Search Results (8)

Adolescent idiopathic scoliosis (AIS) is a 3D structural deformity of the spine that can cause decreased spinal movement, paraspinal muscle weakness, or chronic pain. Our study aims to evaluate biomechanical and viscoelastic properties of the paravertebral muscles in adolescents with idiopathic S-type scoliosis, static plantar pressure, and stabilometry at the beginning of a physical exercise program and after 3 months. The myotonometry performed by using MyotonPro will determine five parameters (frequency, stiffness, logarithmic decrement, stress relaxation time, and ratio of relaxation time to deformation time). Measurements will be taken at the level of the left/right middle trapezius, left/right lower trapezius, left/right latissimus dorsi, and left/right lumbar erector muscles. Static pressure assessment and stabilometry (length described by the center of pressure, confidence area, and speed described by the center of pressure) will be determined by a PoData device in different testing positions (eyes open, eyes closed, head rotated to the right/left, head tilted to the right/left, and head in hyperextension). We expect to record a difference between the muscles on the concave side and the convex side in terms of myotonometric parameters, as well as differences between the initial and 3-month assessment. We predict an improvement in stabilometric parameters after the 3-month physical exercise program. Full article

The recent literature has debated the appropriate level of complexity for spine kinematic models. Multi-segmental analyses have been suggested to be more suitable for activities such as walking and running; however, studies focusing on sport-specific movements remain limited. This study compared four spine segmentation strategies for analyzing exercises simulating flexion and extension in acrobatic elements. Seventeen competitive university-level cheerleaders (male and female) participated in a motion capture study. Each athlete performed six exercises in the same order. Reflective markers were placed on the spinous processes of C7, T10, L1, L2, L3, L4, L5, and S1. From these, four models were constructed: (1) L1 and L5, (2) T10 and S1, (3) L1, L3, and L5, and (4) all lumbar vertebrae. Each model was fitted in the sagittal plane using a polynomial function and compared with the others via Pearson correlation. Model 3 (L1, L3, and L5) and Model 4 (all lumbar vertebrae) showed strong correlations across all trials, with Pearson coefficients approaching 1. These findings support the use of a two-segment representation of the lumbar spine (Model 3: L1–L3 and L3–L5) as a suitable approach for kinematic analysis of flexion–extension in acrobatic athletes. Full article

Background: Lateral lumbar or thoracic interbody fusion (LLIF) is increasingly considered for anterior column reconstruction and restoring segmental lordosis in degenerative, infectious, or deformity conditions. Reports about using LLIF with expandable interbody spacers for spine trauma are scarce. Methods: In this retrospective, single-center observational cohort study, we reviewed all patients treated by an expandable LLIF interbody spacer (ELSA^® Expandable Integrated LLIF Spacer, Globus Medical Inc) for trauma indication at our spine center between September 2018 and January 2024. The primary outcome measures were fusion rate at 12 months, change in segmental sagittal Cobb angle, and clinical outcome according to the MacNab criteria. Secondary outcomes included adverse events and complications. Results: We identified n = 21 patients with a mean age of 48.3 (standard deviation (SD) 15.7), 47.6% were female. LLIF was mostly performed at T11/12 (n = 4; 19.1%) and T12/L1 (n = 10; 47.5%). Indications were AO Spine type A2 (n = 4, 19.1%), A3 (n = 14; 66.7%) or A4 fractures (n = 3; 14.3%) with ligamentous (B2-type) in eight (38.1%) and hyperextension (B3-type) injury in one patient (4.8%). Surgery included the release of the anterior longitudinal ligament in four cases (19.1%). Intraoperative AEs were noted in n = 1 (4.8%), postoperative AEs in n = 3 (14.3%) at discharge, n = 4 (19.1%) at three, and n = 2 (9.5%) at twelve months. Segmental sagittal Cobb angle changed from 1.3° (preoperative) to 13.3° at twelve months (p < 0.001). Functional outcome was excellent/good in n = 15 (71.4%; four missing) at 12 months. The fusion rate at the LLIF level was 100% at the 12-month follow-up. Conclusions: LLIF with expandable interbody spacers for spine trauma (off-label use) is safe, promotes solid fusion (100% fusion rate at 12 months), and enables correction of sagittal segmental Cobb angle (mean improvement of 12°), with good or excellent clinical outcomes in most patients (71.4%). Full article

The purpose of this case report is to describe the case of a patient with ankylosing spinal hyperostosis (ASH) and lumbar spine fracture complicated by ureteral injury mimicking spondylodiscitis with osteomyelitis features and retroperitoneal abscess formation followed by the cervical spine fracture. A consecutive analysis and summary of the medical history, radiological documentation, operative procedure, complications, and outcomes were performed. A 59-year-old man presented with abdominal pain three weeks after sustaining a low-energy fall. The performed CT scans demonstrated a three-column fracture at the L3/L4 level and features of ASH. Additionally, MRI scans demonstrated hyperintense fluid collection within L3/L4 intervertebral space communicating with both psoas major muscles, mimicking spondylodiscitis with osteomyelitis features and retroperitoneal abscess formation. An in situ instrumented lumbar fusion at the L2-L3-L5-S1 levels with implantation vertebral body replacement implant at the L3/L4 level was performed. Postoperative CT imaging revealed evidence of post-traumatic right ureteral injury. Following urological treatment covering nephrectomy and ureter ligation, the patient was maintained at a 2-year follow-up. After this period, the patient presented again with tetraparesis after sustaining a low-energy fall. The performed CT scans demonstrated a three-column fracture at the C5/C6 level. The combined anterior and posterior osteosynthesis at the C4-C5-C6-C7 levels was performed. This case report presents the rare clinical constellation regarding the lumbar spine fracture complicated by ureteral injury followed by a cervical spine fracture regarding the same patient. The potential injury of retroperitoneal structures, including the ureter after hyperextensive lumbar spine fracture, should be considered in ASH patients. In this case, one should be aware of the atypical clinical presentation regarding the observed spondylodiscitis- and osteomyelitis-like features. Full article

Background: Flatfoot is a deformity in which the foot is flattened due to a decrease in or loss of the medial longitudinal arch. Statement of the problem: Few studies have investigated the relationship between the severity of flat feet, trunk strength, and joint flexibility. Purpose: The aim of this study is to investigate the relationship between the severity of flatfoot and joint flexibility and foot and trunk strength in children with flexible flatfoot. Methods: This study included 16 children (boys, 12; girls, 4; age, 4~8 years) with flexible flatfeet. We examined the resting calcaneal stance position angle (RCSPA) and foot posture index (FPI) scores for clinical severity and radiographic parameters, such as calcaneal pitch angle, talometatarsal angle (TMA), and talocalcaneal angle (TCA). Muscle thicknesses of the tibialis posterior (TP), peroneus longus (PL), and L1 multifidus were measured by sonography. Isometric contraction of ankle inversion, eversion in a seating position, and lumbar extension at a prone position were induced using a handheld dynamometer to measure the maximum muscle strength for each muscle. Beighton’s scoring system was used to assess joint flexibility by evaluating the hyperextension of the joint for each category when performing stretching motion. Spearman’s rank correlation coefficient for nonparametric data was used. Results: The FPI showed a moderately negative correlation with the muscle thickness of TP (r = −0.558, p = 0.009) and L1 multifidus (r = −0.527, p = 0.012), and the strength of the ankle inverter (r = −0.580 p = 0.005) and lumbar extensor (r = −0.436 p = 0.043). RCSPA showed a moderately positive correlation with TCA (r = 0.510, p = 0.006). Beighton’s score showed no significant correlation with all parameters. Conclusion: In children with flatfoot, FPI reflected the clinical severity; thus, the more severe the symptoms, the weaker the ankle inverter and lumbar extensor. Full article

Background and purpose: Osteoporotic hyperkyphosis is associated with adverse outcomes, such as fatigue, back pain, or reduced back extensor strength, with a negative impact on functionality and quality of life. The purpose of this review is to assess the effectiveness of spinal orthosis on these adverse effects. Methods: A systematic review following the PRISMA guidelines was performed. Inclusion criteria were (1) women with osteoporosis; (2) randomized controlled trials only; and (3) type of intervention: spinal bracing. Exclusion criteria were (1) article not written in English; (2) full-text not available; and (3) no kyphosis assessment. Quality-of-life variables such as back pain, functional variables such as back extensor strength, and osteoporotic-related variables such as lumbar spine bone mineral density were extracted and recorded before and after the intervention. The characteristics of the intervention programs were also extracted and recorded. The characteristics of studies, interventions, and participants are summarized in a table. Then, the revised Cochrane risk-of-bias tool for randomized trials (RoB 2) was used to assess the quality of the studies. Results and Discussion: Four randomized controlled trials with a low risk of bias were included (n = 326 women with osteoporosis, aged 51–93 years). Interventions consisting of wearing a dynamic hyperextension orthosis for at least two hours per day for six months improved functionality, mobility, back extensor strength, respiratory function, and reduced the thoracic kyphosis angle. Conclusions: Spinal orthosis, especially dynamic hyperextension braces, seems effective in improving the adverse outcomes of osteoporotic hyperkyphosis. It does not seem necessary to wear the orthosis during all daily activities. Full article

The authors report a case in which a 38-year-old male who presented himself to the emergency department with a chief complaint of cervical neck pain and paresthesia radiating from the right pectoral region down his distal right arm following self-manipulation of the patient’s own cervical vertebrae. Initial emergency department imaging via cervical x-ray and magnetic resonance imaging (MRI) without contrast revealed no cervical fractures; however, there was evidence of an acute cervical disc herniation (C3–C7) with severe herniation and spinal stenosis located at C5–C6. Immediate discectomy at C5–C6 and anterior arthrodesis was conducted in order to decompress the cervical spinal cord. Acute traumatic cervical disc herniation is rare in comparison to disc herniation due to the chronic degradation of the posterior annulus fibrosus and nucleus pulposus. Traumatic cervical hernias usually arise due to a very large external force causing hyperflexion or hyperextension of the cervical vertebrae. However, there have been reports of cervical injury arising from cervical spinal manipulation therapy (SMT) where a licensed professional applies a rotary force component. This can be concerning, considering that 12 million Americans receive SMT annually (Powell, F.C.; Hanigan, W.C.; Olivero, W.C. A risk/benefit analysis of spinal manipulation therapy for relief of lumbar or cervical pain. Neurosurgery 1993, 33, 73–79.). This case study involved an individual who was able to apply enough rotary force to his own cervical vertebrae, causing severe neurological damage requiring surgical intervention. Individuals with neck pain should be advised of the complications of SMT, and provided with alternative treatment methods, especially if one is willing to self manipulate. Full article

The purpose of this study was to investigate the recruitment of the paraspinal muscles longissimus and iliocostalis during dynamic contractions of superman exercises on stable and unstable surfaces, and during unloaded bodyweight squats. Surface electromyography (EMG) was measured from these two muscles bilaterally while participants performed the exercises. Participants (n = 17, age 24 ± 3.1 years, body mass 78.5 ± 8.2 kg, height 1.81 ± 7.4 m) performed two sets of 10 repetitions for each exercise in a random order. Correlation analysis demonstrated a strong positive relation between both sides of the participants (longissimus pairs: r = 0.945; and iliocostalis pairs: r = 0.855), demonstrating a symmetric muscle recruitment in all exercises. However, there were no significant differences between the exercises for both muscles in a multiple comparison analysis (longissimus pairs: p = 0.496; and iliocostalis pairs: p = 0.296). The bodyweight squat produces similar muscle activity of the longissimus and iliocostalis compared with superman exercises on stable and unstable surfaces. Considering the dynamic nature of the bodyweight squat, and its implications on functional daily living activities and sports conditions, it seems a more reasonable choice for targeting paraspinal muscles if compared to superman exercises or unstable superman exercises. Full article