Menu
Menu
19 Harley St, London, W1G 9QJ, UK

Day: January 8, 2019

[Depressivity as mediator in the fear-avoidance model : A path analysis investigation of patients with chronic back pain].

By wp_zaman
Related Articles

[Depressivity as mediator in the fear-avoidance model : A path analysis investigation of patients with chronic back pain].

Schmerz. 2013 Dec;27(6):612-8

Authors: Seekatz B, Meng K, Faller H

Abstract
INTRODUCTION: The fear-avoidance model (FAM) has gained widespread acceptance as a conceptual framework predicting chronic pain development. However, there is still a high amount of unexplained variance in the prediction of outcome variables. This study aimed to test depression as a mediator of prospective links between the FAM variables pain intensity, pain-related fear, avoidance behavior and disability in order to achieve a better prediction of model variables.
MATERIAL AND METHODS: Single mediation analyses were conducted using path analysis of longitudinal data from patients with chronic back pain (n = 243).
RESULTS: There was at least partial mediation by depression for all prospective relations of FAM variables analyzed. The mediation effects increased the percentage of explained variance of the predicted model variables.
CONCLUSION: The findings provide support for additional consideration of depressive symptoms to obtain a better understanding of prospective associations between FAM variables. The findings indicate that in the treatment of chronic back pain following a multiple target approach to reduce pain, pain-related fear and avoidance behavior and also depressive symptoms should be considered.

PMID: 24337428 [PubMed – in process]

Excruciating Low Back Pain After Strenuous Exertion: Beware of Lumbar Paraspinal Compartment Syndrome.

By wp_zaman
Related Articles

Excruciating Low Back Pain After Strenuous Exertion: Beware of Lumbar Paraspinal Compartment Syndrome.

J Emerg Med. 2015 Sep 11;

Authors: Vanbrabant P, Moke L, Meersseman W, Vanderschueren G, Knockaert D

Abstract
BACKGROUND: Low back pain is extremely common and usually a minor self-limiting condition. Rarely, however, it is a harbinger of serious medical illness. Paraspinal compartment syndrome is a rare condition, but its timely recognition is important to allow adequate treatment.
CASE REPORT: A 16-year-old boy presented to the Emergency Department (ED) with severe low back pain, necessitating intravenous opioids. Laboratory results showed severe rhabdomyolysis. Magnetic resonance imaging of the lumbar spine showed diffuse edema and swelling in the paraspinal muscles. Aggressive fluid therapy was started but despite narcotic analgesia the pain persisted and creatine kinase (CK) levels increased. Compartment pressures of the erector spinae were found to be increased. The decision was made to proceed with bilateral paraspinal fasciotomies. Postoperatively, the patient noted immediate pain relief with rapid decrease of CK level. The patient is pain free and resumed running and swimming 3 months after admission in the ED. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Although paraspinal compartment syndrome is a rare condition, its recognition is of paramount importance to allow adequate surgical treatment, preventing muscle necrosis. Although back pain most often has a benign course, a careful history and physical examination in patients presenting with low back pain allows determination of “red flags.” Mandatory further diagnostic tests can identify underlying serious illness.

PMID: 26371973 [PubMed – as supplied by publisher]

Aging Changes in Lumbar Discs and Vertebrae and Their Interaction A 15-year Follow-up Study.

By wp_zaman
Related Articles

Aging Changes in Lumbar Discs and Vertebrae and Their Interaction A 15-year Follow-up Study.

Spine J. 2013 Nov 18;

Authors: Videman T, Battié MC, Gibbons LE, Gill K

Abstract
BACKGROUND CONTEXT: Many studies have focused on either the intervertebral disc, as a culprit in back pain problems, or the vertebral body, but very few studies have examined both structures and their relation.
PURPOSE: The goals were to measure the concordant changes in morphology of the discs and vertebrae during 5, 10 and 15-year follow-ups.
STUDY DESIGN: Longitudinal study.
PATIENT SAMPLE: Among a general population sample of 232 men that had been scanned in 1992-1993, 105 men were re-examined in 1997-1998 and 2007-2008. Mean age at 15-year follow-up was 63 years. A confirmatory sample with 10-year follow-up was also included.
METHODS: 1.5 Tesla scanners with surface coils were used at baseline and follow-up. Image analysing software was used to measure distances and areas of interest of mid-sagittal and mid-axial spine images.
RESULTS: The disc heights decreased at 5 years by 3.4% (0.4 mm) and 3.3 % (0.4 mm) and at 15 years 8.7 % (1.0 mm) and 11.3 % (1.3 mm) in the upper and the lower discs respectively (p<0.001). While not clear after 5years, vertebra heights increased in mean by 3.1 % (0.8 mm) in the upper lumbar levels and by 4.7 % (1.1 mm) in the lower vertebrae after 15 years (p<0.001). Vertebra height increases were associated with disc narrowing (P=0.001). The mean annual shortening of the lumbar spine L1-S1 block was 0.13 mm/year, which was in line with the mean standing height, which decreased little (174.7 cm at baseline and 174.4 cm at follow-up).
CONCLUSIONS: Discs and vertebrae degenerate or remodel in concert: decreases in disc height appear to be compensated, in part, by accompanying increases in adjacent vertebra heights. The mechanism behind this novel finding and its implications require further study.

PMID: 24262855 [PubMed – as supplied by publisher]

Comparison of the Cervical Extension Angle and the Upper Trapezius Muscle Activity between Overhead Work and Below-knee Work.

By wp_zaman
Related Articles

Comparison of the Cervical Extension Angle and the Upper Trapezius Muscle Activity between Overhead Work and Below-knee Work.

J Phys Ther Sci. 2013 Oct;25(10):1289-1290

Authors: Yoo WG

Abstract
[Purpose] The purpose of this study was to compare the cervical extension angle and the upper trapezius muscle activity between overhead work and below-knee work. [Subjects] Twelve males aged 20-30 years, were recruited. [Methods] We measured the cervical extension angle and upper trapezius muscle activity during overhead work and below-knee work. [Results] The results show that the cervical extension angle and upper trapezius muscle activity were significantly increased during below-knee work compared to overhead work. [Conclusion] Below-knee work is more likely to cause neck and shoulder pain than overhead work. Therefore, future studies should investigate below-knee work in detail.

PMID: 24259777 [PubMed – as supplied by publisher]

Exploitation of Simple Classification and Space Created by the Tumor for the Treatment of Foramen Magnum Meningiomas.

By Kamruz Zaman
Related Articles

Exploitation of Simple Classification and Space Created by the Tumor for the Treatment of Foramen Magnum Meningiomas.

World Neurosurg. 2016 Mar;87:1-7

Authors: Yamahata H, Yamaguchi S, Takayasu M, Takasaki K, Osuka K, Aoyama M, Yasuda M, Tokimura H, Kurisu K, Arita K

Abstract
OBJECTIVE: The resection of foramen magnum meningiomas (FMMs) presents neurosurgical challenges. We propose a simple classification of the tumor location and the operating space created by the tumor to help treatment planning.
METHODS: We retrospectively analyzed 16 FMMs and divided them into 3 groups based on the tumor location–clival, foraminal, and atlantal tumors. The distance between the condyle and the neuraxis at the level of the foramen magnum was measured and defined as the available operative space (AOS). We also reviewed intraoperative video recordings to assess the surgical exposure of the tumor by the space created by the FMM and compared it with the AOS.
RESULTS: There were 4 clival, 8 foraminal, and 4 atlantal tumors. The AOS of the clival tumors was 10 mm ± 1.7, the AOS of the foraminal tumors was 18 mm ± 3.7, and the AOS of the atlantal tumors was 12 mm ± 2.1. All foraminal and atlantal tumors could be detached without a brain retractor. Because a major portion of the clival tumors was covered by the spinomedullary junction, a brain spatula was needed to obtain the required surgical space. The difference in AOS between clival and foraminal/atlantal tumors was statistically significant (P = 0.044). Although 4 patients experienced postoperative complications, the average postoperative Karnofsky performance scale score improved. The surgical complication rate was significantly lower in foraminal and atlantal FMMs than in clival FMMs (P = 0.027).
CONCLUSIONS: The simple classification of the tumor location helped to assess surgical difficulties. Knowledge of the space created by the FMMs between the condyle and the neuraxis is useful for planning the approach strategy, especially for estimating the available working space without resection of the occipital condyle.

PMID: 26409077 [PubMed – indexed for MEDLINE]