Lumbar Spinal Stenosis with Exacerbation of Back Pain with Extension: A Potential Contraindication for Supine MRI with Sedation

Kuramoto, B A Alan; Chang, Linda; Graham, Jon F.; Holmes, Simon

doi:10.1111/j.1552-6569.2009.00382.x

Cited by 6 publications

(6 citation statements)

References 7 publications

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“…In a clinical situation with a broad population base there can be limitations on patient’s movement ability. Some patients are unable to turn over from supine to prone or even lie down flat on a treatment table due to various problems such as: severe back problems, [ 26 ] obesity, [ 27 ] positional vertigo [ 28 ] or sarcopenia [ 29 ]. Cross-sectional area of the lower limb can also be affected by position [ 30 ].…”

Section: Introductionmentioning

confidence: 99%

Reliability and correlates of cross‐sectional area of abductor hallucis and the medial belly of the flexor hallucis brevis measured by ultrasound

Latey

Burns

Nightingale

et al. 2018

Journal of Foot and Ankle Research

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BackgroundWeakness of the intrinsic foot muscles is thought to produce deformity, disability and pain. Assessing intrinsic foot muscles in isolation is a challenge; however ultrasound might provide a solution. The aims of this study were to assess the reproducibility of assessing the size of abductor halluces (AbH) and the medial belly of flexor hallucis brevis (FHBM) muscles, and identify their relationship with toe strength, foot morphology and balance.MethodsTwenty one participants aged 26–64 years were measured on two occasions for muscle cross-sectional area using a Siemens Acuson X300 Ultrasound System with 5-13 MHz linear array transducer. Great toe flexor strength was measured by pedobarography, the paper grip test and hand-held dynamometry. Foot morphology was assessed by foot length, truncated foot length, Foot Posture Index (FPI) and dorsal arch height. Balance was measured by the maximal step test. Intra-class correlation coefficients (ICC3,1) were used to evaluate intra-rater reliability. Pearson’s correlation coefficients were performed to assess associations between muscle size and strength, morphology and balance measures. To account for the influence of physical body size, partial correlations were also performed controlling for truncated foot length.ResultsIntra-rater reliability was excellent for AbH (ICC3,1 = 0.97) and FHBM (ICC3,1 = 0.96). Significant associations were found between cross-sectional area of AbH and great toe flexion force measured standing by pedobarography (r = .623, p = .003),), arch height measured sitting (r = .597, p = .004) and standing (r = .590, p = .005), foot length (r = .582, p = 006), truncated foot length (r = .580, p = .006), balance (r = .443, p = .044), weight (r = .662, p = .001), height (r = .559, p = .008), and BMI (r = .502, p = .020). Significant associations were found between cross-sectional area of FHBM and FPI (r = .544, p = .011), truncated foot length (r = .483, p = .027) and foot length (r = .451, p = .040). Significant partial associations were found between AbH and great toe flexion force in standing by pedobarography (r = .562, p = .012) and FHBM and the FPI (r = .631, p = .003).ConclusionsMeasuring the cross-sectional area of AbH and FHBM with ultrasound is reproducible. Measures of strength, morphology and balance appear to relate more to the size of AbH than FHBM. After controlling for physical body size, cross-sectional area of AbH remained a significant correlate of great toe flexor strength and might be a useful biomarker to measure early therapeutic response to exercise.

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Section: Introductionmentioning

confidence: 99%

Reliability and correlates of cross‐sectional area of abductor hallucis and the medial belly of the flexor hallucis brevis measured by ultrasound

Latey

Burns

Nightingale

et al. 2018

Journal of Foot and Ankle Research

View full text Add to dashboard Cite

show abstract

“…Furthermore, repetitive lumbar extension and anterior pelvic tilt may contribute to over activation of LES and less activation of TES. Hence, prescribing PTE alone may also increase cervical and/or lumbar lordosis (Kuramoto et al, 2011), which is not desirable for individuals with lumbar extension syndrome. Several modes of exercise have been developed for improving the muscular function of the back (Menacho et al, 2010).…”

Section: Introductionmentioning

confidence: 99%

Electromyographic Analysis of Thoracic and Lumbar Erector Spinae Activity Using the Abdominal Drawing-in Maneuver and Chin Tuck During Prone Thoracic Extension Exercises

Kim

Lee²,

Choi³

et al. 2012

Physical Therapy Korea

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“…As a result, it is expected that the dural sac was strongly pressed and CES occurred immediately. There is an existing case report of CES that progressed according to a similar mechanism [ 11 ]. In the reported case, the patient was diagnosed with spinal stenosis, and an MRI scan was difficult due to the severe pain experienced by the patient when in the supine and back extension position.…”

Section: Discussionmentioning

confidence: 99%

Paraplegia after transforaminal epidural steroid injection in a patient with severe lumbar disc herniation - A case report -

Jeon¹,

Jang²,

Kim³

et al. 2021

Anesth Pain Med

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Background: Transforaminal epidural steroid injection (TFESI) is a conservative treatment for patients with lumbar disc herniation (LDH). However, there are reports of various complications that can occur after TFESI; among these, paraplegia is a serious complication. Case: A 70-year-old woman who was unable to lie supine due to low back pain exacerbation during back extension underwent TFESI. After injection, there was pain relief and the patient was able to lie supine; however, paraplegia developed immediately. Magnetic resonance imaging confirmed cauda equina syndrome (CES) due to nerve compression from L1–2 LDH. We determined that the patient's LDH was already severe enough to be considered CES and that the TFESI procedure performed without an accurate understanding of the patient's condition aggravated the disease. Conclusions: It is important to accurately determine the cause of pain and disease state of a patient to establish a correct treatment plan before TFESI is performed.

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Lumbar Spinal Stenosis with Exacerbation of Back Pain with Extension: A Potential Contraindication for Supine MRI with Sedation

Cited by 6 publications

References 7 publications

Reliability and correlates of cross‐sectional area of abductor hallucis and the medial belly of the flexor hallucis brevis measured by ultrasound

Reliability and correlates of cross‐sectional area of abductor hallucis and the medial belly of the flexor hallucis brevis measured by ultrasound

Electromyographic Analysis of Thoracic and Lumbar Erector Spinae Activity Using the Abdominal Drawing-in Maneuver and Chin Tuck During Prone Thoracic Extension Exercises

Paraplegia after transforaminal epidural steroid injection in a patient with severe lumbar disc herniation - A case report -

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