

  5. Characterization and regulation of mechanical loading-induced compensatory muscle hypertrophy. (United States)

    Adams, Gregory R; Bamman, Marcas M


    In mammalian systems, skeletal muscle exists in a dynamic state that monitors and regulates the physiological investment in muscle size to meet the current level of functional demand. This review attempts to consolidate current knowledge concerning development of the compensatory hypertrophy that occurs in response to a sustained increase in the mechanical loading of skeletal muscle. Topics covered include: defining and measuring compensatory hypertrophy, experimental models, loading stimulus parameters, acute responses to increased loading, hyperplasia, myofiber-type adaptations, the involvement of satellite cells, mRNA translational control, mechanotransduction, and endocrinology. The authors conclude with their impressions of current knowledge gaps in the field that are ripe for future study.

  6. Identification and characterization of chondrogenic progenitor cells in the fascia of postnatal skeletal muscle

    Institute of Scientific and Technical Information of China (English)

    Guangheng Li; Bo Zheng; Laura B. Meszaros; Joseph B. Vella; Arvydas Usas; Tomoyuki Matsumoto; Johnny Huard


    Intramuscular injection of bone morphogenetic proteins (BMPs) has been shown to induce ectopic bone formation.A chondrogenic phase is typically observed in this process,which suggests that there may exist a chondrogenic subpopulation of cells residing in skeletal muscle.Two prospective cell populations were isolated from rat skeletal muscle:fascia-derived cells (FDCs),extracted from gluteus maximus muscle fascia (epimysium) and muscle-derived cells (MDCs) isolated from the muscle body.Both populations were investigated for their cell surface marker profiles (flowcytometry analysis),proliferation rates as well as their myogenic and chondrogenic potentials.The majority of FDCs expressed mesenchymai stromai cell markers but not endothelial cell markers.FDCs underwent chondrogenic differentiation after BMP4 treatment in vitro,but not myogenic differentiation.Although MDCs showed chondrogenic potential,they expressed the myogenic cell marker desmin and readily underwent myogenic differentiation in vitro; however,the chondrogenic potential of the MDCs is confounded by the presence of FDC-like cells residing in the muscle perimysium and endomysium.To clarify the role of the muscle-derived myogenic cells in chondrogenesis,mixed pellets with varying ratios of FDCs and L6 myoblasts were formed and studied for chondrogenic potential.Our results indicated that the chondrogenic potential of the mixed pellets decreased with the increased ratio of myogenic cells to FDCs supporting the role of FDCs in chondrogenesis.Taken together,our results suggest that non-myogenic cells residing in the fascia of skeletal muscle have a strong chondrogenic potential and may represent a novel donor cell source for cartilage regeneration and repair.

  7. Characterization of passive elastic properties of the human medial gastrocnemius muscle belly using supersonic shear imaging. (United States)

    Maïsetti, Olivier; Hug, François; Bouillard, Killian; Nordez, Antoine


    The passive elastic properties of a muscle-tendon complex are usually estimated from the relationship between the joint angle and the passive resistive torque, although the properties of the different structures crossing the joint cannot be easily assessed. This study aimed to determine the passive mechanical properties of the gastrocnemius medialis muscle (GM) using supersonic shear imaging (SSI) that allows the measurement of localized muscle shear modulus (μ). The SSI of the GM was taken for 7 subjects during passive ankle dorsiflexion at a range of knee positions performed on an isokinetic dynamometer. The relationship between normalized μ and the length of the gastrocnemius muscle-tendon units (GMTU) was very well fitted to an exponential model (0.944knee fully extended was calculated. The μ-length relationship was highly correlated with the force-length (0.964knee extended were similar to that reconstructed from all knee angles and displayed good intra-session reliability (for α, SEM: 9.7 m(-1); CV: 7.5%; ICC: 0.652; for l(0), SEM: 0.002 m; CV: 0.4%; ICC: 0.992). These findings indicate that SSI may provide an indirect estimation of passive muscle force, and highlight its clinical applicability to evaluate the passive properties of mono- and bi-articular muscles.

  8. The imaging of lumbar spondylolisthesis

    Energy Technology Data Exchange (ETDEWEB)

    Butt, S. [Department of Radiology, Royal National Orthopaedic Hospital NHS Trust, Stanmore, Middlesex HA7 4LP (United Kingdom); Saifuddin, A. [Department of Radiology, Royal National Orthopaedic Hospital NHS Trust, Stanmore, Middlesex HA7 4LP (United Kingdom) and Institute of Orthopaedics and Musculo-Skeletal Sciences, University College, London (United Kingdom)]. E-mail:


    Lumbar spondylolisthesis is a common finding on plain radiographs. The condition has a variety of causes which can be differentiated on the basis of imaging findings. As the treatment is dependent upon the type of spondylolisthesis, it is important for the radiologist to be aware of these features. We present a pictorial review of the imaging features of lumbar spondylolisthesis and explain the differentiating points between different groups of this disorder. The relative merits of the different imaging techniques in assessing lumbar spondylolisthesis are discussed.

  9. Reproduction of the lumbar lordosis

    DEFF Research Database (Denmark)

    Andreasen, Marianne Løgtholt; Langhoff, Lotte; Jensen, Tue Secher;


    OBJECTIVE: This study investigates whether it is possible to reproduce the lumbar lordosis in the upright position during magnetic resonance imaging (MRI) by positioning the patient supine with straightened lower extremities and investigates intra- and interexaminer reliability of measurements...... supine with straightened lower extremities. These measurements were compared statistically. Intra- and interexaminer reliability was calculated applying the Bland and Altman method. RESULTS: The lumbar lordosis in the standing position was reproduced in the straightened supine position with a median......: The findings of this study show that lumbar lordosis in the upright position can be reproduced by positioning the patient supine with straightened lower extremities....

  10. Anatomia do plano intermuscular lombar entre os músculos multífidus e longuíssimo e planejamento pré-operatório com imagens de ressonância nuclear magnética para artrodeses lombares minimamente invasivas Anatomía del plano lumbar intermuscular, entre el músculo multífido y el músculo longísimo, y el planeamiento preoperatorio con imágenes de resonancia nuclear magnética para artrodesis lumbares míinimamente invasoras Anatomic features of the intermuscular lumbar plane between the multifidus and the longissimus muscles and preoperative planning with MRI images for minimally invasive lumbar fusion

    Directory of Open Access Journals (Sweden)

    Fernando Schmidt


    hasta el plano intermuscular, entre el multífido y el longísimos, y nosotros lo consideramos importante para ea planeamientn preoperatoria de los procedimientos minimamente invasores.OBJECTIVE: The purpose of this work is to review the posterior lumbar muscle anatomy, evince the correlation between the anatomy in the axial plane of the MRI and measure the distance from the medium line to the intermuscular plane, between the multifidus and the longissimus in the lower lumbar levels. METHODS: Using the OSIRIX program for Mac, bilateral measurements of the distance from the medium line to the intermuscular plane between the multifidus and longissimus muscles have been performed in the L3/L4, L4/L5 and L5/S1 levels, in 50 adult patients divided equally by gender. RESULTS: This study brings to the conclusion that there is an average distance of 2.42 cm in L3/L4, of 3.13 cm in L4/L5 and of 3.77 cm in L5/S1 when not separated by gender. The average distance increases in the craniocaudal direction in the lower lumbar levels and there is no statistically significant difference toward the gender in levels L4/L5 and L5/S1. CONCLUSION: We conclude that the MRI allows the surgeon to measure the distance from the midline until the intermuscular plane between the multifidus and longissimus and consider it important for the preoperative planning of minimally invasive approaches.


    Directory of Open Access Journals (Sweden)

    Koji Hashimoto


    Full Text Available Swinging a golf club includes the rotation and extension of the lumbar spine. Golf-related low back pain has been associated with degeneration of the lumbar facet and intervertebral discs, and with spondylolysis. Reflective markers were placed directly onto the skin of 11young male amateur golfers without a previous history of back pain. Using a VICON system (Oxford Metrics, U.K., full golf swings were monitored without a corset (WOC, with a soft corset (SC, and with a hard corset (HC, with each subject taking 3 swings. Changes in the angle between the pelvis and the thorax (maximum range of motion and angular velocity in 3 dimensions (lumbar rotation, flexion-extension, and lateral tilt were analyzed, as was rotation of the hip joint. Peak changes in lumbar extension and rotation occurred just after impact with the ball. The extension angle of the lumbar spine at finish was significantly lower under SC (38° or HC (28° than under WOC (44° conditions (p < 0.05. The maximum angular velocity after impact was significantly smaller under HC (94°/sec than under SC (177°/sec and WOC (191° /sec conditions, as were the lumbar rotation angles at top and finish. In contrast, right hip rotation angles at top showed a compensatory increase under HC conditions. Wearing a lumbar corset while swinging a golf club can effectively decrease lumbar extension and rotation angles from impact until the end of the swing. These effects were significantly enhanced while wearing an HC

  12. Stability of the lumbar spine. A study in mechanical engineering. (United States)

    Bergmark, A


    From the mechanical point of view the spinal system is highly complex, containing a multitude of components, passive and active. In fact, even if the active components (the muscles) were exchanged by passive springs, the total number of elements considerably exceeds the minimum needed to maintain static equilibrium. In other words, the system is statically highly indeterminate. The particular role of the active components at static equilibrium is to enable a virtually arbitrary choice of posture, independent of the distribution and magnitude of the outer load albeit within physiological limits. Simultaneously this implies that ordinary procedures known from the analysis of mechanical systems with passive components cannot be applied. Hence the distribution of the forces over the different elements is not uniquely determined. Consequently nervous control of the force distribution over the muscles is needed, but little is known about how this achieved. This lack of knowledge implies great difficulties at numerical simulation of equilibrium states of the spinal system. These difficulties remain even if considerable reductions are made, such as the assumption that the thoracic cage behaves like a rigid body. A particularly useful point of view about the main principles of the force distributions appears to be the distinction between a local and a global system of muscles engaged in the equilibrium of the lumbar spine. The local system consists of muscles with insertion or origin (or both) at lumbar vertebrae, whereas the global system consists of muscles with origin on the pelvis and insertions on the thoracic cage. Given the posture of the lumbar spine, the force distribution over the local system appears to be essentially independent of the outer load of the body (though the force magnitudes are, of course, dependent on the magnitude of this load). Instead different distributions of the outer load on the body are met by different distributions of the forces in the

  13. Thoracic 9 Spinal Transection-Induced Model of Muscle Spasticity in the Rat: A Systematic Electrophysiological and Histopathological Characterization.

    Directory of Open Access Journals (Sweden)

    Jose A Corleto

    Full Text Available The development of spinal hyper-reflexia as part of the spasticity syndrome represents one of the major complications associated with chronic spinal traumatic injury (SCI. The primary mechanism leading to progressive appearance of muscle spasticity is multimodal and may include loss of descending inhibitory tone, alteration of segmental interneuron-mediated inhibition and/or increased reflex activity to sensory input. Here, we characterized a chronic thoracic (Th 9 complete transection model of muscle spasticity in Sprague-Dawley (SD rats. Isoflurane-anesthetized rats received a Th9 laminectomy and the spinal cord was transected using a scalpel blade. After the transection the presence of muscle spasticity quantified as stretch and cutaneous hyper-reflexia was identified and quantified as time-dependent changes in: i ankle-rotation-evoked peripheral muscle resistance (PMR and corresponding electromyography (EMG activity, ii Hoffmann reflex, and iii EMG responses in gastrocnemius muscle after paw tactile stimulation for up to 8 months after injury. To validate the clinical relevance of this model, the treatment potency after systemic treatment with the clinically established anti-spastic agents baclofen (GABAB receptor agonist, tizanidine (α2-adrenergic agonist and NGX424 (AMPA receptor antagonist was also tested. During the first 3 months post spinal transection, a progressive increase in ankle rotation-evoked muscle resistance, Hoffmann reflex amplitude and increased EMG responses to peripherally applied tactile stimuli were consistently measured. These changes, indicative of the spasticity syndrome, then remained relatively stable for up to 8 months post injury. Systemic treatment with baclofen, tizanidine and NGX424 led to a significant but transient suppression of spinal hyper-reflexia. These data demonstrate that a chronic Th9 spinal transection model in adult SD rat represents a reliable experimental platform to be used in studying the

  14. [Intradural lumbar disk hernia]. (United States)

    Alonso-Bartolomé, P; Canga, A; Vázquez-Barquero, A; García-Valtuille, R; Abascal, F; Cerezal, L


    Intradural disc herniation is a rare complication of degenerative disc disease. A correct diagnosis of this process is frequently difficult. If this entity is not preoperatively diagnosed and is omitted at surgery, severe neurologic sequels may be provoked. We report a case of a pathologically proven intradural disc herniation preoperatively diagnosed by MR imaging. Clinically, it was manifested by sudden onset of right leg ciatalgia and progressive right lower extremity weakness. The patient also referred a one-month history of sexual dysfunction. MR imaging revealed interruption of the low signal of the anulus fibrosus and of the posterior longitudinal ligament at L2-L3 level and a voluminous disc fragment migrated in the dural sac that showed rim enhancement with gadolinium.The clinical, neuroradiological, and surgical management of lumbar intradural disc herniation are reviewed.

  15. Characterization of the primary sonic muscles in Carapus acus (Carapidae): a multidisciplinary approach. (United States)

    Parmentier, E; Gennotte, V; Focant, B; Goffinet, G; Vandewalle, P


    Sound production in carapid fishes results from the action of extrinsic muscles that insert into the swim bladder. Biochemical, histochemical and morphological techniques were used to examine the sonic muscles and compare them with epaxial muscles in Carapus acus. Sonic fibres are thicker than red and thinner than white epaxial fibres, and sonic fibres and myofibrils exhibit an unusual helicoidal organization: the myofibrils of the centre are in a straight line whereas they are more and more twisted towards the periphery. Sonic muscles have both features of red (numerous mitochondria, high glycogen content) and white (alkali-stable ATPase) fibres. They differ also in the isoforms of the light chain (LC3) and heavy chain (HC), in having T tubules at both the Z-line and the A-I junction and in a unique parvalbumin isoform (PAI) that may aid relaxation. All these features lead to the expression of two assumptions about sound generation: the sonic muscle should be able to perform fast and powerful contractions that provoke the forward movement of the forepart of the swim bladder and the stretching and "flapping" of the swim bladder fenestra; the helicoidal organization allows progressive drawing of the swim bladder fenestra which emits a sound when rapidly released in a spring-like manner.

  16. Double labelling immunohistochemical characterization of autonomic sympathetic neurons innervating the sow retractor clitoridis muscle

    Directory of Open Access Journals (Sweden)

    L Ragionieri


    Full Text Available Retrograde neuronal tracing and immunohistochemical methods were used to define the neurochemical content of sympathetic neurons projecting to the sow retractor clitoridis muscle (RCM. Differently from the other smooth muscles of genital organs, the RCM is an isolated muscle that is tonically contracted in the rest phase and relaxed in the active phase. This peculiarity makes it an interesting experimental model. The fluorescent tracer fast blue was injected into the RCM of three 50 kg subjects. After a one-week survival period, the ipsilateral paravertebral ganglion S1, that in a preliminary study showed the greatest number of cells projecting to the muscle, was collected from each animal. The co-existence of tyrosine hydroxylase with choline acetyltransferase, neuronal nitric oxide synthase, calcitonin gene-related peptide, leuenkephalin, neuropeptide Y, substance P and vasoactive intestinal polypeptide was studied under a fluorescent microscope on cryostat sections. Tyrosine hydroxylase was present in about 58% of the neurons projecting to the muscle and was found to be co-localized with each of the other tested substances.Within fast blue-labelled cells negative to the adrenergic marker, small populations of neurons singularly containing each of the other enzymatic markers or peptides were also observed. The present study documents the complexity of the neurochemical interactions that regulate the activity of the smooth myocytes of the RCM and their vascular components.

  17. Lumbar spondylolysis: a review

    Energy Technology Data Exchange (ETDEWEB)

    Leone, Antonio; Magarelli, Nicola; Bonomo, Lorenzo [Dept. of Bioimaging and Radiological Sciences, Catholic Univ., Rome (Italy); Cianfoni, Alessandro [Dept. of Radiology and Radiological Sciences, Medical Univ. of South Carolina, Charleston (United States); Cerase, Alfonso [General Hospital, Unit Neuroimaging and Neurointervention (NINT), Department of Neurosciences, Azienda Ospedaliera Universitaria Senese, Siena (Italy)


    Spondylolysis is an osseous defect of the pars interarticularis, thought to be a developmental or acquired stress fracture secondary to chronic low-grade trauma. It is encountered most frequently in adolescents, most commonly involving the lower lumbar spine, with particularly high prevalence among athletes involved in certain sports or activities. Spondylolysis can be asymptomatic or can be a cause of spine instability, back pain, and radiculopathy. The biomechanics and pathophysiology of spondylolysis are complex and debated. Imaging is utilized to detect spondylolysis, distinguish acute and active lesions from chronic inactive non-union, help establish prognosis, guide treatment, and to assess bony healing. Radiography with satisfactory technical quality can often demonstrate a pars defect. Multislice CT with multiplanar reformats is the most accurate modality for detecting the bony defect and may also be used for assessment of osseous healing; however, as with radiographs, it is not sensitive for detection of the early edematous stress response without a fracture line and exposes the patient to ionizing radiation. Magnetic resonance (MR) imaging should be used as the primary investigation for adolescents with back pain and suspected stress reactions of the lumbar pars interarticularis. Several imaging pitfalls render MR imaging less sensitive than CT for directly visualizing the pars defects (regional degenerative changes and sclerosis). Nevertheless, the presence of bone marrow edema on fluid-sensitive images is an important early finding that may suggest stress response without a visible fracture line. Moreover, MR is the imaging modality of choice for identifying associated nerve root compression. Single-photon emission computed tomography (SPECT) use is limited by a high rate of false-positive and false-negative results and by considerable ionizing radiation exposure. In this article, we provide a review of the current concepts regarding spondylolysis, its

  18. Lumbar peritoneal shunt

    Directory of Open Access Journals (Sweden)

    Yadav Yad


    Full Text Available A lumbar peritoneal (LP shunt is a technique of cerebrospinal fluid (CSF diversion from the lumbar thecal sac to the peritoneal cavity. It is indicated under a large number of conditions such as communicating hydrocephalus, idiopathic intracranial hypertension, normal pressure hydrocephalus, spinal and cranial CSF leaks, pseudomeningoceles, slit ventricle syndrome, growing skull fractures which are difficult to treat by conventional methods (when dural defect extends deep in the cranial base or across venous sinuses and in recurrent cases after conventional surgery, raised intracranial pressure following chronic meningitis, persistent bulging of craniotomy site after operations for intracranial tumors or head trauma, syringomyelia and failed endoscopic third ventriculostomy with a patent stoma. In spite of the large number of indications of this shunt and being reasonably good, safe, and effective, very few reports about the LP shunt exist in the literature. This procedure did not get its due importance due to some initial negative reports. This review article is based on search on Google and PubMed. This article is aimed to review indications, complications, results, and comparison of the LP shunt with the commonly practiced ventriculoperitoneal (VP shunt. Shunt blocks, infections, CSF leaks, overdrainage and acquired Chiari malformation (ACM are some of the complications of the LP shunt. Early diagnosis of overdrainage complications and ACM as well as timely appropriate treatment especially by programmable shunts could decrease morbidity. Majority of recent reports suggest that a LP shunt is a better alternative to the VP shunt in communicating hydrocephalus. It has an advantage over the VP shunt of being completely extracranial and can be used under conditions other than hydrocephalus when the ventricles are normal sized or chinked. More publications are required to establish its usefulness in the treatment of wide variety of indications.

  19. 3D point cloud in the evaluation of processes that generate instability of the lumbar spine

    Directory of Open Access Journals (Sweden)

    José Luis González Gallegos


    Full Text Available OBJECTIVE: To integrate patients with lumbar instability in a multisensor platform in the process of assessment and diagnosis, assigning quantitative parameters for the sagittal balance (SB and muscle function. METHODS: Experimental study involving adult patients diagnosed with diseases that cause alterations in the SB, that were or were not submitted to surgery with posterior instrumentation and fusion. Each patient underwent anthropometric measurements in body composition scale; a kinesiological analysis using a multisensor platform consisting of depth camera to static/dynamic analysis for the quantitative measurement of SB, and surface electromyography to capture the level of abdominal and lumbar muscles activation and through flexion and extension. RESULTS: Seven adult patients: five females (62.5%and two men (37.5% with a mean age 48 years. Images with depth cameras resulted in a SB of from -6.4 to +5.3cm (average -5.7cm. In individuals with positive sagittal balance the percentage of activation (PA of the abdominal muscles was 58.5% and the lower back lumbar was 75.25%; patients with negative SB integrated the PA of the abdominal muscles of 70.25% and lumbar of 65%; the patient with neutral SB exhibited activation of the abdominal muscles of 87.75% and lumbar muscles of 78.25%. CONCLUSIONS: We observed a trend towards positive SB in patients with overweight and obesity by BMI, as well as increased activation of the abdominal muscles. The multi sensor platform is a useful tool for the diagnosis and prognosis of diseases involving sagittal imbalance.

  20. Comparison of selective electromyographic activity of the superficial lumbar multifidus between prone trunk extension and four-point kneeling arm and leg lift exercises. (United States)

    Kim, Jun-Seok; Kang, Min-Hyeok; Jang, Jun-Hyeok; Oh, Jae-Seop


    [Purpose] This study examined the selective electromyographic activity of the lumbar paraspinal muscles in healthy male and female subjects in the prone trunk extension (PTE) and four-point kneeling arm and leg lift (FPKAL) exercises to determine the most beneficial exercise for selective activation of the lumbar multifidus (LM). [Subjects and Methods] Twenty healthy male and female subjects participated in this study. Surface electromyographic data were collected from the left-side lumbar erector spinae (LES) and LM muscles during PTE and FPKAL exercises. [Results] The LM/LES ratio related to selective activation of the lumbar paraspinal muscles during the FPKAL exercise was higher than that during PTE. [Conclusion] FPKAL exercise is safe and effective for the selective activation of the LM muscle.


    Institute of Scientific and Technical Information of China (English)

    王黎; 赖新生


    "Lumbar three-point needling", meaning puncturing Shenshu (BL 23), Dachangshu (BL 25) and Ciliao(BL 32) at the same time, is a commonly used acupuncture method in the treatment of lumbocrural diseases. Points supplemented according to symptoms. Weizhong(BL 40) is supplemented for lumbar vertebra hypertrophy spondylitis; Weizhong (BL 40) and Kunlun(BL 60) supplemented for acute lumbar muscle sprain; Zhibian (BL 54), Huantiao (GB 30) and Ahshi points supplemented for nervi cluniam superior inflammation, and Sanyinjiao (SP 6) and Mingmen(GV 4) supplemented for impotence. Gauge-28 2 curt long needles are used. The needles are inserted perpendicularly into Shenshu(BL 23), Dachengshu(BL 25) and Ciliao(BL 32) to a depth of about 1.2 --- 1.5 cun. Other supplementary points are needled and stimulated with routine manipulations, generally the reducing method is used for excess syndrome, and the reinforcing method applied to deficiency syndrome. The author, on the basis of many years of clinical practice, considers that "lumbar three-point needling" is fairly effective in treating lumbosacral diseases.

  2. Molecular and functional characterization of Kv7 K+ channel in murine gastrointestinal smooth muscles

    DEFF Research Database (Denmark)

    Jepps, Thomas Andrew; Greenwood, Iain A; Moffatt, James D


    Members of the K(v)7 voltage-gated K(+) channel family are important determinants of cardiac and neuronal membrane excitability. Recently, we and others have shown that K(v)7 channels are also crucial regulators of smooth muscle activity. The aim of the present study was to assess the K(v)7 expre...

  3. Isolation and characterization of the novel popeye gene family expressed in skeletal muscle and heart. (United States)

    Andrée, B; Hillemann, T; Kessler-Icekson, G; Schmitt-John, T; Jockusch, H; Arnold, H H; Brand, T


    We identified a novel gene family in vertebrates which is preferentially expressed in developing and adult striated muscle. Three genes of the Popeye (POP) family were detected in human and mouse and two in chicken. Chromosomal mapping indicates that Pop1 and Pop3 genes are clustered on mouse chromosome 10, whereas Pop2 maps to mouse chromosome 16. We found evidence that POP1 and POP3 in chicken may also be linked and multiple transcript isoforms are generated from this locus. The POP genes encode proteins with three potential transmembrane domains that are conserved in all family members. Individual POP genes exhibit specific expression patterns during development and postnatally. Chicken POP3 and mouse Pop1 are first preferentially expressed in atrium and later also in the subepicardial compact layer of the ventricles. Chicken POP1 and mouse Pop2 are expressed in the entire heart except the outflow tract. All three Pop genes are expressed in heart and skeletal muscle of the adult mouse and lower in lung. Pop1 and Pop2 expression is upregulated in uterus of pregnant mice. Like the mouse genes, human POP genes are predominantly expressed in skeletal and cardiac muscle. The strong conservation of POP genes during evolution and their preferential expression in heart and skeletal muscle suggest that these novel proteins may have an important function in these tissues in vertebrates.

  4. Muscle activation of paraspinal muscles in different types of high heels during standing. (United States)

    Han, Dongwook


    [Purpose] This study researched the effects of different types of high heels on the muscles surrounding the cervical spine, the thoracic spine, and the lumbar spine by analyzing muscle activation of the paraspinal muscles during standing while wearing high heels. The high heels were all of the same height: 8 cm. [Subjects and Methods] The 28 subjects in this experiment were females in their 20s with a foot size of 225-230 mm and a normal gait pattern. To measure the muscle activation of the paraspinal muscles, EMG electrodes were attached on the paraspinal muscles around C6, T7, and L5. The muscle activation during standing while wearing 8-cm-high wedge heels, setback heels, and French heels was then measured. The measurements were performed 3 times each, and the mean value was used for analysis. [Results] The levels of muscle activation of the paraspinal muscles induced by standing on wedge heels, setback heels, and French heels in the cervical and lumbar areas were significantly higher than those induced by standing on bare feet. But there was no significant difference according to the heel types. [Conclusion] The height of the heels presented a greater variable than the width of the heels on the muscle activation of paraspinal muscles. Therefore, wearing high heels is not recommended for those who have pain or functional problems in the cervical and/or lumbar spine.

  5. Bilateral gluteal compartment syndrome and severe rhabdomyolysis after lumbar spine surgery. (United States)

    Rudolph, Thomas; Løkebø, Jan Eirik; Andreassen, Lasse


    Gluteal compartment syndrome (GCS) is an extremely rare and potentially devasting disorder, most commonly caused by gluteal muscle compression in extend periods of immobilization. We report a 65-year-old obese man with hypertension, diabetes mellitus type 2 and hypercholesterolemia underwent lumbar spine surgery in knee-chest position because of degenerative lumbar stenosis. Perioperative hypotension occurred. After surgery, the patient developed increasing pain in the buttocks of both sides and oliguria with darkened urine. Stiffness, tenderness and painful swelling of patients gluteal muscles of both sides, high creatine phosphokinase level, myoglobulinuria and oliguria led to diagnosis of bilateral GCS, complicated by severe rhabdomyolysis (RM) and acute renal failure. In conclusion, obese patients with vascular risk factors and perioperative hypotension may be at risk for developing bilateral GCS and RM when performing prolonged lumbar spine surgery. Early diagnosis and treatment is important, as otherwise, the further course may be fatal.

  6. A musculoskeletal lumbar and thoracic model for calculation of joint kinetics in the spine

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Yong Cheol; Ta, Duc manh; Koo, Seung Bum [Chung-Ang University, Seoul (Korea, Republic of); Jung Moon Ki [AnyBody Technology A/S, Aalborg (Denmark)


    The objective of this study was to develop a musculoskeletal spine model that allows relative movements in the thoracic spine for calculation of intra-discal forces in the lumbar and thoracic spine. The thoracic part of the spine model was composed of vertebrae and ribs connected with mechanical joints similar to anatomical joints. Three different muscle groups around the thoracic spine were inserted, along with eight muscle groups around the lumbar spine in the original model from AnyBody. The model was tested using joint kinematics data obtained from two normal subjects during spine flexion and extension, axial rotation and lateral bending motions beginning from a standing posture. Intra-discal forces between spine segments were calculated in a musculoskeletal simulation. The force at the L4-L5 joint was chosen to validate the model's prediction against the lumbar model in the original AnyBody model, which was previously validated against clinical data.

  7. Fat Replacement of Paraspinal Muscles with Aging in Healthy Adults

    DEFF Research Database (Denmark)

    Dahlqvist, Julia R; Vissing, Christoffer R; Hedermann, Gitte


    with sex, BMI, physical activity and lower back pain. RESULTS: Both paraspinal and leg fat fractions correlated directly with age (p... fat fraction (pphysical activity or lower back pain. CONCLUSION: The paraspinal muscles were more susceptible to age-related changes than leg muscles. Further, men had significantly lower fat fractions in lumbar paraspinal muscles and BMI.......0001). The CSA of the muscles did not correlate with age. Knee extension strength correlated with fat fraction (pSex was associated with lumbar paraspinal fat fraction (p

  8. Labeling and label free shotgun proteomics approaches to characterize muscle tissue from farmed and wild gilthead sea bream (Sparus aurata). (United States)

    Piovesana, Susy; Capriotti, Anna Laura; Caruso, Giuseppe; Cavaliere, Chiara; La Barbera, Giorgia; Zenezini Chiozzi, Riccardo; Laganà, Aldo


    The proteome characterization of fish muscle tissues, together with the relative expression of each individual protein, provides knowledge on the biochemical response of the organisms and allows to assess the effect of different types of feeding, growth site and nutritional quality of the investigated species. This type of study is usually performed by gel-based proteomics approaches, however shotgun proteomics can serve as well, reducing analysis time and improving sample high-throughput. In this work, a shotgun proteomics method was thus developed and then applied to the characterization of gilthead sea bream edible muscle. The sarcoplasmic protein fraction was extracted, in-solution digested by trypsin and finally analyzed by nanoHPLC high resolution tandem mass spectrometry. Two different quantification strategies were also tested. One was based on chemical dimethyl labeling and the other one on label free quantification. A comparison between these two analytical workflows was performed, to evaluate their individual performance in the analysis of fish samples and assess the differences induced by farming practice on the final commercial product with respect to wild gilthead sea bream. Quantitative differences were detected, and the most relevant one regarded the common fish allergen parvalbumin, found overexpressed in farmed fish samples.

  9. [Lateral lumbar disk hernia]. (United States)

    Monod, A; Desmoineaux, P; Deburge, A


    Lateral lumbar disc herniations (L.D.H.) develop in the foramen, and compress the nerve root against the overlying vertebral pedicle. In our study of L.D.H. from the clinical, radiographical, and therapeutical aspects, we reviewed 23 cases selected from the 590 patients treated for discal herniation from 1984 to 1987. The frequency of L.D.H. in this series was 3.8 per cent. The clinical pattern brings out some suggestive signs of L.D.H. (frequency of cruralgia, a seldom very positive Lasegue's test, the paucity of spinal signs, non impulsive pain). Saccoradiculography and discography rarely evidenced the L.D.H.. The T.D.M. was the investigation of choice on condition that it was correctly used. When the image was doubtful, disco-CT confirmation should be proceeded too. This latter method of investigation enabled the possibility of sequestration to be explored. 14 patients were treated by chemonucleolysis, with 9 successful outcomes. The 5 failures were cases where chemonucleolysis should not have been indicated, mainly due to associated osseous stenosis. 9 patients underwent immediate surgery with good results in each case.

  10. [Lumbar stabilization exercises]. (United States)

    Vásquez-Ríos, Jorge Rodrigo; Nava-Bringas, Tania Inés


    Antecedentes: el ejercicio es la intervención con mayor grado de evidencia de eficacia para el tratamiento del dolor crónico de la espalda baja, con beneficio superior en términos de dolor y funcionalidad, en comparación con cualquiera otra intervención. Existe una amplia variedad de ejercicios diseñados; sin embargo, actualmente los llamados ejercicios de estabilización lumbar adquiririeron una popularidad creciente entre los clínicos que están en contacto con enfermedades de la columna. Sin embargo, existe controversia en cuanto a la prescripción adecuada de los mismos y los múltiples protocolos publicados. Objetivo: analizar la bibliografía científica acerca del uso y prescripción de estos ejercicios para favorecer la mejor toma de decisiones enlos clínicos y diseñar, con base a la evidencia, el programa más adecuado para cada paciente. Conclusión: se encontró que este programa es una herramienta esencial en el tratamiento del dolor de espalda baja, en la etapa terapéutica y en la preventiva.

  11. Purification and characterization of cathepsin D from herring muscle ( Clupea harengus )

    DEFF Research Database (Denmark)

    Nielsen, L.B.; Nielsen, Henrik Hauch


    Cathepsin D was purified and concentrated 469-fold from a homogenate of Clupea harengus muscle. The purified enzyme is a monomer with a molecular weight of 38 000-39 000. It is inhibited by pepstatin and has optimal activity at pH 2.5 with hemoglobin as the substrate. The isoelectric point is at ...... myosin, actin and tropomyosin. (C) 2001 Elsevier Science Inc. All rights reserved....

  12. Comparison of lumbar and abdominal muscle activation during two types of golf swing: An EMG analysis. (Comparación de la activación muscular abdominal y lumbar en la realización de dos tipos de swing en Golf: Un análisis electromiográfico.

    Directory of Open Access Journals (Sweden)

    Sandhu Jaspal Singh


    Full Text Available AbstractGolf is a popular sport and golf swing is a complex movement which requires a coordinated sequence of muscle activity. Two types of golf swing exists i.e. “Classical” and “Modern”. Classical swing differs from modern swing in several respects, which are important when considering their effects on the lower back. The present study compared muscle activation amplitudes in the trunk region of golfers during two different types of golf swing. 22 golfers (21.5 years ±3.4 were instructed to perform modern and classical golf swing and surface EMG activity was recorded from external oblique (E.O., internal oblique (I.O., and erector spinae (E.S. muscles of both sides. Results showed muscle activity of right and left side of E.O. and I.O. to be lower in modern swing than classical swing (significant difference p menor que 0.05 in downswing and impact phase, whereas it is higher for both sides E.S. in modern swing. The E.S. muscle activity during follow-through phase was significantly higher (p menor que 0.05 in modern swing compared to classical swing. Significant differences in E.S. and other muscles activity suggest inappropriate recruitment of these muscles in golfers during the modern swing. EMG evidence proposes that the modern golf swing produces more extension forces in the lower back compared with the forces of classical swing.Resumen El Golf es un deporte popular y el swing en golf es un movimiento complejo que reclama una secuencia coordinada de movimientos. Existen dos tipos de swing: el clásico y el moderno. El Clásico se diferencia del Moderno en varios aspectos que son importantes cuando se consideran sus efectos en la parte inferior de la espalda. Este estudio comparó la amplitud de la activación muscular en el tronco de los golfistas al realizar los dos tipos de swing. Veintidos jugadores de golf (21.5 años ±3.4 fueron instruidos para realizar el swing moderno y clásico, tomándose la actividad muscular (actividad

  13. The Effects of Psoas Major and Lumbar Lordosis on Hip Flexion and Sprint Performance (United States)

    Copaver, Karine; Hertogh, Claude; Hue, Olivier


    In this study, we analyzed the correlations between hip flexion power, sprint performance, lumbar lordosis (LL) and the cross-sectional area (CSA) of the psoas muscle (PM). Ten young adults performed two sprint tests and isokinetic tests to determine hip flexion power. Magnetic resonance imaging was used to determine LL and PM CSA. There were…

  14. The effects of pelvic diagonal movements and resistance on the lumbar multifidus (United States)

    Lee, Ji-Yeon; Lee, Dong-Yeop; Hong, Ji-Heon; Yu, Jae-Ho; Kim, Jin Seop


    [Purpose] The purpose of this study was to compare the effects of pelvic diagonal movements, made with and without resistance, on the thickness of lumbar multifidus muscles. [Subjects and Methods] Participants in this study were healthy subjects who had no musculoskeletal disorders or lumbar-related pain. Participants were positioned on their side and instructed to lie with their hip flexor at 40 degrees. Ultrasonography was used for measurement, and the values of two calculations were averaged. [Results] The thickness of ipsilateral lumbar multifidus muscles showed a significant difference following the exercise of pelvic diagonal movements. The results of anterior elevation movements and posterior depression movements also demonstrated significant difference. There was no significant difference in lumbar multifidus muscles thickness between movements made with and without resistance. [Conclusion] These findings suggest that pelvic diagonal movements can be an effective method to promote muscular activation of the ipsilateral multifidus. Furthermore, researchers have concluded that resistance is not required during pelvic diagonal movements to selectively activate the core muscles. PMID:28356650

  15. Rehabilitation of Football Players with Lumbar Spine Injury. (Part 2 of 2). (United States)

    Saal, Jeffrey A.


    The training phase of a rehabilitation program for football players who have sustained lower back injuries proceeds after the pain-control phase, and seeks to minimize risk of reinjury. This phase emphasizes movement training and exercise for strengthening abdominal muscles to stabilize the lumbar spine. A removable exercise guide is included.…

  16. Manual therapy treatment of lumbar radiculopathy: A single case report

    Directory of Open Access Journals (Sweden)

    J.A. Riley


    Full Text Available Patients  with  lumbar  radiculopathy  are  often  managed with  manual therapy.  The  aim  of  this  single  case  study  was  to  describe  the outcome of manual therapy treatment of a patient with lumbar radiculopathy.  A 47-year-old female presented with acute, severe left buttock and postero-lateral thigh pain.  Symptom provocation occurred during lumbar flexion, coughing, sneezing, driving and prolonged sitting. her left straight leg raise neurodynamic test was limited and reproduced her pain, as did trigger points in the left lumbar and gluteal muscles. clinical neuro-conduction testing revealed weakness of the big and other toe extensors, as well as eversion and plantar flexion of the left ankle, and a diminished left ankle reflex. This indicated possible involvement of both the l5 and S1 nerve roots.   A  manual  therapy  treatment  approach including  lumbar rotation mobilisations (Maitland approach, massage, trigger point pressure release  and  Transversus  Abdominus muscle activation  was  used.   The  patient  was  symptom  free,  had  full pain-free  range  of  all  lumbar  movements,  a full  pain-free  left  straight leg  raise  neurodynamic  test  and  normal  neurological  conduction  six weeks  after  onset, following seven manual therapy treatments.  Although the results of this case report cannot be generalised, it describes the successful outcome of a patient with severe radicular pain and neurological deficits, whose signs and symptoms  had completely resolved following manual therapy treatment.

  17. Preoperative education for lumbar surgery for radiculopathy


    Louw, A; Louw, Q; L. Crous


    To date no studies have been published on preoperative education forpatients who had lumbar surgery. The aim of this study was to determine if there is a demand for preoperative education for patients who had lumbar surgery for radiculopathy. A convenience sample of 47 patients who had lumbar surgery and a random sample of 141 physiotherapists involved in treating patients who had lumbar surgery completed a newly developed spinal surgery questionnaire. The data were analyzed using descriptive...

  18. [Congenital lumbar hernia and bilateral renal agenesis]. (United States)

    Barrero Candau, R; Garrido Morales, M


    We report a new case of congenital lumbar hernia. This is first case reported of congenital lumbar hernia and bilateral renal agenesis. We review literature and describe associated malformations reported that would be role out in every case of congenital lumbar hernia.

  19. Effects of movement from a postural maintenance position on lumbar hemodynamic changes. (United States)

    Kumamoto, Tsuneo; Seko, Toshiaki; Takahashi, Yui


    [Purpose] To investigate the effects of movement from a postural maintenance position on lumbar hemodynamic changes, in order to prevent lower back pain and develop exercise therapy. [Subjects and Methods] Twenty-five healthy adults (mean age: 23.2 years) participated in the study. During flexion-extension exercise, the subjects moved their trunks gradually to a flexed position from an upright posture while sitting and standing, and then returned to and maintained an upright (re-upright) position. In the extension-flexion exercise, the subjects moved their trunks gradually from an upright posture to an extended position, and back while maintaining an upright (re-upright) position. Lumbar spinal muscle activity and hemodynamic changes were evaluated during both exercises. [Results] During the flexion and extension exercises, increased trunk-flexion angle caused increased muscle activity, decreased oxygenated hemoglobin in the multifidus muscle, and increased deoxygenated hemoglobin in the multifidus and lumbar erector spinae muscles. Moreover, the muscle activities were nearly the same in the re-upright and upright positions, and total hemoglobin also increased. [Conclusion] In both standing and sitting positions, holding the trunk in a flexed position causes ischemic hemodynamic changes in the multifidus muscle; however, the hyperemic response when returning the trunk to an extended position may improve circulation.

  20. Segmentalliverincarcerationthrougha recurrent incisional lumbar hernia

    Institute of Scientific and Technical Information of China (English)

    Nikolaos S. Salemis; Konstantinos Nisotakis; Stavros Gourgiotis; Efstathios Tsohataridis


    BACKGROUND: Lumbar hernia is a rare congenital or acquired defect of the posterior abdominal wall. The acquired type is more common and occurs mainly as an incisional defect after lfank surgery. Incarceration or strangulation of hernia contents is uncommon. METHOD: Segmental liver incarceration through a recurrent incisional lumbar defect was diagnosed in a 58 years old woman by magnetic resonance imaging. RESULTS: The patient underwent an open repair of the com-plicated hernia. An expanded polytetralfouoroethylene (e-PTFE) mesh was fashioned as a sublay prosthesis. She had an uncomplicated postoperative course. Follow-up examinations revealed no evidence of recurrence. CONCLUSIONS: Although lumbar hernia rarely results in incarceration or strangulation, early repair is necessary because of the risks of complications and the increasing dififculty in repairment as it enlarges. Surgical repair is often dififcult and challenging.

  1. T₂ mapping provides multiple approaches for the characterization of muscle involvement in neuromuscular diseases: a cross-sectional study of lower leg muscles in 5-15-year-old boys with Duchenne muscular dystrophy. (United States)

    Arpan, Ishu; Forbes, Sean C; Lott, Donovan J; Senesac, Claudia R; Daniels, Michael J; Triplett, William T; Deol, Jasjit K; Sweeney, H Lee; Walter, Glenn A; Vandenborne, Krista


    Skeletal muscles of children with Duchenne muscular dystrophy (DMD) show enhanced susceptibility to damage and progressive lipid infiltration, which contribute to an increase in the MR proton transverse relaxation time (T₂). Therefore, the examination of T₂ changes in individual muscles may be useful for the monitoring of disease progression in DMD. In this study, we used the mean T₂, percentage of elevated pixels and T₂ heterogeneity to assess changes in the composition of dystrophic muscles. In addition, we used fat saturation to distinguish T₂ changes caused by edema and inflammation from fat infiltration in muscles. Thirty subjects with DMD and 15 age-matched controls underwent T₂ -weighted imaging of their lower leg using a 3-T MR system. T₂ maps were developed and four lower leg muscles were manually traced (soleus, medial gastrocnemius, peroneal and tibialis anterior). The mean T₂ of the traced regions of interest, width of the T₂ histograms and percentage of elevated pixels were calculated. We found that, even in young children with DMD, lower leg muscles showed elevated mean T₂, were more heterogeneous and had a greater percentage of elevated pixels than in controls. T₂ measures decreased with fat saturation, but were still higher (P damage, edema and fat infiltration. This study shows that T₂ mapping provides multiple approaches that can be used effectively to characterize muscle tissue in children with DMD, even in the early stages of the disease. Therefore, T₂ mapping may prove to be clinically useful in the monitoring of muscle changes caused by the disease process or by therapeutic interventions in DMD.

  2. Partial characterization of an effluent produced by cooking of Jumbo squid (Dosidicus gigas) mantle muscle. (United States)

    Rosas-Romero, Zaidy G; Ramirez-Suarez, Juan C; Pacheco-Aguilar, Ramón; Lugo-Sánchez, Maria E; Carvallo-Ruiz, Gisela; García-Sánchez, Guillermina


    Jumbo squid (Dosidicus gigas) mantle muscle was cooked simulating industrial procedures (95 degrees C x 25 min, 1.2:5 muscle:water ratio). The effluent produced was analyzed for chemical and biochemical oxygen demands (COD and BOD(5), respectively), proximate analysis, flavor-related compounds (free amino acids, nucleotides and carbohydrates) and SDS-PAGE. The COD and BOD(5) exhibited variation among samplings (N=3) (27.4-118.5 g O(2)/L for COD and 11.3-26.7 g O(2)/L for BOD(5)). The effluent consisted of 1% total solids, 75% of which represented crude protein. Sixty percent of the total free amino acid content, which imparts flavor in squid species, corresponded to glutamic acid, serine, glycine, arginine, alanine, leucine and lysine. The nucleotide concentration followed this order, Hx>ADP>AMP>ATP>IMP>HxR. The variation observed in the present work was probably due to physiological maturity differences among the squid specimens (i.e., juvenile versus mature). Solids present in squid cooking effluent could be recovered and potentially used as flavor ingredients in squid-analog production by the food industry.

  3. A lumbar disc surgery predictive score card. (United States)

    Finneson, B E


    A lumbar disc surgery predictive score card or questionnaire has been developed to assess potential candidates for excision of a herniated lumbar disc who have not previously undergone lumbar spine surgery. It is not designed to encompass patients who are being considered for other types of lumbar spine surgery, such as decompressive laminectomy or fusion. In an effort to make the "score card" usable by almost all physicians who are involved in lumbar disc surgery, only studies which have broad acceptance and are generally employed are included. Studies which have less widespread use such as electromyogram, discogram, venogram, special psychologic studies (MMPI, pain drawings) have been purposely excluded.

  4. The influence of different sitting postures on head/neck posture and muscle activity. (United States)

    Caneiro, Joao Paulo; O'Sullivan, Peter; Burnett, Angus; Barach, Avi; O'Neil, David; Tveit, Orjan; Olafsdottir, Karolina


    To date the influence that specific sitting posture has on the head/neck posture and cervico-thoracic muscle activity has been insufficiently investigated. Therefore the aim of this study was to investigate whether three different thoraco-lumbar sitting postures affect head/neck posture and cervico-thoracic muscle activity. Twenty (10 men, 10 women) asymptomatic subjects were placed in 3 standardized thoraco-lumbar sitting postures (lumbo-pelvic, thoracic upright and slump) to investigate their influence on cervico-thoracic muscle activity and head/neck posture. There were significant differences in lumbar and thoracic curvatures in the 3 different sitting postures (Ppostures (P=0.015). Upper trapezius (UT) demonstrated no significant difference in muscle activation in the 3 sitting postures (Ppostures affect head/neck posture and cervico-thoracic muscle activity. It highlights the potential importance of thoraco-lumbar spine postural adjustment when training head/neck posture.

  5. [Morphological and physiological characterization of fiber types in the iliofibular muscle of Rana esculenta]. (United States)

    Dauber, W


    In both longitudinal and cross sections of the M. iliofibularis of Rana esculenta three types of muscle fibres are identified by means of light and electron microscopy. These fibretypes called A-, B- and C-fibres are according to the fibres of m. rectus abdominis of the frog. They can be compared with the fibres of the m. rectus abdominis of rat and mouse. But there is another distribution of the fibretypes A, B and C in the m. iliofibularis and in the m. rectus abdominis. The m. iliofibularis is divided into two parts called "Tonusbündel" and "nichttonischer Teil" by means of their reaction to acetylcholine. The surface of the "Tonusbündel" consists of A-, B- and C-fibres while its inside is onlyformed by A- and B-fibres. They continue the "Tonusbündel" in the "nichttonischer Teil". This part chiefly consists of A-fibres. In cross sections their myofibrils are larger in their extent than the A-fibres known before. Therefore the A-fibretype has to be distinguished into two A-fibres: A1 and A2. The new one is called A2-fibre. A1-fibre is described in the "Tonusbündel" and in further investigations. The difference between the two fibres can be understood as a greater manifestation of power of the A1-fibre. The surface of the "nichttonischer Teil" of the m. iliofibularis consists of A2-fibres which easily could be found opposite the "Tonusbündel". At this point in contrary to the "Tonusbündel" could be found a defined morphological substrate for physiological investigations. The different reactions of "Tonusbündel" and "nichttonischer Teil" to acetylcholine could only be explained by the sum of reactions of all fibretypes in each bundle in correspondence with the reaction of the fibres in the neighbour bundle. But their different behaviour by summer- and winterfrogs is unknown. Therefore it is to discuss whether it is allowed to refer generally the results to "muscle" or "musclefibre" got from frogs living in cooled rooms. It is known in literature that not all

  6. Incidental durotomy in lumbar spine surgery - incidence, risk factors and management

    Directory of Open Access Journals (Sweden)

    Adam D.


    Full Text Available Incidental durotomy is a common complication of lumbar spine operations for degenerative disorders. Its incidence varies depending on several risk factors and regarding the intra and postoperative management, there is no consensus. Our objective was to report our experience with incidental durotomy in patients who were operated on for lumbar disc herniation, lumbar spinal stenosis and revision surgeries. Between 2009 and 2012, 1259 patients were operated on for degenerative lumbar disorders. For primary operations, the surgical approach was mino-open, interlamar, uni- or bilateral, as for recurrences, the removal of the compressive element was intended: the epidural scar and the disc fragment. 863 patients (67,7% were operated on for lumbar disc herniation, 344 patients (27,3% were operated on for lumbar spinal stenosis and 52 patients (5% were operated for recurrences. The operations were performed by neurosurgeons with the same professional degree but with different operative volume. Unintentional durotomy occurred in 20 (2,3% of the patients with herniated disc, in 14 (4,07% of the patients with lumbar spinal stenosis and in 12 (23% of the patients who were operated on for recurrences. The most frequent risk factors were: obesity, revised surgery and the physician’s low operative volume. Intraoperative dural fissures were repaired through suture (8 cases, by applying muscle, fat graft or by applying curaspon, tachosil. There existed 4 CSF fistulas which were repaired at reoperation. Incidental dural fissures during operations for degenerative lumbar disorders must be recognized and immediately repaired to prevent complications such as CSF fistula, osteodiscitis and increased medical costs. Preventing, identifying and treating unintentional durotomies can be best achieved by respecting a neat surgical technique and a standardized treatment protocol.

  7. Dumb-bell-type teratoma in the lumbar spine

    Energy Technology Data Exchange (ETDEWEB)

    Okuyama, Koichiro; Misawa, Akiko; Tamura, Yasuki; Chiba, Mitsuho [Dept. of Orthopaedic Surgery, Akita Rosai Hospital, Odate City (Japan); Abe, Eiji [Dept. of Orthopaedic Surgery, Akita University School of Medicine (Japan); Hoshi, Naoto [2. Dept. of Pathology, Akita University School of Medicine (Japan)


    We report a case of a lumbar teratoma in a 50-year-old woman. The teratoma showed a dumb-bell-type expansion at the level of the left L3/4 foramen with massive erosion of the L3 vertebral body. MRI revealed inhomogeneous signal changes in the tumor, which were histologically compatible with a mixture of bone, muscle, fat, and cyst containing sebaceous material. Complete resection of the tumor and spinal arthrodesis with pedicle screw fixation was necessary to obtain stability of the affected spinal segment. (orig.)

  8. Dumb-bell-type teratoma in the lumbar spine. (United States)

    Okuyama, K; Abe, E; Hoshi, N; Misawa, A; Tamura, Y; Chiba, M


    We report a case of a lumbar teratoma in a 50-year-old woman. The teratoma showed a dumb-bell-type expansion at the level of the left L3/4 foramen with massive erosion of the L3 vertebral body. MRI revealed inhomogeneous signal changes in the tumor, which were histologically compatible with a mixture of bone, muscle, fat, and cyst containing sebaceous material. Complete resection of the tumor and spinal arthrodesis with pedicle screw fixation was necessary to obtain stability of the affected spinal segment.

  9. Chondroblastoma of the lumbar vertebra

    Energy Technology Data Exchange (ETDEWEB)

    Leung, L.Y.J.; Shu, S.J.; Chan, M.K.; Chan, C.H.S. [Dept. of Radiology and Imaging, Queen Elizabeth Hospital, Hong Kong (Hong Kong)


    Chondroblastoma of the vertebra is a very rare condition. To our knowledge fewer than 20 cases have been reported in the world literature. We report a 54-year-old man with chondroblastoma of the fifth lumbar vertebra. The clinical and radiological aspects of the tumor are discussed, emphasizing the presence of an extraosseous mass suggestive of locally aggressive behavior. (orig.)

  10. Lumbar myelography with Omnipaque (iohexol)

    Energy Technology Data Exchange (ETDEWEB)

    Lilleaas, F.; Bach-Gansmo, T.; Weber, H.


    Lumbar myelography with iohexol (Omnipaque) was performed in 103 consecutive adult patients with low back pain or sciatica. The patients were observed for 48 h with registration of possible adverse reactions. Mild or moderate transient side effects were recorded in 24 patients. No serious adverse reactions were noted, and EEG recorded in 25 patients showed no changes.

  11. Muscle functional MRI analysis of trunk muscle recruitment during extension exercises in asymptomatic individuals. (United States)

    De Ridder, E M D; Van Oosterwijck, J O; Vleeming, A; Vanderstraeten, G G; Danneels, L A


    The present study examined the activity levels of the thoracic and lumbar extensor muscles during different extension exercise modalities in healthy individuals. Therefore, 14 subjects performed four different types of extension exercises in prone position: dynamic trunk extension, dynamic-static trunk extension, dynamic leg extension, and dynamic-static leg extension. Pre- and post-exercise muscle functional magnetic resonance imaging scans from the latissimus dorsi, the thoracic and lumbar parts of the longissimus, iliocostalis, and multifidus were performed. Differences in water relaxation values (T2-relaxation) before and after exercise were calculated (T2-shift) as a measure of muscle activity and compared between extension modalities. Linear mixed-model analysis revealed higher lumbar extensor activity during trunk extension compared with leg extension (T2-shift of 5.01 ms and 3.55 ms, respectively) and during the dynamic-static exercise performance compared with the dynamic exercise performance (T2-shift of 4.77 ms and 3.55 ms, respectively). No significant differences in the thoracic extensor activity between the exercises could be demonstrated. During all extension exercises, the latissimus dorsi was the least activated compared with the paraspinal muscles. While all extension exercises are equivalent effective to train the thoracic muscles, trunk extension exercises performed in a dynamic-static way are the most appropriate to enhance lumbar muscle strength.

  12. Análise de parâmetros de força e resistência dos músculos eretores da espinha lombar durante a realização de exercício isométrico em diferentes níveis de esforço Análisis de los parametros de fuerza y resistencia de los músculos erectores de la columna lumbar durante la realizacion de exercício isométrico en diferentes níveles de esfuerzo Analysis of strength and resistance parameters of the lumbar spinae erector muscles during isometric exercise at different effort levels

    Directory of Open Access Journals (Sweden)

    Mauro Gonçalves


    los músculos accesorios de este movimiento, la sobrecarga sobre la columna vertebral se desarrolla como consecuencia del compromiso de la estabilidad de la columna vertebral consecuente de la fatiga muscular identificada después del ejercicio isométrico.The low-back pain has demonstrated to be a common finding among athletes and particularly the overload in the lumbar column resulting from a strength or isometric resistance involvement of muscles of this segment as result of the muscular fatigue has been considered as important etiological factor for its development. In this context, tests used for the training evaluation of the lumbar spinae erector muscles are emphasized. In the present study, the analysis of the strength and isometric resistance parameters was used with the objective of evaluating responses of these muscles during maximal and sub-maximal voluntary isometric contractions (MVIC in two situations: with fatigue and without fatigue induced by isometric exercise performed until exhaustion. Nine male healthy volunteers performed MVIC before and after vertebral column extension exercises supporting 5%, 10%, 15% and 20% of the MVIC. In each one of these situations, the electromyographic signal (EMG of the iliocostalis and multifidus muscles as well as the strength level generated in the MVIC were recorded. Muscular fatigue was identified through the MVIC values decrease verification and median frequency (MF of the EMG signals obtained after isometric exercise. The results demonstrated that while the strength was able to evidence muscular fatigue, the MF demonstrated in a statistically significant way the iliocostalis and multifidus muscles fatigue, and the multifidus muscles presented a higher muscular fatigue level. Interestingly, loads between 5% and 20% of the MVIC induced the same level of muscular fatigue. Thus, although the strength generated during vertebral column extension after isometric exercise-induced exhaustion remains unchanged, probably

  13. 龙氏治脊手法结合圆利针斜刺治疗慢性腰肌劳损的临床研究%Clinical Study on Long’s Spinal Manipulation combined with Round Sharp Needle Acupuncture Treating Chronic Lumbar Muscle Strain

    Institute of Scientific and Technical Information of China (English)

    陈耀龙; 陈荣钟; 陈淑慧


    Objective:To verify the clinical effect of the Long’s spinal manipulation combined with round sharp needle acupuncture in Ashi point on chronic lumbar muscle strain,and to explore the future application of the comprehensive therapy in clinical practice.Meth-ods:A prospective,randomized,and controlled trial was conducted.The changes of the scores on clinical symptoms,signs and TCM symptoms before and after the Long’s spinal manipulation combined with round sharp needle acupuncture in Ashi points were observed and compared.A control group was established by applying massage on the back,acupuncture and cupping in Ashi points,as well as in-terference power.Results:After treatment,the scores of clinical symptoms and signs of the patients with the Long’s spinal manipulation combined with round sharp needle acupuncture in Ashi points were significantly less than the patients with the back massage and acu-puncture point cupping,and interference power,and the difference was statistically significant (P0.05 ).Conclusion:Compared with traditional external treatment,Long’s spinal manipulation combined with round sharp needle acupuncture in Ashi points can better im-prove the clinical symptoms and signs of the chronic lumbar muscle strain.%目的:明确龙氏治脊手法结合圆利针斜刺阿是穴对慢性腰肌劳损的临床疗效,探讨该综合疗法在临床中的应用前景。方法:采用前瞻性随机对照的方法,通过临床观察龙氏治脊手法结合圆利针斜刺阿是穴治疗慢性腰肌劳损前后临床症状积分、临床体征积分和中医伴随症状积分的变化,并以目前临床上常用的腰背部推拿+针灸阿是穴+拔罐、腰背部推拿+干扰电作为对照组进行比较。结果:采用龙氏治脊手法结合圆利针斜刺阿是穴的患者治疗后临床症状积分、临床体征积分均明显少于腰背部推拿+针灸阿是穴+拔罐、腰背部推拿+干扰电的患者,

  14. Differences in lumbar spine load due to posture and upper limb external load. (United States)

    Kamińska, Joanna; Roman-Liu, Danuta; Zagrajek, Tomasz; Borkowski, Paweł


    As the lumbar region of the spine is particularly predisposed to musculoskeletal disorders, the aim of this article was to assess lumbar spine load on the basis of an accurate model of this part of the body. The model was developed with the finite element method and the energy criterion for optimising muscle work. Computer calculations confirmed that stresses and compression forces in intervertebral discs increased with an increase in the load force and that they were significantly larger in the bent forwards posture than in the erect posture. This result clearly shows that lifting light objects and the erect posture are important elements in minimising spine load.

  15. A Rare Case of Pediatric Lumbar Spinal Ependymoma Mimicking Meningitis. (United States)

    Ekuma, Ezeali Mike; Ito, Kiyoshi; Chiba, Akihiro; Hara, Yosuke; Kanaya, Kohei; Horiuchi, Tetsuyoshi; Ohaegbulam, Samuel; Hongo, Kazuhiro


    Spontaneous acute subarachnoid hemorrhage (SAH) from lumbar ependymoma in children is rare. We report a case of a14-year-old boy who developed sudden radicular low back pain while playing baseball. He was initially managed conservatively in a local hospital for suspected lumbar disc herniation, but later developed meningeal symptoms and fever before being referred to our hospital. There he underwent a diagnostic lumbar puncture in the emergency room; his cerebrospinal fluid suggested an SAH. Physical examination showed meningeal signs and cauda equina features. Cerebrospinal fluid analysis was negative for bacterial meningitis. Lumbar magnetic resonance imaging revealed a mass characterized as a hemorrhagic lesion. The patient had an emergent evacuation of the mass via the posterior approach. Postoperatively, his symptoms resolved completely. The histological diagnosis was, surprisingly, an ependymoma (WHO grade II). This case is particularly interesting because of its rarity in children, and its pattern of presentation. Though bacterial or viral meningitis is the most frequent cause of meningeal features in children, SAH from a hemorrhagic spinal tumor should be considered. Ultimately, a high index of suspicion is needed for prompt diagnosis.

  16. Comparison of the different surgical approaches for lumbar interbody fusion. (United States)

    Talia, Adrian J; Wong, Michael L; Lau, Hui C; Kaye, Andrew H


    This review will outline the history of spinal fusion. It will compare the different approaches currently in use for interbody fusion. A comparison of the techniques, including minimally invasive surgery and graft options will be included. Lumbar interbody fusion is a commonly performed surgical procedure for a variety of spinal disorders, especially degenerative disease. Currently this procedure is performed using anterior, lateral, transforaminal and posterior approaches. Minimally invasive techniques have been increasing in popularity in recent years. A posterior approach is frequently used and has good fusion rates and low complication rates but is limited by the thecal and nerve root retraction. The transforaminal interbody fusion avoids some of these complications and is therefore preferable in some situations, especially revision surgery. An anterior approach avoids the spinal cord and cauda equina all together, but has issues with visceral exposure complications. Lateral lumbar interbody fusion has a risk of lumbar plexus injury with dissection through the psoas muscle. Studies show less intraoperative blood loss for minimally invasive techniques, but there is no long-term data. Iliac crest is the gold standard for bone graft, although adjuncts such as bone morphogenetic proteins are being used more frequently, despite their controversial history. More high-level studies are needed to make generalisations regarding the outcomes of one technique compared with another.

  17. Electromyographic analysis of the vertebral extensor muscles during the Biering-Sorensen Test

    Directory of Open Access Journals (Sweden)

    Ligia Moreira de Santana


    Full Text Available The purpose of the study was to analyze the electromyographic signal of the multifidus, longissimus thoracis and the lumbar iliocostalis muscles during the Biering-Sorensen test in subjects without lower back pain. Twenty volunteers performed the test on three separate occasions. An analysis of variance detected a difference between the three test times (p = 0.0026. For the frequency domain, it was observed that there were differences between the multifidus and the lumbar erectors muscles; longissimus and iliocostalis muscles. However, in the time domain analysis, no difference was observed. As the values of the slope coefficients of median frequencies were higher for the multifidus muscle, compared to the longissimus and lumbar iliocostalis muscles, this may indicate a higher tendency toward muscle fatigue. Therefore, considering the applied methodology, the study of electromyographic signals in the frequency domain should be considered as an instrument to assess fatigue of the spinal extensor muscles in clinical situations.

  18. Time- and space-resolved spectroscopic characterization of laser-induced swine muscle tissue plasma

    Energy Technology Data Exchange (ETDEWEB)

    Camacho, J.J. [Departamento de Química-Física Aplicada, Facultad de Ciencias, Universidad Autónoma de Madrid, Cantoblanco, 28049 Madrid (Spain); Diaz, L., E-mail: [Instituto de Estructura de la Materia, CFMAC, CSIC, Serrano 121, 28006 Madrid (Spain); Martinez-Ramirez, S. [Instituto de Estructura de la Materia, CFMAC, CSIC, Serrano 121, 28006 Madrid (Spain); Caceres, J.O. [Departamento de Química Analítica, Facultad de Ciencias Químicas, Universidad Complutense, Cuidad Universitaria, 28040 Madrid (Spain)


    The spatial-temporal evolution of muscle tissue sample plasma induced by a high-power transversely excited atmospheric (TEA) CO{sub 2} pulsed laser at vacuum conditions (0.1–0.01 Pa) has been investigated using high-resolution optical emission spectroscopy (OES) and imaging methods. The induced plasma shows mainly electronically excited neutral Na, K, C, Mg, H, Ca, N and O atoms, ionized C{sup +}, C{sup 2+}, C{sup 3+}, Mg{sup +}, Mg{sup 2+}, N{sup +}, N{sup 2+}, Ca{sup +}, O{sup +} and O{sup 2+} species and molecular band systems of CN(B{sup 2}Σ{sup +}–X{sup 2}Σ{sup +}), C{sub 2}(d{sup 3}Π{sub g}–a{sup 3}Π{sub u}), CH(B{sup 2}Σ{sup −}–X{sup 2}Π; A{sup 2}Δ–X{sup 2}Π), NH(A{sup 3}Π–X{sup 3}Σ{sup −}), OH(A{sup 2}Σ{sup +}–X{sup 2} Σ{sup +}), and CaOH(B{sup 2}Σ{sup +}–X{sup 2}Σ{sup +}; A{sup 2}Π–X{sup 2}Σ{sup +}). Time-resolved two-dimensional emission spectroscopy is used to study the expanded distribution of different species ejected during ablation. Spatial and temporal variations of different atoms and ionic excited species are reported. Plasma parameters such as electron density and temperature were measured from the spatio-temporal analysis of different species. Average velocities of some plasma species were estimated. - Highlights: • LIBS of swine muscle tissue sample generated by CO{sub 2} laser pulses has been done for the first time. • Average velocities of some plasma species have been calculated from spatial and temporally resolved 2D OES images. • Electron density (~ 9 × 10{sup 17} cm{sup -3}) has been studied with spatial and temporal resolution. • Temporal evolution of the plasma temperature has been calculated by means of Boltzmann plots.

  19. Characterization and application of shape-changing panels with embedded rubber muscle actuators (United States)

    Peel, Larry D.; Molina, Enrique, Jr.; Baur, Jeffery W.; Justice, Ryan S.


    Cylindrical soft actuators efficiently convert fluid pressure into mechanical energy and thus offer excellent force-to-weight ratios while behaving similar to biological muscle. McKibben-like rubber muscle actuators (RMAs) were embedded into neat elastomer and act as shape-changing panels. The effect of actuator spacing and modeling methods on the performance of these panels was investigated. Simulations from nonlinear finite element models were compared with results from test panels containing four RMAs that were spaced 0, 1/2, 1, and 1.3 RMA diameters apart. Nonlinear ‘laminated plate’ and ‘rod & plate’ finite element (FE) models of individual (non-embedded) RMAs and panels with embedded RMAs were developed. Due to model complexity and resource limitations, several simplified 2D and 3D FE model types, including a 3D ‘Unit Cell’ were created. After subtracting the ‘activation pressure’ needed to initiate contraction, all the models for the individual actuators produced forces consistent with experimental values, but only the more resource-intensive rod & plate models replicated fiber/braid re-orientation and produced more realistic values for actuator contraction. For panel models, the Full 3D rod & plate model appeared to be the most accurate for panel contraction and force, but was not completed for all configurations due to resource limitations. Most embedded panel FE models produced maximum panel actuator force and maximum contraction when the embedded actuators are spaced between 1/2 and 1 diameter apart. Seven panels with embedded RMAs were experimentally fabricated and tested. Panel tests confirmed that maximum or optimal performance occurs when the RMAs are spaced between 1/2 and 1 diameter apart. The tested actuator force was fairly constant in this range, suggesting that minor design or manufacturing differences may not significantly affect panel performance. However, the amount of axial force and contraction decreases significantly at

  20. Pharmacological characterization of the relaxant effect induced by adrenomedullin in rat cavernosal smooth muscle

    Energy Technology Data Exchange (ETDEWEB)

    Leite, L.N. [Programa de Pós-Graduação em Farmacologia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP (Brazil); Laboratório de Farmacologia, Departamento de Enfermagem Psiquiátrica e Ciências Humanas, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP (Brazil); Gonzaga, N.A. [Programa de Pós-Graduação em Farmacologia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP (Brazil); Tirapelli, D.P.C.; Tirapelli, L.F. [Departamento de Cirurgia e Anatomia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP (Brazil); Tirapelli, C.R. [Laboratório de Farmacologia, Departamento de Enfermagem Psiquiátrica e Ciências Humanas, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP (Brazil)


    The aim of the present study was to determine the mechanisms underlying the relaxant effect of adrenomedullin (AM) in rat cavernosal smooth muscle (CSM) and the expression of AM system components in this tissue. Functional assays using standard muscle bath procedures were performed in CSM isolated from male Wistar rats. Protein and mRNA levels of pre-pro-AM, calcitonin receptor-like receptor (CRLR), and Subtypes 1, 2 and 3 of the receptor activity-modifying protein (RAMP) family were assessed by Western immunoblotting and quantitative real-time polymerase chain reaction, respectively. Nitrate and 6-keto-prostaglandin F{sub 1α} (6-keto-PGF{sub 1α}; a stable product of prostacyclin) levels were determined using commercially available kits. Protein and mRNA of AM, CRLR, and RAMP 1, -2, and -3 were detected in rat CSM. Immunohistochemical assays demonstrated that AM and CRLR were expressed in rat CSM. AM relaxed CSM strips in a concentration-dependent manner. AM{sub 22-52}, a selective antagonist for AM receptors, reduced the relaxation induced by AM. Conversely, CGRP{sub 8-37}, a selective antagonist for calcitonin gene-related peptide receptors, did not affect AM-induced relaxation. Preincubation of CSM strips with N{sup G}-nitro-L-arginine-methyl-ester (L-NAME, nitric oxide synthase inhibitor), 1H-(1,2,4)oxadiazolo[4,3-a]quinoxalin-1-one (ODQ, quanylyl cyclase inhibitor), Rp-8-Br-PET-cGMPS (cGMP-dependent protein kinase inhibitor), SC560 [5-(4-chlorophenyl)-1-(4-methoxyphenyl)-3-trifluoromethyl pyrazole, selective cyclooxygenase-1 inhibitor], and 4-aminopyridine (voltage-dependent K{sup +} channel blocker) reduced AM-induced relaxation. On the other hand, 7-nitroindazole (selective neuronal nitric oxide synthase inhibitor), wortmannin (phosphatidylinositol 3-kinase inhibitor), H89 (protein kinase A inhibitor), SQ22536 [9-(tetrahydro-2-furanyl)-9H-purin-6-amine, adenylate cyclase inhibitor], glibenclamide (selective blocker of ATP-sensitive K{sup +} channels), and

  1. Characterization of putative receptors specific for quercetin on bovine aortic smooth-muscle cells

    Energy Technology Data Exchange (ETDEWEB)

    Yu, S.C.; Becker, C.G.


    The authors have reported that tobacco glycoprotein (TGP), rutin-bovine serum albumin conjugates (R-BSA), quercetin, and chlorogenic acid are mitogenic for bovine aortic smooth-muscle cells (SMC). To investigate whether there are binding sites or receptors for these polyphenol-containing molecules on SMC, the authors have synthesized /sup 125/I-labeled rutin-bovine serum albumin ((/sup 125/I)R-BSA) of high specific activity (20 Ci/mmol). SMC were isolated from a bovine thoracic aorta and maintained in Eagle's minimum essential medium with 10% calf serum in culture. These SMC at early subpassages were suspended (3-5 x 10/sup 7/ cells/ml) in phosphate-buffered saline and incubated with (/sup 125/I)R-BSA (10 pmol) in the presence or absence of 200-fold unlabeled R-BSA, TGP, BSA, rutin, quercetin or related polyphenols, and catecholamines. Binding of (/sup 125/I)R-BSA to SMC was found to be reproducible and the radioligand was displaced by R-BSA, and also by TGP, rutin, quercetin, and chlorogenic acid, but not by BSA, ellagic acid, naringin, hesperetin, dopamine, epinephrine, or isoproterenol. The binding was saturable, reversible, and pH-dependent. These results demonstrate the presence of specific binding sites for quercetinon arterial SMC.

  2. Characterization of novel fucosyl- and tyvelosyl-containing glycoconjugates from Trichinella spiralis muscle stage larvae. (United States)

    Wisnewski, N; McNeil, M; Grieve, R B; Wassom, D L


    The monosaccharide composition of an affinity-purified family of antigenically-related Trichinella spiralis larval glycoproteins was determined by gas chromatography/mass spectrometry. This group of 6 major glycoproteins, designated TSL-1, originates in the muscle stage (L1) larval stichosome. They are present on the L1 surface and in excretory/secretory products of L1 larvae, are stage-specific, and are highly immunodominant. The glycosyl composition of the TSL-1 antigens was remarkable in 2 respects: (1) fucose accounted for 36 molar percent of the glycosyl residues; and (2) a 3,6-dideoxyhexose was identified, which accounted for at least 24 molar percent of the glycosyl residues. Previously, 3,6-dideoxyhexoses have been found only in certain Gram-negative bacterial lipopolysaccharides and in ascaroside alcohols (ascarylose) of Ascaris eggs. The 3,6-dideoxyhexose found in the TSL-1 antigens also was found in ES. This Trichinella sugar has been chemically identified as a 3,6-dideoxyarabinohexose, the same as found in Ascaris eggs. However, the absolute configuration of the TSL-1 sugar is D-(tyvelose), not L-(ascarylose) as is found in Ascaris eggs. Methylation analysis indicated that the TSL-1 3,6-dideoxy-D-arabinohexose was present entirely as non-reducing terminal residues. Approximately 83% of the fucose was also present as non-reducing terminal residues, with the remaining fucose found as 3,4-linked branched residues.

  3. Adjacent Lumbar Disc Herniation after Lumbar Short Spinal Fusion

    Directory of Open Access Journals (Sweden)

    Koshi Ninomiya


    Full Text Available A 70-year-old outpatient presented with a chief complaint of sudden left leg motor weakness and sensory disturbance. He had undergone L4/5 posterior interbody fusion with L3–5 posterior fusions for spondylolisthesis 3 years prior, and the screws were removed 1 year later. He has been followed up for 3 years, and there had been no adjacent segment problems before this presentation. Lumbar magnetic resonance imaging (MRI showed a large L2/3 disc hernia descending to the L3/4 level. Compared to the initial MRI, this hernia occurred in an “intact” disc among multilevel severely degenerated discs. Right leg paresis and bladder dysfunction appeared a few days after admission. Microscopic lumbar disc herniotomy was performed. The right leg motor weakness improved just after the operation, but the moderate left leg motor weakness and difficulty in urination persisted.

  4. Fracture of posterior margin of lumbar vertebral body

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    Krishnan Ajay


    Full Text Available Background: Avulsion or fracture of posterior ring apophysis of lumbar vertebra is not a common clinical entity and is missed often. These fractures are mostly traumatic lesions typically seen in adolescents and young adults, because fusion in this area is not complete until the age of 18 to 25 years. These fractures are occult on plain radiographs and are frequently missed due to unfamiliarity with the entity. But, CT scanning and MR imaging shows characteristic picture. Methods: We had 21 cases of fracture of posterior margin of a lumbar vertebral body from 1991 to 2002. Fracture in all patients were classified according to CT imaging, into the three types described by Takata et al. Out of these, 8 patients were of type I, 4 patients of type II and 9 patients of type III respectively. Focal deficit / muscle weakness was present in only three patients. No fractures of type IV (Epstein et al was found. Twelve patients were treated conservatively and 9 patients were treated by posterior decompression with total laminectomy and removal of retropulsed fragment and discectomy. Results: The mean follow-up period was of 42 months. Conventional radiography could locate the fracture in only 6 cases and CT scan was required in all cases for stamping the diagnosis and classification. Though it is uncommon, high index of suspicion is required to diagnose it, in especially adolescent patients. All the 21 patients had good outcome following the management. Conclusion: Avulsion or fracture of posterior margin of lumbar vertebral body is not so rare entity. In children and young adults diagnosed as having lumbar disc herniation, this lesion may be the proper diagnosis. These fractures need to be accurately diagnosed because as compared to simple disc herniations these fractures require more extensive exposure and resection to relieve the nerve impingent.

  5. Tetra-step training to treat thoracic-lumbar spine fracture%四步练功法治疗胸腰椎骨折

    Institute of Scientific and Technical Information of China (English)


    @@ Background:If thoracic- lumbar spine fracture happens, the structure of spinal cord will be destructed and injure spinal cord, and patient with light lesion has mutilation, and patient with serious lesion has paralysis all his life.So it is very important for rehabilitation after injury.Tetra step training,that is oneself reduction therapy,restore the function of spinal cord,and promote fracture healing by dorsum extension exercise step by step,and increasing of muscle strength of back muscle; make compressed vertebra reduction by performing power muscle strength of extensorum and practice posture.It is very good method for therapy of thoracic-lumbar fracture.

  6. [Is there a correlation between back pain and stability of the lumbar spine in pregnancy? A model-based hypothesis]. (United States)

    Liebetrau, A; Puta, C; Schinowski, D; Wulf, T; Wagner, H


    During pregnancy approximately 50% of women suffer from low back pain (LBP), which significantly affects their everyday life. The pain could result in chronic insomnia, limit the pregnant women in their ability to work and produce a reduction of their physical activity. The etiology of the pain is still critically discussed and not entirely understood. In the literature different explanations for LBP are given and one of the most common reasons is the anatomical changes of the female body during pregnancy; for instance, there is an increase in the sagittal moments because of the enlarged uterus and fetus and the occurrence of hyperlordosis.The aim of this study was to describe how the anatomical changes in pregnant women affect the stability and the moments acting on the lumbar spine with the help of a simplified musculoskeletal model.A two-dimensional musculoskeletal model of the lumbar spine in the sagittal plane consisting of five lumbar vertebrae was developed. The model included five centres of rotation and three antagonistic pairs of paraspinal muscles. The concept of altered acting torques during pregnancy was explored by varying the geometrical arrangements. The situations non-pregnant, pregnant and pregnant with hyperlordosis were considered for the model-based approach. These simulations were done dependent on the stability of the erect posture and local countertorques of every lumbar segment.In spite of the simplicity of the model and the musculoskeletal arrangement it was possible to maintain equilibrium of the erect posture at every lumbar spinal segment with one minimum physiological cross-sectional area of all paraspinal muscles. The stability of the musculoskeletal system depends on the muscular activity of the paraspinal muscles and diminishing the muscular activity causes unstable lumbar segments.The relationship between the non-pregnant and the pregnant simulations demonstrated a considerable increase of acting segmental countertorques


    Directory of Open Access Journals (Sweden)

    Prathap Kumar


    Full Text Available Background: The vertebral disorders are the ones which lead to disability and lot of health problems. Since the lumbar part of the vertebral column is the main weight bearing and weight transmitting region, if there is a defective development, the area for muscle attachment and the strong bony structure for the transmission of weight would be missing leading to instability at an early age. In the present case dry and processed fifth lumbar vertebra, of unknown sex which presented the features with absence of spinous process, laminae and the inferior articular processes on both sides which were obtained for teaching the medical undergraduate students in M.S.Ramaiah Medical College, Bangalore. There was absence of spinous process, laminae and the inferior articular processes of fifth lumbar vertebra leading to a wide spina bifida with absence of laminae, inferior articular processes on both sides and spinous process of fifth lumbar vertebra which could be a developmental anomaly.

  8. Taking it to the next level: lumbar radiculopathy from thoracic nerve schwannoma

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    Anene Ukaigwe


    Full Text Available Compression or irritation of the sciatic nerve and its branches, the common fibular and tibial nerves, causes sciatica which is a common syndrome characterized most often by radiating pain from the lower back down the legs and also manifesting as sensory and motor deficits. Sciatica is a common presentation of lumbosacral disc prolapse and degenerative disease of the lumbar spine in ambulatory settings. Schwannomas rarely cause sciatica; hence, it is seldom considered in evaluation of a patient with radiculopathy. Our patient presented with lumbar radiculopathy, mild degenerative changes on lumbar magnetic resonance imaging (MRI scan, and failed conservative treatment. Myelopathy was confirmed with electromyogram (EMG. Thoracolumbar spine MRI revealed the schwannoma in the thoracic region. He recovered neurologic function after tumor excision. This case highlights the diagnostic challenge that may arise in evaluating a patient with lumbar radiculopathy, negative lumbosacral spine imaging, and failure of conservative therapy.

  9. The reproducibility of quantitative measurements in lumbar magnetic resonance imaging of children from the general population

    DEFF Research Database (Denmark)

    Masharawi, Y; Kjær, Per; Bendix, T


    STUDY DESIGN: Quantitative lumbar magnetic resonance imaging (MRI) measurements in children were taken twice and analyzed for intra- and intertester reproducibility. OBJECTIVE: To evaluate the reproducibility of a variety of lumbar quantitative measurements taken from MRIs of children from...... the general population. SUMMARY OF BACKGROUND DATA: The reproducibility of lumbar quantitative measurements has never been tested on MRIs of children from the general population. This is a prerequisite for a reliable anatomic characterization of the immature spine in normal and pathologic conditions. METHODS......--zygoappophyseal tranverse superior facet angles, sagittal VB, and disc wedging, lumbar lordosis, and sacral inclination. Statistical analysis included the concordance correlation coefficient (CCC), and Bland and Altman's limits of agreement (LOA). RESULTS: A total of 6160 measurements were analyzed. Good to excellent...

  10. Lumbar position sense acuity during an electrical shock stressor

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    Fallentin Nils


    Full Text Available Abstract Background Optimal motor control of the spine depends on proprioceptive input as a prerequisite for co-ordination and the stability of the spine. Muscle spindles are known to play an important role in proprioception. Animal experiments suggest that an increase in sympathetic outflow can depress muscle spindle sensitivity. As the muscle spindle may be influenced by sympathetic modulation, we hypothesized that a state of high sympathetic activity as during mental stress would affect the proprioceptive output from the muscle spindles in the back muscles leading to alterations in proprioception and position sense acuity. The aim was to investigate the effect of mental stress, in this study the response to an electrical shock stressor, on position sense acuity in the rotational axis of the lumbar spine. Methods Passive and active position sense acuity in the rotational plane of the lumbar spine was investigated in the presence and absence of an electrical shock stressor in 14 healthy participants. An electrical shock-threat stressor lasting for approximately 12 minutes was used as imposed stressor to build up a strong anticipatory arousal: The participants were told that they were going to receive 8 painful electrical shocks however the participants never received the shocks. To quantify the level of physiological arousal and the level of sympathetic outflow continuous beat-to-beat changes in heart rate (beats*min-1 and systolic, diastolic and mean arterial blood pressure (mmHg were measured. To quantify position sense acuity absolute error (AE expressed in degrees was measured. Two-way analysis of variance with repeated measurements (subjects as random factor and treatments as fixed factors was used to compare the different treatments. Results Significant increases were observed in systolic blood pressure, diastolic blood pressure, and heart rate during the stress sessions indicating elevated sympathetic activity (15, 14 and 10

  11. Lumbar stimulation belt for therapy of low-back pain. (United States)

    Popović, Dejan B; Bijelić, Goran; Miler, Vera; Dosen, Strahinja; Popović, Mirjana B; Schwirtlich, Laszlo


    We developed the STIMBELT, an electrical stimulation system that comprises a lumbar belt with up to eight pairs of embedded electrodes and an eight-channel electronic stimulator. The STIMBELT is an assistive system for the treatment of low-back pain (LBP). We describe here technical details of the system and summarize the results of its application in individuals with subacute and chronic LBP. The direct goals of the treatment were to relieve pain, reduce muscle spasms, increase strength and range of motion, and educate individuals with LBP in reducing the chances of its reoccurrence. The outcome measures include: a Visual Analogue Scale (VAS), the Oswestry LBP Disability Questionnaire, the Short Form (SF)-12 health survey, and the Manual Muscle Test. The results indicate significant benefits for individuals who use the STIMBELT in addition to the conventional therapy as opposed to only the conventional therapy.

  12. Case report and review of lumbar hernia. (United States)

    Walgamage, Thilan B; Ramesh, B S; Alsawafi, Yaqoob


    Lumbar hernias are uncommon and about 300 cases have been reported till date. They commonly occur due to trauma, surgery and infection. They are increasingly being reported after motor vehicle collision injuries. However, spontaneous lumbar hernias are rare and are reported infrequently. It is treated with different surgical approaches and methods. We report a case of primary spontaneous lumbar hernia which was repaired by transperitonial laparoscopic approach using Vypro (polypropylene/polyglactin) mesh and covered with a peritoneal flap.

  13. Biomechanical evaluation of waist back muscle for Tuina manipulation treating lumbar intervertebral disc protrusion%推拿手法治疗腰椎间盘突出症腰背伸肌群生物力学特性评价研究

    Institute of Scientific and Technical Information of China (English)

    周楠; 房敏; 朱清广; 沈国权; 姜淑云; 程英武; 刘鲲鹏


    extensor were tested by Biodex- IE Isokinetic Testing System and TeleMyo 2400 T Surface EMG. Results: The mechanical properties of waist back extensor: There were no significant differences in Peak torque(PT), average power(AP), peak torque of flexor/extensor peak torque ratio(F/E) between two groups before treatment, Treated group was better improved than control group in PT(60°/s), AP( 1207s) after treatment(P<0.05), there was significant difference compared with PT, AP, F/E in treated group after treatment (P<0.05). Surface EMG: there were significant differences in MPF and IEMG between left and right in each group before treatment(P<0.05); there were no significant differences in MPF and IEMG between left and right in treated group after treatment, but control group was not (P<0.05). Treated group was better improved than control group in MPF and IEMG on right after treatment(P<0.05there was significant difference compared with MPF and IEMG in treated group after treatment(P<0.05). Conclusion: Tuina manipulation may improve contraction forces and work efficiency of waist back muscle, improve co-ordination ability of flexors and extensors muscles, increase firing rate of waist back extensor, release fatigue of waist back extensor, and improve imbalance of waist back extensor, to resume biomechanical properties of waist back extensor for the patients with Lumbar Intervertebral Disc Protrusion.

  14. Effects of a therapeutic climbing program on muscle activation and SF-36 scores of patients with lower back pain. (United States)

    Kim, Se-Hun; Seo, Dong-Yel


    [Purpose] This study examined the effects of lumbar stability exercises on chronic lower back pain by using a therapeutic climbing program on lumbar muscle activity and function. [Subjects and Methods] Thirty adult subjects with chronic back pain participated. The subjects were assigned to 2 exercise groups, namely the lumbar stabilization (Mat Ex) and therapeutic climbing exercise groups (TC Ex). Each group trained for 30 minutes, 3 times a week for 4 weeks. The Short-form 36-item Questionnaire (SF-36) was administered and the surface electromyographic (sEMG) activities of the lumbar muscles were measured. [Results] Both therapy groups showed significant increases in the SF-36 score, and the increase was greater in the TC Ex group. Significant increases in the sEMG activities of the lumbar muscles were found in both groups. The increases in the sEMG activities of the rectus abdominis and internal and external oblique muscles of the abdomen were greater in the TC Ex group than in the Mat Ex group. [Conclusion] These findings demonstrate that TC Ex, which is similar to normal lumbar stabilization exercise, is effective at activating and improving the function of the lumbar muscles. These results suggest that TC Ex has a positive impact on the stabilization of the lumbar region.

  15. Lumbar disc excision through fenestration

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    Sangwan S


    Full Text Available Background : Lumbar disc herniation often causes sciatica. Many different techniques have been advocated with the aim of least possible damage to other structures while dealing with prolapsed disc surgically in the properly selected and indicated cases. Methods : Twenty six patients with clinical symptoms and signs of prolapsed lumbar intervertebral disc having radiological correlation by MRI study were subjected to disc excision by interlaminar fenestration method. Results : The assessment at follow-up showed excellent results in 17 patients, good in 6 patients, fair in 2 patients and poor in 1 patient. The mean preoperative and postoperative Visual Analogue Scores were 9.34 ±0.84 and 2.19 ±0.84 on scale of 0-10 respectively. These were statistically significant (p value< 0.001, paired t test. No significant complications were recorded. Conclusion : Procedures of interlaminar fenestration and open disc excision under direct vision offers sufficient adequate exposure for lumbar disc excision with a smaller incision, lesser morbidity, shorter convalescence, early return to work and comparable overall results in the centers where recent laser and endoscopy facilities are not available.

  16. Functional morphology of the thoracolumbar transversospinal muscles. (United States)

    Cornwall, Jon; Stringer, Mark D; Duxson, Marilyn


    STUDY DESIGN. A qualitative and semiquantitative study of the morphology of the human thoracolumbar transversospinal (TSP) muscles. OBJECTIVE. To further define the functional morphology of the thoracolumbar TSP muscles. SUMMARY OF BACKGROUND DATA. The TSP muscle group plays an important role in vertebral function but few studies have rigorously investigated their morphology throughout the thoracolumbar region and details on the location of motor endplates (MEPs) and fiber types are sparse. METHODS. Thoracolumbar TSP muscles were examined by microdissection in five cadavers (seven sides). MEPs were identified using acetylcholinesterase histochemistry in muscles between T5 and S4 unilaterally in two cadavers. The relative proportions of type I and type II skeletal muscle fibers were determined using immunohistochemistry on whole cross sections of every TSP muscle from one side of one cadaver (T5-S4). RESULTS.TSP morphology was homogeneous and consistent throughout the thoracolumbar region. Notable differences to standard descriptions included: (1) consistent attachments between muscles; (2) no discrete cleavage planes between muscles; and (3) attachment sites over the sacrum and to lumbar zygapophysial joints. Previously undescribed small muscles were found attaching to the medial sacrum. All TSP muscles were multipennate, with fibers arranged in parallel having one MEP per muscle fiber. Muscles were highly aerobic (mean proportion of type I fibers 89%), with the proportion of type I fibers decreasing caudally. A significantly greater proportion of type I fibers were found in the midthoracic compared to the low lumbar regions. CONCLUSION. The complex morphology of the TSP muscles indicates that they would be better classified as spinotransverse muscles. They are multipennate, highly aerobic, with fibers organized in parallel, an arrangement lending itself to "fine-tuning" of vertebral movements. Understanding their morphology has implications for investigation

  17. Differences in Gait Characteristics of Patients with Lumbar Spinal Canal Stenosis (L4 Radiculopathy) and Those with Osteoarthritis of the Hip. (United States)

    Yokogawa, Noriaki; Toribatake, Yasumitsu; Murakami, Hideki; Hayashi, Hiroyuki; Yoneyama, Takeshi; Watanabe, Tetsuyou; Tsuchiya, Hiroyuki


    It is important to differentially diagnose thigh pain from lumbar spinal stenosis (particularly lumbar fourth nerve root radiculopathy) and osteoarthritis of the hip. In this study, using a treadmill and a motion analysis method, gait characteristics were compared between these conditions. Patients with lumbar fourth nerve root radiculopathy had increased physiological knee flexion immediately after foot-ground contact, possibly owing to a slight decrease in the muscle strength of the quadriceps femoris muscle. Patients with osteoarthritis of the hip had decreased range of motion of the hip joint probably due to anatomically limited mobility as well as gait strategy to avoid pain resulting from increased internal pressure on the hip joint during its extension. Our facile and noninvasive method can be useful for the differential diagnosis of lumbar spinal canal stenosis from osteoarthritis of the hip.

  18. Effects of lumbar stabilization exercises on the flexion-relaxation phenomenon of the erector spinae. (United States)

    Park, San-Seong; Choi, Bo-Ram


    [Purpose] This study evaluated the differences in the flexion-relaxation phenomenon (FRP) of the right and left erector spinae muscles in asymptomatic subjects and the effect of lumbar stabilization exercises on these differences. [Subjects and Methods] Twenty-six participants (12 in the exercise group and 14 in the control group) with a difference in the FRP in the right and left erector spinae muscles were recruited from among healthy students attending Silla University. The exercise group performed two lumbar stabilization exercises (back bridge exercise and hand-knee exercise) for 4 weeks. The control group did not exercise. [Results] No significant group-by-exercise interaction was found. The right and left erector spinae muscles did show a difference in FRP between the control and exercise groups (119.2 ± 69.2 and 131.1 ± 85.2 ms, respectively). In addition, the exercise group showed a significant decrease in post-exercise (50.0 ± 27.0 ms) compared to pre-exercise (112.3 ± 41.5 ms) differences in the right and left FRP. [Conclusion] These results suggest that lumbar stabilization exercises may counter asymmetry of the FRP in the erector spinae muscles, possibly preventing low back pain in the general population.

  19. Muscle as a secretory organ

    DEFF Research Database (Denmark)

    Pedersen, Bente K


    Skeletal muscle is the largest organ in the body. Skeletal muscles are primarily characterized by their mechanical activity required for posture, movement, and breathing, which depends on muscle fiber contractions. However, skeletal muscle is not just a component in our locomotor system. Recent...... proteins produced by skeletal muscle are dependent upon contraction. Therefore, it is likely that myokines may contribute in the mediation of the health benefits of exercise....... evidence has identified skeletal muscle as a secretory organ. We have suggested that cytokines and other peptides that are produced, expressed, and released by muscle fibers and exert either autocrine, paracrine, or endocrine effects should be classified as "myokines." The muscle secretome consists...


    Directory of Open Access Journals (Sweden)

    Joseph M. Hart


    Full Text Available The purpose of this study was to determine the contribution of hamstrings and quadriceps fatigue to quadriceps inhibition following lumbar extension exercise. Regression models were calculated consisting of the outcome variable: quadriceps inhibition and predictor variables: change in EMG median frequency in the quadriceps and hamstrings during lumbar fatiguing exercise. Twenty-five subjects with a history of low back pain were matched by gender, height and mass to 25 healthy controls. Subjects performed two sets of fatiguing isometric lumbar extension exercise until mild (set 1 and moderate (set 2 fatigue of the lumbar paraspinals. Quadriceps and hamstring EMG median frequency were measured while subjects performed fatiguing exercise. A burst of electrical stimuli was superimposed while subjects performed an isometric maximal quadriceps contraction to estimate quadriceps inhibition after each exercise set. Results indicate the change in hamstring median frequency explained variance in quadriceps inhibition following the exercise sets in the history of low back pain group only. Change in quadriceps median frequency explained variance in quadriceps inhibition following the first exercise set in the control group only. In conclusion, persons with a history of low back pain whose quadriceps become inhibited following lumbar paraspinal exercise may be adapting to the fatigue by using their hamstring muscles more than controls

  1. Lumbar spinal loading during bowling in cricket: a kinetic analysis using a musculoskeletal modelling approach. (United States)

    Zhang, Yanxin; Ma, Ye; Liu, Guangyu


    The objective of the study was to evaluate two types of cricket bowling techniques by comparing the lumbar spinal loading using a musculoskeletal modelling approach. Three-dimensional kinematic data were recorded by a Vicon motion capture system under two cricket bowling conditions: (1) participants bowled at their absolute maximal speeds (max condition), and (2) participants bowled at their absolute maximal speeds while simultaneously forcing their navel down towards their thighs starting just prior to ball release (max-trunk condition). A three-dimensional musculoskeletal model comprised of the pelvis, sacrum, lumbar vertebrae and torso segments, which enabled the motion of the individual lumbar vertebrae in the sagittal, frontal and coronal planes to be actuated by 210 muscle-tendon units, was used to simulate spinal loading based on the recorded kinematic data. The maximal lumbar spine compressive force is 4.89 ± 0.88BW for the max condition and 4.58 ± 0.54BW for the max-trunk condition. Results showed that there was no significant difference between the two techniques in trunk moments and lumbar spine forces. This indicates that the max-trunk technique may not increase lower back injury risks. The method proposed in this study could be served as a tool to evaluate lower back injury risks for cricket bowling as well as other throwing activities.

  2. Effect of cryotherapy on the lumbar spine in elderly men with back pain. (United States)

    Giemza, Czesław; Matczak-Giemza, Magdalena; Ostrowska, Bożena; Bieć, Ewa; Doliński, Mirosław


    Whole-body cryotherapy (WBC) is a procedure which is more and more often successfully applied in medicine. Used in physiotherapy programs improves the efficiency of physiotherapeutic exercises applied in different aliments. The aim of the research was to determine the influence of WBC treatment on the improvement of spine activity in elderly men. The evaluation was based on subjects suffering from chronic lower back pain. The research was conducted on 96 male in the age of 65-75 years suffering from chronic pain in the lumbar spine, lasting >3 months. All the subjects performed physical exercises at a gym. Half of the examined patients performed only physical exercises while the second half of the group participated in WBC before performing the same exercises. The research evaluated the mobility of lumbar spine at all movement planes and examined the values of active potentials of erector spinae in the lumbar part of the spine. The group of men who participated in WBC showed significantly lower values of active potentials of erector spinae muscles in the lumbar part of the spine and a significant increase in the range of the lumbar spine mobility, in comparison to the group which did not use WBC.

  3. Generation and Characterization of Vascular Smooth Muscle Cell Lines Derived from a Patient with a Bicuspid Aortic Valve

    Directory of Open Access Journals (Sweden)

    Pamela Lazar-Karsten


    Full Text Available Thoracic aortic dilation is the most common malformation of the proximal aorta and is responsible for 1%–2% of all deaths in industrialized countries. In approximately 50% of patients with a bicuspid aortic valve (BAV, dilation of any or all segments of the aorta occurs. BAV patients with aortic dilation show an increased incidence of cultured vascular smooth muscle cell (VSMC loss. In this study, VSMC, isolated from the ascending aorta of BAV, was treated with Simian virus 40 to generate a BAV-originated VSMC cell line. To exclude any genomic DNA or cross-contamination, highly polymorphic short tandem repeats of the cells were profiled. The cells were then characterized using flow cytometry and karyotyping. The WG-59 cell line created is the first reported VSMC cell line isolated from a BAV patient. Using an RT2 Profiler PCR Array, genes within the TGFβ/BMP family that are dependent on losartan treatment were identified. Endoglin was found to be among the regulated genes and was downregulated in WG-59 cells following treatment with different losartan concentrations, when compared to untreated WG-59 cells.

  4. Experimental characterization of thermally-activated artificial muscles based on coiled nylon fishing lines

    Directory of Open Access Journals (Sweden)

    Antonello Cherubini


    Full Text Available The discovery of an innovative class of thermally activated actuators based on twisted polymeric fibres has opened new horizons toward the development of effective devices that can be easily manufactured using inexpensive materials such as fishing lines or sewing threads. These new devices show large deformations when heated together with promising performance in terms of energy and power densities. With the aim of providing information and data useful for the future engineering applications, we present the results of a thermo-mechanical characterization conducted on a specific type of twisted polymeric fibre (i.e. nylon-made coiled actuators that is considered particularly promising. A custom experimental test-bench and procedure have been developed and employed to run isothermal and isometric tensile tests on a set of specimens that are fabricated with a simple and repeatable process. The results of the experiments highlight some important issues related to the response of these actuators such as hysteresis, repeatability, predictability and stored elastic energy.

  5. Lumbar disc herniation in a patient with congenital vertebral body anomaly: a case report. (United States)

    Atabey, Cem; Eroğlu, Ahmet; Topuz, Ali Kivanc; Velioğlu, Murat; Demircan, Mehmet Nusret


    Lumbar disc herniation is characterized with low back and leg pain resulting from the degenerated lumbar disc compressing the spinal nerve root. The etiology of degenerative spine is related to age, smoking, microtrauma, obesity, disorders of familial collagen structure, occupational and sports-related physical activity. However, disc herniations induced by congenital lumbar vertebral anomalies are rarely seen. Vertebral fusion defect is one of the causes of congenital anomalies. The pathogenesis of embryological corpus vertebral fusion anomaly is not fully known. In this paper, a 30-year-old patient who had the complaints of low back and right leg pain after falling from a height is presented. She had right L5-S1 disc herniation that had developed on the basis of S1 vertebra corpus fusion anomaly in Lumbar computed tomography. This case has been discussed in the light of literature based on evaluations of Lumbar Computed Tomography (CT) and Magnetic Resonance Imaging (MRI). This case is unique in that it is the first case with development of lumbar disc herniation associated with S1 vertebral corpus fusion anomaly. Congenital malformations with unusual clinical presentation after trauma should be evaluated through advanced radiological imaging techniques.

  6. Functional characterization of serum- and growth factor-induced phenotypic changes in intact bovine tracheal smooth muscle

    NARCIS (Netherlands)

    Gosens, R; Meurs, H; Bromhaar, MMG; McKay, S; Nelemans, SA; Zaagsma, J


    1 The present study aims to investigate whether phenotypic changes, reported to occur in cultured isolated airway smooth muscle (ASM) cells, are of relevance to intact ASM. Moreover, we aimed to gain insight into the signalling pathways involved. 2 Culturing of bovine tracheal smooth muscle (BTSM) s

  7. Genetic association studies in lumbar disc degeneration

    DEFF Research Database (Denmark)

    Eskola, Pasi J; Lemmelä, Susanna; Kjaer, Per;


    Low back pain is associated with lumbar disc degeneration, which is mainly due to genetic predisposition. The objective of this study was to perform a systematic review to evaluate genetic association studies in lumbar disc degeneration as defined on magnetic resonance imaging (MRI) in humans....

  8. Primary lumbar hernia: A rarely encountered hernia

    Directory of Open Access Journals (Sweden)

    Sharada Sundaramurthy


    Conclusion: A surgeon may encounter a primary lumbar hernia perhaps once in his lifetime making it an interesting surgical challenge. Sound anatomical knowledge and adequate imaging are indispensable. Inspite of advances in minimally invasive surgery, it cannot be universally applied to patients with lumbar hernia and management requires a more tailored approach.

  9. [Neonatal occlusion due to a lumbar hernia]. (United States)

    Hunald, F A; Ravololoniaina, T; Rajaonarivony, M F V; Rakotovao, M; Andriamanarivo, M L; Rakoto-Ratsimba, H


    A Petit lumbar hernia is an uncommon hernia. Congenital forms are seen in children. Incarceration may occur as an unreducible lumbar mass, associated with bilious vomiting and abdominal distention. Abdominal X-ray shows sided-wall bowel gas. In this case, reduction and primary closure must be performed as emergency repair.

  10. Remote cerebellar hemorrhage after lumbar spinal surgery

    Energy Technology Data Exchange (ETDEWEB)

    Cevik, Belma [Baskent University Faculty of Medicine, Department of Radiology, Fevzi Cakmak Cad. 10. sok. No: 45, Bahcelievler, Ankara 06490 (Turkey)], E-mail:; Kirbas, Ismail; Cakir, Banu; Akin, Kayihan; Teksam, Mehmet [Baskent University Faculty of Medicine, Department of Radiology, Fevzi Cakmak Cad. 10. sok. No: 45, Bahcelievler, Ankara 06490 (Turkey)


    Background: Postoperative remote cerebellar hemorrhage (RCH) as a complication of lumbar spinal surgery is an increasingly recognized clinical entity. The aim of this study was to determine the incidence of RCH after lumbar spinal surgery and to describe diagnostic imaging findings of RCH. Methods: Between October 1996 and March 2007, 2444 patients who had undergone lumbar spinal surgery were included in the study. Thirty-seven of 2444 patients were scanned by CT or MRI due to neurologic symptoms within the first 7 days of postoperative period. The data of all the patients were studied with regard to the following variables: incidence of RCH after lumbar spinal surgery, gender and age, coagulation parameters, history of previous arterial hypertension, and position of lumbar spinal surgery. Results: The retrospective study led to the identification of two patients who had RCH after lumbar spinal surgery. Of 37 patients who had neurologic symptoms, 29 patients were women and 8 patients were men. CT and MRI showed subarachnoid hemorrhage in the folia of bilateral cerebellar hemispheres in both patients with RCH. The incidence of RCH was 0.08% among patients who underwent lumbar spinal surgery. Conclusion: RCH is a rare complication of lumbar spinal surgery, self-limiting phenomenon that should not be mistaken for more ominous pathologic findings such as hemorrhagic infarction. This type of bleeding is thought to occur secondary to venous infarction, but the exact pathogenetic mechanism is unknown. CT or MRI allowed immediate diagnosis of this complication and guided conservative management.

  11. Lumbar Epidural Varix Mimicking Disc Herniation. (United States)

    Bursalı, Adem; Akyoldas, Goktug; Guvenal, Ahmet Burak; Yaman, Onur


    Lumbar radiculopathy is generally caused by such well-recognized entity as lumbar disc herniation in neurosurgical practice; however rare pathologies such as thrombosed epidural varix may mimic them by causing radicular symptoms. In this case report, we present a 26-year-old man with the complaint of back and right leg pain who was operated for right L4-5 disc herniation. The lesion interpreted as an extruded disc herniation preoperatively was found to be a thrombosed epidural varix compressing the nerve root preoperatively. The nerve root was decompressed by shrinking the lesion with bipolar thermocoagulation and excision. The patient's complaints disappeared in the postoperative period. Thrombosed lumbar epidural varices may mimic lumbar disc herniations both radiologically and clinically. Therefore, must be kept in mind in the differential diagnosis of lumbar disc herniations. Microsurgical techniques are mandatory for the treatment of these pathologies and decompression with thermocoagulation and excision is an efficient method.

  12. Lower extremity joint kinetics and lumbar curvature during squat and stoop lifting

    Directory of Open Access Journals (Sweden)

    Kim Youngho


    Full Text Available Abstract Background In this study, kinematics and kinetics of the lower extremity joint and the lumbar lordosis during two different symmetrical lifting techniques(squat and stoop were examined using the three-dimensional motion analysis. Methods Twenty-six young male volunteers were selected for the subjects in this study. While they lifted boxes weighing 5, 10 and 15 kg by both squat and stoop lifting techniques, their motions were captured and analyzed using the 3D motion analysis system which was synchronized with two forceplates and the electromyographic system. Joint kinematics was determined by the forty-three reflective markers which were attached on the anatomical locations based on the VICON Plug-in-Gait marker placement protocol. Joint kinetics was analyzed by using the inverse dynamics. Paired t-test and Kruskal-Wallis test was used to compare the differences of variables between two techniques, and among three different weights. Correlation coefficient was calculated to explain the role of lower limb joint motion in relation to the lumbar lordosis. Results There were not significant differences in maximum lumbar joint moments between two techniques. The hip and ankle contributed the most part of the support moment during squat lifting, and the knee flexion moment played an important role in stoop lifting. The hip, ankle and lumbar joints generated power and only the knee joint absorbed power in the squat lifting. The knee and ankle joints absorbed power, the hip and lumbar joints generated power in the stoop lifting. The bi-articular antagonist muscles' co-contraction around the knee joint during the squat lifting and the eccentric co-contraction of the gastrocnemius and the biceps femoris were found important for maintaining the straight leg during the stoop lifting. At the time of lordotic curvature appearance in the squat lifting, there were significant correlations in all three lower extremity joint moments with the lumbar joint

  13. Segmental fibre type composition of the rat iliopsoas muscle. (United States)

    Vlahovic, Hrvoje; Bazdaric, Ksenija; Marijancic, Verner; Soic-Vranic, Tamara; Malnar, Daniela; Arbanas, Juraj


    The iliopsoas of the rat is composed of two muscles - the psoas major muscle and the iliacus muscle. The psoas major muscle arises from all the lumbar vertebrae and the iliacus muscle from the fifth and sixth lumbar vertebrae and ilium. Their common insertion point is the lesser trochanter of the femur, and their common action is the lateral rotation of the femur and flexion of the hip joint. Unlike humans, the rat is a quadruped and only occasionally rises up on its hind legs. Therefore, it is expected that the fibre type composition of the rat iliopsoas muscle will be different than that of humans. The iliopsoas muscle of the rat is generally considered to be a fast muscle. However, previous studies of the fibre type composition of the rat psoas muscle showed different results. Moreover, very little is known about the composition of the rat iliacus muscle. The aim of our study was to examine the fibre type composition of the rat iliopsoas muscle in order to better understand the complex function of the listed muscle. The psoas major muscle was examined segmentally at four different levels of its origin. Type I, IIA, IIB and IIX muscle fibres were typed using monoclonal antibodies for myosin heavy chain identification. The percentage of muscle fibre types and muscle fibre cross-sectional areas were calculated. In our study we showed that in the rat iliopsoas muscle both the iliacus and the psoas major muscles had a predominance of fast muscle fibre types, with the highest percentage of the fastest IIB muscle fibres. Also, the IIB muscle fibres showed the largest cross-sectional area (CSA) in both muscles. As well, the psoas major muscle showed segmental differences of fibre type composition. Our results showed changes in percentages, as well as the CSAs of muscle fibre types in cranio-caudal direction. The most significant changes were visible in type IIB muscle fibres, where there was a decrease of percentages and the CSAs from the cranial towards the caudal part

  14. Feature of surface electromyography of lumbar erector spinae muscle in fighter pilots with nonspecific%歼击机飞行员非特异性慢性腰背痛患者腰部竖脊肌表面肌电特征

    Institute of Scientific and Technical Information of China (English)

    卫杰; 赵平; 范宇; 郭伟; 甄鹰; 孙梅; 陈立君; 马中立


    目的 测量分析非特异性慢性腰背痛歼击机飞行员与对照组歼击机飞行员腰部竖脊肌表面肌电(surface electromyography,sEMG),为歼击机飞行员非特异性慢性腰背痛患者的客观诊断评价提供参考依据.方法 芬兰ME6000-T8表面肌电仪测量39名非特异性慢性腰背痛歼击机飞行员(病例组)与12名无症状歼击机飞行员(对照组)腰部竖脊肌俯卧位等长收缩、站立位屈伸运动时的表面肌电.MEGAWIN700046,2.4版软件处理等长收缩时疲劳性肌电信号,获取中位频率下降率(median frequency slope,MFs)、平均功率频率下降率(mean power frequency slope,MPFs)、过零率下降频率(zero crossing rate slope,ZCRs)、平均电压下降率(average electromyography slope,AEMGs),分析屈伸动作时的肌电信号,得出屈曲伸直动作时的平均肌电电压(average electromyography,AEMG),并由此计算屈曲伸直比(flexion extension ratio,FER).分析病例组与对照组各指标的差别.结果 竖脊肌等长收缩时病例组与对照组疲劳性肌电指标之间无统计学差异.屈伸运动时病例组与对照组AEMG及FER指标有统计学差异(t=1.979~5.387,P<0.05或P<0.01).结论 非特异性慢性腰背痛歼击机飞行员与无症状歼击机飞行员之间的表面肌电指标FER差异显著,屈曲时竖脊肌AEMG增高,伸直时竖脊肌AEMG降低,FER可以作为歼击机飞行员非特异性慢性腰背痛诊断及疗效评价的客观量化参考指标.%Objective To explore objective diagnostic and evaluative surface electromyography (sEMG) feature for the fighter pilots with nonspecific low back pain.Methods The erector spinae muscle sEMG of 39 fighter pilots with nonspecific low back pain (as case group) and 12 pilots without painful symptom (as control group) was measured by ME-6000-T8 electromyograph.All pilots were asked to contract their lumbar muscle steadily and move from an erect to a flexion posture.sEMG signal processing was

  15. Muscle Disorders (United States)

    Your muscles help you move and help your body work. Different types of muscles have different jobs. There are many problems that can affect muscles. Muscle disorders can cause weakness, pain or even ...

  16. Muscle Cramps (United States)

    Muscle cramps are sudden, involuntary contractions or spasms in one or more of your muscles. They often occur ... minutes. It is a very common muscle problem. Muscle cramps can be caused by nerves that malfunction. Sometimes ...

  17. Characterization of DLK1+ cells emerging during skeletal muscle remodeling in response to myositis, myopathies, and acute injury

    DEFF Research Database (Denmark)

    Andersen, Ditte C; Petersson, Stine J; Jørgensen, Louise H


    , DLK1 was upregulated in all human myopathies analyzed, including Duchenne- and Becker muscular dystrophies. Substantial numbers of DLK1(+) satellite cells were observed in normal neonatal and Duchenne muscle, and furthermore, myogenic DLK1(+) cells were identified during muscle regeneration in animal...... nonmyogenic DLK1(+) cells and small spindle-shaped cells coexpressing DLK1 and muscle-specific markers were observed. Myogenic differentiation was achieved when sorted DLK1(+) cells were cocultured together with primary myoblasts revealing a myogenic potential that was 10% of the DLK1(-) population...

  18. Fractal analysis of lumbar vertebral cancellous bone architecture. (United States)

    Feltrin, G P; Macchi, V; Saccavini, C; Tosi, E; Dus, C; Fassina, A; Parenti, A; De Caro, R


    Osteoporosis is characterized by bone mineral density (BMD) decreasing and spongy bone rearrangement with consequent loss of elasticity and increased bone fragility. Quantitative computed tomography (QCT) quantifies bone mineral content but does not describe spongy architecture. Analysis of trabecular pattern may provide additional information to evaluate osteoporosis. The aim of this study was to determine whether the fractal analysis of the microradiography of lumbar vertebrae provides a reliable assessment of bone texture, which correlates with the BMD. The lumbar segment of the spine was removed from 22 cadavers with no history of back pain and examined with standard x-ray, traditional tomography, and quantitative computed tomography to measure BMD. The fractal dimension, which quantifies the image fractal complexity, was calculated on microradiographs of axial sections of the fourth lumbar vertebra to determine its characteristic spongy network. The relationship between the values of the BMD and those of the fractal dimension was evaluated by linear regression and a statistically significant correlation (R = 0.96) was found. These findings suggest that the application of fractal analysis to radiological analyses can provide valuable information on the trabecular pattern of vertebrae. Thus, fractal dimensions of trabecular bone structure should be considered as a supplement to BMD evaluation in the assessment of osteoporosis.


    Institute of Scientific and Technical Information of China (English)

    PAN Yu-tao; CAO Peng; LIANG Yu; GONG Yao-cheng; ZHENG Tao; ZHANG Xing-kai; WU Wen-jian


    Objective To evaluate the long-term outcomes of fenestrated discectomy for lumbar disc herniation and analyze the correlative influence factors.Methods Eighty-two cases of lumbar disc herniation, from February 1996 to May 1999, were retrospectively studied. All patients were treated with simple fenestrated discectomy. The average follow-up time was 8 years and 7 months (from 7 years to10 years and 3months). There were 13, 38 and 31 cases at L3-L4, L4-L5 and L5-S1 level, respectively.Results The average scales before operation were as following: Japanes Orthopaedics Association (JOA) scale 6.5 (5-9), visual analysis scale (VAS) of low back pain 4.8 (0-8), and VAS of sciatica 7.2 (4-10). At the final follow-up, the above parameters were 13.2 (10-14), 1.8 (0-10) and 1.2 (0-7), respectively. The average increase ratio of JOA scale was 78.8%. The average disc-vertebra height ratio (Mochida method) was 80.2%. At the final follow-up, 7 cases reoccurred disc herniation. The final clinical satisfaction rate was 80% (modified Macnab method).Conclusion With appropriate surgical indications, the successful long-term outcomes could be expected with fenestrated discectomy. Discectomy improves sciatica to a greater extent than low back pain. The occurrence of low back pain is related to intervertebral disc height, segment stability, disc degeneration, and lumbar muscle disability.

  20. Quadratus Lumborum Block as an Alternative to Lumbar Plexus Block for Hip Surgery: A Report of 2 Cases. (United States)

    La Colla, Luca; Ben-David, Bruce; Merman, Rita


    Quadratus lumborum (QL) block was first described several years ago, but few articles have been published regarding this technique, for the most part case series involving abdominal surgery. We report 2 cases of prolonged, extensive block of thoracic and lumbar dermatomes after QL block in patients undergoing different hip surgery procedures for whom QL block was used in place of lumbar plexus block. Further prospective studies comparing these 2 techniques are necessary to better characterize the role of QL block in hip surgery.

  1. Lumbar pedicle cortical bone trajectory screw

    Institute of Scientific and Technical Information of China (English)

    Song Tengfei; Wellington K Hsu; Ye Tianwen


    Objective The purpose of this study was to demonstrate the lumbar pedicle cortical bone trajectory (CBT) screw fixation technique,a new fixation technique for lumbar surgery.Data sources The data analyzed in this review are mainly from articles reported in PubMed published from 1994 to 2014.Study selection Original articles and critical reviews relevant to CBT technique and lumbar pedicle fixation were selected.Results CBT technique was firstly introduced as a new fixation method for lumbar pedicle surgery in 2009.The concepts,morphometric study,biomechanical characteristics and clinical applications of CBT technique were reviewed.The insertional point of CBT screw is located at the lateral point of the pars interarticularis,and its trajectory follows a caudocephalad path sagittally and a laterally directed path in the transverse plane.CBT technique can be used for posterior fixation during lumbar fusion procedures.This technique is a minimally invasive surgery,which affords better biomechanical stability,fixation strength and surgical safety.Therefore,CBT technique has the greatest benefit in lumbar pedicle surgery for patients with osteoporosis and obesity.Conclusion CBT technique is a better alternative option of lumbar pedicle fixation,especially for patients with osteoporosis and obesity.

  2. Misunderstanding of foot drop in a patient with charcot-marie-tooth disease and lumbar disk herniation. (United States)

    Han, Youngmin; Kim, Kyoung-Tae; Cho, Dae-Chul; Sung, Joo-Kyung


    We report the case of 57-year-old woman diagnosed with Charcot-Marie-Tooth (CMT) disease and lumbar disk herniation (LDH). She had left leg weakness and foot numbness, foot deformity (muscle atrophy, high arch, and clawed toes). The lumbar spine MRI showed LDH at L4-5. Additionally, electrophysiology results were consistent with chronic peripheral motor-sensory polyneuropathy (axonopathy). In genetic testing, 17p11.2-p12 duplication/deletions characteristic of CMT disease were observed. We confirmed the patient's diagnosis as CMT disease and used conservative treatment.

  3. Axial loaded MRI of the lumbar spine

    Energy Technology Data Exchange (ETDEWEB)

    Saifuddin, A. E-mail:; Blease, S.; MacSweeney, E


    Magnetic resonance imaging is established as the technique of choice for assessment of degenerative disorders of the lumbar spine. However, it is routinely performed with the patient supine and the hips and knees flexed. The absence of axial loading and lumbar extension results in a maximization of spinal canal dimensions, which may in some cases, result in failure to demonstrate nerve root compression. Attempts have been made to image the lumbar spine in a more physiological state, either by imaging with flexion-extension, in the erect position or by using axial loading. This article reviews the literature relating to the above techniques.

  4. Lumbar hernia: a short historical survey. (United States)

    Cavallaro, Antonino; De Toma, Giorgio; Cavallaro, Giuseppe


    Lumbar hernia is a rare form of abdominal hernia, which has been recognized later along the early development of the modern surgery. it has been, on many occasions, the object of heavy debate regarding its anatomical background and as well its etiology. The authors reports the historical aspects of this rare pathology, focusing on the earliest descriptions of hernia arising in lumbar regions, on the first reports of surgical repair, and on the anatomical description of the lumbar weakness areas, that are currently named Petit's triangle and Grynfeltt and Lesshaft's triangle.

  5. Minimal Invasive Decompression for Lumbar Spinal Stenosis

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    Victor Popov


    Full Text Available Lumbar spinal stenosis is a common condition in elderly patients and may lead to progressive back and leg pain, muscular weakness, sensory disturbance, and/or problems with ambulation. Multiple studies suggest that surgical decompression is an effective therapy for patients with symptomatic lumbar stenosis. Although traditional lumbar decompression is a time-honored procedure, minimally invasive procedures are now available which can achieve the goals of decompression with less bleeding, smaller incisions, and quicker patient recovery. This paper will review the technique of performing ipsilateral and bilateral decompressions using a tubular retractor system and microscope.

  6. Analysis and treatment of surgical complications after percutaneous transforaminal endoscopic discectomy for treating lumbar disc herniation and lumbar intervertebral foraminal stenosis

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    Guang HAN


    Full Text Available Objective To analyze the causes of surgical complications after treatment of lumbar disc herniation (LDH and lumbar intervertebral foraminal stenosis by percutaneous transforaminal endoscopic discectomy (PTED.  Methods From December 2009 to December 2014, 286 patients with LDH (N = 201 and lumbar intervertebral foraminal stenosis (N = 85 were confirmed by X-ray, CT or MRI and treated by PTED in our hospital. Visual Analogue Scale (VAS was used to evaluate the degree of pain in each paitent before and after operation. The curative effect was evaluated by Macnab score. Surgical complications were recorded to find out the causes and methods to prevent them.  Results All cases were followed up for 3 months, and the VAS score decreased significantly compared with preoperation [1.00 (0.00, 1.05 vs 8.50 (7.75, 9.25; Z = 2.825, P = 0.050]. According to Macnab score, the rate of excellent and good functional recovery was 95.45% (273/286. Procedure-related complications included nerve injury in 8 cases (2.80%, hemorrhage at the operation site and hematoma formation around nerve root in 6 cases (2.10%, rupture of dural sac in one case (0.35%, muscle cramps in 3 cases (1.05%, surgical infection in one case (0.35%, postoperative recurrence in 4 cases (1.40%. All patients with complications were cured after symptomatic treatment. Conclusions The overall effect of percutaneous transforaminal endoscopic discectomy for treating lumbar disc herniation and lumbar intervertebral foraminal stenosis is satisfactory, which has a low incidence rate of postoperative complications. Some tips can effectively reduce the rate of surgical complications such as preoperative evaluation, precise performance, careful hemostasis, shortening the operation time and postoperatively symptomatic treatment, etc. DOI: 10.3969/j.issn.1672-6731.2016.04.007

  7. Characterization of the in vitro expressed autoimmune rippling muscle disease immunogenic domain of human titin encoded by TTN exons 248-249

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    Zelinka, L. [Biomedical Sciences Program, Kent State University, Kent, OH (United States); McCann, S.; Budde, J.; Sethi, S.; Guidos, M.; Giles, R. [Center for Applied Chemical Biology, Department of Biological Sciences, Youngstown State University, One University Plaza, Youngstown, OH 44555 (United States); Walker, G.R., E-mail: [Center for Applied Chemical Biology, Department of Biological Sciences, Youngstown State University, One University Plaza, Youngstown, OH 44555 (United States); Biomedical Sciences Program, Kent State University, Kent, OH (United States)


    Highlights: {yields} Affinity purification of the autoimmune rippling muscle disease immunogenic domain of titin. {yields} Partial sequence analysis confirms that the peptides is in the I band region of titin. {yields} This region of the human titin shows high degree of homology to mouse titin N2-A. -- Abstract: Autoimmune rippling muscle disease (ARMD) is an autoimmune neuromuscular disease associated with myasthenia gravis (MG). Past studies in our laboratory recognized a very high molecular weight skeletal muscle protein antigen identified by ARMD patient antisera as the titin isoform. These past studies used antisera from ARMD and MG patients as probes to screen a human skeletal muscle cDNA library and several pBluescript clones revealed supporting expression of immunoreactive peptides. This study characterizes the products of subcloning the titin immunoreactive domain into pGEX-3X and the subsequent fusion protein. Sequence analysis of the fusion gene indicates the cloned titin domain (GenBank ID: (EU428784)) is in frame and is derived from a sequence of N2-A spanning the exons 248-250 an area that encodes the fibronectin III domain. PCR and EcoR1 restriction mapping studies have demonstrated that the inserted cDNA is of a size that is predicted by bioinformatics analysis of the subclone. Expression of the fusion protein result in the isolation of a polypeptide of 52 kDa consistent with the predicted inferred amino acid sequence. Immunoblot experiments of the fusion protein, using rippling muscle/myasthenia gravis antisera, demonstrate that only the titin domain is immunoreactive.

  8. Muscle as a secretory organ. (United States)

    Pedersen, Bente K


    Skeletal muscle is the largest organ in the body. Skeletal muscles are primarily characterized by their mechanical activity required for posture, movement, and breathing, which depends on muscle fiber contractions. However, skeletal muscle is not just a component in our locomotor system. Recent evidence has identified skeletal muscle as a secretory organ. We have suggested that cytokines and other peptides that are produced, expressed, and released by muscle fibers and exert either autocrine, paracrine, or endocrine effects should be classified as "myokines." The muscle secretome consists of several hundred secreted peptides. This finding provides a conceptual basis and a whole new paradigm for understanding how muscles communicate with other organs such as adipose tissue, liver, pancreas, bones, and brain. In addition, several myokines exert their effects within the muscle itself. Many proteins produced by skeletal muscle are dependent upon contraction. Therefore, it is likely that myokines may contribute in the mediation of the health benefits of exercise.

  9. Minimally invasive lumbar interbody fusion via MAST Quadrant retractor versus open surgery: a prospective randomized clinical trial

    Institute of Scientific and Technical Information of China (English)

    WANG Hong-li; L(U) Fei-zhou; JIANG Jian-yuan; MA Xin; XIA Xin-lei; WANG Li-xun


    Background In recent years,a variety of minimally invasive lumbar surgery techniques have achieved desirable efficacy,but some dispute remains regarding the advantages over open surgery.This study aimed to compare minimally invasive lumbar interbody fusion via MAST Quadrant retractor with open surgery in terms of perioperative factors,postoperative back muscle function,and 24-month postoperative follow-up results.Methods From September 2006 to June 2008,patients with single-level degenerative lumbar spine disease who were not responsive to conservative treatment were enrolled in this study.Patients were randomized to undergo either minimally invasive surgery (MIS,transforaminal lumbar interbody fusion via MAST Quadrant retractor,41 cases) or open surgery (improved transforaminal lumbar interbody fusion,38 cases).Results The MIS group had longer intraoperative fluoroscopy time than the open surgery group,and the open surgery group had significantly increased postoperative drainage volume and significantly prolonged postoperative recovery time compared with the MIS group (P <0.05 for all).MRI scanning showed that the T2 relaxation time in the multifidus muscle was significantly shorter in the MIS group than in the open surgery group at 3 months after surgery (P <0.01).Surface electromyography of the sacrospinalis muscle showed that the average discharge amplitude and frequency were significantly higher in the MIS group than in the open surgery group (P <0.01).The Oswestry disability index and visual analog scale scores were better at 3,6,12 and 24 months postoperatively than preoperatively in both groups.Both groups of patients met the imaging convergence criteria at the last follow-up.Conclusions MIS can effectively reduce sacrospinalis muscle injury compared with open surgery,which is conducive to early functional recovery.In the short term,MIS is superior to open surgery,but in the long term there is no significant difference between the two procedures.

  10. Lumbar herniated disc: spontaneous regression (United States)

    Yüksel, Kasım Zafer


    Background Low back pain is a frequent condition that results in substantial disability and causes admission of patients to neurosurgery clinics. To evaluate and present the therapeutic outcomes in lumbar disc hernia (LDH) patients treated by means of a conservative approach, consisting of bed rest and medical therapy. Methods This retrospective cohort was carried out in the neurosurgery departments of hospitals in Kahramanmaraş city and 23 patients diagnosed with LDH at the levels of L3−L4, L4−L5 or L5−S1 were enrolled. Results The average age was 38.4 ± 8.0 and the chief complaint was low back pain and sciatica radiating to one or both lower extremities. Conservative treatment was administered. Neurological examination findings, durations of treatment and intervals until symptomatic recovery were recorded. Laségue tests and neurosensory examination revealed that mild neurological deficits existed in 16 of our patients. Previously, 5 patients had received physiotherapy and 7 patients had been on medical treatment. The number of patients with LDH at the level of L3−L4, L4−L5, and L5−S1 were 1, 13, and 9, respectively. All patients reported that they had benefit from medical treatment and bed rest, and radiologic improvement was observed simultaneously on MRI scans. The average duration until symptomatic recovery and/or regression of LDH symptoms was 13.6 ± 5.4 months (range: 5−22). Conclusions It should be kept in mind that lumbar disc hernias could regress with medical treatment and rest without surgery, and there should be an awareness that these patients could recover radiologically. This condition must be taken into account during decision making for surgical intervention in LDH patients devoid of indications for emergent surgery. PMID:28119770


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    BROSCATEAN, Emanuela-Flavia


    Full Text Available Lumbar disc degeneration is a disorder whose clinical manifestations are represented by episodic pain in the lumbar spine, without lumbar blockage and minor muscle contraction. Because lumbalgia caused by lumbar disc degeneration is not always very high intensity pain, the easiest to apply treatment is drug therapy. The aim of this study was to analyze the potential role of rehabilitation treatment in the recovery of patients and the prevention of complications compared to drug therapy alone. The study included 28 patients (17 women and 11 men aged between 23-60 years, assigned to two groups: 20 patients who received rehabilitation treatment (consisting of massage, kinesiotherapy, hydrokinesiotherapy, electrotherapy and medication and 8 patients who received drug treatment consisting of anti-inflammatory and analgesic drugs. The treatment duration was 10 days. For the evaluation of pain, the visual analogue scale was used, for the degree of disability, the Oswestry questionnaire, and for joint mobility and muscle strength, articular and muscular testing. At the end of treatment, the study group compared to the control group had a statistically significant result for pain (p=0.001, as well as for the Oswestry score (p=0.030. The mean age of the patients was 35.51±3.026, which shows an increased incidence among young adults. A possible connection between the development of the disease in women and age less than 45 years was also investigated, but the result was not statistically significant, p=0.22. Our data suggest the fact that rehabilitation treatment plays an important role in the reduction of pain and the improvement of the quality of life of patients with lumbar disc degeneration by decreasing the degree of disability. In the future, it can be proposed to monitor patients with lumbar disc degeneration over a longer time period in order to see the effects of kinetic rehabilitation programs in relation to the delay of chronicization. As


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    Full Text Available ABSTRACT Objectives: To determine the standard of treatment of degenerative lumbar spondylolisthesis in its different clinical presentations in UMAE Dr. Victorio de la Fuente Narváez. Methods: Six cases found in the literature were presented to 36 experts in spine surgery, along with treatment options, to thereby obtain a standard prescription for the treatment of degenerative lumbar spondylolisthesis. Analytical observational cross-sectional descriptive study. Results: It was found that the treatment of choice in cases of degenerative lumbar spondylolisthesis with axial symptoms is conservative. The surgical treatment of choice for both stable and unstable patients with radiculopathy and/or claudication is decompression + posterolateral graft + transpedicular instrumentation + discectomy (graft. Conclusions: We managed to define the degenerative lumbar spondylolisthesis treatment guidelines in our unit, which can serve as a basis for the development of a clinical practice guide.

  13. Lumbar Epidural Varix Mimicking Perineural Cyst (United States)

    Pusat, Serhat; Kural, Cahit; Aslanoglu, Atilla; Kurt, Bulent


    Lumbar epidural varices are rare and usually mimick lumbar disc herniations. Back pain and radiculopathy are the main symptoms of lumbar epidural varices. Perineural cysts are radiologically different lesions and should not be confused with epidural varix. A 36-year-old male patient presented to us with right leg pain. The magnetic resonance imaging revealed a cystic lesion at S1 level that was compressing the right root, and was interpreted as a perineural cyst. The patient underwent surgery via right L5 and S1 hemilaminectomy, and the lesion was coagulated and removed. The histopathological diagnosis was epidural varix. The patient was clinically improved and the follow-up magnetic resonance imaging showed the absence of the lesion. Lumbar epidural varix should be kept in mind in the differential diagnosis of the cystic lesions which compress the spinal roots. PMID:23741553

  14. Genetically Determined Insulin Resistance is Characterized by Down-Regulation of Mitochondrial Oxidative Metabolism in Human Skeletal Muscle

    DEFF Research Database (Denmark)

    Kristensen, Jonas M; Skov, Vibe; Wojtaszewski, Jørgen


    Transcriptional profiling of skeletal muscle from patients with type 2 diabetes and high-risk individuals have demonstrated a co-ordinated down-regulation of oxidative phosphorylation (OxPhos) genes, suggesting a link between insulin resistance and mitochondrial dysfunction. However, whether...... mitochondrial dysfunction is a cause or consequence of insulin resistance remains to be clarified. In the present study, we tested the hypothesis that mitochondrial oxidative metabolism was down-regulated in skeletal muscle of patients with genetically determined insulin resistance. Skeletal muscle biopsies.......02), and complex V (ATP5B; p=0.005). Our data demonstrate that genetically determined insulin resistance is associated with a co-ordinated down-regulation of OxPhos components both at the transcriptional and translational level. These findings suggest that an impaired biological response to insulin in skeletal...

  15. The effects of lumbar stabilization exercises on foot pressure of older individuals while walking. (United States)

    Jung, Sunmi; Shim, Jemyung; Mun, Dongchul


    [Purpose] The purpose of this study was to examine the effect of lumbar stabilization on pressure distribution in old women. [Subjects] The subjects of this study were 14 women aged 65 or older who agreed to participate in this study. They had a sufficient range of motion and muscle strength to perform the postures in this study's program and were without gait problems, congenital deformity, orthopedic disorder, or neurological disorder. [Methods] The participants performed a group exercise program that promotes lumbar stabilization for 50 minutes per session by following the instructions of a physical therapist. Gait Analyzer was used to measure the foot pressure of individual participants from three measurements for each lumbar stabilization exercise, and the mean values were used. The mean values were then compared between before and after the exercises by paired t-test. [Results] Pressure in F3 and F6 statistically significantly decreased from 2.06±1.23% N/cm(2) to 1.55±1.02% N/cm(2) and from 7.40±1.52% N/cm(2) to 5.95±1.76% N/cm(2), respectively, after the intervention, but no significant differences were found in the other foot areas. [Conclusion] The lumbar stabilization exercises affected the pressure evenly over the entire foot and, in particular, in the inner area of the forefoot.

  16. Posteroanterior versus anteroposterior lumbar spine radiology

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    Tsuno, M.M.; Shu, G.J. (Cleveland Chiropractic College, Los Angeles, CA (USA))


    The posteroanterior view of the lumbar spine has important features including radiation protection and image quality; these have been studied by various investigators. Investigators have shown that sensitive tissues receive less radiation dosage in the posteroanterior view of the spine for scoliosis screening and intracranial tomography without altering the image quality. This paper emphasizes the importance of the radiation safety aspect of the posteroanterior view and shows the improvement in shape distortion in the lumbar vertebrae.

  17. Fem Modelling of Lumbar Vertebra System

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    Rimantas Kačianauskas


    Full Text Available The article presents modeling of human lumbar vertebra and it‘sdeformation analysis using finite elements method. The problemof tissue degradation is raised. Using the computer aided modelingwith SolidWorks software the models of lumbar vertebra(L1 and vertebra system L1-L4 were created. The article containssocial and medical problem analysis, description of modelingmethods and the results of deformation test for one vertebramodel and for model of 4 vertebras (L1-L4.

  18. CT and MRI assessment and characterization using segmentation and 3D modeling techniques: applications to muscle, bone and brain

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    Paolo Gargiulo


    Full Text Available This paper reviews the novel use of CT and MRI data and image processing tools to segment and reconstruct tissue images in 3D to determine characteristics of muscle, bone and brain.This to study and simulate the structural changes occurring in healthy and pathological conditions as well as in response to clinical treatments. Here we report the application of this methodology to evaluate and quantify: 1. progression of atrophy in human muscle subsequent to permanent lower motor neuron (LMN denervation, 2. muscle recovery as induced by functional electrical stimulation (FES, 3. bone quality in patients undergoing total hip replacement and 4. to model the electrical activity of the brain. Study 1: CT data and segmentation techniques were used to quantify changes in muscle density and composition by associating the Hounsfield unit values of muscle, adipose and fibrous connective tissue with different colors. This method was employed to monitor patients who have permanent muscle LMN denervation in the lower extremities under two different conditions: permanent LMN denervated not electrically stimulated and stimulated. Study 2: CT data and segmentation techniques were employed, however, in this work we assessed bone and muscle conditions in the pre-operative CT scans of patients scheduled to undergo total hip replacement. In this work, the overall anatomical structure, the bone mineral density (BMD and compactness of quadriceps muscles and proximal femoral was computed to provide a more complete view for surgeons when deciding which implant technology to use. Further, a Finite element analysis provided a map of the strains around the proximal femur socket when solicited by typical stresses caused by an implant press fitting. Study 3 describes a method to model the electrical behavior of human brain using segmented MR images. The aim of the work is to use these models to predict the electrical activity of the human brain under normal and pathological

  19. Caracterização da performance muscular em atletas profissionais de futebol Characterization of professional soccer players' muscle performance

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    Sérgio T. da Fonseca


    . However, there is a paucity of data that characterizes the muscular performance in Brazilian professional soccer athletes. Therefore, the objective of this study was to make a descriptive analysis of parameters related to the muscular performance of this population. METHODS: The sample of this study was composed of 117 athletes belonging to professional soccer clubs in Minas Gerais State. In order to evaluate the muscular performance of the athletes, an isokinetic dynamometer was used and the tests involved maximum voluntary contractions of the selected muscles. Hip abductors and adductors were assessed at the speeds of 30º/s, 60º/s and 120º/s; knee flexors and extensors at 60º/s, 180º/s and 300º/s; and ankle dorsiflexors, plantarflexors, invertors and evertors at 30º/s, 60º/s and 180º/s. Descriptive statistics were used to present the normative data and paired t-tests were used to identify significant differences between legs considering the parameters evaluated in this study. RESULTS: This study generated normative data to characterize the profile of Brazilian professional soccer players relative to their capacity of producing torque, muscle work and power. Significant differences were observed between legs considering some of the study's variables. CONCLUSION: The established normative data can be used as reference values in the prevention, training and rehabilitation of the athletes. In addition, these data may be used as reference for future studies with the objective of testing the association between muscular performance and incidence of injury in soccer practice.

  20. Scoliosis secondary to lumbar osteoid osteoma (United States)

    Zhang, Haiping; Niu, Xingbang; Wang, Biao; He, Simin; Hao, Dingjun


    Abstract Rationale: Lumbar osteoid osteoma has a low incidence, which could easily lead to scoliosis. Patient concerns: Scoliosis secondary to lumbar osteoid osteoma could be easily misdiagnosed when patients do not complain of obvious symptoms. Diagnoses: We reported a case of a 9-year-old boy with back deformity that was firstly diagnosed with scoliosis at the local hospital. After prescribed with orthosis, the patient experienced aggravating pain that could not be relieved with painkillers. After he admitted to our hospital for further medical advice, he was prescribed to complete radiological examinations. Considering his radiological examination results and his medical history, correct diagnosis of lumbar osteoid osteoma was made. Interventions: Surgical intervention of posterior lesion resection was conducted after diagnosis. Intra-operative frozen pathology indicated features of osteoid osteoma. As the lesion involved inferior articular process of L5, which could cause lumbar instability after lesion resection, internal fixation was conducted at L4-S1 segment, and posterolateral bone fusion was also conducted at L5-S1 segment. Outcomes: Three months after operation, the patient showed marked improvement of scoliosis deformity and great relief of lumbar pain. Lessons subsections: Although spine osteoid osteoma is clinically rare, it shall not be overlooked when young patients present with scoliosis first. Radiological results including computed tomography and magnetic resonance imaging shall be taken carefully as reference when making diagnosis. Surgical intervention of lesion resection could well improve scoliosis and relieve lumbar pain. PMID:27893671

  1. Preoperative education for lumbar surgery for radiculopathy

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    A. Louw


    Full Text Available To date no studies have been published on preoperative education forpatients who had lumbar surgery. The aim of this study was to determine if there is a demand for preoperative education for patients who had lumbar surgery for radiculopathy. A convenience sample of 47 patients who had lumbar surgery and a random sample of 141 physiotherapists involved in treating patients who had lumbar surgery completed a newly developed spinal surgery questionnaire. The data were analyzed using descriptiveand inferential statistical tests. Results showed that 100% of the patients and 99% of therapists view preoperative education to be an important component for lumbar surgery for radiculopathy. The most important factors identifiedfor inclusion in preoperative educational programs were reason for surgery, risks associated with surgery, limitations following surgery and more education regarding pain. The preferred method of education delivery was verbal one-on-one education. This study demonstrates that there is a demand for preoperative education for patients who had lumbar surgery.

  2. Skeletal muscle (United States)

    There are approximately 650-850 muscles in the human body these include skeletal (striated), smooth and cardiac muscle. The approximation is based on what some anatomists consider separate muscle or muscle systems. Muscles are classified based on their anatomy (striated vs. smooth) and if they are v...

  3. Spinal osteoblastoma: relationship between paravertebral muscle abnormalities and scoliosis

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    Saifuddin, A. [Department of Radiology, Royal National Orthopaedic Hospital Trust, 45-51 Bolsover Street, London W1P 8AQ (United Kingdom)]|[Department of Radiology, Royal National Orthopaedic Hospital Trust, Stanmore (United Kingdom); Sherazi, Z. [Department of Radiology, Royal National Orthopaedic Hospital Trust, Stanmore (United Kingdom); Shaikh, M.I. [Department of Radiology, Royal National Orthopaedic Hospital Trust, Stanmore (United Kingdom); Natali, C. [Department of Orthopaedics, Royal National Orthopaedic Hospital Trust, Stanmore (United Kingdom); Ransford, A.O. [Department of Orthopaedics, Royal National Orthopaedic Hospital Trust, Stanmore (United Kingdom); Pringle, J.A.S. [Department of Histopathology, Royal National Orthopaedic Hospital Trust, Stanmore (United Kingdom)


    Objective. To illustrate the variety of paravertebral muscle abnormalities as seen on computed tomography (CT) or magnetic resonance imaging (MRI) in association with spinal osteoblastomas and correlate the findings with the presence of scoliosis. Design. In a retrospective study the clinical notes, plain radiographic, CT and/or MRI features were reviewed for the presence of scoliosis and paravertebral muscle abnormality (either inflammation or atrophy). Patients. Twelve patients (7 male, 5 female) with a mean age of 17 years were studied. Three lesions occurred in the cervical spine, five in the thoracic spine and four in the lumbar spine. Results and conclusions. Nine patients had scoliosis. All patients with a thoracic or lumbar lesion and scoliosis (n=8) had an associated abnormality of the paravertebral muscles (usually atrophy with fatty replacement). One patient with a lumbar lesion and no scoliosis had normal paravertebral muscles. One patient with a cervical lesion had thoracic scoliosis but no muscle abnormality in the cervical region, while two patients with cervical lesions and no scoliosis showed muscle abnormalities. The results support the clinical hypothesis that scoliosis in patients with spinal osteoblastoma is due to paravertebral muscle spasm, although this would not appear to be the case for cervical lesions. (orig.). With 4 figs., 1 tab.

  4. Foot drop caused by lumbar degenerative disease: clinical features, prognostic factors of surgical outcome and clinical stage.

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    Kun Liu

    Full Text Available OBJECTIVE: The purpose of this study was to analyze the clinical features and prognostic factors of surgical outcome of foot drop caused by lumbar degenerative disease and put forward the clinical stage. METHODS: We retrospectively reviewed 135 patients with foot drop due to lumbar degenerative disease. The clinical features and mechanism were analyzed. Age, sex, duration of palsy, preoperative muscle strength of tibialis anterior (TA, sensation defect of affected lower limb, affected foot, diagnosis and compressed nerve roots were recorded and compared with surgical outcome. RESULTS: Foot drop was observed in 8.1% of all inpatients of lumbar degenerative disease. L5 nerve root compression was observed in 126 of all 135 patients (93.3%. Single, double and triple roots compression was observed respectively in 43, 83, and 9 patients (31.9%, 61.5%, and 6.6%. But there was no significant relationship between preoperative muscle strength of TA and the number of compressed roots. The muscle strength of TA was improved in 113 (83.7% patients after surgery, but it reached to >=4 in only 21 (15.6% patients. Improvement of the muscle strength of TA was almost stable at the 6-month follow-up. At the last follow-up, the muscle strength of TA was 1, 2, 3, 4, 5 respectively in 28, 24, 62, 13, 8 patients. Multivariate logistic regression showed duration of palsy (p=0.0360, OR=2.543, preoperative muscle strength of TA (p=0.0064, OR=5.528 and age (p=0.0309, OR=3.208 were factors that influenced recovery following an operation. CONCLUSIONS: L5 nerve root was most frequently affected. The muscle strength of TA improved in most patients after surgery, but few patients can get a good recovery from foot drop. Patients of shorter duration of palsy, better preoperative muscle strength of TA and younger age showed a better surgical outcome.

  5. Skin, bone and muscle collagen extraction from the trash fish, leather jacket (Odonus niger) and their characterization. (United States)

    Muralidharan, Nagarajan; Jeya Shakila, Robinson; Sukumar, Durairaj; Jeyasekaran, G


    Acid soluble (ASC) and pepsin soluble (PSC) collagens were extracted from the skin, bone and muscle of a trash fish, leather jacket (Odonus niger) by three different extraction methods. Method I gave 46-50% yield for ASC, Method II gave 49-58% yield for both ASC and PSC and Method III gave 64-71% yield for PSC. The addition of pepsin had increased the yield by 30-45%. The yields of collagen from skin and bone were higher than muscle. SDS-PAGE pattern revealed that skin and bone collagen as Type I collagen with a typical (α1)2α2 chains and muscle collagen as Type V collagen with a typical α1α3α2 chains. Td values of bone and muscle collagen were high (30-32 °C) compared to skin collagen (27-28 °C). The higher imino acids (190 residues/1,000 residues) were found responsible for the higher Td values. The trash fish, leather jacket can therefore be exploited effectively for collagen as it has got good thermal properties for pharmaceutical and biomedical applications.

  6. Molecular characterization of the Akt-TOR signaling pathway in rainbow trout: potential role in muscle growth/degradation (United States)

    The Akt-TOR signaling pathway plays a key role in cellular metabolism and muscle growth. Hormone, nutrition and stress factors affect the Akt-TOR pathway by regulating gene transcription, protein synthesis and degradation. In addition, we previously showed that energetic demands elevate during vit...

  7. A Comparative Study of Lateral Lumbar Interbody Fusion and Posterior Lumbar Interbody Fusion in Degenerative Lumbar Spondylolisthesis (United States)

    Hughes, Alexander P.; Sama, Andrew A.; Girardi, Federico P.; Lebl, Darren R.; Cammisa, Frank P.


    Study Design Level 4 retrospective review. Purpose To compare the radiographic and clinical outcomes between posterior lumbar interbody fusion (PLIF) and lateral lumbar interbody fusion (LLIF) with posterior segmental spinal instrumentation (SSI) for degenerative lumbar spondylolisthesis. Overview of Literature Both PLIF and LLIF have been performed for degenerative spondylolisthesis with good results, but no study has directly compared these two techniques so far. Methods The electronic medical and radiographic records of 78 matched patients were analyzed. In one group, 39 patients underwent PLIF with SSI at 41 levels (L3-4/L4-5), while in the other group, 39 patients underwent the LLIF procedure at 48 levels (L3-4/L4-5). Radiological outcomes such as restoration of disc height and neuroforaminal height, segmental lumbar lordosis, total lumbar lordosis, incidence of endplate fracture, and subsidence were measured. Perioperative parameters were also recorded in each group. Clinical outcome in both groups was assessed by the short form-12, Oswestry disability index and visual analogue scale scores. The average follow-up period was 16.1 months in the LLIF group and 21 months in the PLIF group. Results The restoration of disc height, foraminal height, and segmental lumbar lordosis was significantly better in the LLIF group (p<0.001). The duration of the operation was similar in both groups, but the average blood loss was significantly lower in the LLIF group (p<0.001). However, clinical outcome scores were similar in both groups. Conclusions Safe, effective interbody fusion can be achieved at multiple levels with neuromonitoring by the lateral approach. LLIF is a viable treatment option in patients with new onset symptoms due to degenerative spondylolisthesis who have had previous lumbar spine surgery, and it results in improved sagittal alignment and indirect foraminal decompression. PMID:26435782

  8. Mechanical characterization of the mouse diaphragm with optical coherence elastography reveals fibrosis-related change of direction-dependent muscle tissue stiffness (United States)

    Wang, Shang; Loehr, James A.; Larina, Irina V.; Rodney, George G.; Larin, Kirill V.


    The diaphragm, composed of skeletal muscle, plays an important role in respiration through its dynamic contraction. Genetic and molecular studies of the biomechanics of mouse diaphragm can provide great insights into an improved understanding and potential treatment of the disorders that lead to diaphragm dysfunction (i.e. muscular dystrophy). However, due to the small tissue size, mechanical assessment of mouse diaphragm tissue under its proper physiological conditions has been challenging. Here, we present the application of noncontact optical coherence elastography (OCE) for quantitative elastic characterization of ex vivo mouse diaphragm. Phase-sensitive optical coherence tomography was combined with a focused air-puff system to capture and measure the elastic wave propagation from tissue surface. Experiments were performed on wildtype and dystrophic mouse diaphragm tissues containing different levels of fibrosis. The OCE measurements of elastic wave propagation were conducted along both the longitudinal and transverse axis of the muscle fibers. Cross-correlation of the temporal displacement profiles from different spatial locations was utilized to obtain the propagation time delay, which was used to calculate the wave group velocity and to further quantify the tissue Young's modulus. Prior to and after OCE assessment, peak tetanic force was measured to monitor viability of the tissue during the elasticity measurements. Our experimental results indicate a positive correlation between fibrosis level and tissue stiffness, suggesting this elastic-wave-based OCE method could be a useful tool to monitor mechanical properties of skeletal muscle under physiological and pathological conditions.

  9. Characterization of RyR1-slow, a ryanodine receptor specific to slow-twitch skeletal muscle. (United States)

    Morrissette, J; Xu, L; Nelson, A; Meissner, G; Block, B A


    Two distinct skeletal muscle ryanodine receptors (RyR1s) are expressed in a fiber type-specific manner in fish skeletal muscle (11). In this study, we compare [(3)H]ryanodine binding and single channel activity of RyR1-slow from fish slow-twitch skeletal muscle with RyR1-fast and RyR3 isolated from fast-twitch skeletal muscle. Scatchard plots indicate that RyR1-slow has a lower affinity for [(3)H]ryanodine when compared with RyR1-fast. In single channel recordings, RyR1-slow and RyR1-fast had similar slope conductances. However, the maximum open probability (P(o)) of RyR1-slow was threefold less than the maximum P(o) of RyR1-fast. Single channel studies also revealed the presence of two populations of RyRs in tuna fast-twitch muscle (RyR1-fast and RyR3). RyR3 had the highest P(o) of all the RyR channels and displayed less inhibition at millimolar Ca(2+). The addition of 5 mM Mg-ATP or 2.5 mM beta, gamma-methyleneadenosine 5'-triphosphate (AMP-PCP) to the channels increased the P(o) and [(3)H]ryanodine binding of both RyR1s but also caused a shift in the Ca(2+) dependency curve of RyR1-slow such that Ca(2+)-dependent inactivation was attenuated. [(3)H]ryanodine binding data also showed that Mg(2+)-dependent inhibition of RyR1-slow was reduced in the presence of AMP-PCP. These results indicate differences in the physiological properties of RyRs in fish slow- and fast-twitch skeletal muscle, which may contribute to differences in the way intracellular Ca(2+) is regulated in these muscle types.

  10. An update on the management of chronic lumbar discogenic pain. (United States)

    Manchikanti, Laxmaiah; Hirsch, Joshua A


    Lumbar degenerative disc disease without disc herniation, also known as discogenic pain, is an elusive diagnosis of chronic low back pain. Lumbar provocation discography and fusion surgery have been frequently utilized for several decades as the gold standards for the diagnosis and treatment of symptomatic lumbar discogenic pain, though controversial, based on conjecture, rather than evidence. In addition to lumbar fusion, various other operative and nonoperative modalities of treatments are available in managing chronic lumbar discogenic pain. This review provides an updated assessment of the management of chronic lumbar discogenic pain with a critical look at the many modalities of treatments that are currently available.

  11. Spinaplasty following lumbar laminectomy for multilevel lumbar spinal stenosis to prevent iatrogenic instability

    Directory of Open Access Journals (Sweden)

    Surendra Mohan Tuli


    Conclusion: Spinaplasty following posterior decompression for multilevel lumbar canal stenosis is a simple operation, without any serious complications, retaining median structures, maintaining the tension band and the strength with least disturbance of kinematics, mobility, stability and lordosis of the lumbar spine.

  12. Muscle Deoxygenation Causes Muscle Fatigue (United States)

    Murthy, G.; Hargens, A. R.; Lehman, S.; Rempel, D.


    Muscle fatigue is a common musculoskeletal disorder in the work place, and may be a harbinger for more disabling cumulative trauma disorders. Although the cause of fatigue is multifactorial, reduced blood flow and muscle oxygenation may be the primary factor in causing muscle fatigue during low intensity muscle exertion. Muscle fatigue is defined as a reduction in muscle force production, and also occurs among astronauts who are subjected to postural constraints while performing lengthy, repetitive tasks. The objectives of this research are to: 1) develop an objective tool to study the role of decreased muscle oxygenation on muscle force production, and 2) to evaluate muscle fatigue during prolonged glovebox work.

  13. Characterization of distinct mesenchymal-like cell populations from human skeletal muscle in situ and in vitro

    Energy Technology Data Exchange (ETDEWEB)

    Lecourt, Severine, E-mail: [UPMC/AIM UMR S 974, Groupe Hospitalier Pitie-Salpetriere, Paris (France); INSERM U974, Groupe Hospitalier Pitie-Salpetriere, Paris (France); CNRS UMR 7215, Groupe Hospitalier Pitie-Salpetriere, Paris (France); Laboratoire de Therapie Cellulaire, Hopital Saint Louis, Paris (France); Marolleau, Jean-Pierre, E-mail: [Laboratoire de Therapie Cellulaire, Hopital Saint Louis, Paris (France); CHU Amiens Hopital Sud, Service d' Hematologie Clinique, UPJV, Amiens (France); Fromigue, Olivia, E-mail: [INSERM U606, Universite Paris 07, Hopital Lariboisiere, Paris (France); Vauchez, Karine, E-mail: [UPMC/AIM UMR S 974, Groupe Hospitalier Pitie-Salpetriere, Paris (France); INSERM U974, Groupe Hospitalier Pitie-Salpetriere, Paris (France); CNRS UMR 7215, Groupe Hospitalier Pitie-Salpetriere, Paris (France); Genzyme S.A.S., Saint-Germain en Laye (France); Andriamanalijaona, Rina, E-mail: [Laboratoire de Biochimie des Tissus Conjonctifs, Faculte de Medecine, Caen (France); Ternaux, Brigitte, E-mail: [Laboratoire de Therapie Cellulaire, Hopital Saint Louis, Paris (France); Lacassagne, Marie-Noelle, E-mail: [Laboratoire de Therapie Cellulaire, Hopital Saint Louis, Paris (France); Robert, Isabelle, E-mail: [Laboratoire de Therapie Cellulaire, Hopital Saint Louis, Paris (France); Boumediene, Karim, E-mail: [Laboratoire de Biochimie des Tissus Conjonctifs, Faculte de Medecine, Caen (France); Chereau, Frederic, E-mail: [Myosix S.A., Saint-Germain en Laye (France); Marie, Pierre, E-mail: [INSERM U606, Universite Paris 07, Hopital Lariboisiere, Paris (France); and others


    Human skeletal muscle is an essential source of various cellular progenitors with potential therapeutic perspectives. We first used extracellular markers to identify in situ the main cell types located in a satellite position or in the endomysium of the skeletal muscle. Immunohistology revealed labeling of cells by markers of mesenchymal (CD13, CD29, CD44, CD47, CD49, CD62, CD73, CD90, CD105, CD146, and CD15 in this study), myogenic (CD56), angiogenic (CD31, CD34, CD106, CD146), hematopoietic (CD10, CD15, CD34) lineages. We then analysed cell phenotypes and fates in short- and long-term cultures of dissociated muscle biopsies in a proliferation medium favouring the expansion of myogenic cells. While CD56{sup +} cells grew rapidly, a population of CD15{sup +} cells emerged, partly from CD56{sup +} cells, and became individualized. Both populations expressed mesenchymal markers similar to that harboured by human bone marrow-derived mesenchymal stem cells. In differentiation media, both CD56{sup +} and CD15{sup +} cells shared osteogenic and chondrogenic abilities, while CD56{sup +} cells presented a myogenic capacity and CD15{sup +} cells presented an adipogenic capacity. An important proportion of cells expressed the CD34 antigen in situ and immediately after muscle dissociation. However, CD34 antigen did not persist in culture and this initial population gave rise to adipogenic cells. These results underline the diversity of human muscle cells, and the shared or restricted commitment abilities of the main lineages under defined conditions.

  14. Muscle disorder (United States)

    Myopathic changes; Myopathy; Muscle problem ... Blood tests sometimes show abnormally high muscle enzymes. If a muscle disorder might also affect other family members, genetic testing may be done. When someone has symptoms and signs ...

  15. Neurogenic muscle hypertrophy: a case report (United States)

    Shin, Hyun Ho; Jeon, Young Hoon; Jang, Seung Won


    Muscular hypertrophy is caused mainly due to myopathic disorder. But, it is also rarely produced by neurogenic disorder. A 74-year-old woman complained of right calf pain with hypertrophy for several years. Recent lumbar spine magnetic resonance imaging (MRI) showed central and lateral canal narrowing at the L4-L5 intervertebral space. Lower extremity MRI revealed fatty change of right medial head of the gastrocnemius and soleus, causing right calf hypertrophy. Electrodiagnostic examinations including electromyography and nerve conduction velocity testing demonstrated 5th lumbar and 1st sacral polyradiculopathy. Integrating all the results, the diagnosis was neurogenic muscle hypertrophy. Neurogenic muscle hypertrophy is very rare, but we recommend that clinicians consider this problem when a patient complains of lower limb hypertrophy and pain.

  16. Co-occurrence of lumbar spondylolysis and lumbar disc herniation with lumbosacral nerve root anomaly

    Directory of Open Access Journals (Sweden)

    Tevfik Yilmaz


    Full Text Available Lumbosacral nerve root anomalies are the leading cause of lumbar surgery failures. Although co-occurrence of lumbar spondylolysis and disc herniation is common, it is very rare to observe that a nerve root anomaly accompanies these lesions. A 49-year-old male patient presented with sudden-onset right leg pain. Examinations revealed L5/S1 lumbar spondylolysis and disc herniation. At preoperative period, he was also diagnosed with lumbosacral root anomaly. Following discectomy and root decompression, stabilization was performed. The complaints of the patient diagnosed with lumbosacral root anomaly at intraoperative period were improved at postoperative period. It should be remembered that in patients with lumbar disc herniation and spondylolysis, lumbar root anomalies may coexist when clinical and neurological picture is severe. Preoperative and perioperative assessments should be made meticulously to prevent neurological injury.

  17. The effects of backward adjustable thoracic support in wheelchair on spinal curvature and back muscle activation for elderly people.

    Directory of Open Access Journals (Sweden)

    Chun-Ting Li

    Full Text Available To investigate the effects of backward adjustable thoracic support on spinal curvature and back muscle activation during wheelchair sitting.Twenty elderly people were recruited for this study. The backward adjustable thoracic support sitting posture was compared with the slumped, normal, and lumbar support sitting postures. Spinal curvatures (pelvic, lumbar, and thoracic angles and muscle activations of 4 back muscles on both sides (maximal voluntary isometric contraction of the lumbar multifidus, lumbar erector spinae, iliocostalis lumborum pars thoracis, and thoracic erector spinae at T9 were measured and compared between the different sitting postures using one-way analysis of variance with repeated measures.The backward adjustable thoracic support sitting posture showed a relatively neutral pelvic tilt (-0.32±4.80° when compared with the slumped (22.84±5.27° and lumbar support (-8.97±3.31° sitting postures (P<0.001, and showed relatively higher lumbar lordosis (-23.38±6.50° when compared with the slumped (14.77±7.83°, normal (0.44±7.47°, and lumbar support (-16.76±4.77° sitting postures (P<0.05. It also showed relatively lower back muscle activity when compared with the normal and lumbar support sitting postures (P<0.05.The backward adjustable thoracic support sitting concept was suggested because it maintains a more neutral pelvic tilt, higher lumbar lordosis, and lower back muscle activation, which may help maintain a better sitting posture and reduce the risk of back pain.

  18. Footwear affects the behavior of low back muscles when jogging. (United States)

    Ogon, M; Aleksiev, A R; Spratt, K F; Pope, M H; Saltzman, C L


    Use of modified shoes and insole materials has been widely advocated to treat low back symptoms from running impacts, although considerable uncertainty remains regarding the effects of these devices on the rate of shock transmission to the spine. This study investigated the effects of shoes and insole materials on a) the rate of shock transmission to the spine, b) the temporal response of spinal musculature to impact loading, and c) the time interval between peak lumbar acceleration and peak lumbar muscle response. It was hypothesised that shoes and inserts a) decrease the rate of shock transmission, b) decrease the low back muscle response time, and c) shorten the time interval between peak lumbar acceleration and peak lumbar muscle response. Twelve healthy subjects were tested while jogging barefoot (unshod) or wearing identical athletic shoes (shod). Either no material, semi-rigid (34 Shore A), or soft (9.5 Shore A) insole material covered the force plate in the barefoot conditions and was placed as insole when running shod. Ground reaction forces, acceleration at the third lumbar level, and erector spinae myoelectric activity were recorded simultaneously. The rate of shock transmission to the spine was greater (p < 0.0003) unshod (acceleration rate: Means +/- SD 127.35 +/- 87.23 g/s) than shod (49.84 +/- 33.98 g/s). The temporal response of spinal musculature following heel strike was significantly shorter (p < 0.023) unshod (0.038 +/- 0.021 s) than shod (0.047 +/- 0.036 s). The latency between acceleration peak (maximal external force) and muscle response peak (maximal internal force) was significantly (p < 0.021) longer unshod (0.0137 +/- 0.022s) than shod (0.004 +/- 0.040 s). These results suggest that one of the benefits of running shoes and insoles is improved temporal synchronization between potentially destabilizing external forces and stabilizing internal forces around the lumbar spine.

  19. Differences between two subgroups of low back pain patients in lumbopelvic rotation and symmetry in the erector spinae and hamstring muscles during trunk flexion when standing. (United States)

    Kim, Min-hee; Yoo, Won-gyu; Choi, Bo-ram


    The present study was performed to examine lumbopelvic rotation and to identify asymmetry of the erector spinae and hamstring muscles in people with and without low back pain (LBP). The control group included 16 healthy subjects, the lumbar-flexion-rotation syndrome LBP group included 17 subjects, and the lumbar-extension-rotation syndrome LBP group included 14 subjects. Kinematic parameters were recorded using a 3D motion-capture system, and electromyography parameters were measured using a Noraxon TeleMyo 2400T. The two LBP subgroups showed significantly more lumbopelvic rotation during trunk flexion in standing than did the control group. The muscle activity and flexion-relaxation ratio asymmetries of the erector spinae muscles in the lumbar-flexion-rotation syndrome LBP group were significantly greater than those in the control group, and the muscle activity and flexion-relaxation ratio asymmetry of the hamstring muscles in the lumbar-extension-rotation syndrome LBP group were significantly greater than those in the control group. Imbalance or asymmetry of passive tissue could lead to asymmetry of muscular activation. Muscle imbalance can cause asymmetrical alignment or movements such as unexpected rotation. The results showed a greater increase in lumbopelvic rotation during trunk flexion in standing among the lumbar-flexion-rotation syndrome and lumbar-extension-rotation syndrome LBP groups compared with the control group. The differences between the two LBP subgroups may be a result of imbalance and asymmetry in erector spinae and hamstring muscle properties.

  20. MRI after successful lumbar discectomy

    Energy Technology Data Exchange (ETDEWEB)

    Goethem, J.W.M. van [Department of Radiology, University of Antwerp, Wilrijkstraat 10, B-2650 Edegem (Belgium); Kelft, E. van de [Department of Neurosurgery, University of Antwerp, Edegem (Belgium); Biltjes, I.G.G.M. [Department of Radiology, University of Antwerp, Wilrijkstraat 10, B-2650 Edegem (Belgium); Hasselt, B.A.A.M. van [Department of Radiology, University of Antwerp, Wilrijkstraat 10, B-2650 Edegem (Belgium); Hauwe, L. van den [Department of Radiology, University of Antwerp, Wilrijkstraat 10, B-2650 Edegem (Belgium); Parizel, P.M. [Department of Radiology, University of Antwerp, Wilrijkstraat 10, B-2650 Edegem (Belgium); Schepper, A.M.A. de [Department of Radiology, University of Antwerp, Wilrijkstraat 10, B-2650 Edegem (Belgium)


    Our aim was to establish the normal range of MRI findings after successful lumbar discectomy. We prospectively examined 34 consecutive patients with an excellent clinical outcome by MRI 6 weeks and 6 months after surgery. All examinations included sagittal and axial spin-echo (SE) T1-weighted images before and after intravenous gadolinium-DTPA and fast SE T2-weighted images. Contrast enhancement along the surgical tract was seen in all patients 6 weeks and 6 months after surgery. After 6 months minimal or no mass effect on the dural sac by epidural scar was seen. In 20 % of patients there was recurrent disc herniation, with mass effect. Enhancing nerve roots were seen in 20 % of patients 6 weeks postoperatively, and half of these were associated with recurrent disc herniation at the same side. None of these patients still showed nerve root enhancement 6 months after surgery. Postoperative MRI studies must be interpreted with great care since the features described in the failed back surgery syndrome are also found, to some extent, in asymptomatic postoperative patients. (orig.). With 7 figs., 2 tabs.

  1. MR-guided lumbar sympathicolysis

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    Koenig, Claudius W.; Schott, Ulrich G.; Pereira, Philippe L.; Truebenbach, Jochen; Claussen, Claus D.; Duda, Stephan H. [Department of Diagnostic Radiology, University of Tuebingen (Germany); Schneider, Wilke [Department of Vascular Surgery, University of Tuebingen (Germany)


    The aim of this study was to demonstrate the feasibility of MR-guided lumbar sympathicolysis (LSL) in a non-selected patient population. One hundred one MR-guided LSL procedures were performed in 89 patients according to Haaga's technique using a horizontally open clinical MR system (0.2 T) and non-ferromagnetic 20-G cannulas (neurolysis, n=93; blockade, n=8). Only gradient-recalled sequences in either single or multislice mode [fast imaging with steady-state precession (FISP) and fast low-angle shot] were applied for anatomical survey and needle guiding. Bupivacaine injection was monitored with MR fluoroscopically. Fluid distribution was subsequently documented in a CT scan in 65 patients. Ninety-one LSL procedures could be successfully completed. Ten patients were not treated using MR due to patient inconvenience, severe motion artifacts (n=4 each), excessive spondylophytes, and retroperitoneal hematoma (n=1 each). One case of ureteral necrosis occurred. Motion artifacts were rated less severe in single-slice FISP sequences and in obese patients. An average of 3.48 sequence measurements were required for definitive needle placement. Average table time was 32.3 min. An MR-guided LSL is feasible and can be performed with acceptable safety and time effort. It can be recommended for repeated sympathetic blockades in younger patients to avoid cumulative irradiation associated with CT guidance. (orig.)

  2. Petit lumbar hernia--a double-layer technique for tension-free repair. (United States)

    Bigolin, André Vicente; Rodrigues, André Petter; Trevisan, Camila Gueresi; Geist, Ana Brochado; Coral, Roberto Viña; Rinaldi, Natalino; Coral, Roberto Pelegrini


    This report describes an alternative technique for Petit hernia repair. The treatment of lumbar hernias should follow the concept of tension-free surgery, and the preperitoneal space can be the best place for prosthesis placement. An obese patient had a bulge in the right lumbar region, which gradually grew and became symptomatic, limiting her daily activities and jeopardizing her quality of life. She had previously undergone 2 surgical procedures with different incisions. We created a preperitoneal space and attached a mesh in this position. Another prosthesis was placed on the muscles, with a suitable edge beyond the limits of the defect. There were no complications. It has been described as a safe and tension-free repair for Petit hernia. In larger defects, a second mesh can be used to prevent further enlargement of the triangle and also to provide additional protection beyond the bone limits.

  3. Effect of compressive follower preload on the flexion-extension response of the human lumbar spine. (United States)

    Patwardhan, Avinash G; Havey, Robert M; Carandang, Gerard; Simonds, James; Voronov, Leonard I; Ghanayem, Alexander J; Meade, Kevin P; Gavin, Thomas M; Paxinos, Odysseas


    Traditional experimental methods are unable to study the kinematics of whole lumbar spine specimens under physiologic compressive preloads because the spine without active musculature buckles under just 120 N of vertical load. However, the lumbar spine can support a compressive load of physiologic magnitude (up to 1200 N) without collapsing if the load is applied along a follower load path. This study tested the hypothesis that the load-displacement response of the lumbar spine in flexion-extension is affected by the magnitude of the follower preload and the follower preload path. Twenty-one fresh human cadaveric lumbar spines were tested in flexion-extension under increasing compressive follower preload applied along two distinctly different optimized preload paths. The first (neutral) preload path was considered optimum if the specimen underwent the least angular change in its lordosis when the full range of preload (0-1200 N) was applied in its neutral posture. The second (flexed) preload path was optimized for an intermediate specimen posture between neutral and full flexion. A twofold increase in flexion stiffness occurred around the neutral posture as the preload was increased from 0 to 1200 N. The preload magnitude (400 N and larger) significantly affected the range of motion (ROM), with a 25% decrease at 1200 N preload applied along the neutral path. When the preload was applied along a path optimized for an intermediate forward-flexed posture, only a 15% decrease in ROM occurred at 1200 N. The results demonstrate that whole lumbar spine specimens can be subjected to compressive follower preloads of in vivo magnitudes while allowing physiologic mobility under flexion-extension moments. The optimized follower preload provides a method to simulate the resultant vector of the muscles that allow the spine to support physiologic compressive loads induced during flexion-extension activities.

  4. Characterization and ontogenetic expression analysis of the myosin light chains from the fast white muscle of mandarin fish Siniperca chuatsi. (United States)

    Chu, W Y; Chen, J; Zhou, R X; Zhao, F L; Meng, T; Chen, D X; Nong, X X; Liu, Z; Lu, S Q; Zhang, J S


    Three full-length complementary DNA (cDNA) clones were isolated encoding the skeletal myosin light chain 1 (MLC1; 1237 bp), myosin light chain 2 (MLC2; 1206 bp) and myosin light chain 3 (MLC3; 1079 bp) from the fast white muscle cDNA library of mandarin fish Siniperca chuatsi. The sequence analysis indicated that MLC1 and MLC3 were not produced from differentially spliced messenger RNAs (mRNA) as reported in birds and rodents but were encoded by different genes. The MLC2 encodes 170 amino acids, which include four EF-hand (helix-loop-helix) structures. The primary structures of the Ca(2+)-binding domain were well conserved among the MLC2s of seven other fish species. The ontogenetic expression analysis by real-time PCR showed that the three light-chain mRNAs were first detected in the gastrula stage, and their expression increased from the tail bud stage to the larval stage. All three MLC mRNAs showed longitudinal expression variation in the fast white muscle of S. chuatsi, especially MLC1 which was highly expressed at the posterior area. Taken together, the study provides a better understanding about the MLC gene structure and their expression pattern in muscle development of S. chuatsi.

  5. Economic impact of minimally invasive lumbar surgery (United States)

    Hofstetter, Christoph P; Hofer, Anna S; Wang, Michael Y


    Cost effectiveness has been demonstrated for traditional lumbar discectomy, lumbar laminectomy as well as for instrumented and noninstrumented arthrodesis. While emerging evidence suggests that minimally invasive spine surgery reduces morbidity, duration of hospitalization, and accelerates return to activites of daily living, data regarding cost effectiveness of these novel techniques is limited. The current study analyzes all available data on minimally invasive techniques for lumbar discectomy, decompression, short-segment fusion and deformity surgery. In general, minimally invasive spine procedures appear to hold promise in quicker patient recovery times and earlier return to work. Thus, minimally invasive lumbar spine surgery appears to have the potential to be a cost-effective intervention. Moreover, novel less invasive procedures are less destabilizing and may therefore be utilized in certain indications that traditionally required arthrodesis procedures. However, there is a lack of studies analyzing the economic impact of minimally invasive spine surgery. Future studies are necessary to confirm the durability and further define indications for minimally invasive lumbar spine procedures. PMID:25793159

  6. Tractography of lumbar nerve roots: initial results

    Energy Technology Data Exchange (ETDEWEB)

    Balbi, Vincent; Budzik, Jean-Francois; Thuc, Vianney le; Cotten, Anne [Hopital Roger Salengro, Service de Radiologie et d' Imagerie musculo-squelettique, Lille Cedex (France); Duhamel, Alain [Universite de Lille 2, UDSL, Lille (France); Bera-Louville, Anne [Service de Rhumatologie, Hopital Roger Salengro, Lille (France)


    The aims of this preliminary study were to demonstrate the feasibility of in vivo diffusion tensor imaging (DTI) and fibre tracking (FT) of the lumbar nerve roots, and to assess potential differences in the DTI parameters of the lumbar nerves between healthy volunteers and patients suffering from disc herniation. Nineteen patients with unilateral sciatica related to posterolateral or foraminal disc herniation and 19 healthy volunteers were enrolled in this study. DTI with tractography of the L5 or S1 nerves was performed. Mean fractional anisotropy (FA) and mean diffusivity (MD) values were calculated from tractography images. FA and MD values could be obtained from DTI-FT images in all controls and patients. The mean FA value of the compressed lumbar nerve roots was significantly lower than the FA of the contralateral nerve roots (p=0.0001) and of the nerve roots of volunteers (p=0.0001). MD was significantly higher in compressed nerve roots than in the contralateral nerve root (p=0.0002) and in the nerve roots of volunteers (p=0.04). DTI with tractography of the lumbar nerves is possible. Significant changes in diffusion parameters were found in the compressed lumbar nerves. (orig.)

  7. Integration core exercises elicit greater muscle activation than isolation exercises. (United States)

    Gottschall, Jinger S; Mills, Jackie; Hastings, Bryce


    The American College of Sports Medicine and the United States Department of Health and Human Services advocate core training as a means to improve stability, reduce injury, and maintain mobility. There are countless exercises that target the primary core trunk muscles (abdominal and lumbar) with the aim of providing these benefits. However, it is unknown as to which exercises elicit the greatest activation thereby maximizing functional gains and peak performance. Thus, our purpose was to determine whether integration core exercises that require activation of the distal trunk muscles (deltoid and gluteal) elicit greater activation of primary trunk muscles in comparison with isolation core exercises that only require activation of the proximal trunk muscles. Twenty participants, 10 men and 10 women, completed 16 randomly assigned exercises (e.g., crunch, upper body extension, and hover variations). We measured muscle activity with surface electromyography of the anterior deltoid, rectus abdominus, external abdominal oblique, lumbar erector spinae, thoracic erector spinae, and gluteus maximus. Our results indicate that the activation of the abdominal and lumbar muscles was the greatest during the exercises that required deltoid and gluteal recruitment. In conclusion, when completing the core strength guidelines, an integrated routine that incorporates the activation of distal trunk musculature would be optimal in terms of maximizing strength, improving endurance, enhancing stability, reducing injury, and maintaining mobility.

  8. Tuina Therapy for Prolapsed Lumbar Intervertebral Disc

    Institute of Scientific and Technical Information of China (English)

    ZHANG Bi-meng; WU Huan-gan; SHEN Jian; XIAO Yuan-chun


    Recurrent low back pain and reflex sciatica of lower limbs are the two leading symptoms of prolapsed lumbar intervertebral disc, which can be confirmed in the history, symptoms, signs and imaging examination such as CT scan and MRI. It should be differentiated from those conditions characterized by lumbago and/or possible sciatica. Tuina was performed mostly on the Bladder Meridian,Gallbladder Meridian and Governor Vessel, as well as their acupoints such as Jiaji (Ex-B 2) points,Shenshu (BL 23), Dachangshu (BL 25), Yaoyangguan (GV 3), Huantiao (GB 30), Weizhong (BL 40),Chengshan (BL 57), Yanglingquan (GB 34) and Ashi points. Thumb-massaging manipulation, rolling manipulation, pulling manipulation, pressing manipulation, kneading manipulation and grasping manipulation are often performed.%反复下腰痛和下肢反射性坐骨神经痛是腰椎间盘突出症的两大症状.根据病史、症状、体征以及影像学(包括CT、MRI等)结果,可以确诊.需与以腰痛为主要表现的疾病,以腰痛伴坐骨神经痛为主要表现的疾病和以坐骨神经痛为主要表现的疾病相鉴别.推拿保守治疗多以足太阳膀胱经、足少阳胆经及督脉为主,取相应的夹脊穴、肾俞、大肠俞、腰阳关、环跳、委中、承山、阳陵泉及阿是穴等以一指禅推法、滚法、扳法、按法、揉法和拿法等进行治疗.

  9. CT five years after myelographic diagnosis of lumbar disk herniation

    Energy Technology Data Exchange (ETDEWEB)

    Hurme, M.; Katevuo, K.; Nykvist, F.; Aalto, T.; Alaranta, H.; Einola, S. (Turku Univ. Central Hospital (Finland). Dept. of Surgery Turku Univ. Central Hospital (Finland). Dept. of Diagnostic Radiology Social Insurance Inst., Turku (Finland). Rehabilitation Research Centre)


    Fifty-seven patients were examined with CT 5 years after primary myelography for disabling sciatica and suspected herniated lumbar disk. Forty were in an operated group, 22 with good and 18 with poor results evaluated by occupational handicap (21) 5 years after surgery. Seventeen patients had myelography indicating disk herniation, but were treated conservatively, 9 with good and 8 with poor result. Various spinal dimensions measured at CT did not correlate with outcome. Operated patients had narrower canals than others, and male canals were broader than those in females. Increased amount of scar tissue at L4 level correlated with poor result (p=0.008). Operated patients with poor result had more advanced lateral stenosis than those treated conservatively (p<0.001). Patients with good result after operation had more degeneration observed on CT of erector spinae muscle than those treated conservatively with good outcome. Only 9% of operated patients did not have muscle degeneration. A tendency for more frequent recurrent disk herniations could be ssen for conservatively treated patients. The narrowing of the spinal canal 5 years after operation did not correlate with the 5-year outcome. (orig.).

  10. Age-related changes in muscle strength and spinal kyphosis angles in an elderly Japanese population. (United States)

    Kasukawa, Yuji; Miyakoshi, Naohisa; Hongo, Michio; Ishikawa, Yoshinori; Kudo, Daisuke; Suzuki, Masazumi; Mizutani, Takashi; Kimura, Ryouta; Ono, Yuichi; Shimada, Yoichi


    Lumbar kyphosis and the decreased mobility of the lumbar spine increase the risk of falls and impair both the quality of life and the ability to perform activities of daily living. However, in the elderly Japanese population, little is known about the age-related changes and sex-related differences in muscle strength, including of the upper and lower extremities and back extensors. An adequate kyphotic or lordotic angle has also not been determined. In this study, we evaluated the age-related changes in muscle strength and spinal kyphosis in 252 males and 320 females ≥50 years of age. Grip, back extensor, hip flexor, and knee extensor strength; thoracic and lumbar kyphosis; and spinal inclination in the neutral standing position were assessed, together with the range of motion of the thoracic and lumbar spine and spinal inclination. Grip strength, back extensor strength, and the strength of the hip flexors and knee extensors decreased significantly with aging, both in males (Pstrength and the thoracic kyphosis angle were significant variables influencing the lumbar kyphosis angle in both sexes. Spinal inclination correlated significantly with both the lumbar kyphosis angle and hip flexor strength in males, as well as with the lumbar kyphosis angle in females.

  11. Laparoscopic lumbar hernia repair in a child with lumbocostovertebral syndrome. (United States)

    Jones, Sarah L; Thomas, Iona; Hamill, James


    Lumbocostovertebral syndrome is the association of a congenital lumbar hernia with rib and vertebral anomalies. We report the first case of a laparoscopic repair of a lumbar hernia in a child with lumbocostovertebral syndrome. Laparoscopic lumbar hernia repair appears to be safe and feasible in children.

  12. 49 CFR 572.9 - Lumbar spine, abdomen, and pelvis. (United States)


    ... 49 Transportation 7 2010-10-01 2010-10-01 false Lumbar spine, abdomen, and pelvis. 572.9 Section... Percentile Male § 572.9 Lumbar spine, abdomen, and pelvis. (a) The lumbar spine, abdomen, and pelvis consist... minutes after the release. (d) When the abdomen is subjected to continuously applied force in...

  13. 49 CFR 572.19 - Lumbar spine, abdomen and pelvis. (United States)


    ... 49 Transportation 7 2010-10-01 2010-10-01 false Lumbar spine, abdomen and pelvis. 572.19 Section 572.19 Transportation Other Regulations Relating to Transportation (Continued) NATIONAL HIGHWAY...-Year-Old Child § 572.19 Lumbar spine, abdomen and pelvis. (a) The lumbar spine, abdomen, and...

  14. 49 CFR 572.115 - Lumbar spine and pelvis. (United States)


    ... 49 Transportation 7 2010-10-01 2010-10-01 false Lumbar spine and pelvis. 572.115 Section 572.115... 50th Percentile Male § 572.115 Lumbar spine and pelvis. The specifications and test procedure for the lumbar spine and pelvis are identical to those for the SID dummy as set forth in § 572.42 except that...

  15. Relationship between New Osteoporotic Vertebral Fracture and Instrumented Lumbar Arthrodesis


    Kim, Bung-Hak; Choi, Dong-Hyuk; Jeon, Seong-Hun; Choi, Yong-Soo


    Study Design Retrospective study. Purpose To evaluate the relationship between a new osteoporotic vertebral fracture and instrumented lumbar arthrodesis. Overview of Literature In contrast to the growing recognition of the importance of adjacent segment disease after lumbar arthrodesis, relatively little attention has been paid to the relationship between osteoporotic vertebral fractures and instrumented lumbar arthrodesis. Methods Twenty five patients with a thoracolumbar vertebral fracture ...

  16. Development of the multi-segment lumbar spine for humanoid robots

    Directory of Open Access Journals (Sweden)

    Penčić Marko M.


    Full Text Available The paper presents development of multi-segment lumbar structure based on the human spine. The research is performed within the project based on development of socially acceptable robot named "SARA". Two approaches for spine realization of humanoids exist: multi-joint viscoelastic structures (5-10 joints that have variable flexibility and structures that consist of one joint - torso/waist joint, which has low elasticity and high stiffness. We propose multi-joint flexible structure with stiff, low backlash and self-locking mechanisms that require small actuators. Based on kinematic-dynamic requirements dynamical model of robot is formed. Dynamical simulation is performed for several postures of the robot and driving torques of lumbar structure are determined. During development of the lumbar structure 16 variant solutions are considered. Developed lumbar structure consists of three equal segments, it has 6 DOFs (2 DOFs per segment and allows movements of lateral flexion ±30° and torsion ±45°, as well as the combination of these two movements. In development phase the movements of flexion/extension are excluded, for the bending of the body forward to an angle of 45° is achieved by rotation in the hip joints. Proposed solution of the lumbar structure is characterized by self-locking of mechanisms (if for any reason actuators stop working, lumbar structure retains current posture, low backlash (high positioning accuracy and repeatability of movements, compactness, high carrying capacity and small dimensions. [Projekat Ministarstva nauke Republike Srbije, br. III44008 and by Provincial secretariat for science and technological development under contract 114-451-2116/2011

  17. Traumatic lumbar hernia: report of a case. (United States)

    Torer, Nurkan; Yildirim, Sedat; Tarim, Akin; Colakoglu, Tamer; Moray, Gokhan


    Traumatic lumbar hernias are very rare. Here, we present a case of secondary lumbar hernia. A 44-year-old man sustained a crushing injury. On admission, ecchymotic, fluctuating swelling was present on his left flank with normal vital signs. Subcutaneous intestinal segments were revealed at his left flank on abdominal CT. Emergency laparotomy revealed a 10-cm defect on the left postero-lateral abdominal wall. The splenic flexure was herniated through the defect. Herniated segments was reduced, the defect was repaired with a polypropylene mesh graft. There was also a serosal tear and an ischemic area 3mm wide on the splenic flexure and was repaired primarily. The patient had an uneventful recovery. Most traumatic lumbar hernias are caused by blunt trauma. Trauma that causes abdominal wall disruption also may cause intraabdominal organ injury. Abdominal CT is useful in the diagnosis and allows for diagnosis of coexisting organ injury. Emergency laparotomy should be performed to repair possible coexisting injuries.

  18. Lumbar hernia repaired using a new technique. (United States)

    Di Carlo, Isidoro; Toro, Adriana; Sparatore, Francesca; Corsale, Giuseppe


    Lumbar hernia is uncommon and occurs in Grynfeltt's triangle on the left side, more frequently in men than in women. Acquired lumbar hernias are the result of iliac crest bone harvest or blunt trauma and seat belt injuries in road accidents. Many surgical options have been reported for repairing this hernia through primary closure of the defect or through use of aponeurotic or prosthetic materials. The Dowd technique is the technique most often used. The authors describe a patient with posttraumatic inferior triangle lumbar hernia who underwent laparoscopy and, 10 days later, laparotomy. Both procedures failed. Finally, a novel lumbotomic surgical approach was used, involving the Dowd technique and prosthetic mesh. The patient was free of recurrence 3 months after the procedure.

  19. Mechanism to induce scoliosis in Duchenne muscular dystrophy; A study of paraspinal muscle by X-ray computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Ando, Noriaki; Fujimoto, Yasuyo (National Nishinara Hosital, Nara (Japan)); Takayanagi, Tetsuya; Mano, Yukio


    We studied the mechanism to induce scoliosis in Duchenne muscular dystrophy (DMD) by use of X-ray computed tomography (CT) of paraspinal muscles. CT examination of paraspinal muscles was performed on 15 DMD patients at the following six levels: (1) Th3 vertebrae (upper thoracic spine level); (2) Th6 vertebrae (middle thoracic spine level); (3) Th10 vertebrae (lower thoracic spine level); (4) L1 vertebrae (upper lumbar spine level); (5) L3 vertebrae (middle lumbar spine level); (6) L5 vertebrae (lower lumbar spine level). We evaluated the degeneration of paraspinal muscle by a decrese in ratio-density of the muscle which indicates infiltration of fatty tissue. The degeneration of the lateral portion of paraspinal muscle was more marked than that of the medial portion. The muscle was most severely affected at the middle lumbar spine level, showing a tendency to increase degeneration at the lower level of the spine. In cases showing laterality of the degeneration of paraspinal muscle, the less affected muscle on CT was located at the convex site of scoliosis. We speculate that the scoliosis occurs when DMD patients have asymmetrical paraspinal muscle degeneration, leading them to take compensatory posture. (author).

  20. Adverse Event Recording and Reporting in Clinical Trials Comparing Lumbar Disk Replacement with Lumbar Fusion: A Systematic Review


    HIRATZKA, JAYME; Rastegar, Farbod; Contag, Alec G.; Norvell, Daniel C.; Anderson, Paul A.; Hart, Robert A


    Study Design Systematic review. Objectives (1) To compare the quality of adverse event (AE) methodology and reporting among randomized trials comparing lumbar fusion with lumbar total disk replacement (TDR) using established AE reporting systems; (2) to compare the AEs and reoperations of lumbar spinal fusion with those from lumbar TDR; (3) to make recommendations on how to report AEs in randomized controlled trials (RCTs) so that surgeons and patients have more-detailed and comprehensive inf...

  1. Gestational diabetes is characterized by reduced mitochondrial protein expression and altered calcium signaling proteins in skeletal muscle.

    Directory of Open Access Journals (Sweden)

    Kristen E Boyle

    Full Text Available The rising prevalence of gestational diabetes mellitus (GDM affects up to 18% of pregnant women with immediate and long-term metabolic consequences for both mother and infant. Abnormal glucose uptake and lipid oxidation are hallmark features of GDM prompting us to use an exploratory proteomics approach to investigate the cellular mechanisms underlying differences in skeletal muscle metabolism between obese pregnant women with GDM (OGDM and obese pregnant women with normal glucose tolerance (ONGT. Functional validation was performed in a second cohort of obese OGDM and ONGT pregnant women. Quantitative proteomic analysis in rectus abdominus skeletal muscle tissue collected at delivery revealed reduced protein content of mitochondrial complex I (C-I subunits (NDUFS3, NDUFV2 and altered content of proteins involved in calcium homeostasis/signaling (calcineurin A, α1-syntrophin, annexin A4 in OGDM (n = 6 vs. ONGT (n = 6. Follow-up analyses showed reduced enzymatic activity of mitochondrial complexes C-I, C-III, and C-IV (-60-75% in the OGDM (n = 8 compared with ONGT (n = 10 subjects, though no differences were observed for mitochondrial complex protein content. Upstream regulators of mitochondrial biogenesis and oxidative phosphorylation were not different between groups. However, AMPK phosphorylation was dramatically reduced by 75% in the OGDM women. These data suggest that GDM is associated with reduced skeletal muscle oxidative phosphorylation and disordered calcium homeostasis. These relationships deserve further attention as they may represent novel risk factors for development of GDM and may have implications on the effectiveness of physical activity interventions on both treatment strategies for GDM and for prevention of type 2 diabetes postpartum.

  2. Corrective sitting strategies: An examination of muscle activity and spine loading. (United States)

    Castanharo, Raquel; Duarte, Marcos; McGill, Stuart


    The purpose of this study was to quantify the load on the lumbar spine of subjects when they are asked to adjust from a slouched sitting posture into an upright posture with one of three different strategies: "free" (no instruction) and two coached patterns: "lumbopelvic" dominant and "thoracic" dominant. The activity of selected muscles and kinematic data was recorded from 20 volunteers while performing the three movement patterns to adjust sitting posture. Moments and forces at the lumbar spine were computed from an anatomically detailed model that uses kinematics and muscle activation as input variables. The lumbopelvic pattern produces less joint moment on the lumbar spine (on average 31.2±3.9Nm) when compared to the thoracic pattern (43.8±5.8Nm). However, the joint compression force was similar for these two patterns, but it was smaller in the free pattern, when no coaching was given (lumbopelvic: 1279±112N, thoracic: 1367±(125N, free: 1181±118N). Lower thoracic erector muscle activity and higher lumbar erector activity were measured in the lumbopelvic pattern in comparison with the other two. In summary the lumbopelvic pattern strategy using predominantly the movement of anterior pelvic tilt results in smaller joint moments on the lumbar spine and also positions the lumbar spine closest to the neutral posture minimizing passive tissue stress. This may be the strategy of choice for people with low back flexion intolerance.

  3. Lumbar vertebral pedicles: radiologic anatomy and pathology

    Energy Technology Data Exchange (ETDEWEB)

    Patel, N.P.; Kumar, R.; Kinkhabwala, M.; Wengrover, S.I.


    With the advancement of high-resolution computed tomography (CT) scanning the spine has added new knowledge to the various conditions affecting the pedicles. We wish to review the entire spectrum of pedicular lesions: the embryology, normal anatomy, normal variants, pitfalls, congenital anomalies, and pathological conditions are discussed. Different imaging modalities involving CT, isotope bone scanning, and Magnetic Resonance Imaging (MRI) are used to complement plain films of the lumbar spine. This subject review is an excellent source for future reference to lumbar pedicular lesions. 27 references.

  4. Mini-open anterior lumbar interbody fusion. (United States)

    Gandhoke, Gurpreet S; Ricks, Christian; Tempel, Zachary; Zuckerbraun, Brian; Hamilton, D Kojo; Okonkwo, David O; Kanter, Adam S


    In deformity surgery, anterior lumbar interbody fusion provides excellent biomechanical support, creates a broad surface area for arthrodesis, and induces lordosis in the lower lumbar spine. Preoperative MRI, plain radiographs, and, when available, CT scan should be carefully assessed for sacral slope as it relates to pubic symphysis, position of the great vessels (especially at L4/5), disc space height, or contraindication to an anterior approach. This video demonstrates the steps in an anterior surgical procedure with minimal open exposure. The video can be found here: .

  5. Analysis of Muscle Contraction on Pottery Manufacturing Process Using Electromyography (EMG) (United States)

    Soewardi, Hartomo; Azka Rahmayani, Amalia


    One of the most common problems in pottery manufacturing process is musculoskeletal disorders on workers. This disorder was caused by uncomfortable posture where the workers sit on the floor with one leg was folded and another was twisted for long duration. Back, waist, buttock, and right knee frequently experience the disorders. The objective of this research is to investigate the muscle contraction at such body part of workers in manufacturing process of pottery. Electromyography is used to investigate the muscle contraction based on the median frequency signal. Focus measurements is conducted on four muscles types. They are lower interscapular muscle on the right and left side, dorsal lumbar muscle, and lateral hamstring muscle. Statistical analysis is conducted to test differences of muscle contraction between female and male. The result of this research showed that the muscle which reached the highest contraction is dorsal lumbar muscle with the average of median frequency is 51,84 Hz. Then followed by lower interscapular muscle on the left side with the average of median frequency is 31,30 hz, lower interscapular muscle on the right side average of median frequency is 31,24 Hz, and lateral hamstring muscle average of median frequency is 21,77 Hz. Based on the statistic analysis result, there were no differences between male and female on left and right lower interscapular muscle and dorsal lumbar muscle but there were differences on lateral hamstring muscle with the significance level is 5%. Besides that, there were differences for all combination muscle types with the level of significance is 5%.

  6. Soluble calcium-binding proteins (SCBPs) of the earthworm Lumbricus terrestris: molecular characterization and localization by FISH in muscle and neuronal tissue. (United States)

    Thiruketheeswaran, Prasath; Kiehl, Ernst; D'Haese, Jochen


    Soluble calcium-binding proteins (SCBPs) of invertebrates probably serve like their vertebrate counterpart-the parvalbumins-as soluble relaxing factors in muscles. Three SCBP isoforms (SCBP1-3) have been isolated and biochemically characterized in the earthworm Lumbricus terrestris (Huch et al. in J Comp Physiol B 158:325-334, 1988). For SCBP2, we found two isoforms named SCBP2a/2b. Both of them together with SCBP3 are present in the body wall muscle. In the gizzard solely, SCBP2b and no SCBP2a or SCBP3 could be detected. The coding sequences of all three isoforms consist of 534 bp for 178 amino acids and contain four EF-hand motifs, of which the second EF-hands are truncated. Recombinant proteins show heat stability and a Ca(2+)-dependent mobility shift similar to the native proteins, indicating comparable calcium-binding properties. All three isoforms are encoded by three distinct and differentially expressed genes. The genes for SCBP2a, SCBP2b, and SCBP3 are interrupted by only one intron, inserting at nearly the same positions. Northern blot analysis revealed two mRNA transcripts for SCBP2 of approximately 1250 and 1500 kb and one transcript for SCBP3 of approximately 1250 kb. SCBP mRNA was localized by fluorescent in situ hybridization in the body wall and the gizzard. The distribution of the staining intensities resembles that for the myosin ATPase activity and indicates a correlation between the amount of SCBP and speed of muscle contraction. In addition, SCBP mRNA was localized within the nervous tissue, the cerebral and subesophageal ganglia and the ventral nerve cord.

  7. Separation and partial characterization of smooth muscle contractile material in the venom of the scorpion Heterometrus bengalensis. (United States)

    Kar, P K; Sarangi, B; Datta, A; Gomes, A; Lahiri, S C


    A smooth muscle contractile material was separated from crude venom of the scorpion Heterometrus bengalensis (found in Eastern India) by solvent extraction, gel filtration and thin layer chromatography. Smooth muscle contractile material could be extracted, in descending order of efficiency, with methanol, butanol, ethanol and acetone. The contractile material separated by gel filtration (Sephadex G-25) when further extracted, using the Folch procedure, showed a single spot in thin layer chromatography with one solvent system. Rechromatography of an eluate from this spot with another solvent system resolved it into three spots (SL1, SL2 and SL3, the mixture being designated as Substance L) which could be visualized either with iodine vapour, ninhydrin or molybdenum reagent. Eluates from the three spots contracted guinea-pig ileum which had been pretreated with antagonists of ACh, histamine, 5-HT and prostaglandins. Substance L and its fractions (SL1, SL2 and SL3) contain inorganic phosphorus, amino nitrogen and amino sugar, which point to the likelihood of their being glycophosphatides.

  8. Entropy measures of back muscles EMG for subjects with and without pain (United States)

    Zurcher, Ulrich; Kaufman, Miron; Vyhnalek, Bryan; Sung, Paul


    We have previously reported that the time-dependent entropy S(t) calculated from electromyography time series of low back muscles exhibit plateau-like behavior for intermediate times [50 ,ms low back pain [J. Rehab. Res. Dev. 44, 599 (2007)]. We report results of a larger study, and compare the entropies for the left -and right thoracic and left- and right lumbar muscles. We also compare entropies from muscles before and after physical therapy intervention.

  9. Anatomy of the Lumbar Innervation


    Gómez Vega, Juan Carlos; Pontificia Universidad Javeriana; Acevedo González, Juan Carlos; Pontificia Universidad Javeriana


    Chronic low back pain affects most adults at some point in their lives with, and has a prevalence of 20%-30%, representing the most common physical limitation in people younger than 45 years old. In a small percentage are able to obtain a definitive diagnosis. Low back pain is caused by sensitive structures of the spine (facet joints, spinal ligaments and paraspinal muscles. These anatomical structures are nerves that mediate pain (nociceptors), so alteration involved in the generation of the...

  10. Percutaneous fusion of lumbar facet with bone allograft

    Directory of Open Access Journals (Sweden)

    Félix Dolorit Verdecia


    Full Text Available OBJECTIVE: To assess the evolution of the cases treated with percutaneous facet fusion with bone allograft in lumbar facet disease. METHOD: Between 2010 and 2014, 100 patients (59 women and 41 men diagnosed with lumbar facet disease underwent surgery. RESULTS: The lumbar facet fusion with bone allograft shows good clinical results, is performed on an outpatient basis, and presents minimal complications and rapid incorporation of the patient to the activities of daily living. CONCLUSIONS: The lumbar facet fusion with bone allograft appears to be an effective treatment for lumbar facet disease.

  11. The shape of the human lumbar vertebral canal A forma do canal vertebral lombar humano

    Directory of Open Access Journals (Sweden)

    Edmundo Zarzur


    Full Text Available Literature on the anatomy of the human vertebral column characterizes the shape of the lumbar vertebral canal as triangular. The purpose of the present study was to determine the precise shape of the lumbar vertebral canal. Ten lumbar vertebral columns of adult male cadavers were dissected. Two transverse sections were performed in the third lumbar vertebra. One section was performed at the level of the lower border of the ligamenta flava, and the other section was performed at the level of the pedicles. The shape of the lumbar vertebral canal at the level of the pedicles tends to be oval or circular, whereas the shape of the lumbar vertebral canal at the level of the lower border of the ligamenta flava is triangular. Thus, the shape of the human lumbar vertebral canal is not exclusively triangular, as reported in the literature. It is related to the level of the transversal section performed on the lumbar vertebra. This finding should be taken into consideration among factors involved in the spread of solutions introduced into the epidural space.A literatura sobre a anatomia da coluna vertebral descreve como sendo triangular o formato do canal vertebral na região lombar. O objetivo deste estudo é determinar a real forma do canal da coluna vertebral lombar.Dez colunas vertebrais de cadáveres de homens adultos foram dissecadas. Dois cortes transversais foram executados na terceira vértebra lombar. Um corte foi feito no nível das bordas inferiores de dois ligamentos amarelos vizinhos e o outro corte foi transversal, no nível dos pedículos. A forma do canal vertebral variou: no nível dos pedículos ela tende a ser oval ou circular e junto às bordas inferiores dos ligamentos amarelos passa a ser triangular. Portanto, a forma do canal vertebral lombar não é somente triangular; ela depende do nível em que se faz o corte transversal da vértebra. Estes achados devem ser levados em consideração entre os fatores envolvidos na difusão das

  12. An investigation of jogging biomechanics using the full-body lumbar spine model: Model development and validation. (United States)

    Raabe, Margaret E; Chaudhari, Ajit M W


    The ability of a biomechanical simulation to produce results that can translate to real-life situations is largely dependent on the physiological accuracy of the musculoskeletal model. There are a limited number of freely-available, full-body models that exist in OpenSim, and those that do exist are very limited in terms of trunk musculature and degrees of freedom in the spine. Properly modeling the motion and musculature of the trunk is necessary to most accurately estimate lower extremity and spinal loading. The objective of this study was to develop and validate a more physiologically accurate OpenSim full-body model. By building upon three previously developed OpenSim models, the full-body lumbar spine (FBLS) model, comprised of 21 segments, 30 degrees-of-freedom, and 324 musculotendon actuators, was developed. The five lumbar vertebrae were modeled as individual bodies, and coupled constraints were implemented to describe the net motion of the spine. The eight major muscle groups of the lumbar spine were modeled (rectus abdominis, external and internal obliques, erector spinae, multifidus, quadratus lumborum, psoas major, and latissimus dorsi), and many of these muscle groups were modeled as multiple fascicles allowing the large muscles to act in multiple directions. The resulting FBLS model׳s trunk muscle geometry, maximal isometric joint moments, and simulated muscle activations compare well to experimental data. The FBLS model will be made freely available ( for others to perform additional analyses and develop simulations investigating full-body dynamics and contributions of the trunk muscles to dynamic tasks.

  13. Comparison of displacement and acceleration transducers for the characterization of mechanics of muscle and subcutaneous tissues by system identification of a mechanomyogram. (United States)

    Uchiyama, Takanori; Shinohara, Keita


    The purpose of this study was to clarify the performance of transducers for the mechanical characterization of muscle and subcutaneous tissue with the aid of a system identification technique. The common peroneal nerve was stimulated, and a mechanomyogram (MMG) of the anterior tibialis muscle was detected with a laser displacement meter or an acceleration sensor. The transfer function between stimulation and the MMG was identified by the singular value decomposition method. The MMG detected with a laser displacement meter, DMMG, was approximated with a second-order model, but that detected with an acceleration sensor, AMMG, was approximated with a sixth-order model. The natural frequency of the DMMG coincided with that in the literature and was close to the lowest natural frequency of the AMMG. The highest natural frequency of the AMMG was within the range of the resonance frequencies of human soft tissue. The laser displacement meter is suitable for the precise identification of the MMG, which has a natural frequency of around 3 Hz. The acceleration transducer is suitable for the identification of the MMG with natural frequencies of tens of hertz.

  14. Proteomic signature of muscle atrophy in rainbow trout (United States)

    Muscle deterioration arises as a physiological response to elevated energetic demands of fish sexual maturation and spawning. Previously, we used this model to characterize the transcriptomic mechanisms associated with muscle degradation in fish and identified potential biological markers of muscle...

  15. Genetics Home Reference: myostatin-related muscle hypertrophy (United States)

    ... Conditions myostatin-related muscle hypertrophy myostatin-related muscle hypertrophy Enable Javascript to view the expand/collapse boxes. ... Open All Close All Description Myostatin-related muscle hypertrophy is a rare condition characterized by reduced body ...

  16. Congenital lumbar hernia associated to lumbar costovertebral syndrome. A case report.

    Directory of Open Access Journals (Sweden)

    Zoe Quintero Delgado


    Full Text Available Reported the case of a born patient of color of white skin, 6 years old, of pregnancy and normal childbirth that it was valued in the Service of Surgery of the Pediatric Hospital ¨Paquito González Cueto¨ because it presented increase of volume in both lumbar regions, without another associate sintomatology. Congenital bilateral lumbar hernia associated to syndrome lumbocostovertebral, strange affection in the pediatric age.

  17. Effect of pelvic tilt on lumbar spine geometry. (United States)

    Delisle, A; Gagnon, M; Sicard, C


    The purpose of this study was to use a noninvasive method to determine the effect of pelvic tilt on the lumbar spine geometry in the sagittal plane. Five healthy male subjects were instructed in performing active forward and backward pelvic tilt manoeuvres in the standing position. The lumbar spine geometry (severity of lordosis, pelvis and lumbar vertebrae orientations) was estimated with a lumbar spine geometric model. The voluntary backward pelvic tilt succeeded in reducing the depth of the lumbar spine curvature, but the forward tilt did not change it. Both pelvic tilt manoeuvres influenced the absolute orientations of the lower lumbar vertebrae and the relative orientations of some lumbar vertebrae. Interestingly, the L5/S1 joint showed was little affected by the pelvic tilt manoeuvres.

  18. Characterization of a PLGA sandwiched cell/fibrin tubular construct and induction of the adipose derived stem cells into smooth muscle cells

    Energy Technology Data Exchange (ETDEWEB)

    Wang Xiaohong, E-mail: [BIT Research Centre, School of Science and Technology, Aalto University, P.O. Box 15500, 00076 Aalto (Finland); Key Laboratory for Advanced Materials Processing Technology, Ministry of Education and Center of Organ Manufacturing, Department of Mechanical Engineering, Tsinghua University, Beijing 100084 (China); Maekitie, Antti A.; Paloheimo, Kaija-Stiina; Tuomi, Jukka; Paloheimo, Markku [BIT Research Centre, School of Science and Technology, Aalto University, P.O. Box 15500, 00076 Aalto (Finland); Sui Shaochun [Key Laboratory for Advanced Materials Processing Technology, Ministry of Education and Center of Organ Manufacturing, Department of Mechanical Engineering, Tsinghua University, Beijing 100084 (China); Zhang Qiqing [Institute of Biomedical Engineering, Chinese Academy of Medical Science and Peking Union Medical College, Key Laboratory of Biomedical Material of Tianjin, Tianjin 300192 (China)


    A poly(DL-lactic-co-glycolic acid) (PLGA) sandwiched adipose derived stem cell (ADSC)/fibrin tubular construct, fabricated using a step-by-step mold/extraction method, was characterized in this work. The ADSCs were also induced into smooth-muscle-like cells using growth factors such as hepatocyte growth factor (HGF), platelet-derived growth factor BB (PDGF-BB), transforming growth factor {beta}1 (TGF{beta}1), and basic fibroblast growth factor (b-FGF). Compared with the non-induced cells, the proliferation ability of induced cells was much smaller. The PLGA sandwiched cell/hydrogel construct was shown to be useful for controlling the cellular microenvironment and cellular behaviors such as growth, migration, proliferation and differentiation. This strategy seems promising in tissue engineering and organ manufacturing.

  19. Numerical Analysis on Quantitative Role of Trunk Muscles in Spinal Stabilization (United States)

    Kim, Yoon Hyuk; Kim, Kyungsoo

    The human lumbar spine can support much larger compressive loads if it is applied along a follower load path that approximates the tangent to the curve of the lumbar spine compared with the vertical load path. In this study, a musculoskeletal finite element model of the simplified lumbar spine including idealized psoas major muscles in the frontal plane was developed and the quantitative role of psoas major muscles was investigated to generate the follower load by using stiffness methods when vertical loads are given. The muscle force distributions were analyzed under various loading cases and follower load constraints. The validity of the developed model was assessed through comparison with previous modeling and experimental studies.

  20. Effect of continuous lumbar traction on the size of herniated disc material in lumbar disc herniation. (United States)

    Ozturk, Bulent; Gunduz, Osman Hakan; Ozoran, Kursat; Bostanoglu, Sevinc


    We investigated the effects of continuous lumbar traction in patients with lumbar disc herniation on clinical findings, and size of the herniated disc measured by computed tomography (CT). In this prospective, randomized, controlled study, 46 patients with lumbar disc herniation were included, and randomized into two groups as the traction group (24 patients), and the control group (22 patients). The traction group was given a physical therapy program and continuous lumbar traction. The control group was given the same physical therapy program without traction, for the same duration of time. Data for the clinical symptoms and signs were collected before and after the treatment together with calculation of a herniation index, from the CT images that showed the size of the herniated disc material. In the traction group, most of the clinical findings significantly improved with treatment. Size of the herniated disc material in CT decreased significantly only in the traction group. In the traction group the herniation index decreased from 276.6+/-129.6 to 212.5+/-84.3 with treatment (p0.05). Patients with greater herniations tended to respond better to traction. In conclusion, lumbar traction is both effective in improving symptoms and clinical findings in patients with lumbar disc herniation and also in decreasing the size of the herniated disc material as measured by CT.

  1. [Renal angiomyolipoma rupture as a cause of lumbar pain: report of one case]. (United States)

    Cifuentes, Melissa; Calleja, Félix; Hola, José; Daviú, Antonio; Jara, Danilo; Vallejos, Humberto


    Renal angiomyolipoma is a benign tumor formed by smooth muscle, adipose tissue and blood vessels. It is commonly found incidentally and its clinical manifestations are pain and abdominal mass or spontaneous tumor rupture with retroperitoneal bleeding. The clinical presentation of a hemorrhagic shock secondary to a retroperitoneal hematoma is uncommon. We report a 40 year-old male who presented to the emergency room with lumbar pain and deterioration of hemodynamic parameters. The CT scan showed a left renal injury associated to an expansive retroperitoneal process. The abdominal exploration, vascular control of the renal pedicle and nephrectomy allowed a successful outcome.

  2. Idiopathic septic arthritis of a lumbar facet joint associated with paraspinal abscess. (United States)

    Kitova-John, Margarita Borislavova; Azim-Araghi, Ali; Sheikh, Faraz Tariq; Kitov, Borislav Dimitrov


    A 48-year-old woman presented with a 1-month history of severe lower back pain on a background of 24 h of mild fever and general tiredness with an associated right-sided foot drop. Five weeks after the onset and with no improvement in symptoms in spite of analgesia and physiotherapy, the patient had a lumbar spine MRI which demonstrated a collection extending from the facet joints of L5 and L6 to the iliacus muscle on the right. A CT-guided aspiration was performed with a lengthy hospital stay for intravenous antibiotic treatment. The culture and sensitivity study of the aspirate isolated Streptococcus pneumoniae.

  3. A case of inferior lumbar hernia

    Directory of Open Access Journals (Sweden)

    Vidhyasagar M. Sharma


    Full Text Available In this article we report a case of inferior lumbar hernia. The patient underwent preperitoneal meshplasty. The patient is well on follow up with no recurrence. The relevant literature has been reviewed and management discussed in brief. [Int J Res Med Sci 2013; 1(1.000: 33-35


    NARCIS (Netherlands)



    This paper deals with the effect of motion upon the stenotic lumbar spinal canal and its contents. A review is presented of personal investigations and relevant data from the literature. The normal spinal canal and its lateral recesses are naturally narrowed by retroflexion and/or axial loading, as

  5. Multiple lumbar arachnoid cysts. Case report. (United States)

    Pappalardo, S; Cassarino, A; Braidotti, P


    Arachnoid cysts are a rare cause of compression of the contents of the lumbar spinal canal; in the literature only about 100 cases are reported. The various methods of diagnosis are discussed in the light of a recent case observed by the authors.

  6. Age-associated tyrosine nitration of rat skeletal muscle glycogen phosphorylase b: characterization by HPLC-nanoelectrospray-tandem mass spectrometry. (United States)

    Sharov, Victor S; Galeva, Nadezhda A; Kanski, Jaroslaw; Williams, Todd D; Schöneich, Christian


    We identified age-dependent post-translational modifications of skeletal muscle glycogen phosphorylase b (Ph-b), isolated from F1 hybrids of Fisher 344 x Brown Norway rats. Ph-b isolated from 34 months old rats showed a statistically significant decrease in specific activity compared to 6 months old animals: 13.8+/-0.7 vs. 20.6+/-0.8 U mg(-1) protein, respectively. Western blot analysis of the purified Ph-b with anti-3-NT antibodies revealed an age-dependent accumulation of 3-nitrotyrosine (3-NT), quantified by reverse-phase HPLC-UV analysis to increase from 0.05+/-0.03 to 0.34+/-0.11 (mol 3-NT/mol Ph-b) for 6 vs. 34 months old rats, respectively. HPLC-nanoelectrospray ionization-tandem mass spectrometry revealed the accumulation of 3-NT on Tyr113, Tyr161 and Tyr573. While nitration of Tyr113 was detected for both young and old rats, 3-NT at positions 161 and 573 was identified only for Ph-b isolated from 34 months old rats. The sequence of the rat muscle Ph-b was corrected based on our protein sequence mapping and a custom rat PHS2 sequence containing 17 differently located amino acid residues was used instead of the database sequence. The in vitro reaction of peroxynitrite with Ph-b resulted in the nitration of multiple Tyr residues at positions 51, 52, 113, 155, 185, 203, 262, 280, 404, 473, 731, and 732. Thus, the in vitro nitration conditions only mimic the nitration of a single Tyr residue observed in vivo suggesting alternative pathways controlling the accumulation of 3-NT in vivo. Our data show a correlation of age-dependent 3-NT accumulation with Ph-b inactivation.

  7. Comparison between muscle activation measured by electromyography and muscle thickness measured using ultrasonography for effective muscle assessment. (United States)

    Kim, Chang-Yong; Choi, Jong-Duk; Kim, Suhn-Yeop; Oh, Duck-Won; Kim, Jin-Kyung; Park, Ji-Whan


    In this study, we aimed to compare the intrarater reliability and validity of muscle thickness measured using ultrasonography (US) and muscle activity via electromyography (EMG) during manual muscle testing (MMT) of the external oblique (EO) and lumbar multifidus (MF) muscles. The study subjects were 30 healthy individuals who underwent MMT at different grades. EMG was used to measure the muscle activity in terms of ratio to maximum voluntary contraction (MVC) and root mean square (RMS) metrics. US was used to measure the raw muscle thickness, the ratio of muscle thickness at MVC, and the ratio of muscle thickness at rest. One examiner performed measurements on each subject in 3 trials. The intrarater reliabilities of the % MVC RMS and raw RMS metrics for EMG and the % MVC thickness metrics for US were excellent (ICC=0.81-0.98). There was a significant difference between all the grades measured using the % MVC thickness metric (pEMG measurement methods than with the others (r=0.51-0.61). Our findings suggest that the % MVC thickness determined by US was the most sensitive of all methods for assessing the MMT grade.

  8. The effect of increasing resistance on trunk muscle activity during extension and flexion exercises on training devices. (United States)

    Stevens, Veerle K; Parlevliet, Thierry G; Coorevits, Pascal L; Mahieu, Nele N; Bouche, Katie G; Vanderstraeten, Guy G; Danneels, Lieven A


    Although progressive resistance training of trunk muscles on devices is very common, today, the effects of increasing resistance on trunk muscle activity during dynamic extension and flexion movements on training devices have not been reported yet. Thirty healthy subjects participated in maximal isometric and submaximal dynamic (at 30%, 50% and 70% of maximum mean torque (MMT)) extension and flexion exercises on Tergumed lumbar training devices. The normalized (as a percentage of maximal voluntary isometric contractions (MVIC)) electromyographic activity of 16 abdominal and back muscles was investigated. The results of the present study indicated that in general, with increasing resistance from 30% MMT to 50% MMT and 70% MMT, the activity of all back muscles during the extension exercises and the activity of all abdominal muscles during the flexion exercises increased significantly. To train strength (>60% of MVIC), low intensities (30% and 50% MMT) appeared sufficient to affect the back muscles, but for the abdominals higher resistance (70% MMT) was required. In contrast to the other back muscles, the lumbar multifidus demonstrated high activity levels during both the extension and the flexion exercises. As the lumbar multifidus is demonstrated to be an important muscle in segmental stabilization of the lumbar spine, this finding may help in understanding the efficacy of rehabilitation programs using specific training devices.

  9. Changes in the flexion-relaxation response induced by hip extensor and erector spinae muscle fatigue

    Directory of Open Access Journals (Sweden)

    Cantin Vincent


    Full Text Available Abstract Background The flexion-relaxation phenomenon (FRP is defined by reduced lumbar erector spinae (ES muscle myoelectric activity during full trunk flexion. The objectives of this study were to quantify the effect of hip and back extensor muscle fatigue on FRP parameters and lumbopelvic kinematics. Methods Twenty-seven healthy adults performed flexion-extension tasks under 4 different experimental conditions: no fatigue/no load, no fatigue/load, fatigue/no load, and fatigue/load. Total flexion angle corresponding to the onset and cessation of myoelectric silence, hip flexion angle, lumbar flexion angle and maximal trunk flexion angle were compared across different experimental conditions by 2 × 2 (Load × Fatigue repeated-measures ANOVA. Results The angle corresponding to the ES onset of myoelectric silence was reduced after the fatigue task, and loading the spine decreased the lumbar contribution to motion compared to the hip during both flexion and extension. A relative increment of lumbar spine motion compared to pelvic motion was also observed in fatigue conditions. Conclusions Previous results suggested that ES muscles, in a state of fatigue, are unable to provide sufficient segmental stabilization. The present findings indicate that, changes in lumbar-stabilizing mechanisms in the presence of muscle fatigue seem to be caused by modulation of lumbopelvic kinematics.

  10. Non-invasive assessment of human multifidus muscle stiffness using ultrasound shear wave elastography: A feasibility study. (United States)

    Moreau, Baptiste; Vergari, Claudio; Gad, Hisham; Sandoz, Baptiste; Skalli, Wafa; Laporte, Sébastien


    There is a lack of numeric data for the mechanical characterization of spine muscles, especially in vivo data. The multifidus muscle is a major muscle for the stabilization of the spine and may be involved in the pathogenesis of chronic low back pain (LBP). Supersonic shear wave elastography (SWE) has not yet been used on back muscles. The purpose of this prospective study is to assess the feasibility of ultrasound SWE to measure the elastic modulus of lumbar multifidus muscle in a passive stretching posture and at rest with a repeatable and reproducible method. A total of 10 asymptotic subjects (aged 25.5 ± 2.2 years) participated, 4 females and 6 males. Three operators performed 6 measurements for each of the 2 postures on the right multifidus muscle at vertebral levels L2-L3 and L4-L5. Repeatability and reproducibility have been assessed according to ISO 5725 standard. Intra-class correlation coefficients (ICC) for intra- and inter-observer reliability were rated as both excellent [ICC=0.99 and ICC=0.95, respectively]. Reproducibility was 11% at L2-L3 level and 19% at L4-L5. In the passive stretching posture, shear modulus was significantly higher than at rest (µ < 0.05). This preliminary work enabled to validate the feasibility of measuring the shear modulus of the multifidus muscle with SWE. This kind of measurement could be easily introduces into clinical routine like for the medical follow-up of chronic LBP or scoliosis treatments.

  11. Severe insulin-resistant diabetes mellitus in patients with congenital muscle fiber type disproportion myopathy

    DEFF Research Database (Denmark)

    Vestergaard, H; Klein, H H; Hansen, T


    Congenital muscle fiber type disproportion myopathy (CFTDM) is a chronic, nonprogressive muscle disorder characterized by universal muscle hypotrophy and growth retardation. Histomorphometric examination of muscle shows a preponderance of smaller than normal type 1 fibers and overall fiber size...

  12. Lumbar and radial bone mineral density in children and adolescents with X-linked hypophosphatemia: evaluation with dual X-ray absorptiometry

    Energy Technology Data Exchange (ETDEWEB)

    Shore, R.M.; Poznanski, A.K. [Department of Radiology, Children' s Memorial Hospital, Chicago, IL (United States); Langman, C.B. [Department of Pediatrics, Children' s Memorial Hospital and Northwestern University Medical School, Chicago, IL (United States)


    Objective. To evaluate the bone mineral status of children being treated for X-linked hypophosphatemia, including potential differences between cortical bone in the radial diaphysis and combined cortical and trabecular bone in the lumbar spine.Design and patients. Forty-four bone mineral evaluations were performed in 11 children and adolescents with X-linked hypophosphatemia. Bone mineral density (BMD) of the lumbar spine and the radial diaphysis were measured by dual X-ray absorptiometry (DXA), second metacarpal cortical thickness was measured on hand radiographs, and these results were expressed as Z-scores (standard deviations from the mean). Results. For the 11 initial examinations, Z-scores (mean{+-}SD) were: radial BMD, -2.73{+-}1.15, lumbar BMD, +1.28{+-}1.53; and cortical thickness, -2.21{+-}0.95. Lumbar BMD Z-scores were significantly greater than those for radial BMD and cortical thickness. On follow-up examinations there was a mild increase in radial BMD and decrease in lumbar BMD. Although these changes were statistically significant, they were quite small and the discordance between radial and lumbar BMD was not corrected. Conclusions. Children and adolescents who are being treated for X-linked hypophosphatemia manifest a bone mineral disorder characterized by decreased BMD in the appendicular skeleton and increased BMD in the lumbar spine. Although current therapy is successful in its anti-rachitic effects, it does not correct this bone mineral disorder and additional therapeutic trials should be considered. (orig.)

  13. Muscle biopsy (United States)

    ... Inflammatory diseases of muscle (such as polymyositis or dermatomyositis ) Diseases of the connective tissue and blood vessels ( ... disease that involves inflammation and a skin rash ( dermatomyositis ) Inherited muscle disorder ( Duchenne muscular dystrophy ) Inflammation of ...

  14. Simulation and training of lumbar punctures using haptic volume rendering and a 6DOF haptic device (United States)

    Färber, Matthias; Heller, Julika; Handels, Heinz


    The lumbar puncture is performed by inserting a needle into the spinal chord of the patient to inject medicaments or to extract liquor. The training of this procedure is usually done on the patient guided by experienced supervisors. A virtual reality lumbar puncture simulator has been developed in order to minimize the training costs and the patient's risk. We use a haptic device with six degrees of freedom (6DOF) to feedback forces that resist needle insertion and rotation. An improved haptic volume rendering approach is used to calculate the forces. This approach makes use of label data of relevant structures like skin, bone, muscles or fat and original CT data that contributes information about image structures that can not be segmented. A real-time 3D visualization with optional stereo view shows the punctured region. 2D visualizations of orthogonal slices enable a detailed impression of the anatomical context. The input data consisting of CT and label data and surface models of relevant structures is defined in an XML file together with haptic rendering and visualization parameters. In a first evaluation the visible human male data has been used to generate a virtual training body. Several users with different medical experience tested the lumbar puncture trainer. The simulator gives a good haptic and visual impression of the needle insertion and the haptic volume rendering technique enables the feeling of unsegmented structures. Especially, the restriction of transversal needle movement together with rotation constraints enabled by the 6DOF device facilitate a realistic puncture simulation.

  15. Analysis of electromyographic activities of the lumbar erector spinae caused by inversion traction. (United States)

    Kim, Chung Yoo; Kang, Jong Ho


    [Purpose] The purpose of this study was to analyze changes in the electromyographic activities of the lumbar erector spinae caused by inversion traction in order to verify the relaxation effect. [Subjects and Methods] The subjects included 60 healthy male adults who were equally and randomly assigned to a 30-30° group, a 30-60° group, and a 60-60° group. Inversion traction was performed for six minutes, and the electromyographic activities of the lumbar erector spinae (L2, L4) were measured before and after inversion traction. [Results] The root mean square values at the L2 and L4 levels on both sides were statistically significantly higher after inversion traction compared with before inversion traction. Before inversion traction, the root mean square values at the L2 and L4 levels on both sides in the 30-60° group and 60-60° group were significantly higher than those in the 30-30° group, while the root mean square values at the L2 and L4 levels on both sides showed no significant differences between the groups before inversion traction. [Conclusion] The findings of this study indicated that IT is more likely to elicits an increase in muscle tension and prevent relaxation of the lumbar erector spinae.

  16. Effects of lumbar extensor fatigue and surface inclination on postural control during quiet stance. (United States)

    Lin, Dingding; Nussbaum, Maury A


    A number of work environments require workers to perform tasks on inclined surfaces. Such tasks, along with muscle fatigue, can impair postural control and increase falling risks. The objective of this study was to determine the effects of surface inclination angle, standing direction, and lumbar extensor fatigue on postural control during quiet standing. A group of 16 young, healthy participants were tested while standing on inclined surfaces before and after lumbar extensor fatigue (induced by repetitive isotonic exercise). Three inclination angles (0°, 18° and 26°) and three standing directions (uphill, downhill, and lateral facing) were examined. Postural control was assessed using several measures derived from center-of-pressure time series and subjectively perceived stability. Significant main and interactive effects of inclination angle and standing direction were found for all dependent measures. The adverse effects of standing on inclined surfaces were found to differ between the three standing directions. In general, dose-response relationships with inclination angle were evident, particularly in the lateral-facing direction. Fatigue-related effects differed between conditions, suggesting that the adverse effect of lumbar extensor fatigue on postural control depend on inclination angle and standing direction. These findings may facilitate the development of fall prevention interventions for work involving inclined surfaces.

  17. Modeling Muscles (United States)

    Goodwyn, Lauren; Salm, Sarah


    Teaching the anatomy of the muscle system to high school students can be challenging. Students often learn about muscle anatomy by memorizing information from textbooks or by observing plastic, inflexible models. Although these mediums help students learn about muscle placement, the mediums do not facilitate understanding regarding integration of…

  18. Countermeasures against lumbar spine deconditioning in prolonged bed rest: resistive exercise with and without whole body vibration. (United States)

    Belavý, Daniel L; Armbrecht, Gabriele; Gast, Ulf; Richardson, Carolyn A; Hides, Julie A; Felsenberg, Dieter


    To evaluate the effect of short-duration, high-load resistive exercise, with and without whole body vibration on lumbar muscle size, intervertebral disk and spinal morphology changes, and low back pain (LBP) incidence during prolonged bed rest, 24 subjects underwent 60 days of head-down tilt bed rest and performed either resistive vibration exercise (n = 7), resistive exercise only (n = 8), or no exercise (n = 9; 2nd Berlin Bed-Rest Study). Discal and spinal shape was measured from sagittal plane magnetic resonance images. Cross-sectional areas (CSAs) of the multifidus, erector spinae, quadratus lumborum, and psoas were measured on para-axial magnetic resonance images. LBP incidence was assessed with questionnaires at regular intervals. The countermeasures reduced CSA loss in the multifidus, lumbar erector spinae and quadratus lumborum muscles, with greater increases in psoas muscle CSA seen in the countermeasure groups (P ≤ 0.004). There was little statistical evidence for an additional effect of whole body vibration above resistive exercise alone on these muscle changes. Exercise subjects reported LBP more frequently in the first week of bed rest, but this was only significant in resistive exercise only (P = 0.011 vs. control, resistive vibration exercise vs. control: P = 0.56). No effect of the countermeasures on changes in spinal morphology was seen (P ≥ 0.22). The results suggest that high-load resistive exercise, with or without whole body vibration, performed 3 days/wk can reduce lumbar muscle atrophy, but further countermeasure optimization is required.


    Directory of Open Access Journals (Sweden)

    Vivekananda S


    Full Text Available STUDY DESI GN: Non - randomized, prospective analysis of 68 patients of lumbar disc herniation treated with ozone nucleolysis. OBJECTIVE: To assess the patients with lumbar disc herniation treated with intradiscal ozone, pre and post ozone nucleolysis, for pain using Visual Analog Scale (VAS functional & disability score using Japanese Orthopedic Association (JOA Clinical Symptom Score. SUMMARY OF BACKGROUN D DATA: Ozone therapy for disc herniation is becoming popu lar because of its minimal invasive, lesser recurrences and remarkably fewer side effects. Successful outcomes of ozone therapy have been reported from various European & Indian centers. METHODS: A series of 68 patients were treated with ozone therapy for lumbar disc herniation from January 2009 to January 2012. The procedure is done under C - arm guidance under local anesthesia by “Single sitting double injection technique”. All patients were assessed using VAS for radiation pain & back pain, Clinical Symptom Score of the Japanese Orthopaedic Association (JOA for a Patient with Lumbar Disc Herniation, pre op and post op, on day one, after a week, two weeks, first month, third months, sixth month one year second year. Were classified them as Good, Moder ate & Poor outcome. RESULTS: Out of 68 patients 89.7% (61/68 patients had good outcome, 7.35% (5/68 patients had moderate outcome, 2.95% (2/68 had poor outcome. Intra - op in 1 patient where ozone spread in Para spinal muscles but had no postoperative pro blem.4 patients had mild nausea, 2 had mild headache & No infection. CONCLUSIONS: Ozone nucleolysis is a new, minimally invasive procedure done under local anesthesia & has shown effective results in the treatment of contained intervertebral disc herniatio n with no side effects.

  20. Possibilities of balneotherapy in treatment of subjective symptoms of chronic low back pain (lumbar syndrome)


    Batsialou Ioanna


    Introduction Chronic low back pain is a degenerative rheumatic disease and is characterized by various symptoms and clinical signs. Balneotherapy Balneotherapy represents a therapy by various hot or warm baths in natural mineral waters of specific physical and chemical characteristics. When used externally, they have mechanical, chemical and thermic effects. Balneotherapy of lumbar syndrome includes: individual baths, swimming in the pool, hydrokinesitherapy, underwater massage, underwater ex...

  1. The effects of infrared laser therapy and weightbath traction hydrotherapy as components of complex physical treatment in disorders of the lumbar spine: a controlled pilot study with follow-up (United States)

    Oláh, Csaba; Oláh, Mihály; Demeter, Béla; Jancsó, Zoltán; Páll, Valéria; Bender, Tamás


    Introduction: The therapeutic modalities available for the conservative management of chronic lumbar pain included infrared laser therapy and underwater traction, which usefulness is not universally acknowledged. This study was intended to ascertain any beneficial impact of infrared laser therapy and weightbath treatment on the clinical parameters and quality of life of patients with lumbar discopathy. Material and methods: The study population comprised 54 randomised subjects. I. group of 18 patents received only infrared laser therapy to lumbar region and painful Valley points. II. group of 18 subjects each received underwater traction therapy of lumbar spine with add-on McKenzie exercise and iontophoresis. The remaining III. group treated with exercise and iontophoresis, served as control. VAS, Oswestry index, SF36 scores, range of motion, neurological findings and thermography were monitored to appraise therapeutic afficacy in lumbar discopathy. A CT or MRI scan was done at baseline and after 3 months follow-up. Result:Infrared laser therapy and underwater traction for discopathy achieved significant improvement of all study parameters, which was evident 3 months later. Among the controls, significant improvement of only a single parameter was seen in patients with lumbar discopathy. Conclusions: Infrared laser therapy and underwater traction treatment effectively mitigate pain, muscle spasms, enhance joint flexibility, and improve the quality of life of patients with lumbar discopathy.

  2. Combined Anterior and Posterior Lumbar Rhizotomy for Treatment of Mixed Dystonia and Spasticity in Children With Cerebral Palsy (United States)

    Nada, Mohamed; Mahran, Mahmoud A.; Aboud, Ahmed; Mahran, Moustafa G.; Nasef, Marwa A.A.; Gaber, Mohamed; Sabry, Tamer; Ibrahim, Mohamed H.; Taha, Mohamed H.


    BACKGROUND: Children with cerebral palsy (CP) can present with severe secondary dystonia with or without associated spasticity of their extremities. OBJECTIVE: To assess the outcomes of combined anterior and posterior lumbar rhizotomy for the treatment of mixed hypertonia in the lower extremities of children with CP. METHODS: Fifty children with CP were subjected to combined anterior and posterior lumbar rhizotomies in a prospective study. Clinical outcome measurements were recorded preoperatively and were evaluated at 2, 6, and 12 months postoperatively. The operative techniques were performed by laminotomy from L1-S1, and intraoperative monitoring was used in all cases. All patients underwent intensive postoperative physiotherapy programs. RESULTS: Changes in muscle tone, joint range of motion, and dystonia were significant (P = .000) at postoperative assessment visits. CONCLUSION: This study demonstrated the potential of combined anterior and posterior lumbar rhizotomies to improve activities of daily living in children with CP and with mixed spasticity and dystonia. ABBREVIATIONS: BAD, Barry-Albright Dystonia Scale CAPR, combined anterior and posterior lumbar rhizotomy CP, cerebral palsy ITB, intrathecal baclofen MAS, modified Ashworth Scale ROM, range of motion SDR, selective dorsal rhizotomy PMID:27244465

  3. Effects of six-week exercise training protocol on pain relief in patients with lumbar disc herniation

    Directory of Open Access Journals (Sweden)

    Amir Hossein Yazdani


    Full Text Available Introduction: Paraspinal, abdominal, and core muscles are playing the main role in lumbar disc herniation. The aim of the present study was to investigate the efficacy of a 6 weeks exercise training protocol on pain relief in males and females with lumbar disc herniation. Methods: In this before-after trial study, 64 patients with lumbar disc herniation were assigned to a 6 weeks exercise training program. Training protocol included leg press, trunk lateral flexion, trunk rotation, trunk flexion/extension, and stretching exercises in two sessions a week with 25-30 minutes each. Pain was measured with visual analog scale (VAS at 1st, 6th, and 12th sessions. Results: A total of 64 patients (13 males with mean age 47.53 ± 11.71 years and 51 females with mean age 46.50 ± 11.76 years completed the protocol. The pain was significantly reduced in both males and females during sessions 6 and 12 in comparison with the first session (P = 0.001. The amount of pain relief in males was higher than females (P = 0.047. Conclusion: About 6 weeks exercise training program could reduce more pain in males with lumbar disc herniation compared to females. This core stabilizing exercise protocol could be a good recommendation for patients with disk herniated low back pain (LBP.

  4. TranS1 VEO system: a novel psoas-sparing device for transpsoas lumbar interbody fusion

    Directory of Open Access Journals (Sweden)

    Hardenbrook MA


    Full Text Available Mitchell A Hardenbrook,1,2 Larry E Miller,3,4 Jon E Block4 1Advanced Spine Institute of Greater Boston, North Billerica, MA, 2Department of Orthopedic Surgery, Tufts University School of Medicine, Boston, MA, 3Miller Scientific Consulting Inc, Arden, NC, 4The Jon Block Group, San Francisco, CA, USA Abstract: Minimally invasive approaches for lumbar interbody fusion have been popularized in recent years. The retroperitoneal transpsoas approach to the lumbar spine is a technique that allows direct lateral access to the intervertebral disc space while mitigating the complications associated with traditional anterior or posterior approaches. However, a common complication of this procedure is iatrogenic injury to the psoas muscle and surrounding nerves, resulting in postsurgical motor and sensory deficits. The TranS1 VEO system (TranS1 Inc, Raleigh, NC, USA utilizes a novel, minimally invasive transpsoas approach to the lumbar spine that allows direct visualization of the psoas and proximal nerves, potentially minimizing iatrogenic injury risk and resulting clinical morbidity. This paper describes the clinical uses, procedural details, and indications for use of the TranS1 VEO system. Keywords: fusion, lateral, lumbar, minimally invasive, transpsoas, VEO

  5. Effects of lumbar stabilization exercise on functional disability and lumbar lordosis angle in patients with chronic low back pain. (United States)

    Cho, Igsoo; Jeon, Chunbae; Lee, Sangyong; Lee, Daehee; Hwangbo, Gak


    [Purpose] This study examined the effects of lumbar stabilization exercises on the functional disability and lumbar lordosis angles in patients with chronic low back pain. [Subjects] The subjects were 30 patients with chronic low back pain divided into a lumbar stabilization exercise group (n = 15) and a conservative treatment group (n = 15). [Methods] The lumbar stabilization exercise and conservative treatment groups performed an exercise program and conservative physical treatment, respectively. Both programs were performed 3 times a week for 6 weeks. The degree of functional disability was assessed by the Oswestry disability index, and lumbar lordosis angles were measured by plain radiography. [Results] The Oswestry disability index decreased significantly in the both groups; however, it was significantly lower in the lumbar stabilization exercise group. The lumbar lordosis angle increased significantly in the lumbar stabilization exercise group after treatment and was also significantly greater than that in the conservative treatment group. [Conclusion] Lumbar stabilization exercise is more effective than conservative treatment for improving functional disability and lumbar lordosis angles.

  6. Three slow skeletal muscle troponin genes in small-tailed Han sheep (Ovis aries): molecular cloning, characterization and expression analysis. (United States)

    Sun, Yan; Wang, Guizhi; Ji, Zhibin; Chao, Tianle; Liu, Zhaohua; Wang, Xiaolong; Liu, Guanqing; Wu, Changhao; Wang, Jianmin


    To explore the basic characteristics and expressing profile of the three slow skeletal muscle troponin genes TNNC1 (Troponin C type 1), TNNI1 (troponin I type 1) and TNNT1 (troponin T type 1). Three purebred Dorper sheep and another three purebred small-tailed Han sheep were selected. The sequence of the genes from the small-tailed Han sheep was cloned using rapid amplification of cDNA ends and reverse transcription-polymerase chain reaction; The characteristics of the predicted amino acids sequences were analyzed using bioinformatics analysis software; Gene expression analyses were performed using quantitative reverse transcription PCR. The full-length cDNA sequences of the genes were 707, 898, and 1001 bp, respectively, and were submitted to GenBank under accession numbers KR153938, KT218688 and KT218690. The three predicted proteins were predicted to be hydrophilic, non-secretory proteins and contain several phosphorylation sites. Multiple alignments and phylogenetic tree analyses showed that the predicted proteins were relatively conserved in mammals. The expression results of the three genes in eight tissues of Dorper and small-tailed Han sheep revealed that the three genes had a similar mRNA expression pattern, whereas distinct differences were observed among the eight tissues of the two sheep species. We cloned the full-length cDNA of the three genes, analyzed the amino acid sequences, and determined the expression levels of the genes. These results might play important roles in facilitating the future research of the three genes.

  7. Design and characterization of a low-viscous muscle tissue mimicking media at the ISM-band (2.4–2.48 GHz) for easy antenna displacement in in vitro measurements

    DEFF Research Database (Denmark)

    Jónasson, Sævar Þór; Zhurbenko, Vitaliy; Johansen, Tom Keinicke


    Phantoms mimicking electromagnetic properties of biological tissues are widely used in evaluation of electromagnetic field distribution in human body. In this paper, low-viscous, optically transparent liquids that mimic muscle tissue, are designed and characterized. Various mixing ratios of de-io...... be produced. For example, a recipe for the grey matter of the human brain is suggested, resulting in less than 4.7% deviation. An improved recipe for muscle tissue, where Triton X-100 is added, improves the target recipe to less than 1% deviation from the reference....

  8. [Idiopathic Lumbar Hernia: A Case Report]. (United States)

    Tsujino, Takuya; Inamoto, Teruo; Matsunaga, Tomohisa; Uchimoto, Taizo; Saito, Kenkichi; Takai, Tomoaki; Minami, Koichiro; Takahara, Kiyoshi; Nomi, Hayahito; Azuma, Haruhito


    A 68-year-old woman, complained of an indolent lump about 60 × 70 mm in size in the left lower back. We conducted a computed tomography scan, which exhibited a hernia of Gerota'sfascia-commonly called superior lumbar hernia. In the right lateral position, the hernia contents were observed to attenuate, hence only closure of the hernial orifice was conducted by using Kugel patch, without removal of the hernia sack. Six months after the surgery, she has had no relapse of the hernia. Superior lumbar hernia, which occurs in an anatomically brittle region in the lower back, is a rare and potentially serious disease. The urologic surgeon should bear in mind this rarely seen entity.

  9. Laparoscopic transabdominal extraperitoneal repair of lumbar hernia

    Directory of Open Access Journals (Sweden)

    Sharma A


    Full Text Available Lumbar hernias need to be repaired due to the risk of incarceration and strangulation. A laparoscopic intraperitoneal approach in the modified flank position causes the intraperitoneal viscera to be displaced medially away from the hernia. The creation of a wide peritoneal flap around the hernial defect helps in mobilization of the colon, increased length of margin is available for coverage of mesh and more importantly for secure fixation of the mesh under vision to the underlying fascia. Laparoscopic lumbar hernia repair by this technique is a tensionless repair that diffuses total intra-abdominal pressure on each square inch of implanted mesh. The technique follows current principles of hernia repair and appears to confer all benefits of a minimal access approach.

  10. Single incision endoscopic surgery for lumbar hernia. (United States)

    Kawaguchi, Masahiko; Ishikawa, Norihiko; Shimizu, Satsuki; Shin, Hisato; Matsunoki, Aika; Watanabe, Go


    Single Incision Endoscopic Surgery (SIES) has emerged as a less invasive surgery among laparoscopic surgeries, and this approach for incisional hernia was reported recently. This is the first report of SIES for an incisional lumbar hernia. A 66-year-old Japanese woman was referred to our institution because of a left flank hernia that developed after left iliac crest bone harvesting. A 20-mm incision was created on the left side of the umbilicus and all three trocars (12, 5, and 5 mm) were inserted into the incision. The hernial defect was 14 × 9 cm and was repaired with intraperitoneal onlay mesh and a prosthetic graft. The postoperative course was uneventful. SIES for lumbar hernia offers a safe and effective outcome equivalent compared to laparoscopic surgery. In addition, SIES is less invasive and has a cosmetic benefit.

  11. Hemophilic pseudotumor of the first lumbar vertebra

    Directory of Open Access Journals (Sweden)

    Gurusamy Nachimuthu


    Full Text Available Hemophilic pseudotumor involving the spine is extremely uncommon and presents a challenging problem. Preoperative planning, angiography, intra and perioperative monitoring with factor VIII cover and postoperative care for hemophilic pseudotumor is vital. Recognition of the artery of Adamkiewicz in the thoracolumbar junction helps to avoid intraoperative neurological injury. We report the case of a 26-year-old male patient with hemophilia A, who presented with a massive pseudotumor involving the first lumbar vertebra and the left iliopsoas. Preoperative angiography revealed the artery of Adamkiewicz arising from the left first lumbar segmental artery. Excision of pseudotumor was successfully carried out with additional spinal stabilization. At 2 years followup, there was no recurrence and the patient was well stabilized with a satisfactory functional status. Surgical excision gives satisfactory outcome in such cases.

  12. Oriental Medical Treatment of Lumbar Spinal Stenosis

    Directory of Open Access Journals (Sweden)

    Hae-Yeon Lee


    Full Text Available Lumbar spinal stenosis results from the progressive combined narrowing of the central spinal canal, the neurorecesses, and the neuroforaminal canals. In the absence of prior surgery, tumor, or infection, the spinal canal may become narrowed by bulging or protrusion of the intervertebral disc annulus, herniation of the nucleus pulposis posteriorly, thickening of the posterior longitudinal ligament, hypertrophy of the ligamentum flavum, epidural fat deposition, spondylosis of the intervertebral disc margins, or a combination of two or more of the above factors. Patients with spinal stenosis become symptomatic when pain, motor weakness, paresthesia, or other neurologic compromise causes distress. In one case, we administrated oriental medical treatment with acupuncture treatment and herb-medicine. Oriental medical treatment showed desirable effect on lumbar spinal stenosis.

  13. Costs and effects in lumbar spinal fusion

    DEFF Research Database (Denmark)

    Soegaard, Rikke; Christensen, Finn Bjarke; Christiansen, Terkel


    ) instrumented posterolateral lumbar spinal fusion, or (3) instrumented posterolateral lumbar spinal fusion + anterior intervertebral support. Analysis of costs was performed at the patient-level, from an administrator's perspective, by means of Activity-Based-Costing. Clinical effects were measured by means...... of the Dallas Pain Questionnaire and the Low Back Pain Rating Scale at baseline and 2 years postoperatively. Regression models were used to reveal determinants for costs and effects. Costs and effects were analyzed as a net-benefit measure to reveal determinants for cost-effectiveness, and finally, adjusted...... of the present investigation is a recommendation to focus further on determinants of cost-effectiveness. For example, patient characteristics that are modifiable at a relatively low expense may have greater influence on cost-effectiveness than the surgical technique itself--at least from an administrator...

  14. [Covering of a thoraco-lumbar defect by omentoplasty]. (United States)

    Le Fourn, B; Loirat, Y; Sartre, J Y; Lejeune, F; Pannier, M


    With a case of thoraco-lumbar defect, the authors discuss about different procedures to cover it. In this place, the better procedure is certainly the latissimus dorsi flap, in all combinations. The indication for omentoplasty at this spinal site should not be performed by first intention but by exclusion of other procedures, as in the case considered by the authors. It was a 37-year-old man, paraplegic from the age of 16, with a deep chronic spinal wound, secondary to sepsis of a posterior segmental fixations. A staphylococcus aureus infection which developed as a surgical complication was initially treated with antibiotics and surgical cleaning procedures without removing instrumentation. However, the infection remained active and the material was finally removed. Spinal immobilisation was strengthened by external fixation. The area was cleared of all suspect material, including bone graft, leaving a wide back-wound open to the spine. Spontaneous healing was first attempted, but the size and the chronicity of the wound led us to use pedicled greater omentum to close the defect. The omentum was pedicled on the right gastroepiploic vessels and transferred to the back wound through the posterior abdominal wall muscles, next to the right kidney. This procedure allows rapid healing. In association with suitable antibiotics, it has prevented any recurrent infection after 18 months of follow-up. It was no feasible to cover the wound with a latissimus dorsi flap, considering the importance of this muscle in the movements of a paraplegic and considering the initial impossibility of removing the external fixation.

  15. Mast Quadrant-assisted Minimally Invasive Modified Transforaminal Lumbar Interbody Fusion: Single Incision Versus Double Incision

    Directory of Open Access Journals (Sweden)

    Xin-Lei Xia


    Full Text Available Background: The concept of minimally invasive techniques is to make every effort to reduce tissue damage. Certainly, reducing skin incision is an important part of these techniques. This study aimed to investigate the clinical feasibility of Mast Quadrant-assisted modified transforaminal lumbar interbody fusion (TLIF with a small single posterior median incision. Methods: During the period of March 2011 to March 2012, 34 patients with single-segment degenerative lumbar disease underwent the minimally invasive modified TLIF assisted by Mast Quadrant with a small single posterior median incision (single incision group. The cases in this group were compared to 37 patients with single-segment degenerative lumbar disease in the double incision group. The perioperative conditions of patients in these two groups were statistically analyzed and compared. The Oswestry Disability Index (ODI scores, Visual Analog Scale (VAS scores, and sacrospinalis muscle damage evaluation indicators before operation and 3, 12 months postoperation were compared. Results: A total of 31 and 35 cases in the single incision and double incision groups, respectively, completed at least 12 months of systemic follow-up. The differences in perioperative conditions between the two groups were not statistically significant. The incision length of the single incision group was significantly shorter than that of the double incision group (P < 0.01. The ODI and VAS scores of patients in both groups improved significantly at 3 and 12 months postoperation. However, these two indicators at 3 and 12 months postoperation and the sacrospinalis muscle damage evaluation indicators at 3 months postoperation did not differ significantly between the two groups (P ≥ 0.05. Conclusions: Mast Quadrant-assisted modified TLIF with a small single posterior median incision has excellent clinical feasibility compared to minimally invasive TLIF with a double paramedian incision.

  16. Mast Quadrant-assisted Minimally Invasive Modified Transforaminal Lumbar Interbody Fusion: Single Incision Versus Double Incision

    Institute of Scientific and Technical Information of China (English)

    Xin-Lei Xia; Hong-Li Wang; Fei-Zhou Lyu; Li-Xun Wang; Xiao-Sheng Ma; Jian-Yuan Jiang


    Background:The concept of minimally invasive techniques is to make every effort to reduce tissue damage.Certainly,reducing skin incision is an important part of these techniques.This study aimed to investigate the clinical feasibility of Mast Quadrant-assisted modified transforaminal lumbar interbody fusion (TLIF) with a small single posterior median incision.Methods:During the period of March 2011 to March 2012,34 patients with single-segment degenerative lumbar disease underwent the minimally invasive modified TLIF assisted by Mast Quadrant with a small single posterior median incision (single incision group).The cases in this group were compared to 37 patients with single-segment degenerative lumbar disease in the double incision group.The perioperative conditions of patients in these two groups were statistically analyzed and compared.The Oswestry Disability Index (ODI) scores,Visual Analog Scale (VAS) scores,and sacrospinalis muscle damage evaluation indicators before operation and 3,12 months postoperation were compared.Results:A total of 31 and 35 cases in the single incision and double incision groups,respectively,completed at least 12 months of systemic follow-up.The differences in perioperative conditions between the two groups were not statistically significant.The incision length of the single incision group was significantly shorter than that of the double incision group (P < 0.01).The ODI and VAS scores of patients in both groups improved significantly at 3 and 12 months postoperation.However,these two indicators at 3 and 12 months postoperation and the sacrospinalis muscle damage evaluation indicators at 3 months postoperation did not differ significantly between the two groups (P ≥ 0.05).Conclusions:Mast Quadrant-assisted modified TLIF with a small single posterior median incision has excellent clinical feasibility compared to minimally invasive TLIF with a double paramedian incision.

  17. Decreased task duration and unchanged trunk muscle activity in low-back pain patients during stair climbing after back extensor muscle fatigue

    DEFF Research Database (Denmark)

    Larsen, Lars Henrik; Østergaard, Gert Værge; Brogner, Heidi Marie


    Low-back pain (LBP) is a major problem. Spine control and stability mechanisms are important but the knowledge of these parameters in functions is sparse. 7 healthy / 5 recurrent mild-to-moderate LBP patients participated in assessment of abdominal, lumbar and gluteal muscles' surface EMG and video......- and abdominal muscle activity in healthy than in patients in most phases, but during descend transfer patients activity decreased. In LBP patients back extensor fatigue resulted in decreased muscular activity in the trunk muscles during stair stepping compared to healthy. Decreased duration of the motor tasks...... recording during 10 concurrent stair steps pre / post lumbar extensor muscle exhaustion. Duration of gait tasks were shorter in LBP patients generally and longer during load and shorter during transfer in descend stepping after back extensor fatigue. Back extensor fatigue resulted in higher back...

  18. Pedicular stress fracture in the lumbar spine

    Energy Technology Data Exchange (ETDEWEB)

    Chong, V.F.H.; Htoo, M.M. [Singapore General Hospital, Singapore, (Singapore). Department of Diagnostic Radiology


    Spondylolisthesis with or without spondylolysis is common in the lumbar spine. Associated fracture in the pedicle (`pediculolysis`) is unusual. The margins of pedicular stress fractures, like spondylolysis, usually appear sclerotic. A patient with a pedicular stress fracture with minimal marginal sclerosis suggesting an injury of recent onset is presented here. There was associated bilateral spondylolysis. The findings in this patient suggest that established pediculolysis probably represents a stress fracture that has failed to heal. (authors). 10 refs., 2 figs.

  19. Lumbar discal cyst in an elite athlete. (United States)

    Singleton, Alex; Agarwal, Vikas; Casagranda, Bethany; Hughes, Marion A; Rothfus, William E


    Our patient, a 22-year-old starting wide receiver for an NCAA Division I football team, presented with low back pain and sciatica. A lumbar-spine MRI without contrast demonstrated findings suspicious for discal cyst. The patient was referred for surgery, and the lesion was resected. The rarity of discal cyst makes it difficult to diagnose because most radiologists are not aware of the entity. An organized approach to diagnosis can facilitate appropriate management.

  20. Computed tomography as the primary radiological examination of lumbar spine

    Energy Technology Data Exchange (ETDEWEB)

    Ilkko, E.; Laehde, S.


    A series of 235 patients examined by lumbar CT because of sciatica or other low back disorder was studied. The need of additional examinations and correlations to surgical findings were evaluated. Inadequate information was the cause of additional examination, mostly myelography in 20 patients (8,5%). It was concluded that lumbar CT is a suitable first examination of the lumbar spine in sciatica and low back pain. The indications to complementary myelography and its benefit are discussed.

  1. Etiology of lumbar lordosis and its pathophysiology: a review of the evolution of lumbar lordosis, and the mechanics and biology of lumbar degeneration. (United States)

    Sparrey, Carolyn J; Bailey, Jeannie F; Safaee, Michael; Clark, Aaron J; Lafage, Virginie; Schwab, Frank; Smith, Justin S; Ames, Christopher P


    The goal of this review is to discuss the mechanisms of postural degeneration, particularly the loss of lumbar lordosis commonly observed in the elderly in the context of evolution, mechanical, and biological studies of the human spine and to synthesize recent research findings to clinical management of postural malalignment. Lumbar lordosis is unique to the human spine and is necessary to facilitate our upright posture. However, decreased lumbar lordosis and increased thoracic kyphosis are hallmarks of an aging human spinal column. The unique upright posture and lordotic lumbar curvature of the human spine suggest that an understanding of the evolution of the human spinal column, and the unique anatomical features that support lumbar lordosis may provide insight into spine health and degeneration. Considering evolution of the skeleton in isolation from other scientific studies provides a limited picture for clinicians. The evolution and development of human lumbar lordosis highlight the interdependence of pelvic structure and lumbar lordosis. Studies of fossils of human lineage demonstrate a convergence on the degree of lumbar lordosis and the number of lumbar vertebrae in modern Homo sapiens. Evolution and spine mechanics research show that lumbar lordosis is dictated by pelvic incidence, spinal musculature, vertebral wedging, and disc health. The evolution, mechanics, and biology research all point to the importance of spinal posture and flexibility in supporting optimal health. However, surgical management of postural deformity has focused on restoring posture at the expense of flexibility. It is possible that the need for complex and costly spinal fixation can be eliminated by developing tools for early identification of patients at risk for postural deformities through patient history (genetics, mechanics, and environmental exposure) and tracking postural changes over time.

  2. Subarachnoid hemorrhage due to retained lumbar drain. (United States)

    Guppy, Kern H; Silverthorn, James W; Akins, Paul T


    Intrathecal spinal catheters (lumbar drains) are indicated for several medical and surgical conditions. In neurosurgical procedures, they are used to reduce intracranial and intrathecal pressures by diverting CSF. They have also been placed for therapeutic access to administer drugs, and more recently, vascular surgeons have used them to improve spinal cord perfusion during the treatment of thoracic aortic aneurysms. Insertion of these lumbar drains is not without attendant complications. One complication is the shearing of the distal end of the catheter with a resultant retained fragment. The authors report the case of a 65-year-old man who presented with a subarachnoid hemorrhage due to the migration of a retained lumbar drain that sheared off during its removal. To the best of the authors' knowledge, this is the first case of rostral migration of a retained intrathecal catheter causing subarachnoid hemorrhage. The authors review the literature on retained intrathecal spinal catheters, and their findings support either early removal of easily accessible catheters or close monitoring with serial imaging.

  3. X-Ray parameters of lumbar spine

    Directory of Open Access Journals (Sweden)

    Otabek Ablyazov


    Full Text Available Knowledge of anatomic spinal structures, especially its relation-ship to the functions performed, is necessary to form a correct diagnosis. The anatomical structure of the vertebrae varies de-pending on the level of the spinal segment. Normal anatomical parameters, derived from bone structures of the spine, are roughly determined by X-ray method.This paper presents the results of the survey radiography of the lumbar spine in a straight line and lateral projections in 30 individ-uals without pathology spine, aged 21-60 years with frequently observed lumbar spinal stenosis stenosis. Applying X-ray method there were studied shape, height, and the contours of the vertebral bodies and intervertebral disc in the front (interpedicular and sagittal planes; there were measured dimensions of the lumbar canal and foramen holes in the same planes. Using X-ray method can fully identify the bone parameters of vertebral column. How-ever, the informativity of the method depends on knowledge of radiologist about topographic anatomical features of spine.

  4. A proposta biomecânica para a avaliação de sobrecarga na coluna lombar: efeito de diferentes variáveis demográficas na fadiga muscular A biomechamical approach for assessment of overload on lumbar spine: the effects of different demographic variables on muscle fatigue

    Directory of Open Access Journals (Sweden)

    Fernando Sérgio Silva Barbosa


    Full Text Available OBJETIVOS: Analisar a fadiga de músculos lombares e determinar as variáveis demográficas relacionadas com a fadiga destes músculos. MÉTODOS: A atividade eletromiográfica (EMG dos músculos iliocostal direito (IL-D, iliocostal esquerdo (IL-E, multífido direito (MU-D e multífido esquerdo (MU-E de 18 voluntários foi captada durante contrações isométricas sub-máximas. Valores de root mean square (RMS e freqüência mediana (FM foram correlacionados com o tempo de resistência isométrica (TRI. Slopes de RMS positivos e de FM negativos indicaram a ocorrência da fadiga muscular. Procedimentos de regressão múltipla foram realizados para verificar as variáveis demográficas relacionadas com a fadiga muscular. RESULTADOS: A fadiga foi identificada em todos os músculos e intensidades de contração (pOBJECTIVES: To assess low back muscles fatigue and to determine the demographic variables associated to fatigue on these muscles. METHODS: The electromyographic (EMG activity of the right iliocostal (R-IL, left iliocostal (L-IL, right multifidus (R-MU and left multifidus (L-MU of 18 volunteers was recorded during submaximal isometric contractions. Root mean square (RMS and median frequency (MF values were correlated with isometric endurance time (IET. Positive RMS and negative MF slopes indicated occurrence of muscle fatigue. Multiple regression procedures were performed in order to verify the demographic variables related with the muscle fatigue. RESULTS: Fatigue was identified in all muscles and contraction intensities (p<0.01, except for MU-E at 5% in RMS slope analysis. Significant differences were found between the endurance time of 5% and 15% (p=0.01, 5% and 20% (p=0.0002. Higher levels of fatigue were found bilaterally in the multifidus muscles in the MF slope analysis. The combination of endurance time, age and body mass of the volunteers was identified as the determinant factor for the occurrence of muscle fatigue in the assessed

  5. Intradural lumbar disc herniation after percutaneous endoscopic lumbar discectomy: case report. (United States)

    Tamaki, Yasuaki; Sakai, Toshinori; Miyagi, Ryo; Nakagawa, Takefumi; Shimakawa, Tateaki; Sairyo, Koichi; Chikawa, Takashi


    A 64-year-old man was referred to the authors with low-back pain (LBP) and right leg pain with a history of previously diagnosed lumbar disc herniation (LDH) at L4-5. He had undergone 2 percutaneous endoscopic lumbar discectomies (PELDs) for the herniation at another institution, and according to the surgical record of the second surgery, a dural tear occurred intraoperatively but was not repaired. Postoperative conservative treatments such as an epidural block and blood patch had not relieved his persistent LBP or right leg pain. Upon referral to the authors, MRI and myelography revealed an intradural LDH. The herniated mass was removed by durotomy, and posterior lumbar interbody fusion was performed. His symptoms were partially improved after surgery. Primary suture is technically difficult when a dural tear occurs during PELD. Therefore, close attention should be paid to avoiding such tears, and surgeons should increase their awareness of intradural LDH as a possible postoperative complication of PELD.

  6. Effects of age and inactivity due to prolonged bed rest on atrophy of trunk muscles. (United States)

    Ikezoe, Tome; Mori, Natsuko; Nakamura, Masatoshi; Ichihashi, Noriaki


    This study investigated the effects of age and inactivity due to being chronically bedridden on atrophy of trunk muscles. The subjects comprised 33 young women (young group) and 41 elderly women who resided in nursing homes or chronic care institutions. The elderly subjects were divided into two groups: independent elderly group who were able to perform activities of daily living involving walking independently (n = 28) and dependent elderly group who were chronically bedridden (n = 13). The thickness of the following six trunk muscles was measured by B-mode ultrasound: the rectus abdominis, external oblique, internal oblique, transversus abdominis, thoracic erector spinae (longissimus) and lumbar multifidus muscles. All muscles except for the transversus abdominis and lumbar multifidus muscles were significantly thinner in the independent elderly group compared with those in the young group. The thicknesses of all muscles in the dependent elderly group was significantly smaller than that in the young group, whereas there were no differences between the dependent elderly and independent elderly groups in the muscle thicknesses of the rectus abdominis and internal oblique muscles. In conclusion, our results suggest that: (1) age-related atrophy compared with young women was less in the deep antigravity trunk muscles than the superficial muscles in the independent elderly women; (2) atrophy associated with chronic bed rest was more marked in the antigravity muscles, such as the back and transversus abdominis.

  7. The Effects of Stretching with Lumbar Traction on VAS and Oswestry Scales of Patients with Lumbar 4-5 Herniated Intervertebral Disc. (United States)

    Yang, Hae-Sun; Yoo, Won-Gyu


    [Purpose] This study investigated the effect of stretching with lumbar traction on VAS and Oswestry scale scores of lumbar 4-5 herniated intervertebral disc (HIVD) patients. [Subjects] We recruited 20 lumbar 4-5 HIVD patients. [Methods] We performed stretching with lumbar traction for lumbar 4-5 HIVD patients during 4 weeks. The VAS and Oswestry scales were measured before and 4 weeks after the intervention. [Results] The results showed a significant decrease in VAS scale scores for stretching with lumbar traction in lumbar 4-5 HIVD patients, from 18±1.29 to 2.1±1.35. The Oswestry scale scores also decreased significantly, from 20.35±2.01 to 3.5±2.84, after stretching with lumbar traction. [Conclusion] Thus, we suggest stretching with lumbar traction for lumbar 4-5 HIVD patients.

  8. The Variation in the Lumbar Facet Joint Orientation in an Adult Asian Population and Its Relationship with the Cross-Sectional Area of the Multifidus and Erector Spinae (United States)

    Katayose, Masaki; Watanabe, Kota


    Study Design Cross-sectional study of healthy volunteers. Purpose We aimed to investigate the variation in the lumbar facet joint orientation in an adult Asian population. The relationship between the facet joint orientation and muscle cross-sectional area (CSA) of multifidus and erector spinae was also clarified. Overview of Literature Several studies have reported that lumbar pathologies, such as lumbar spondylolysis and degenerative spondylolisthesis, were related to the horizontally shaped lumbar facet joint orientation at the lower lumbar level. However, data regarding variations in the facet joint orientation in asymptomatic subjects have not been well documented. Methods In 31 healthy male adult Asian volunteers, the facet joint orientation and CSA of multifidus and erector spinae were measured using magnetic resonance imaging at the L4–5 and L5–S1 levels. Variation in the facet joint orientation was examined using coefficients of variation (CV). Pearson's product-moment coefficient was used to investigate the relationship between the facet joint orientation and CSA of multifidus and erector spinae. Results Lumbar facet joint orientation had a wider range of variation at L5–S1 (CV=0.30) than at L4–5 (CV=0.18). The L4–5 facet joint orientation had a weak but significant correlation with the CSA of erector spinae (r=0.40; p=0.031). The CSA of the multifidus had no relationship with the facet joint orientation at the L4–5 (r=0.19; p=0.314) and the L5–S1 level (r=0.19; p=0.312). Conclusions The lumbar facet joint orientation was found to have a wide variation, particularly at the L5–S1 in the Asian adult population, and the facet joint orientation had a relationship with the CSA of the erector spinae at the L4–5.

  9. Percutaneous lumbar foraminoplasty via posterolateral approach and transforaminal endoscopic discectomy%经皮侧后路腰椎间孔成形与经椎间孔完全内镜下腰椎间盘摘除术

    Institute of Scientific and Technical Information of China (English)

    李振宙; 侯树勋


    Conventional open discectomy is a standard surgical method for lumbar disc herniation. But iatrogenic injury to paraspinal muscle and facet joint may cause postoperative chronic low back pain and segamental instability, which can lead to reoccurence of lumbar disc herniation. Epidural scarr fomation arised from flavum resection in open discectomy is inavoidable with 10%of it leading to failed back sugery syndrome. Transforaminal endoscopic discectomy can be performed without iatrogenic injury to paraspinal muscle, facet joint and flavum ligament. Foraminoplasty is a technique that enlarge the low part of intervertebral foramen with different tools so that working channel and endoscope can be introduced into epidural space anterior to dura sac where protruted disc tissue can be targeted resected and nerve root complete decompressed. It can be treated as an alternative surgical technique for lumbar disc herniation.

  10. Combined anterior lumbar interbody fusion and instrumented posterolateral fusion for degenerative lumbar scoliosis: indication and surgical outcomes


    Hsieh, Ming-Kai; Chen, Lih-Huei; Niu, Chi-Chien; Fu, Tsai-Sheng; Lai, Po-Liang; Chen, Wen-Jer


    Background Traditional approaches to deformity correction of degenerative lumbar scoliosis include anterior-posterior approaches and posterior-only approaches. Most patients are treated with posterior-only approaches because the high complication rate of anterior approach. Our purpose is to compare and assess outcomes of combined anterior lumbar interbody fusion and instrumented posterolateral fusion with posterior alone approach for degenerative lumbar scoliosis with spinal stenosis. Methods...

  11. Stabilization of lumbar-pelvic region in the syndrome of inespecific lumbar pain


    Kock Schulz, Alejandro; Morales Osorio, Marco Antonio; Mejia Mejia, Johana Milena


    Objective. To learn about the various tissues which may contribute to stabilization of lumbar-pelvic region and integrate them to treatment of non-specific lumbar pain syndrome. Methodology. An electronic sear was carried out at PEDro, Cochrane, MEDLINE, CINAHL, EMBASE y  ScienceDirect data bases, of articles published between January 01, 1990, through December 31, 201. 105 potentially eligible articles were identified, selected in function of the title, and summary; 20 primary documents of w...

  12. Cerebrospinal fluid pulse pressure amplitude during lumbar infusion in idiopathic normal pressure hydrocephalus can predict response to shunting

    Directory of Open Access Journals (Sweden)

    Brean Are


    Full Text Available Abstract Background We have previously seen that idiopathic normal pressure hydrocephalus (iNPH patients having elevated intracranial pressure (ICP pulse amplitude consistently respond to shunt surgery. In this study we explored how the cerebrospinal fluid pressure (CSFP pulse amplitude determined during lumbar infusion testing, correlates with ICP pulse amplitude determined during over-night ICP monitoring and with response to shunt surgery. Our goal was to establish a more reliable screening procedure for selecting iNPH patients for shunt surgery using lumbar intrathecal infusion. Methods The study population consisted of all iNPH patients undergoing both diagnostic lumbar infusion testing and continuous over-night ICP monitoring during the period 2002-2007. The severity of iNPH was assessed using our NPH grading scale before surgery and 12 months after shunting. The CSFP pulse was characterized from the amplitude of single pressure waves. Results Totally 62 iNPH patients were included, 45 of them underwent shunt surgery, in whom 78% were shunt responders. Among the 45 shunted patients, resistance to CSF outflow (Rout was elevated (≥ 12 mmHg/ml/min in 44. The ICP pulse amplitude recorded over-night was elevated (i.e. mean ICP wave amplitude ≥ 4 mmHg in 68% of patients; 92% of these were shunt responders. In those with elevated overnight ICP pulse amplitude, we found also elevated CSFP pulse amplitude recorded during lumbar infusion testing, both during the opening phase following lumbar puncture and during a standardized period of lumbar infusion (15 ml Ringer over 10 min. The clinical response to shunting after 1 year strongly associated with the over-night ICP pulse amplitude, and also with the pulsatile CSFP during the period of lumbar infusion. Elevated CSFP pulse amplitude during lumbar infusion thus predicted shunt response with sensitivity of 88 and specificity of 60 (positive and negative predictive values of 89 and 60

  13. Immunoreactivity for alpha-smooth muscle actin characterizes a potentially aggressive subgroup of little basal cell carcinomas

    Directory of Open Access Journals (Sweden)

    L Pilloni


    Full Text Available Basal cell carcinoma (BCC is a very common malignant skin tumor that rarely metastatizes, but is often locally aggressive. Several factors, like large size (more than 3 cm, exposure to ultraviolet rays, histological variants, level of infiltration and perineural or perivascular invasion, are associated with a more aggressive clinical course. These morphological features seem to be more determinant in mideface localized BCC, which frequently show a significantly higher recurrence rate. An immunohistochemical profile, characterized by reactivity of tumor cells for p53, Ki67 and alpha-SMA has been associated with a more aggressive behaviour in large BCCs. The aim of this study was to verify if also little (less than 3 cm basal cell carcinomas can express immunohistochemical markers typical for an aggressive behaviour.

  14. Lumbar disk herniation surgery: outcome and predictors. (United States)

    Sedighi, Mahsa; Haghnegahdar, Ali


    Study Design A retrospective cohort study. Objectives To determine the outcome and any differences in the clinical results of three different surgical methods for lumbar disk herniation and to assess the effect of factors that could predict the outcome of surgery. Methods We evaluated 148 patients who had operations for lumbar disk herniation from March 2006 to March 2011 using three different surgical techniques (laminectomy, microscopically assisted percutaneous nucleotomy, and spinous process osteotomy) by using Japanese Orthopaedic Association (JOA) Back Pain Evaluation Questionnaire, Resumption of Activities of Daily Living scale and changes of visual analog scale (VAS) for low back pain and radicular pain. Our study questionnaire addressed patient subjective satisfaction with the operation, residual complaints, and job resumption. Data were analyzed with SPSS version 16.0 (SPSS, Inc., Chicago, Illinois, United States). Statistical significance was set at 0.05. For statistical analysis, chi-square test, Mann-Whitney U test, Kruskal-Wallis test, and repeated measure analysis were performed. For determining the confounding factors, univariate analysis by chi-square test was used and followed by logistic regression analysis. Results Ninety-four percent of our patients were satisfied with the results of their surgeries. VAS documented an overall 93.3% success rate for reduction of radicular pain. Laminectomy resulted in better outcome in terms of JOA Back Pain Evaluation Questionnaire. The outcome of surgery did not significantly differ by age, sex, level of education, preoperative VAS for back, preoperative VAS for radicular pain, return to previous job, or level of herniation. Conclusion Surgery for lumbar disk herniation is effective in reducing radicular pain (93.4%). All three surgical approaches resulted in significant decrease in preoperative radicular pain and low back pain, but intergroup variation in the outcome was not achieved. As indicated

  15. Age-related changes in muscle strength and spinal kyphosis angles in an elderly Japanese population (United States)

    Kasukawa, Yuji; Miyakoshi, Naohisa; Hongo, Michio; Ishikawa, Yoshinori; Kudo, Daisuke; Suzuki, Masazumi; Mizutani, Takashi; Kimura, Ryouta; Ono, Yuichi; Shimada, Yoichi


    Lumbar kyphosis and the decreased mobility of the lumbar spine increase the risk of falls and impair both the quality of life and the ability to perform activities of daily living. However, in the elderly Japanese population, little is known about the age-related changes and sex-related differences in muscle strength, including of the upper and lower extremities and back extensors. An adequate kyphotic or lordotic angle has also not been determined. In this study, we evaluated the age-related changes in muscle strength and spinal kyphosis in 252 males and 320 females ≥50 years of age. Grip, back extensor, hip flexor, and knee extensor strength; thoracic and lumbar kyphosis; and spinal inclination in the neutral standing position were assessed, together with the range of motion of the thoracic and lumbar spine and spinal inclination. Grip strength, back extensor strength, and the strength of the hip flexors and knee extensors decreased significantly with aging, both in males (P<0.0001) and in females (P=0.0015 to P<0.0001). The lumbar but not the thoracic kyphosis angle decreased significantly with aging, only in females (P<0.0001). Spinal inclination increased significantly with aging in both males (P=0.002) and females (P<0.0001). Back extensor strength and the thoracic kyphosis angle were significant variables influencing the lumbar kyphosis angle in both sexes. Spinal inclination correlated significantly with both the lumbar kyphosis angle and hip flexor strength in males, as well as with the lumbar kyphosis angle in females.

  16. The Effects of Stretching with Lumbar Traction on VAS and Oswestry Scales of Patients with Lumbar 4–5 Herniated Intervertebral Disc


    Yang, Hae-sun; Yoo, Won-gyu


    [Purpose] This study investigated the effect of stretching with lumbar traction on VAS and Oswestry scale scores of lumbar 4–5 herniated intervertebral disc (HIVD) patients. [Subjects] We recruited 20 lumbar 4–5 HIVD patients. [Methods] We performed stretching with lumbar traction for lumbar 4–5 HIVD patients during 4 weeks. The VAS and Oswestry scales were measured before and 4 weeks after the intervention. [Results] The results showed a significant decrease in VAS scale scores for stretchin...


    Sheshaberidze, E; Merabishvili, I; Loria, M


    The goal of the paper is to substantiate the essence of ridetherapy biomechanics as the pathogenetic therapeutic and prophylactic method at lumbar dysplastic (the I and II degrees) and static (short-legged induced) scoliosis. Uneven lower extremities caused by any reason and asymmetric support induce the change in the arrangement of trochantin to the vertebra and correspondingly the uneven loading of lumbar muscles. The asymmetric strength of lumbar muscles evoked by the change in rotator condition becomes the cause of the formation of scoliosis primary arc which, in its turn, causes a compensatory spinal curvature. In case of dysplastic scoliosis a leading role belongs to the beginning of dystrophic changes in intervertebral discs and its further decentration. At riding position the lower extremities are completely disengaged from the antigravity redistribution, the child is in direct contact with vibrations and jolts coming from the horseback; the antigravity loading is distributed on the muscles of the torso and thus, it creates an opportunity to purposefully affect the correction of the spine. During scoliosis the pathogenic essence of ridetherapy is due to the comprehensiveness of its procedures, expressed in the fact that during one procedure several factors are influenced simultaneously: nucleus pulpous, the torso and iliopsoas muscles, the antigravity system, etc. According to the clinical-functional and radiographic studies carried out in the dynamics on 11-16 years old adolescents it has been established that in those groups where the rehabilitation was conducted in a complex with ridetherapy the authentically higher results were obtained as compared to the groups where the rehabilitation was held using therapeutic exercises and massage.

  18. Breast muscle tissue characteristics in growing broilers (United States)

    Muscle cell development in broilers influences growth rate, breast meat yield, and meat quality. The objective of this study was to characterize muscle tissue changes in breast muscles from two commercial lines of broilers from 21 to 56 days of age. The experiment was designed as a 2×2×6 factorial...

  19. Intramuscular variation in fresh ham muscle color (United States)

    This experiment was conducted to characterize a defect involving pale muscle tissue in the superficial, ventral portion of ham muscles, resulting in two-toned appearance of cured ham products. Biceps femoris muscles (n = 200), representing 3 production systems, were obtained from the ham-boning lin...

  20. Comparison of percutaneous endoscopic lumbar discectomy and open lumbar surgery for adjacent segment degeneration and recurrent disc herniation. (United States)

    Chen, Huan-Chieh; Lee, Chih-Hsun; Wei, Li; Lui, Tai-Ngar; Lin, Tien-Jen


    Objective. The goal of the present study was to examine the clinical results of percutaneous endoscopic lumbar discectomy (PELD) and open lumbar surgery for patients with adjacent segment degeneration (ASD) and recurrence of disc herniation. Methods. From December 2011 to November 2013, we collected forty-three patients who underwent repeated lumbar surgery. These patients, either received PELD (18 patients) or repeated open lumbar surgery (25 patients), due to ASD or recurrence of disc herniation at L3-4, L4-5, or L5-S1 level, were assigned to different groups according to the surgical approaches. Clinical data were assessed and compared. Results. Mean blood loss was significantly less in the PELD group as compared to the open lumbar surgery group (P < 0.0001). Hospital stay and mean operating time were shorter significantly in the PELD group as compared to the open lumbar surgery group (P < 0.0001). Immediate postoperative pain improvement in VAS was 3.5 in the PELD group and -0.56 in the open lumbar surgery group (P < 0.0001). Conclusion. For ASD and recurrent lumbar disc herniation, PELD had more advantages over open lumbar surgery in terms of reduced blood loss, shorter hospital stay, operating time, fewer complications, and less postoperative discomfort.

  1. Comparison of Percutaneous Endoscopic Lumbar Discectomy and Open Lumbar Surgery for Adjacent Segment Degeneration and Recurrent Disc Herniation

    Directory of Open Access Journals (Sweden)

    Huan-Chieh Chen


    Full Text Available Objective. The goal of the present study was to examine the clinical results of percutaneous endoscopic lumbar discectomy (PELD and open lumbar surgery for patients with adjacent segment degeneration (ASD and recurrence of disc herniation. Methods. From December 2011 to November 2013, we collected forty-three patients who underwent repeated lumbar surgery. These patients, either received PELD (18 patients or repeated open lumbar surgery (25 patients, due to ASD or recurrence of disc herniation at L3-4, L4-5, or L5-S1 level, were assigned to different groups according to the surgical approaches. Clinical data were assessed and compared. Results. Mean blood loss was significantly less in the PELD group as compared to the open lumbar surgery group P<0.0001. Hospital stay and mean operating time were shorter significantly in the PELD group as compared to the open lumbar surgery group P<0.0001. Immediate postoperative pain improvement in VAS was 3.5 in the PELD group and −0.56 in the open lumbar surgery group P<0.0001. Conclusion. For ASD and recurrent lumbar disc herniation, PELD had more advantages over open lumbar surgery in terms of reduced blood loss, shorter hospital stay, operating time, fewer complications, and less postoperative discomfort.

  2. Rehabilitation nursing experience for acute lumbar sprain%急性腰扭伤的康复护理体会

    Institute of Scientific and Technical Information of China (English)

    吴花梅; 吴玲; 刘岩


    @@ TREATMENT EXPERIENCE FOR LUMBAR SPRAIN Massage and traction are often used in treatment of lumbar sprainto alleviate adhesion of muscle and ligament, enlarge intervertebralspace. At the same time, local dialysis, physical therapy might beused, also acupuncture moxibustion. To massage treatment, painpoints at lumbodorsal or lumbosacral part are massaged for 15minutes, thereafter pressed for 10 minutes to promote lumbosacralblood circulation and excite himbosacral nerves. After pain, spasmare relieved, local compression of traditional Chinese medicine isperformed; Prescription includes: club-moss 15 g, burred tuber 12g, zedoary 12 g, large-leaf gentian root 12 g, ledeboriella root 9 g,erythrina bark 12 g, achyranthes root 10 g, chaenomeles fruit 10 g,safflower 10 g, Chinese angelica 10 g, homalomena rhizoma 12 g,sappan wood 10 g, decoted in water for compression on affectedsite.

  3. Troponin T3 expression in skeletal and smooth muscle is required for growth and postnatal survival: characterization of Tnnt3(tm2a(KOMP)Wtsi) mice. (United States)

    Ju, Yawen; Li, Jie; Xie, Chao; Ritchlin, Christopher T; Xing, Lianping; Hilton, Matthew J; Schwarz, Edward M


    The troponin complex, which consists of three regulatory proteins (troponin C, troponin I, and troponin T), is known to regulate muscle contraction in skeletal and cardiac muscle, but its role in smooth muscle remains controversial. Troponin T3 (TnnT3) is a fast skeletal muscle troponin believed to be expressed only in skeletal muscle cells. To determine the in vivo function and tissue-specific expression of Tnnt3, we obtained the heterozygous Tnnt3+/flox/lacZ mice from Knockout Mouse Project (KOMP) Repository. Tnnt3(lacZ/+) mice are smaller than their WT littermates throughout development but do not display any gross phenotypes. Tnnt3(lacZ/lacZ) embryos are smaller than heterozygotes and die shortly after birth. Histology revealed hemorrhagic tissue in Tnnt3(lacZ/lacZ) liver and kidney, which was not present in Tnnt3(lacZ/+) or WT, but no other gross tissue abnormalities. X-gal staining for Tnnt3 promoter-driven lacZ transgene expression revealed positive staining in skeletal muscle and diaphragm and smooth muscle cells located in the aorta, bladder, and bronchus. Collectively, these findings suggest that troponins are expressed in smooth muscle and are required for normal growth and breathing for postnatal survival. Moreover, future studies with this mouse model can explore TnnT3 function in adult muscle function using the conditional-inducible gene deletion approach

  4. Identification of a new target muscle for treatment in patients with Parkinson's disease who have lateral trunk flexion? (United States)

    Kataoka, Hiroshi; Sawa, Nobuhiro; Ueno, Satoshi


    Parkinson's disease (PD) can present with lateral trunk flexion (LTF). Abnormal posture associated with PD has been treated, but the effectiveness of these treatments is limited, resulting in unsatisfactory outcomes. Unilateral hypertrophy and unilateral hyperactivity may be useful for deciding targets for injection of botulinum toxin or physical rehabilitation. However, such findings may be limited such as the obliquus abdominis muscle or thoracic paraspinal muscles, and several other muscles may have a causative role in LTF. We investigated 8 patients whether other muscles show unilateral hypertrophy by analyzing computed tomographic scans. Cobb's angle was 11° to 34°. The area of the paravertebral muscles was large contralateral to the bending side and this trend intensified from L4 to Th10. The lumbar quadrate muscle and psoas major muscle showed unilateral enlargement. These larger muscles were prominent contralateral to the bending side in five patients and ipsilateral to the bending side in two patients. This unilateral muscle change was mildly seen in the internal and external abdominal oblique muscles. The lumbar quadrate muscle or psoas major muscle showed two hypertrophic patterns, and these muscles might be new therapeutic targets for treatments such as botulinum toxin.


    Institute of Scientific and Technical Information of China (English)



    @@ The 3rd lumbar transverse process syndrome is a frequently encountered disease in clinic. It is caused by prolonged stimulation of the fascia of the psoas major muscles by the pointed end of the excessive long transverse processes, leading to inflammation of the fibrous tissues around the transverse processes.

  6. Effect of 10-week core stabilization exercise training and detraining on pain-related outcomes in patients with clinical lumbar instability

    Directory of Open Access Journals (Sweden)

    Puntumetakul R


    Full Text Available Rungthip Puntumetakul,1,2 Pattanasin Areeudomwong,1,2 Alongkot Emasithi,1 Junichiro Yamauchi3,4 1School of Physical Therapy, Faculty of Associated Medical Sciences, Muang District, Kohn Kaen, Thailand; 2Back, Neck and Other Joint Pain Research Group, Khon Kaen University, Khon Kaen, Thailand; 3Graduate School of Human Health Sciences, Tokyo Metropolitan University, Tokyo, Japan; 4Future Institute for Sport Sciences, Tokyo, Japan Background and aims: Clinical lumbar instability causes pain and socioeconomic suffering; however, an appropriate treatment for this condition is unknown. This article examines the effect of a 10 week core stabilization exercise (CSE program and 3 month follow-up on pain-related outcomes in patients with clinical lumbar instability. Methods: Forty-two participants with clinical lumbar instability of at least 3 months in duration were randomly allocated either to 10 weekly treatments with CSE or to a conventional group (CG receiving trunk stretching exercises and hot pack. Pain-related outcomes including pain intensity during instability catch sign, functional disability, patient satisfaction, and health-related quality of life were measured at 10 weeks of intervention and 1 and 3 months after the last intervention session (follow-up; trunk muscle activation patterns measured by surface electromyography were measured at 10 weeks. Results: CSE showed significantly greater reductions in all pain-related outcomes after 10 weeks and over the course of 3 month follow-up periods than those seen in the CG (P<0.01. Furthermore, CSE enhanced deep abdominal muscle activation better than in the CG (P<0.001, whereas the CG had deterioration of deep back muscle activation compared with the CSE group (P<0.01. For within-group comparison, CSE provided significant improvements in all pain-related outcomes over follow-up (P<0.01, whereas the CG demonstrated reduction in pain intensity during instability catch sign only at 10 weeks (P<0

  7. Muscle cramping over the diagnosis. (United States)

    Lally, David R; Moster, Mark L; Foroozan, Rod


    A 44-year-old man with hypogonadism and adrenal insufficiency presented with transient blurred vision and halos around lights. Visual acuity was 20/20 in both eyes, and he had mild bilateral optic disk edema. Brain imaging was unremarkable, and lumbar puncture showed an opening pressure of 28.5 cm H2O with elevated protein. He also complained of muscle cramping, and magnetic resonance imaging of the spine demonstrated a heterogenous bone marrow signal. Bone survey showed a mixed lytic and sclerotic lesion within the left femur that proved to be a plasmacytoma. Serum protein electrophoresis had a small IgA spike, and plasma vascular endothelial growth factor (VEGF) was elevated. He was diagnosed with POEMS syndrome and underwent radiation to the plasmacytoma. Two years later he had a stable neuro-ophthalmologic exam with no signs of multiple myeloma. POEMS syndrome is a rare paraneoplastic syndrome from a plasma cell dyscrasia that may cause optic disk edema.

  8. Classification of the lumbar disc degeneration using MRI

    Energy Technology Data Exchange (ETDEWEB)

    Yoshida, Hirotoshi; Shinomiya, Kenichi; Okamoto, Akihiko; Muto, Naoko; Furuya, Kotaro (Tokyo Medical and Dental Univ. (Japan). School of Medicine)


    Magnetic resonance (MR) imaging has been performed in consecutive 114 patients with a chief complaint of lumbar pain. A retrospective review of MR images of a total of 570 lumbar vertebrae from these patients were done to examine lumbar disc degeneration. According to the MR intensity of nucleus pulposus on T2-wighted sagittal images, lumbar disc degeneration was graded on a scale of 0-4: 0=uniform hyperintensity; 1=slight hypointensity; 2=centrally band-like hypointensity with marginal hyperintensity; 3=irregular hypointensity in both the central and marginal sites; 4=uniform hypointensity. Lumbar disc degeneration was observed in 76%; and it was rapidly increased in frequency in the 30 or older age groups. Of 570 vertebrae, 51 (8.9%) had narrowing of intervertebral cavity. For these vertebrae, a mean score of lumbar disc degeneration was 3.1. Lumbar disc herniation was seen in 93 vertebrae, with a mean score of lumbar disc degeneration being 3.07. Changes in vertebral body marrow were seen in 14 vertebrae (2.5%), in which a mean score of intervertebral disc degeneration was 3.71. (N.K.).

  9. [Cortical venous thrombosis after a diagnostic lumbar puncture]. (United States)

    Pfeilschifter, W; Neumann-Haefelin, T; Hattingen, E; Singer, O C


    We present the case of a 49-year-old female patient who underwent a lumbar puncture in the context of an extended diagnostic work-up after a transient ischemic attack. A few days later the patient who suffered from severe post-lumbar puncture headache, developed a lobar hemorrhage due to a cortical venous thrombosis requiring decompression surgery.

  10. Sensitivity of lumbar spine loading to anatomical parameters

    DEFF Research Database (Denmark)

    Putzer, Michael; Ehrlich, Ingo; Rasmussen, John;


    models for four different postures. The in uence of the dimensions of vertebral body, disc, posterior parts of the vertebrae as well as the curvature of the lumbar spine were studied. Additionally, simulations with combinations of selected parameters were conducted. Changes in L4/L5 resultant joint force......Musculoskeletal simulations of lumbar spine loading rely on a geometrical representation of the anatomy. However, this data has an inherent inaccuracy. This study evaluates the in uence of dened geometrical parameters on lumbar spine loading utilizing ve parametrized musculoskeletal lumbar spine...... were used as outcome variable. Variations of the vertebral body height, disc height, transverse process width and the curvature of the lumbar spine were the most in uential. The results indicated that measuring these parameters from X-rays would be most important to morph an existing musculoskeletal...

  11. [A swollen, painless calf caused by neurogenic muscle (pseudo)-hypertrophy

    NARCIS (Netherlands)

    Warrenburg, B.P.C. van de; Zwarts, M.J.; Engelen, B.G.M. van


    Neurogenic muscle (pseudo) hypertrophy of the calf was diagnosed in a 60-year-old man, who presented with chronic, painless and unilateral calf enlargement caused by a chronic S1 radiculopathy due to a lumbar disc hernia in the L5-S1 interspace. The differential diagnosis of a swelling of the calf i

  12. Posterior muscle chain activity during various extension exercises: an observational study


    De Ridder, Eline MD; Oosterwijck, Jessica O; Vleeming, Andry; Vanderstraeten, Guy G.; Danneels, Lieven A


    Background: Back extension exercises are often used in the rehabilitation of low back pain. However, at present it is not clear how the posterior muscles are recruited during different types of extension exercises. Therefore, the present study will evaluate the myoelectric activity of thoracic, lumbar and hip extensor muscles during different extension exercises in healthy persons. Based on these physiological observations we will make recommendations regarding the use of extensions exercises...

  13. Limbus lumbar and sacral vertebral fractures. (United States)

    Mendez, Jorge S; Huete, Isidro L; Tagle, Patricio M


    We evaluated the fractures of the lumbar and sacral vertebral limbus by disc impingement at the peripheral ring apophysis in 23 adults associated with trauma in 16 of them. Lumbalgia, radicular pain and narrow canal symptoms are the presenting forms of this underdiagnosed pathology. CT is the best method of examination, while plain roentgenograms and MR are usually negative. Accurate diagnosis and surgical technique with larger exposure are needed to resect the fractured fragments and protruded disc material for decompressing the roots and the dural sac. Our results were very good on the majority of cases.

  14. [Severe Raynaud's syndrome treated by lumbar sympathectomy]. (United States)

    Thomsen, Thomas Laden; Roeder, Ole


    Avoiding exposure of extremities to cold combined with pharmacologic treatment usually suffice in the attempt to suppress the related symptoms of Raynaud's syndrome. This case report describes a severe case of Raynaud's syndrome affecting the lower extremities of a 16-year-old female. She was referred to a centre of vascular surgery with severe vasospasms of the feet. After failed attempts of pharmacologic treatment, a laparoscopic lumbar sympathectomy was performed with no complications and a slight reduction of symptoms three years post-surgically.

  15. Percutaneous treatment of lumbar disc herniation

    Energy Technology Data Exchange (ETDEWEB)

    Leonardi, M.; Resta, F.; Bettinelli, A. [Ospedale Maggiore di Milano (Italy); Lavaroni, A.; Fabris, G. [Ospedale Civile di Udine (Italy); Abelli, F. [Fondazione Clinica del Lavorno, Pavia (Italy)


    918 patients were subjected to percutaneous treatment of lumbar herniated disc. 733 of these were treated through enzymatic nucleolysis with chymopapain, for a total 883 levels. Chemonucleolysis was carried out on 733 patients (79.8%). Automated discectomy has been carried out in 185 cases (20.1%). Chemonucleolysis has led to the resolution of the symptoms in a high percentage of cases (82.2%). Nucleotomy has proved to be an effective method in 74.6% of cases. (author). 7 refs, 6 figs, 1 tab.

  16. Chemoembolization for Hepatocellular Carcinoma Supplied by a Lumbar Artery

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Han Myun, E-mail: [Hallym University College of Medicine, Department of Radiology, Kangnam Sacred Heart Hospital (Korea, Republic of); Kim, Hyo-Cheol, E-mail:; Woo, Sungmin, E-mail: [Seoul National University College of Medicine, Institute of Radiation Medicine, Seoul National University Medical Research Center, and Clinical Research Institute, Seoul National University Hospital, Department of Radiology (Korea, Republic of); Son, Kyu Ri, E-mail: [Korea University College of Medicine, Department of Radiology, Korea University Medical Center (Korea, Republic of); Cho, Seong Whi, E-mail: [Kangwon National University College of Medicine, Department of Radiology, Kangwon National University Hospital (Korea, Republic of); Chung, Jin Wook, E-mail: [Seoul National University College of Medicine, Institute of Radiation Medicine, Seoul National University Medical Research Center, and Clinical Research Institute, Seoul National University Hospital, Department of Radiology (Korea, Republic of)


    PurposeTo describe the radiologic findings and imaging response of hepatocellular carcinoma (HCC) supplied by the lumbar artery.MethodsBetween April 2004 and December 2012, we encountered HCC supplied by a lumbar artery in 21 patients. Two investigators retrospectively reviewed clinical and radiological findings of HCC supplied by the lumbar artery using computed tomography (CT) scans and digital subtraction angiograms.ResultsPatients had received 1–27 sessions of previous chemoembolization procedures (mean 7.7 sessions, median 4 sessions). Mean tumor size was 5.3 cm. The locations of HCC supplied by lumbar artery were the bare area (n = 14, 67 %) and segment VI (n = 7, 33 %). Tumor-feeding arteries arose from the main lumbar artery (n = 7), proximal anterior division (n = 4), and distal anterior division (n = 14). In 20 patients, selective chemoembolization through the tumor-feeding arteries of the lumbar artery was achieved. In 1 patient, nonselective embolization at the main lumbar artery was performed. There was no complication such as skin necrosis or paralysis. On the first follow-up enhanced CT scan, target tumors fed by the lumbar artery showed complete response (n = 6), partial response (n = 4), stable disease (n = 3), and progressive disease (n = 8), but overall tumor response was partial response (n = 1) and progressive disease (n = 20).ConclusionWhen HCC is located in the inferior tip or bare area of the liver, a lumbar artery may supply the tumor. Although selective chemoembolization via the tumor-feeding vessel of the lumbar artery can be achieved in most cases, overall tumor response is commonly unfavorable.

  17. Effect of back muscle strength and sagittal spinal imbalance on locomotive syndrome in Japanese men. (United States)

    Hirano, Kenichi; Imagama, Shiro; Hasegawa, Yukiharu; Wakao, Norimitsu; Muramoto, Akio; Ishiguro, Naoki


    The Japanese Orthopaedic Association has proposed the term locomotive syndrome to designate a condition of individuals in high-risk groups with musculoskeletal disease who are highly likely to require nursing care. This study investigates the influence of spinal factors on locomotive syndrome in Japanese men. A total of 105 men older than 50 years were enrolled in the study. Those answering yes to least 1 of 7 categories in a self-assessment checklist for locomotive syndrome were defined as having locomotive syndrome. The authors evaluated lateral lumbar radiographs, sagittal parameters, sagittal balance using the spinal inclination angle as an index, spinal range of motion as determined with SpinalMouse (Idiag, Volkerswill, Switzerland), back muscle strength, and body mass index. Age, back muscle strength, and spinal inclination angle significantly correlated with locomotive syndrome. Multiple logistic regression analysis indicated that a decrease in back muscle strength (odds ratio, 0.964; Pmuscle strength had significant negative correlations with age and spinal inclination angle. Spinal inclination angle had significant negative correlations with back muscle strength and lumbar and total spinal range of motion and significant positive correlations with age, body mass index, sacral slope angle, and lumbar kyphosis. A decrease in back muscle strength and an increase in spinal inclination angle may be the most important risk factors for locomotive syndrome in Japanese men. Back muscle strengthening and spinal range of motion exercises could be useful for improving the symptoms of locomotive syndrome.

  18. Identification and Characterization of MicroRNAs from Longitudinal Muscle and Respiratory Tree in Sea Cucumber (Apostichopus japonicus Using High-Throughput Sequencing.

    Directory of Open Access Journals (Sweden)

    Hongdi Wang

    Full Text Available MicroRNAs (miRNAs, as a family of non-coding small RNAs, play important roles in the post-transcriptional regulation of gene expression. Sea cucumber (Apostichopus japonicus is an important economic species which is widely cultured in East Asia. The longitudinal muscle (LTM and respiratory tree (RPT are two important tissues in sea cucumber, playing important roles such as respiration and movement. In this study, we identified and characterized miRNAs in the LTM and RPT of sea cucumber (Apostichopus japonicus using Illumina HiSeq 2000 platform. A total of 314 and 221 conserved miRNAs were identified in LTM and RPT, respectively. In addition, 27 and 34 novel miRNAs were identified in the LTM and RPT, respectively. A set of 58 miRNAs were identified to be differentially expressed between LTM and RPT. Among them, 9 miRNAs (miR-31a-3p, miR-738, miR-1692, let-7a, miR-72a, miR-100b-5p, miR-31b-5p, miR-429-3p, and miR-2008 in RPT and 7 miRNAs (miR-127, miR-340, miR-381, miR-3543, miR-434-5p, miR-136-3p, and miR-300-3p in LTM were differentially expressed with foldchange value being greater than 10. A total of 14,207 and 12,174 target genes of these miRNAs were predicted, respectively. Functional analysis of these target genes of miRNAs were performed by GO analysis and pathway analysis. This result provided in this work will be useful for understanding biological characteristics of the LTM and RPT of sea cucumber and assisting molecular breeding of sea cucumber for aquaculture.

  19. 49 CFR 572.75 - Lumbar spine, abdomen, and pelvis assembly and test procedure. (United States)


    ... 49 Transportation 7 2010-10-01 2010-10-01 false Lumbar spine, abdomen, and pelvis assembly and...) ANTHROPOMORPHIC TEST DEVICES 6-Year-Old Child § 572.75 Lumbar spine, abdomen, and pelvis assembly and test procedure. (a) Lumbar spine, abdomen, and pelvis assembly. The lumbar spine, abdomen, and pelvis consist...

  20. Physiological response to submaximal isometric contractions of the paravertebral muscles (United States)

    Jensen, B. R.; Jorgensen, K.; Hargens, A. R.; Nielsen, P. K.; Nicolaisen, T.


    STUDY DESIGN: Brief (30-second) isometric trunk extensions at 5%, 20%, 40%, 60%, and 80% of maximal voluntary contraction (MVC) and 3 minutes of prolonged trunk extension (20% MVC) in erect position were studied in nine healthy male subjects. OBJECTIVES: To investigate the intercorrelation between intramuscular pressure and tissue oxygenation of the paravertebral muscles during submaximal isometric contractions and further, to evaluate paravertebral electromyogram and intramuscular pressure as indicators of force development. SUMMARY OF BACKGROUND DATA: Local physiologic responses to muscle contraction are incompletely understood. METHODS: Relative oxygenation was monitored with noninvasive near-infrared spectroscopy, intramuscular pressure was measured with a transducer-tipped catheter, and surface electromyogram was monitored at three recording sites. RESULTS: The root mean square amplitudes of the paravertebral electromyogram (L4, left and right; T12, right) and intramuscular pressure measured in the lumbar multifidus muscle at L4 increased with greater force development in a curvilinear manner. A significant decrease in the oxygenation of the lumbar paravertebral muscle in response to muscle contraction was found at an initial contraction level of 20% MVC. This corresponded to a paravertebral intramuscular pressure of 30-40 mm Hg. However, during prolonged trunk extension, no further decrease in tissue oxygenation was found compared with the tissue oxygenation level at the end of the brief contractions, indicating that homeostatic adjustments (mean blood pressure and heart rate) over time were sufficient to maintain paravertebral muscle oxygen levels. CONCLUSION: At a threshold intramuscular pressure of 30-40 mm Hg during muscle contraction, oxygenation in the paravertebral muscles is significantly reduced. The effect of further increase in intramuscular pressure on tissue oxygenation over time may be compensated for by an increase in blood pressure and heart

  1. Evaluation of spinopelvic balance among patients undergoing surgical treatment for lumbar disk hernia

    Directory of Open Access Journals (Sweden)

    Rafael de Paiva Oliveira


    Full Text Available OBJECTIVE: to evaluate spinopelvic balance using the pelvic incidence, sacral slope and pelvic tilt among patients with lumbar disk hernias who underwent surgical treatment.METHODS: thirty patients at the spinal services of Hospital Santa Casa de Misericórdia de Vitória and Hospital Vila Velha were evaluated by measuring their spinopelvic balance from the angles of pelvic tilt, sacral slope and pelvic incidence, with their respective means, on simple lateral-view lumbopelvic radiographs that needed to encompass the lumbar spine, sacrum and proximal third of the femur.RESULTS: the spinopelvic balance measurements obtained from the mean angles of the population studied, for pelvic incidence, sacral slope and pelvic tilt, were 45◦ , 36.9◦ and 8.1◦ , respectively. The confidence interval for the mean pelvic incidence was from 41.9 to 48.1 (95% CI, thus including a reference value that characterized it as low, for an asymptomatic population, thus confirming that the sample was extracted from a population with this characteristic.CONCLUSION: among these patients with lumbar disk hernias who underwent surgical treatment, the average spinopelvic balance was found to have pelvic incidence lower than what has been reported in the literature for an asymptomatic population.

  2. Lumbar Ureteral Stenosis due to Endometriosis: Our Experience and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Salvatore Butticè


    Full Text Available Endometriosis is a chronic gynaecological disorder characterized by the presence of endometrial tissue outside the uterus. The disease most often affects the ovaries, uterine ligaments, fallopian tubes, and cervical-vaginal region. Urinary tract involvement is rare, accounting for around 1%-2% of all cases, of which 84% are in the bladder. We report a case of isolated lumbar ureteral stenosis due to endometriosis in a 37-year-old patient. The patient came to our observation complaining from lumbar back pain and presented with severe fever. The urological examination found monolateral left positive sign of Giordano. Blood tests evidenced marked lymphocytosis and increased valued of C-reactive protein. Urologic ultrasound showed hydronephrosis of first degree in the left kidney and absence of images related to stones bilaterally. Uro-CT scan evidenced ureteral stenosis at the transition between the iliac and pelvic tracts. We addressed the patient to surgery, and performed laparoscopic excision of the paraureteral bulk, endoscopic mechanical ureteral dilation, and stenting. The histological examination evidenced glandular structures lined by simple epithelium and surrounded by stroma. Immunohistochemical test of the glandular epithelium showed positivity for estrogen and progesterone receptors and moreover stromal cells were positive for CD10. The finding suggested a very rare diagnosis of isolated lumbar ureteral endometriosis.

  3. The effect of disc degeneration on anterior shear translation in the lumbar spine. (United States)

    Melnyk, Angela D; Kelly, Adrienne; Chak, Jason D; Wen, Tian Lin; Cripton, Peter A; Dvorak, Marcel F; Oxland, Thomas R


    Many pathologies involving disc degeneration are treated with surgery and spinal implants. It is important to understand how the spine behaves mechanically as a function of disc degeneration. Shear loading is especially relevant in the natural and surgically stabilized lumbar spine. The objective of our study was to determine the effect of disc degeneration on anterior translation of the lumbar spine under shear loading. We tested 30 human cadaveric functional spinal units (L3-4 and L4-5) in anterior shear loading. First, the specimens were imaged in a 1.5 T magnetic resonance scanner. The discs were graded according to the Pfirrmann classification. The specimens were then loaded up to 250 N in anterior shear with an axial compression force of 300 N. Motion of the vertebrae was captured with an optoelectronic camera system. Inter- and intra-observer reliability for disc grading was determined (Cohen's and Fleiss' Kappa), and a non-parametric test was performed on the translation data to characterize the effect of disc degeneration on this parameter. We found fair to moderate agreement between and within observers for the disc grading. We found no significant effect of disc degeneration on anterior shear translation (Kruskal-Wallis ANOVA). Our results indicate that disc degeneration, as classified with the Pfirrmann scale, does not predict lumbar spinal motion in shear.

  4. Quantitative analysis of the nonlinear displacement-load behavior of the lumbar spine. (United States)

    Hanlon, Andrew D; Cook, Daniel J; Yeager, Matthew S; Cheng, Boyle C


    There is currently no universal model or fitting method to characterize the visco-elastic behavior of the lumbar spine observed in displacement versus load hysteresis loops. In this study, proposed methods for fitting these loops, along with the metrics obtained, were thoroughly analyzed. A spline fitting technique was shown to provide a consistent approximation of spinal kinetic behavior that can be differentiated and integrated. Using this tool, previously established metrics were analyzed using data from two separate studies evaluating different motion preservation technologies. Many of the metrics, however, provided no significant differences beyond range of motion analysis. Particular attention was paid to how different definitions of the neutral zone capture the high-flexibility region often seen in lumbar hysteresis loops. As a result, the maximum slope was introduced and shown to be well defined. This new parameter offers promise as a descriptive measurement of spinal instability in vitro and may have future implications in clinical diagnosis and treatment of spinal instability. In particular, it could help in assigning treatments to specific stabilizing effects in the lumbar spine.

  5. Lumbar spine degenerative disease : effect on bone mineral density measurements in the lumbar spine and femoral neck

    Energy Technology Data Exchange (ETDEWEB)

    Juhng, Seon Kwan [Wonkwang Univ. School of Medicine, Iksan (Korea, Republic of); Koplyay, Peter; Jeffrey Carr, J.; Lenchik, Leon [Wake Forest Univ. School of Medicine, Winston-salem (United States)


    To determine the effect of degenerative disease of the lumbar spine on bone mineral density in the lumbar spine and femoral neck. We reviewed radiographs and dual energy x-ray absorptiometry scans of the lumbar spine and hip in 305 Caucasian women with suspected osteoporosis. One hundred and eight-six patient remained after excluding women less than 40 years of age (n=18) and those with hip osteoarthritis, scoliosis, lumbar spine fractures, lumbar spinal instrumentation, hip arthroplasty, metabolic bone disease other than osteoporosis, or medications known to influence bone metabolism (n=101). On the basis of lumbar spine radiographs, those with absent/mild degenerative disease were assigned to the control group and those with moderate/severe degenerative disease to the degenerative group. Spine radiographs were evaluated for degenerative disease by two radiologists working independently; discrepant evaluations were resolved by consensus. Lumbar spine and femoral neck bone mineral density was compared between the two groups. Forty-five (24%) of 186 women were assigned to the degenerative group and 141 (76%) to the control group. IN the degenerative group, mean bone mineral density measured 1.075g/cm? in the spine and 0.788g/cm{sup 2} in the femoral neck, while for controls the corresponding figures were 0.989g/cm{sup 2} and 0.765g/cm{sup 2}. Adjusted for age, weight and height by means of analysis of variance, degenerative disease of the lumbar spine was a significant predictor of increased bone mineral density in the spine (p=0.0001) and femoral neck (p=0.0287). Our results indicate a positive relationship between degenerative disease of the lumbar spine and bone mineral density in the lumbar spine and femoral neck, and suggest that degenerative disease in that region, which leads to an intrinsic increase in bone mineral density in the femoral neck, may be a good negative predictor of osteoporotic hip fractures.

  6. [Characterization of the latent periods of excitation and shortening of anterior tibial muscle of white rats depending on the blood level of triiodothyronine]. (United States)

    Stanishevs'ka, T I; Soboliev, V I


    In experiments in situ it was shown an expressed negative correlation between the duration of latent periods of excitation and contraction of the anterior tibial muscle of white rats and the blood level of free triiodothyronine. The difference in mean values of latent periods at starting and final points of scale of physiological fluctuations of triiodothyronine level amounted 15.5% and 37.0% respectively. In parallel with lengthening of latent period of anterior tibial muscle excitation it was found an increase in latent period of this muscle contraction. Interestingly, at high values of the latent periods of excitation such dependence disappeared.

  7. Musculoskeletal support of lumbar spine stability. (United States)

    Wagner, H; Anders, Ch; Puta, Ch; Petrovitch, A; Mörl, F; Schilling, N; Witte, H; Blickhan, R


    Using a biomechanical model and experimental data the self-stabilising behaviour of antagonistic trunk muscles was analyzed. The biomechanical model is constituted of a pair of antagonistic Hill-type muscles, their geometric arrangement with respect to the spine, and the instantaneous centre of rotation in frontal plane. Using Ljapunov's theory, the stability of certain motion and loading situations was analyzed. Applying a sensitivity analysis, the influence of different muscle properties and the geometric arrangement on stability was investigated. The simulations revealed that the stability of spinal movements depended primarily on the geometrical arrangement of muscles and the position of the centre of rotation of the spine, the latter was affected in turn by the activities of the profound muscles. To stabilize the situations simulated oblique muscle arrangements were necessary. In order to define an instantaneous centre of rotation in the lower region of the spine negative attachment angles (medio-lateral decline) of muscles were necessary, corresponding to the real anatomy of obliquus externus muscles. More cranially located instantaneous centres of rotation required positive attachment angles for stability, corresponding to obliquus internus or multifidus muscles. Furthermore, the fibre-type distribution of muscles influenced the stability of the system, i.e. a high percentage of fast-twitch-fibres supported the stabilisation. Conclusions drawn from the simulations were supported by experimental data. Sudden loads and quick-release perturbations with two different amplitudes were applied to the upper body of ten male subjects. In comparison to sudden load situations preactivation of muscles due to an external load, i.e. quick-release perturbation, led to significantly less dependency of the amplitude of deflection on the amplitude of the perturbation. This observation relates to the self-stabilising properties of the musculoskeletal system. In conclusion

  8. Computed Tomography of the lumbar facet joints

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    Choi, Mi Ryoung; Kim, Yung Soon; Lee, Joo Hyuk; Jeon, Hae Sang; Kim, Dae Yung [Kang Nam General Hospital, Seoul (Korea, Republic of)


    The lumbar facet disease is a frequently overlooked cause of sciatic pain, but the lumbar facet joints are well-recognized source of low back pain and radiating leg pain which can be confused with sciatica due to herniated disc. We measured the angulation of the facet joints on axial spine CT films in 149 cases which contains 41 normal group and 108 abnormal group and studied the relationship between the angulation and degeneration of the facets, the asymmetry of each sided facets and facet degeneration, the asymmetry and disc protrusion, and the asymmetry and annular bulging of the disc. The results were as follows: 1. Facet angulation in abnormal group were more sagittally oriented than the normal group. 2. The angulation of right facet was more sagittally oriented than the left in L4-5 level of abnormal group. 3. Degeneration of facet joints occur asymmetrically, and the more facet joint degenerates, the more it orients sagittally, particularly in L4-5. 4. Asymmetry in facet joint degeneration and unilateral disc protrusion of L5-SI level is greater than the normal gro0008.

  9. Sacroiliac joint motion in patients with degenerative lumbar spine disorders. (United States)

    Nagamoto, Yukitaka; Iwasaki, Motoki; Sakaura, Hironobu; Sugiura, Tsuyoshi; Fujimori, Takahito; Matsuo, Yohei; Kashii, Masafumi; Murase, Tsuyoshi; Yoshikawa, Hideki; Sugamoto, Kazuomi


    OBJECT Usually additional anchors into the ilium are necessary in long fusion to the sacrum for degenerative lumbar spine disorders (DLSDs), especially for adult spine deformity. Although the use of anchors is becoming quite common, surgeons must always keep in mind that the sacroiliac (SI) joint is mobile and they should be aware of the kinematic properties of the SI joint in patients with DLSDs, including adult spinal deformity. No previous study has clarified in vivo kinematic changes in the SI joint with respect to patient age, sex, or parturition status or the presence of DLSDs. The authors conducted a study to clarify the mobility and kinematic characteristics of the SI joint in patients with DLSDs in comparison with healthy volunteers by using in vivo 3D motion analysis with voxel-based registration, a highly accurate, noninvasive method. METHODS Thirteen healthy volunteers (the control group) and 20 patients with DLSDs (the DLSD group) underwent low-dose 3D CT of the lumbar spine and pelvis in 3 positions (neutral, maximal trunk flexion, and maximal trunk extension). SI joint motion was calculated by computer processing of the CT images (voxel-based registration). 3D motion of the SI joint was expressed as both 6 df by Euler angles and translations on the coordinate system and a helical axis of rotation. The correlation between joint motion and the cross-sectional area of the trunk muscles was also investigated. RESULTS SI joint motion during trunk flexion-extension was minute in healthy volunteers. The mean rotation angles during trunk flexion were 0.07° around the x axis, -0.02° around the y axis, and 0.16° around the z axis. The mean rotation angles during trunk extension were 0.38° around the x axis, -0.08° around the y axis, and 0.08° around the z axis. During trunk flexion-extension, the largest amount of motion occurred around the x axis. In patients with DLSDs, the mean rotation angles during trunk flexion were 0.57° around the x axis, 0.01

  10. Muscle atrophy (United States)

    ... a single nerve, such as carpal tunnel syndrome Guillain-Barre syndrome Nerve damage caused by injury, diabetes, toxins, ... chap 421. Read More Amyotrophic lateral sclerosis (ALS) Guillain-Barré syndrome Hypotonia Muscle cramps Muscular dystrophy Polio Review ...

  11. Preliminary evaluation of posterior dynamic lumbar stabilization in lumbar degenerative disease in Chinese patients

    Institute of Scientific and Technical Information of China (English)

    JIA Yu-hua; SUN Peng-fei


    Background There has been some controversy related to the use of the Wallis system,rather than disc fusion in the treatment of patients with degenerative spine disease.Furthermore,there are no reports concerning the application of this dynamic stabilization system in Chinese patients,who have a slightly different lifestyle with Western patients.The aim of this study was to assess the safety and efficacy of the dynamic stabilization system in the treatment of degenerative spinal diseases in Chinese patients.Methods The clinical outcomes of 20 patients with lumbar degenerative disease treated by posterior decompression with the Wallis posterior dynamic lumbar stabilization implant were studied.All of the patients completed the visual analogue scale and the Chinese version of the Oswestry Disability Index.The following radiologic parameters were measured in all patients:global lordotic angles and segmental lordotic angles (stabilized segments,above and below adjacent segments).The range of motion was then calculated.Results Nineteen patients (95%) were available for follow-up.The mean follow-up period was (27.25±5.16) months (range 16-35 months).The visual analogue scale decreased from 8.55±1.21 to 2.20±1.70 (P <0.001),and the mean score on the Chinese version of the Oswestry Disability Index was improved from 79.58%±15.93% to 22.17%±17.24% (P <0.001).No significant changes were seen in the range of motion at the stabilized segments (P=0.502) and adjacent segments (above,P=0.453; below,P=0.062).The good to excellent result was 94.4% at the latest follow-up.No complications related to the use of the Wallis posterior dynamic lumbar stabilization occurred.Conclusions It was found to be both easy and safe to use the Wallis posterior dynamic lumbar stabilization implant in the treatment of degenerative lumbar disease,and the early therapeutic effectiveness is good.The Wallis system provides an alternative method for the treatment of lumbar degenerative

  12. Fibrohistiocitoma benigno ósseo na coluna lombar Benign fibrous histiocytoma of the lumbar spine

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    Osmar Avanzi


    Full Text Available CONTEXTO: O fibrohistiocitoma benigno intra-ósseo é uma neoplasia rara, caracterizada por proliferação fibroblástica e fibras colágenas. A dor na região lombar é uma queixa freqüente em muitos pacientes, mas, na maioria das vezes está relacionada com causa muscular ou degenerativa. RELATO DE CASO: Relata-se aqui o caso de um paciente com diagnóstico de fibrohistiocitoma benigno ósseo na coluna lombar que apresentava queixa de lombalgia há cinco meses antes do diagnóstico. Foi submetida à biópsia aberta transpedicular na quarta vértebra lombar ,e, posteriormente realizada curetagem da lesão via anterior retroperitonial e artrodese vertebral de L3-L5 com enxerto de fíbula. CONCLUSÃO: Apesar de raro, o fibrohistiocitoma benigno intra-ósseo deve ser uma das hipóteses quando observamos uma lesão primária na coluna vertebral.CONTEXT: Benign intraosseous fibrous histiocytoma is a rare neoplasia, characterized by fibroblastic and collagenous fiber proliferation. Pain in the lumbar region is a frequent complaint in many patients, but most of times it is associated to muscular or degenerative causes. CASE REPORT: Here we report a case of a patient diagnosed with benign bone fibrous histiocytoma in the lumbar spine who complained of lumbar pain dating five months prior to diagnosis. The patient was submitted to open transpedicular biopsy in the forth lumbar vertebra, and subsequently, lesion curettage was performed via anterior retroperitoneal and L3-L5 vertebral arthrodesis using a fibular graft. CONCLUSION: Although rare, benign intraosseous fibrohistiocytoma should be taken into consideration when a primary lesion is observed in the spine.


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    Luis Muñiz Luna


    Full Text Available ABSTRACT Objectives: To demonstrate the recovery of lumbar sagittal pelvic alignment and sagittal pelvic balance after surgical reduction of lumbar spondylolisthesis and establish the benefits of the surgery for reduction and fixation of the lumbar spondylolisthesis with 360o circumferential arthrodesis for 2 surgical approaches by clinical and functional evaluation. Method: Eight patients with lumbar spondylolisthesis treated with surgical reduction and fixation of listhesis and segmental circumferential fusion with two surgical approaches were reviewed. They were evaluated before and after treatment with Oswestry, Visual Analogue for pain and Odom scales, performing radiographic measurement of lumbar sagittal alignment and pelvic sagittal balance with the technique of pelvic radius. Results: Oswestry scales and EVA reported improvement of symptoms after treatment in 8 cases; the Odom scale had six outstanding cases reported. The lumbar sagittal alignment presented a lumbosacral lordosis angle and a lumbopelvic lordosis angle reduced in 4 cases and increased in 4 other cases; pelvic sagittal balance increased the pelvic angle in 4 cases and decreased in 3 cases and the sacral translation of the hip axis to the promontory increased in 6 cases. Conclusion: The surgical procedure evaluated proved to be useful by modifying the lumbar sagittal alignment and the pelvic balance, besides reducing the symptoms, enabling the patient to have mobility and movement and the consequent satisfaction with the surgery.

  14. Limited effect of fly-wheel and spinal mobilization exercise countermeasures on lumbar spine deconditioning during 90 d bed-rest in the Toulouse LTBR study (United States)

    Belavý, Daniel L.; Ohshima, Hiroshi; Bareille, Marie-Pierre; Rittweger, Jörn; Felsenberg, Dieter


    We examined the effect of high-load fly-wheel (targeting the lower-limb musculature and concurrent loading of the spine via shoulder restraints) and spinal movement countermeasures against lumbar spine muscle atrophy, disc and spinal morphology changes and trunk isokinetic torque loss during prolonged bed-rest. Twenty-four male subjects underwent 90 d head-down tilt bed-rest and performed either fly-wheel (FW) exercises every three days, spinal movement exercises in lying five times daily (SpMob), or no exercise (Ctrl). There was no significant impact of countermeasures on losses of isokinetic trunk flexion/extension ( p≥0.65). Muscle volume change by day-89 of bed-rest in the psoas, iliacus, lumbar erector spinae, lumbar multifidus and quadratus lumborum, as measured via magnetic resonance imaging (MRI), was statistically similar in all three groups ( p≥0.33). No significant effect on MRI-measures of lumbar intervertebral disc volume, spinal length and lordosis ( p≥0.09) were seen either, but there was some impact ( p≤0.048) on axial plane disc dimensions (greater reduction than in Ctrl) and disc height (greater increases than in Ctrl). MRI-data from subjects measured 13 and 90-days after bed-rest showed partial recovery of the spinal extensor musculature by day-13 after bed-rest with this process complete by day-90. Some changes in lumbar spine and disc morphology parameters were still persistent 90-days after bed-rest. The present results indicate that the countermeasures tested were not optimal to maintain integrity of the spine and trunk musculature during bed rest.

  15. The role of quadratus lumborum asymmetry in the occurrence of lesions in the lumbar vertebrae of cricket fast bowlers. (United States)

    de Visser, Hans; Adam, Clayton J; Crozier, Stuart; Pearcy, Mark J


    In cricket fast bowlers an increased incidence of stress fractures or lesions in the L4 pars interarticularis is observed, which shows a strong statistical correlation with the presence of hypertrophy in the contralateral Quadratus Lumborum (QL) muscle. This study aims to find a physical explanation for this correlation. A mathematical model was used to estimate the forces and moments on the L3 and L4 vertebrae in six postures attained during fast bowling. These forces and moments were used in finite element models to estimate the stresses in the pars interarticularis. Two scenarios were examined per posture: symmetric QL muscles, and right QL muscle volume 30% enlarged. Influence of muscle activation was also investigated. QL asymmetry only correlates with significant stress increases when stress levels are relatively low. When stress levels are high, due to extreme posture or muscle activation, asymmetry only causes small stress changes, suggesting that asymmetry is not the cause of stress fractures in the pars. There are even indications that asymmetry might help to reduce stresses, but more detailed knowledge of the size and activation of the lumbar muscles is needed to confirm this.

  16. Functional morphology and three-dimensional kinematics of the thoraco-lumbar region of the spine of the two-toed sloth. (United States)

    Nyakatura, John A; Fischer, Martin S


    Given the importance of thoraco-lumbar spine movements in the locomotion of mammals, it is surprising that in vivo three-dimensional (3-D) data on the intervertebral movement of the mammalian thoraco-lumbar vertebral column during symmetrical gaits is limited to horses and dogs. To test whether kinematic patterns similar to those published for these cursorial species are also present during a contrasting mode of quadrupedalism, we quantified thoraco-lumbar intervertebral movements, the resulting pelvic displacements and relative femoral movements during the trot-like steady-state suspensory quadrupedal locomotion of the two-toed sloth (Xenarthra, Choloepus didactylus). Scientific rotoscoping, a new, non-invasive approach that combines synchronous biplanar high speed X-ray videos and the reconstruction of skeletal elements from computed tomography bone scans, was used to quantify 3-D kinematics. An analysis of vertebral anatomy and epaxial muscle topography suggests that the thoraco-lumbar spine of sloths is well suited to producing lateral bending and long-axis rotation, but limits powerful sagittal extension. Sloths exhibit complex 3-D movements in the thoraco-lumbar spine that are comparable to those observed in other arboreal quadrupedal mammals. Monophasic lateral bending and long-axis rotation, biphasic sagittal bending and maximal amplitude of sagittal bending at the lumbo-sacral joint were also found in other quadruped mammals and may represent general aspects of mammalian symmetric gaits. Maximal amplitude of lateral bending and long-axis rotation vary in regard to the vertebral level. It is suggested that a cranio-caudal pattern of angular deflections of the spine results from the out-of-phase movement of diagonal forelimbs and hindlimbs in other walking gaits, because it is not evident in the trot-like locomotion analyzed here. The analysis also illustrates the difficulties that arise when lumbar movement is deduced from intervertebral joint morphology

  17. Direction of the formation of anterior lumbar vertebral osteophytes

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    Akeda Koji


    Full Text Available Abstract Background X-ray images of lumbar degenerative diseases often show not only claw osteophytes, but also pairs of osteophytes that form in a direction away from the adjacent disc. We have investigated the direction of the formation of anterior lumbar vertebral osteophytes across the lumbar vertebrae using a sufficient number of lumbar radiographs, because osteophytes images can provide essential information that will contribute to the understanding of the pathology and progress of lumbar spine degeneration. Methods The direction of the formation of 14,250 pairs of anterior lumbar vertebral osteophytes across the adjacent intervertebral discs in 2,850 patients who were all over 60 years old was investigated. Anterior lumbar vertebral osteophytes were distributed into six groups based on the direction of extension of each pair of osteophytes across the intervertebral disc space. Results In L1–L2 and L2–L3, the number of patients classified into groups B (the pair of osteophytes extended in the direction of the adjacent disc and C (almost complete bone bridge formation by a pair of osteophytes across the intervertebral disc space was larger than that classified into group D (the pair of osteophytes extended in a direction away from the adjacent disc. In L3–L4, L4–L5 and L5-S1, the number of patients in group D was greater than that of patients belonging to groups B and C. Conclusion Our study showed that pairs of osteophytes frequently formed in the direction of the adjacent disc in the upper lumbar vertebrae (L1–L2 and L2–L3 and in the direction away from the adjacent disc in middle or lower lumbar vertebrae (L3–L4, L4–L5, and L5-S1.

  18. Dynamic stabilization for degenerative spondylolisthesis and lumbar spinal instability. (United States)

    Ohtonari, Tatsuya; Nishihara, Nobuharu; Suwa, Katsuyasu; Ota, Taisei; Koyama, Tsunemaro


    Lumbar interbody fusion is a widely accepted surgical procedure for patients with lumbar degenerative spondylolisthesis and lumbar spinal instability in the active age group. However, in elderly patients, it is often questionable whether it is truly necessary to construct rigid fixation for a short period of time. In recent years, we have been occasionally performing posterior dynamic stabilization in elderly patients with such lumbar disorders. Posterior dynamic stabilization was performed in 12 patients (6 women, 70.9 ± 5.6 years old at the time of operation) with lumbar degenerative spondylolisthesis in whom % slip was less than 20% or instability associated with lumbar disc herniation between March 2011 and March 2013. Movement occurs through the connector linked to the pedicle screw. In practice, 9 pairs of D connector system where the rod moves in the perpendicular direction alone and 8 pairs of Dynamic connector system where the connector linked to the pedicle screw rotates in the sagittal direction were installed. The observation period was 77-479 days, and the mean recovery rate of lumbar Japanese Orthopedic Association (JOA) score was 65.6 ± 20.8%. There was progression of slippage due to slight loosening in a case with lumbar degenerative spondylolisthesis, but this did not lead to exacerbation of the symptoms. Although follow-up was short, there were no symptomatic adjacent vertebral and disc disorders during this period. Posterior dynamic stabilization may diminish the development of adjacent vertebral or disc disorders due to lumbar interbody fusion, especially in elderly patients, and it may be a useful procedure that facilitates decompression and ensures a certain degree of spinal stabilization.

  19. The Basis of Muscle Regeneration

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    Antonio Musarò


    Full Text Available Muscle regeneration recapitulates many aspects of embryonic myogenesis and is an important homeostatic process of the adult skeletal muscle, which, after development, retains the capacity to regenerate in response to appropriate stimuli, activating the muscle compartment of stem cells, namely, satellite cells, as well as other precursor cells. Moreover, significant evidence suggests that while stem cells represent an important determinant for tissue regeneration, a “qualified” environment is necessary to guarantee and achieve functional results. It is therefore plausible that the loss of control over these cell fate decisions could lead to a pathological transdifferentiation, leading to pathologic defects in the regenerative process. This review provides an overview about the general aspects of muscle development and discusses the cellular and molecular aspects that characterize the five interrelated and time-dependent phases of muscle regeneration, namely, degeneration, inflammation, regeneration, remodeling, and maturation/functional repair.

  20. Incidence, Predictors, and Postoperative Complications of Blood Transfusion in Thoracic and Lumbar Fusion Surgery: An Analysis of 13,695 Patients from the American College of Surgeons National Surgical Quality Improvement Program Database. (United States)

    Aoude, Ahmed; Nooh, Anas; Fortin, Maryse; Aldebeyan, Sultan; Jarzem, Peter; Ouellet, Jean; Weber, Michael H


    Study Design Retrospective cohort study. Objective To identify predictive factors for blood transfusion and associated complications in lumbar and thoracic fusion surgeries. Methods The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database was used to identify patients who underwent lumbar or thoracic fusion from 2010 to 2013. Multivariate analysis was used to determine predictive factors and postoperative complications associated with transfusion. Results Out of 13,695 patients, 13,170 had lumbar fusion and 525 had thoracic fusion. The prevalence of transfusion was 31.8% for thoracic and 17.0% for lumbar fusion. The multivariate analysis showed that age between 50 and 60, age between 61 and 70, age > 70, dyspnea, American Society of Anesthesiologists class 3, bleeding disease, multilevel surgery, extended surgical time, return to operation room, and higher preoperative blood urea nitrogen (BUN) were predictors of blood transfusion for lumbar fusion. Multilevel surgery, preoperative BUN, and extended surgical time were predictors of transfusion for thoracic fusion. Patients receiving transfusions who underwent lumbar fusion were more likely to develop wound infection, venous thromboembolism, pulmonary embolism, and myocardial infarction and had longer hospital stay. Patients receiving transfusions who underwent thoracic fusion were more likely to have extended hospital stay. Conclusion This study characterizes incidence, predictors, and postoperative complications associated with blood transfusion in thoracic and lumbar fusion. Pre- and postoperative planning for patients deemed to be at high risk of requiring blood transfusion might reduce postoperative complications in this population.

  1. Grynfelt lumbar hernias. Presentation of a congenital case.

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    Cleopatra Cabrera Cuellar


    Full Text Available Lumbar hernias are uncommon and are reported rarely, they are informed only few more than 300 in literature and of them only 10 cases are congenital. The hernias that are produced through the superior lumbar space or Grynfelt-Lesshalf´s hernia, are due to the fact that they are more constant and larger they are usually more frequent than the Petit triangle. We are reporting a Newborn infant with the diagnosis of bilateral lumbar hernias and malformation of the vertebral column.

  2. Microendoscopic discectomy for treatment of lumbar disc herniation

    Institute of Scientific and Technical Information of China (English)

    ARJUN Sinkemani; WU Xiao-tao


    A lumbar microendoscopic discectomy ( MED ) is a minimally invasive surgical technique performed through a tubular device which is designed for the pain relieve caused by herniated discs pressing the nerve roots . In 1997, a new minimally invasive surgical approach for the management of symptomatic lumbar disc herniation , MED was introduced .This technique uses a tubular retractor system and a microendoscope for visualization rather than the operating microscope .However , recent literature suggests that MED is an effective microendoscopic system which has a fine long-term outcome in treating lumbar disc herniation .This article describes the operative tech-niques and outcomes reported in the literature for MED .

  3. Traumatic Lumbar Hernia Diagnosed by Ultrasonography: A Case Report

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    Lee, Kwang Lae; Yim, Yoon Myung; Lim, Oh Kyung; Park, Ki Deok; Choi, Chung Hwan; Lee, Ju Kang [Gachon University of Medicine and Science, Incheon (Korea, Republic of)


    Traumatic lumbar hernia describes the extrusion of intraperitoneal or extraperitoneal contents through a defect in the posterolateral abdominal wall caused by a trauma. This is a rare entity and usually diagnosed by computed tomography. A 64-year-old male received an injury on his cervical spinal cord after an accident in which he fell down. He complained of a mass on his left posterolateral back area. We diagnosed the mass as a traumatic lumbar hernia by ultrasonography and confirmed it by computed tomography. We conclude that the ultrasonography can be a useful diagnostic tool for traumatic lumbar hernia

  4. [Clinical manifestation and surgical treatment of superior lumbar disc herniation]. (United States)

    Klishin, D N; Dreval', O N; Gorozhanin, A V


    On the basis of analysis of presentation and surgical treatment of 103 patients with lumbar disc herniation the authors performed comparative assessment of symptoms and therapeutic techniques in patients with higher and lower lumbar disc disease. Short-term and long-term results were evaluated using visual analogue scale and Oswestry disability index (ODI). Statistically significant differences in dynamics of pain and ODI were not present. In spite of differences in clinical presentation, the results of surgical treatment in both groups were similar. They depended on severity of preoperative neurological deficit regardless of level of lesion. Specific features of surgical procedure in superior lumbar disk herniation are described.

  5. A global CT to US registration of the lumbar spine (United States)

    Nagpal, Simrin; Hacihaliloglu, Ilker; Ungi, Tamas; Rasoulian, Abtin; Osborn, Jill; Lessoway, Victoria A.; Rohling, Robert N.; Borschneck, Daniel P.; Abolmaesumi, Purang; Mousavi, Parvin


    During percutaneous lumbar spine needle interventions, alignment of the preoperative computed tomography (CT) with intraoperative ultrasound (US) can augment anatomical visualization for the clinician. We propose an approach to rigidly align CT and US data of the lumbar spine. The approach involves an intensity-based volume registration step, followed by a surface segmentation and a point-based registration of the entire lumbar spine volume. A clinical feasibility study resulted in mean registration error of approximately 3 mm between CT and US data.

  6. Successful operative management of an upper lumbar spinal canal stenosis resulting in multilevel lower nerve root radiculopathy

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    Shearwood McClelland


    Full Text Available Lumbar stenosis is a common disorder, usually characterized clinically by neurogenic claudication with or without lumbar/sacral radiculopathy corresponding to the level of stenosis. We present a case of lumbar stenosis manifesting as a multilevel radiculopathy inferior to the nerve roots at the level of the stenosis. A 55-year-old gentleman presented with bilateral lower extremity pain with neurogenic claudication in an L5/S1 distribution (posterior thigh, calf, into the foot concomitant with dorsiflexion and plantarflexion weakness. Imaging revealed grade I spondylolisthesis of L3 on L4 with severe spinal canal stenosis at L3-L4, mild left L4-L5 disc herniation, no stenosis at L5-S1, and no instability. EMG revealed active and chronic L5 and S1 radiculopathy. The patient underwent bilateral L3-L4 hemilaminotomy with left L4-L5 microdiscectomy for treatment of his L3-L4 stenosis. Postoperatively, he exhibited significant improvement in dorsiflexion and plantarflexion. The L5-S1 level was not involved in the operative decompression. Patients with radiculopathy and normal imaging at the level corresponding to the radiculopathy should not be ruled out for operative intervention should they have imaging evidence of lumbar stenosis superior to the expected affected level.

  7. Development and Kinematic Verification of a Finite Element Model for the Lumbar Spine: Application to Disc Degeneration

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    Elena Ibarz


    Full Text Available The knowledge of the lumbar spine biomechanics is essential for clinical applications. Due to the difficulties to experiment on living people and the irregular results published, simulation based on finite elements (FE has been developed, making it possible to adequately reproduce the biomechanics of the lumbar spine. A 3D FE model of the complete lumbar spine (vertebrae, discs, and ligaments has been developed. To verify the model, radiological images (X-rays were taken over a group of 25 healthy, male individuals with average age of 27.4 and average weight of 78.6 kg with the corresponding informed consent. A maximum angle of 34.40° is achieved in flexion and of 35.58° in extension with a flexion-extension angle of 69.98°. The radiological measurements were 33.94 ± 4.91°, 38.73 ± 4.29°, and 72.67°, respectively. In lateral bending, the maximum angles were 19.33° and 23.40 ± 2.39, respectively. In rotation a maximum angle of 9.96° was obtained. The model incorporates a precise geometrical characterization of several elements (vertebrae, discs, and ligaments, respecting anatomical features and being capable of reproducing a wide range of physiological movements. Application to disc degeneration (L5-S1 allows predicting the affection in the mobility of the different lumbar segments, by means of parametric studies for different ranges of degeneration.

  8. Comparison of the Dynesys Dynamic Stabilization System and Posterior Lumbar Interbody Fusion for Lumbar Degenerative Disease.

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    Yang Zhang

    Full Text Available There have been few studies comparing the clinical and radiographic outcomes between the Dynesys dynamic stabilization system and posterior lumbar interbody fusion (PLIF. The objective of this study is to compare the clinical and radiographic outcomes of Dynesys and PLIF for lumbar degenerative disease.Of 96 patients with lumbar degenerative disease included in this retrospectively analysis, 46 were treated with the Dynesys system and 50 underwent PLIF from July 2008 to March 2011. Clinical and radiographic outcomes were evaluated. We also evaluated the occurrence of radiographic and symptomatic adjacent segment degeneration (ASD.The mean follow-up time in the Dynesys group was 53.6 ± 5.3 months, while that in the PLIF group was 55.2 ± 6.8 months. At the final follow-up, the Oswestry disability index and visual analogue scale score were significantly improved in both groups. The range of motion (ROM of stabilized segments in Dynesys group decreased from 7.1 ± 2.2° to 4.9 ± 2.2° (P < 0.05, while that of in PLIF group decreased from 7.3 ± 2.3° to 0° (P < 0.05. The ROM of the upper segments increased significantly in both groups at the final follow-up, the ROM was higher in the PLIF group. There were significantly more radiographic ASDs in the PLIF group than in the Dynesys group. The incidence of complications was comparable between groups.Both Dynesys and PLIF can improve the clinical outcomes for lumbar degenerative disease. Compared to PLIF, Dynesys stabilization partially preserves the ROM of the stabilized segments, limits hypermobility in the upper adjacent segment, and may prevent the occurrence of ASD.

  9. Nociceptive input from the rat thoracolumbar fascia to lumbar dorsal horn neurones. (United States)

    Hoheisel, Ulrich; Taguchi, Toru; Treede, Rolf-Detlef; Mense, Siegfried


    In anaesthetised rats, systematic electrophysiological recordings from dorsal horn neurones in spinal segments Th13-L5 were made to obtain information about the spinal nociceptive processing from the lumbar thoracolumbar fascia. Six to fourteen percent of the neurones in the spinal segments Th13-L2 had nociceptive input from the thoracolumbar fascia in naïve animals, no neurones responsive to input from the lumbar fascia were found in segments L3-L5. The segmental location of the receptive fields in the fascia was shifted 2-4 segments caudally relative to the spinal segment recorded from. Most neurones were convergent in that they received additional input from other deep somatic tissues in the low back (87%) and from the skin in the abdominal wall or the proximal leg (50%). The proportion of neurones responsive to input from the thoracolumbar fascia rose significantly from 4% to 15% (Pfascia in normal animals - responded to fascia input in animals with inflamed muscle. The data suggest that the nociceptive input from the thoracolumbar fascia contributes to the pain in low back pain patients.

  10. Epidemiology, Treatment, and Prevention of Lumbar Spine Injuries in Major League Baseball Players. (United States)

    Camp, Christopher L; Conti, Matthew S; Sgroi, Terrance; Cammisa, Frank P; Dines, Joshua S


    In recent years, increased attention has been paid to injuries occurring in Major League Baseball (MLB) players. Although most of the current orthopedic literature regarding baseball injuries pertains to the shoulder and elbow, lumbar spine injuries are another common reason for time out of play. Back and core injuries may represent as many as 12% of all injuries that result in time out of play from MLB. This high rate of injury is likely related to the critical role that the spine plays in every major baseball-related movement. Linking the upper extremities to the hips and lower extremities, a healthy, strong, and stable spine and core is a prerequisite for performance in all levels of baseball. It has been well documented that baseball players with poor spinal control and stabilization are at increased risk for future injury. Common etiologies of lumbar injuries include stress fractures, muscle injury, annular tears with or without disc herniation, facet joint pain, sacroiliac joint pain, and stenosis. This review discusses the epidemiology of spinal injuries in baseball. Special attention is paid to the role of the spine in baseball-related activities, common injuries, tips for making the correct diagnosis, treatment options, outcomes, rehabilitation, and injury prevention.

  11. Feasibility study and preliminary design of load-assisting clothes for lumbar protection inspired by human musculoskeletal systems (United States)

    Hashimoto, Riho; Masuda, Arata; Chen, Hao; Kobayashi, Sou


    The purpose of this paper is to develop load assisting clothes for caregivers. Low back pain is one of the most major reasons for caregivers to leave their jobs. In this study, load assisting clothes which reduce the risks of low back pain of caregivers are designed and manufactured, targeting at the use in small care-houses and family caregiving. The load assisting clothes should have two functions. One is to reduce the compressive load acting on the lumbar spine as well as the tensile load on the lumbar muscles by providing an appropriate assisting force. The other is not to interfere with wearers' motion. The proposed approach in this study is to put elastic compressive members and tensioner belts integrated in the garment to provide the assisting forces without hindering natural movement and comfortable feeling. We study human musculoskeletal systems in the lumbar part, and consider to construct a parallel reinforcement of it on the body surface by embedding passive support structures. The arrangement of those elements is determined based on the study of the principal strain directions and the non-extension directions of the body surface to manage the appropriate assisting force without spoiling the mobility. The effectiveness of the proposed support principle is verified through experimental studies.

  12. Traumatic lumbar artery rupture after lumbar spinal fracture dislocation causing hypovolemic shock: An endovascular treatment. (United States)

    Eun, Jong-Pil; Oh, Young-Min


    Recently, we observed a case of lumbar artery injury after trauma, which was treated by endovascular embolization. A 67-year-old woman who was injured in a traffic accident was brought to the emergency room. She was conscious and her hemodynamic condition was stable, but she had paraplegia below L1 dermatome. Contrast-enhanced computed tomography scan of abdomen and pelvis revealed fracture dislocation of L3/4 along with retroperitoneal hematomas. However, there was no evidence of traumatic injury in both thoracic and abdominal cavity. At that time, her blood pressure suddenly decreased to 60/40 mmHg and her mental status deteriorated. Also, her hemoglobin level was 5.4 g/dl. While her hemodynamic condition stabilized with massive fluid resuscitation including blood transfusion, an angiography was immediately performed to look for and embolize site of retroperitoneal hemorrhage. On the angiographic images, there was an active extravasation from ruptured left 3rd lumbar artery, and we performed complete embolization with GELFOAM and coil. Lumbar artery injury after trauma is rare and endovascular treatment is useful in case of hemodynamic instability.

  13. Lumbar extension exercises in conjunction with mechanical traction for the management of a patient with a lumbar herniated disc. (United States)

    Gagne, Allison R; Hasson, Scott M


    Low back pain resulting from lumbar disc herniation is a common reason for referral for physical therapy. There is no evidence to support the management of lumbar disc herniation and derangement using mechanical traction combined with lumbar extension exercises. Therefore, the purpose of this case report was to describe and discuss the use of mechanical traction in conjunction with lumbar extension exercises for a patient with a lumbar herniated disc. The patient was a 49-year-old male referred to physical therapy with a medical diagnosis of a lumbar herniated disc at L5-S1 with compression of the L5 nerve root confirmed by MRI. The patient's chief complaint was pain over the left lumbosacral and central lumbar region with radiating pain into the left buttock accompanied by numbness and tingling in the left lower leg and foot. The patient was seen for a total of 14 visits. The first 5 days (2 weeks) of therapy consisted of lumbar extension exercises. For the following nine visits (over a 3-week period), mechanical traction was added as an adjunct to the extension exercises. Outcome measures included the Oswestry Disability Questionnaire, Back Pain Function Scale (BPFS), and the Numeric Pain Rating Scale (NPRS). Results from initial evaluation to discharge (Oswestry: 36% to 0%; BPFS: 33/60 to 57/60; NPRS: 7/10 to 0/10) demonstrated that the patient no longer experienced low back pain and improved in terms of functional status and pain-related disability. The patient no longer complained of numbness and tingling in the left lower extremity and the goals for the patient had been attained. The data from this case report suggests lumbar extension exercises in conjunction with mechanical traction facilitated the patient's improvement in pain and return to prior level of function.

  14. Muscle channelopathies and electrophysiological approach

    Directory of Open Access Journals (Sweden)

    Cherian Ajith


    Full Text Available Myotonic syndromes and periodic paralyses are rare disorders of skeletal muscle characterized mainly by muscle stiffness or episodic attacks of weakness. Familial forms are caused by mutation in genes coding for skeletal muscle voltage ionic channels. Familial periodic paralysis and nondystrophic myotonias are disorders of skeletal muscle excitability caused by mutations in genes coding for voltage-gated ion channels. These diseases are characterized by episodic failure of motor activity due to muscle weakness (paralysis or stiffness (myotonia. Clinical studies have identified two forms of periodic paralyses: hypokalemic periodic paralysis (hypoKPP and hyperkalemic periodic paralysis (hyperKPP, based on changes in serum potassium levels during the attacks, and three distinct forms of myotonias: paramyotonia congenita (PC, potassium-aggravated myotonia (PAM, and myotonia congenita (MC. PC and PAM have been linked to missense mutations in the SCN4A gene, which encodes α subunit of the voltage-gated sodium channel, whereas MC is caused by mutations in the chloride channel gene (CLCN1. Exercise is known to trigger, aggravate, or relieve symptoms. Therefore, exercise can be used as a functional test in electromyography to improve the diagnosis of these muscle disorders. Abnormal changes in the compound muscle action potential can be disclosed using different exercise tests. Five electromyographic (EMG patterns (I-V that may be used in clinical practice as guides for molecular diagnosis are discussed.

  15. Lumbar disc cyst with contralateral radiculopathy

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    Kishore Tourani


    Full Text Available Disc cysts are uncommon intraspinal cystic lesions located in the ventrolateral epidural space. They communicate with the nucleus pulposus of the intervertebral disc and cause symptoms by radicular compression. We report a unique case of lumbar disc cyst that was associated with disc herniation and contralateral radiculopathy. A 22 year old male presented with one month history of back-ache radiating to the left leg. Magnetic Resonance Imaging (MRI showed L3-L4 disc herniation with annular tear and cystic lesion in the extradural space anterior to the thecal sac on right side, which increased in size over a period of 3 weeks. L3 laminectomy and bilateral discectomy and cyst excision was done with partial improvement of patients symptoms.

  16. [Lumbar myelography with metrizamid (author's transl)]. (United States)

    Kehler, M


    A series of lumbar myelographies -- 105 in 98 patients - was carried out with water-soluble Metrizamid (Amipaque R) in a concentration of 170 mg I/ml and showed side-effects in 32% and a quality of contrast similar to that of other water-soluble contrast media used before. The side effects were mild, of short duration and needed no treatment. There were no epileptic fits, tonic or clonic carried out 1 - 12 months later showed no signs of arachnoiditis. Dangers of more serious complications appeared to increase, the higher the level of injection into the spinal canal. A short survey of contrast media used in myelography and earlier experience of experimental or clinical side effects caused by Medtrizamid in myelography follows.

  17. The Stress Distribution on the Zygapophyseal Joint of Lumbar Vertebra by ANSYS Program

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    Summer S. M. Mukhtar


    Full Text Available Zygapophyseal joints (or facet joints, are a plane synovial joint which located between the articular facet processes of the vertebral arch which is freely guided movable joints. Ten dried vertebrae were used for the lumbar region and taking (L4 as a sample to reveal stress pathways across the joints by using ANSYS program under different loading conditions which used Finite Elements Analysis model. Results obtained from the ANSYS program are important in understanding the boundary conditions for load analysis and the points of stress concentration which explained from the anatomical point of view and linked to muscle and ligament attachments. This model used as a computational tool to joint biomechanics and to prosthetic implant analysis.

  18. Shock absorption in lumbar disc prosthesis: a preliminary mechanical study. (United States)

    LeHuec, J C; Kiaer, T; Friesem, T; Mathews, H; Liu, M; Eisermann, L


    Lumbar disc prostheses have been used in treating symptomatic degenerative disc diseases. A few prostheses of the ball-socket design are currently available for clinical use, the joint mechanism being materialized either with a hard polymer core or a metal-to-metal couple. Other prostheses of "shock absorber" design were not available at the time of the study. The objective of this work was to establish whether there was a difference in the shock absorption capacity between a device having an ultra-high-molecular-weight polyethylene center core and a device having a metal-on-metal bearing. Vibration and shock loading were applied to two lumbar total disc prostheses: PRODISC, manufactured by Spine Solutions, and MAVERICK Total Disc Replacement, manufactured by Medtronic Sofamor Danek. The shock absorption capacity of the device was evaluated by comparing the input and the output force measurements. The disc prosthesis was mounted onto a test apparatus. Each side of the device was equipped with a force sensor. The input shock load and the output resulting forces were simultaneously measured and recorded. The loading force pattern included 1). a static preload of 350 N plus an oscillating vibration of 100 N with frequency sweeping from 0 to 100 Hz and 2). a sudden shock load of 250 N applied over a 0.1-second interval. Both input and output signal data were processed and were transformed into their frequency spectrums. The vibration and shock transmissibility of the device, defined as the ratio of the output spectrum over the input spectrum, were calculated in sweeping the frequency from 0 to 100 Hz. The phase deviation was calculated to characterize the shock absorber effects. For both tested devices under vibration and shock loading, the phase angle displacement between the input and the output signals was 10 degrees. Under oscillating vibration loading, both tested devices had a transmission ratio higher than 99.8%. Over the frequency interval 1-100 Hz, the

  19. Muscle activation imbalance and low-back injury in varsity athletes. (United States)

    Reeves, N Peter; Cholewicki, Jacek; Silfies, Sheri P


    There are conflicting findings in the literature regarding erector spinae activation imbalance in people with low-back pain (LBP). Some studies have found asymmetric recruitment between muscle pairs in people with LBP, whilst other studies have not; some reported people with LBP recruit more lumbar muscles whilst other have reported greater thoracic activity. Using 242 varsity athletes, EMG activity of thoracic and lumbar erector spinae pairs was recorded during an isometric trunk extension. Activation imbalance among muscle pairs and levels was compared between athletes with and without a history of low-back injury (HxLBI). There were no group differences in the imbalance between sides, but the HxLBI group had greater activation imbalance between lumbar and thoracic levels than the No HxLBI group. Activation imbalance between levels was similar for individuals with No HxLBI and those who sustained first time injury suggesting that imbalance does not cause LBI. There was no difference between the athletes with single and multiple episode LBI, nor between short and long symptom duration suggesting that the presence of imbalance is not an impairment. Interestingly, activation imbalance occurred in both directions, meaning more thoracic activity for some, and more lumbar activity for others, which might be a functional adaptation related to pathology.

  20. [Features of the clinical course of intravertebral disk herniation in degenerative lumbar stenosis]. (United States)

    Kariev, M Kh; Norov, A U; Ishmukhamedov, S N; Iugaĭ, I A


    The paper presents a clinical and neurological analysis of 110 patients with discal hernias who were divided into 2 groups: 1) 50 patients with normal sizes of the vertebral column; 2) 51 patients with its stenosis. Compression syndromes were major in all cases. In patients in whom discal hernia was concurrent with lumbar stenosis, the clinical course was characterized by dull or aching pains in the low back and legs, by symptoms of dysbasia neurasthenica intermittens, severe motor and sensory disorders with autonomic impositions.

  1. Laparoscopic tension-free hernioplasty for lumbar hernia. (United States)

    Maeda, K; Kanehira, E; Shinno, H; Yamamura, K


    Lumbar hernia, a defect of the posterior abdominal wall, is a very rare condition. The repair of a posterior abdominal wall hernia by simply closing the hernia port with sutures may not be adequate, especially when the herniation is due to a weakness in the abdominal wall. Recently, a simple, logical method of tension-free repair has become a popular means for the treatment of various abdominal wall hernias. Previous studies have advocated the use of tension-free repair for lumbar hernia; the technique uses a mesh replacement and requires an extensive incision. Herein we present a case of superior lumbar hernia. Our technique consisted of a laparoscopic tension-free hernioplasty with the application of a Prolene mesh. This technique, which provides an excellent operative view, is safe, feasible, and minimally invasive. We conclude that laparoscopic tension-free repair should be the preferred option for the treatment of lumbar hernia.

  2. Functional outcome of surgical management of degenerative lumbar canal stenosis

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    Rajendra Nath


    Conclusion: Operative treatment in patients of degenerative lumbar canal stenosis yields excellent results as observed on the basis of JOA scoring system. No patient got recurrence of symptoms of nerve compression.

  3. Lumbar puncture in patients using anticoagulants and antiplatelet agents. (United States)

    Domingues, Renan; Bruniera, Gustavo; Brunale, Fernando; Mangueira, Cristóvão; Senne, Carlos


    The use of anticoagulants and antiplatelet agents has largely increased. Diagnostic lumbar puncture in patients taking these drugs represents a challenge considering the opposing risks of bleeding and thrombotic complications. To date there are no controlled trials, specific guidelines, nor clear recommendations in this area. In the present review we make some recommendations about lumbar puncture in patients using these drugs. Our recommendations take into consideration the pharmacology of these drugs, the thrombotic risk according to the underlying disease, and the urgency in cerebrospinal fluid analysis. Evaluating such information and a rigorous monitoring of neurological symptoms after lumbar puncture are crucial to minimize the risk of hemorrhage associated neurological deficits. An individualized patient decision-making and an effective communication between the assistant physician and the responsible for conducting the lumbar puncture are essential to minimize potential risks.

  4. Lumbar puncture in patients using anticoagulants and antiplatelet agents

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    Renan Domingues


    Full Text Available ABSTRACT The use of anticoagulants and antiplatelet agents has largely increased. Diagnostic lumbar puncture in patients taking these drugs represents a challenge considering the opposing risks of bleeding and thrombotic complications. To date there are no controlled trials, specific guidelines, nor clear recommendations in this area. In the present review we make some recommendations about lumbar puncture in patients using these drugs. Our recommendations take into consideration the pharmacology of these drugs, the thrombotic risk according to the underlying disease, and the urgency in cerebrospinal fluid analysis. Evaluating such information and a rigorous monitoring of neurological symptoms after lumbar puncture are crucial to minimize the risk of hemorrhage associated neurological deficits. An individualized patient decision-making and an effective communication between the assistant physician and the responsible for conducting the lumbar puncture are essential to minimize potential risks.

  5. Degenerative lumbar spondylolisthesis: an epidemiological perspective: the Copenhagen Osteoarthritis Study

    DEFF Research Database (Denmark)

    Jacobsen, Steffen; Sonne-Holm, Stig; Rovsing, Hans


    STUDY DESIGN: A cross-sectional epidemiological survey of 4151 participants of the Copenhagen Osteoarthritis Study. OBJECTIVE: To identify prevalences and individual risk factors for degenerative lumbar spondylolisthesis. SUMMARY OF BACKGROUND DATA: The Copenhagen Osteoarthritis Study has...

  6. Lumbar hernia misdiagnosed as a subcutaneous lipoma: a case report

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    Amelio Gianfranco


    Full Text Available Abstract Introduction Lumbar hernia is a rare abdominal wall defect and clinical suspicion is necessary for diagnosis. Case presentation We report the case of a 40-year-old Caucasian woman with a superior lumbar hernia (Grynfeltt hernia initially misdiagnosed as a recurrent lipoma. The correct diagnosis was made intra-operatively and the hernia was repaired using synthetic mesh. The patient was free of recurrence at 4 months after the operation. Conclusion A lumbar or flank mass should always raise suspicion of a lumbar hernia. Ultrasound and computed tomography may confirm the diagnosis. Adequate surgical treatment should be planned on the basis of etiology and hernia size. Both open and laparoscopic techniques can be used with good results.

  7. Muscle-specific expression of hypoxia-inducible factor in human skeletal muscle

    DEFF Research Database (Denmark)

    Mounier, Rémi; Pedersen, Bente Klarlund; Plomgaard, Peter


    from triceps brachii (characterized by a high proportion of type II fibres), from soleus (characterized by a high proportion of type I fibres) and from vastus lateralis (characterized by an equal proportion of type I and II fibres). The hypothesis was that type I muscle fibres would have lower HIF-1...... a significantly higher VEGF protein content than vastus lateralis and triceps muscle. In conclusion, we have shown that there are muscle-specific differences in HIF-1alpha and VEGF expression within human skeletal muscle at rest in normoxic conditions. Recent results, when combined with the findings described...

  8. The influence of specific training on trunk muscle recruitment patterns in healthy subjects during stabilization exercises. (United States)

    Stevens, Veerle K; Coorevits, Pascal L; Bouche, Katie G; Mahieu, Nele N; Vanderstraeten, Guy G; Danneels, Lieven A


    Low back pain is a major problem involving high medical costs, therefore effective prevention strategies are essential. Stabilization exercises seem to facilitate the neuromuscular control of the lumbar spine and may be useful in prevention programs. To investigate whether specific lumbar stabilization training has an effect on muscle recruitment patterns in a healthy population, in the present study 30 subjects were recruited to perform two types of testing exercises, i.e. bridging exercises and exercises in four-point kneeling, both before and after training. Surface electromyographic data of different abdominal and back muscles were obtained. After training, analysis of the relative muscle activity levels (percentage of maximal voluntary isometric contraction) showed a higher activity of the local (segmental-stabilizing) abdominal muscles, but not of the local back muscles; minimal changes in global (torque-producing) muscle activity also occurred. Analysis of the loca