The Recent Trend in Diagnosis and Treatment of Chronic Low Back Pain

Kikuchi, Shinichi

doi:10.22603/ssrr.1.2016-0022

Cited by 22 publications

(14 citation statements)

References 95 publications

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“…In addition, we speculate the mechanism of the postural and symmetrical LBP improvement as being that the loads to the facet joint and disc bilaterally were improved because of the bilateral LEP relief by the decompression of the bilateral nerve root and cauda equina. Minimally invasive surgery particularly can also result in a favorable outcome for the treatment of patients with chronic LBP and spinal stenosis and our present results also support this finding [14]. By contrast, greater preoperative LBP results in a poorer surgical outcome after the decompression surgery [15].…”

Section: Discussionsupporting

confidence: 84%

Unilateral laminectomy for bilateral decompression improves low back pain while standing equally on both sides in patients with lumbar canal stenosis: analysis using a detailed visual analogue scale

Takahashi

Aoki

Saito

et al. 2019

BMC Musculoskelet Disord

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Background Unilateral laminectomy for bilateral decompression (ULBD) for lumbar spinal stenosis (LSS) is a less invasive technique compared to conventional laminectomy. Recently, several authors have reported favorable results of low back pain (LBP) in patients of LSS treated with ULBD. However, the detailed changes and localization of LBP before and after ULBD for LSS remain unclear. Furthermore, unsymmetrical invasion to para-spinal muscle and facet joint may result in the residual unsymmetrical symptoms. To clarify these points, we conducted an observational study and used detailed visual analog scale (VAS) scores to evaluate the characteristics and bilateral changes of LBP and lower extremity symptoms. Methods We included 50 patients with LSS treated with ULBD. A detailed visual analogue scale (VAS; 100 mm) score of LBP in three different postural positions: motion, standing, and sitting, and bilateral VAS score (approached side versus opposite side) of LBP, lower extremity pain (LEP), and lower extremity numbness (LEN) were measured. Oswestry Disability Index (ODI) was used to quantify the clinical improvement. Results Detailed LBP VAS score before surgery was 51.5 ± 32.5 in motion, 63.0 ± 30.1 while standing, and 37.8 ± 31.8 while sitting; and showed LBP while standing was significantly greater than LBP while sitting ( p < 0.01). After surgery, LBP while standing was significantly improved relative to that while sitting ( p < 0.05), and levels of LBP in the three postures became almost the same with ODI improvement. Bilateral VAS scores showed significant improvement equally on both sides ( p < 0.01). Conclusions ULBD improves LBP while standing equally on both sides in patients with LCS. The improvement of LBP by the ULBD surgery suggests radicular LBP improved because of decompression surgery. Furthermore, the symmetric improvement of LBP by the ULBD surgery suggests unsymmetrical invasion of the paraspinal muscles and facet joints is unrelated to residual LBP.

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Section: Discussionsupporting

confidence: 84%

Unilateral laminectomy for bilateral decompression improves low back pain while standing equally on both sides in patients with lumbar canal stenosis: analysis using a detailed visual analogue scale

Takahashi

Aoki

Saito

et al. 2019

BMC Musculoskelet Disord

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“… 22 Numerous previous studies have reported the relationships between musculoskeletal pain and LoS. 16 , 44 – 47 Recently, biopsychosocial factors were shown to be essential components associated with not only low back pain 48 , 49 but also knee pain, 50 , 51 because pain is affected by actual tissue damage and psychological experience. Psychometric properties have been reported to predict pain and disability outcomes not only in patients with low back pain 52 , 53 but also in patients with symptomatic knee OA.…”

Section: Discussionmentioning

confidence: 99%

Locomotive syndrome: clinical perspectives

Ikemoto¹,

Arai²

2018

CIA

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The deterioration of locomotive components, which comprise bones, joints, and intervertebral discs, and muscles and nerves, can lead to symptoms such as pain, limitations in the range of joint mobility, malalignment, impaired balance, and difficulty walking. Locomotive syndrome (LoS) was proposed by the Japanese Orthopedic Association in 2007 as a concept for people who are at a high risk of developing a musculoskeletal ambulation disability attributed to locomotor organs. Although many international articles related to LoS have been published, an international consensus of this concept seems to be lacking. This review article on LoS introduces the concept, the related assessment methods, and the condition’s prevalence based on the most up-to-date literature, and discusses discrimination from frailty and sarcopenia, relevance to musculoskeletal problems, management plan, and future directions. Familiarity with recent evidence would be useful for the health care providers in an aging society to educate individuals with LoS or pre-LoS and to maintain their well-being and prevent them from requiring long-term care.

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“…Low back pain (LBP) is a common condition and one of the most serious physiological issues worldwide [1][2][3][4][5] . LBP can be caused by several factors in any part of the complex lower back system, such as the interconnected network of the spinal muscles, bones, discs, nerves, or tendons in the lumbar spine.…”

Section: Introductionmentioning

confidence: 99%

Association between Spinopelvic Alignment and Lumbar Intervertebral Disc Degeneration Quantified with Magnetic Resonance Imaging T2 Mapping in Patients with Chronic Low Back Pain

Ogon

Takashima

Morita

et al. 2020

Spine Surg Relat Res

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Introduction: Although intervertebral disc degeneration (IVDD) and spinopelvic malalignment are likely key structural features of spinal degeneration and chronic low back pain (CLBP), the correlation analysis has not been fully conducted. This cross-sectional quantitative magnetic resonance imaging (MRI) T2 mapping study aimed to elucidate the association between IVDD and spinopelvic alignment in CLBP patients. Methods: The subjects included 45 CLBP patients (19 men and 26 women; mean age, 63.8 ± 2.0 years; range, 41-79 years). The T2 values of the anterior annulus fibrosus (AF), the nucleus pulposus (NP), and the posterior AF were evaluated using MRI T2 mapping. We compared the possible correlations of spinopelvic parameters with T2 values of anterior AF, NP, and posterior AF using Pearson's correlation coefficient analysis. T2 values in these regions were classified into upper (L1-L2 and L2-L3), middle (L3-L4), and lower (L4-L5 and L5-S1) disc levels, and we analyzed the correlations with spinopelvic parameters. Results: There were significant correlations of the anterior AF T2 values with lumbar lordosis (r = 0.51, p < 0.01), sacral slope (r = 0.43, p < 0.01), sagittal vertical axis (r = −0.40, p < 0.01), and pelvic tilt (r = −0.33, p < 0.01). In all lumbar levels, T2 values of anterior AF had significantly positive correlation with LL and significantly negative correlation with SVA. In lower disc level, T2 values of anterior AF had significantly positive correlation with SS and significantly negative correlation with PT. T2 values of NP and posterior AF had no significant correlations with spinopelvic parameters in all lumbar disc levels.-2-Conclusion: In summary, this study indicated that the anterior AF degeneration is associated with hypolordosis of the lumbar spine, anterior translation of the body trunk, and posterior inclination of the pelvis in CLBP. Anterior AF degeneration in all lumbar disc levels was associated with hypolordosis of the lumbar spine and anterior translation of the body trunk.

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The Recent Trend in Diagnosis and Treatment of Chronic Low Back Pain

Cited by 22 publications

References 95 publications

Unilateral laminectomy for bilateral decompression improves low back pain while standing equally on both sides in patients with lumbar canal stenosis: analysis using a detailed visual analogue scale

Unilateral laminectomy for bilateral decompression improves low back pain while standing equally on both sides in patients with lumbar canal stenosis: analysis using a detailed visual analogue scale

Locomotive syndrome: clinical perspectives

Association between Spinopelvic Alignment and Lumbar Intervertebral Disc Degeneration Quantified with Magnetic Resonance Imaging T2 Mapping in Patients with Chronic Low Back Pain

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