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JBJS Case Connect 2021 Apr 19;11(2). Epub 2021 Apr 19.

Department of Surgery, Sir H.N. Reliance Foundation Hospital, Girgaon, Mumbai, India.

Case: A 41-year-old woman sustained a degloving injury over her lumbosacral and perineal region with fractures of her right tibia and fibula. After diversion colostomy and osteosynthesis for the fractures at a primary center, a missed grade 2 lumbosacral dislocation was diagnosed at a tertiary center and the degloving injury was treated with debridement and skin grafting. After 5 months, the dislocation had progressed to grade 4 and she underwent delayed posterior lumbosacral reduction, interbody fusion, and L4-S1 fixation, with superior gluteal artery perforator flap and subsequent colostomy closure, with good outcomes (Oswestry Disability Index 10%) at the 3-year follow-up. Read More

PLoS One 2021 12;16(5):e0250742. Epub 2021 May 12.

Department of Brain and Cognitive Engineering, Korea University, Seoul, South Korea.

Neurogenic claudication is a typical manifestation of lumbar spinal stenosis (LSS). However, its pathophysiology is still unclear. The severity of clinical symptoms has been shown not to correlate with the degree of structural stenosis. Read More

A A Pract 2021 May 10;15(5):e01457. Epub 2021 May 10.

Urology, Indiana University School of Medicine, Riley Hospital for Children, Indianapolis, Indiana.

A 6-year-old male undergoing bilateral hydrocelectomy was to receive caudal analgesia after induction of general anesthesia. After insertion of the caudal needle, cerebrospinal fluid was unexpectedly aspirated and the caudal was abandoned. The surgeon performed bilateral ilioinguinal nerve blocks just before incision. Read More

Spine (Phila Pa 1976) 2021 May 10. Epub 2021 May 10.

Center for Evidence-Based Imaging (CEBI) Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA Department of Biomedical Informatics, Harvard Medical School, Boston, MA, USA Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.

Study Design: A case-control study of risk alleles for Degenerative Disc Disease (DDD) using magnetic resonance (MR) imaging for phenotyping.

Objective: We aim to provide the first statistically adequately powered study of the relationship between the presence of common risk alleles and occurrence of DDD in Eastern US population.

Summary Of Background Data: Many genetic pre-disposing factors have been identified in elevating the risk of DDD, including common variants in VDR, COL1A1, AGC1, COL9A2/3 genes. Read More

Pain Pract 2021 May 11. Epub 2021 May 11.

Department of Rehabilitation Medicine, College of Medicine, Yeungnam University, Daegu, Republic of Korea.

Objectives: Transforaminal epidural steroid injection (TFESI) is widely used to manage lumbosacral radicular pain due to herniated lumbar disc (HLD).

Objectives: We evaluated the long-term outcomes of TFESI in patients with lumbosacral radicular pain due to a HLD by the location, type, and size of the HLD.

Methods: In total, 114 patients who received the initial TFESI at least 4 years ago completed a phone interview. Read More

Br J Neurosurg 2021 May 8:1-6. Epub 2021 May 8.

Department of Physical Medicine and Rehabilitation, Shiraz University of Medical Sciences, Shiraz, Iran.

Background: Lumbosacral spinal stenosis (LSS) is the narrowing of the lumbar spinal canal. LSS usually happens in older people who do not have the proper physical condition to undergo surgery. Therefore, minimally invasive methods such as Ozone therapy and epidural injection can be used in these patients. Read More

Am J Physiol Renal Physiol 2021 May 10. Epub 2021 May 10.

Department of Urology, University of Pittsburgh, United Statesgrid.21925.3d.

This study evaluated the time-course changes in bladder and external urinary sphincter (EUS) activity as well as the expression of mechanosensitive channels in lumbosacral dorsal root ganglia (DRG) after spinal cord injury (SCI). Female C57BL/6N mice in the SCI group underwent transection of the Th8/9 spinal cord. Spinal intact mice and SCI mice at 2, 4 and 6 weeks post SCI were evaluated by single-filling cystometry and EUS-electromyography (EMG). Read More

World J Clin Cases 2021 Apr;9(12):2838-2844

Department of Critical Care Medicine, Nanping First Hospital Affiliated to Fujian Medical University, Nanping 353000, Fujian Province, China.

Background: Rhabdomyolysis is a serious complication of heat stroke. Unlike that in acute kidney injury, the risk of muscle bleeding in rhabdomyolysis is often ignored and can substantially increase the widespread use of anticoagulants, leading to the formation of intramuscular hematoma.

Case Summary: During the summer, a middle-aged man and an elderly man were diagnosed with heat stroke, rhabdomyolysis, and acute renal impairment. Read More

J Orthop Sci 2021 May 6. Epub 2021 May 6.

Niigata University Hospital, Japan.

Background: Proper identification of lumbosacral transitional vertebrae (LSTV) is important to characterize the relationship between the transitional segment and adjacent levels. Classical classification schemes are inaccurate with respect to the whole spine. We propose a precise vertebral numbering method and investigated the relationship between LSTV and whole-body sagittal alignment. Read More

Vet Med Sci 2021 May 9. Epub 2021 May 9.

Peninsula Emergency and Referral Hospital, Mornington, Vic., Australia.

A 5-month-old female entire Dachshund presented with an acute onset of left hind limb lameness following intense play. There were concurrent intermittent neurological deficits in the left hind limb, and pain in the lumbosacral region and on dorsal flexion of the tail. Computed tomography (CT) imaging revealed an asymmetric widening of the left sacroiliac joint with loss of cortical margins, accompanied by mild osteolytic changes of the adjacent ilium and sacrum highly suggestive of septic sacroiliitis. Read More

Neurosurg Rev 2021 May 8. Epub 2021 May 8.

Department of Neurosurgery, Medical University of Innsbruck, Anichstrasse 35, MZA 3rd floor, Tyrol, 6020, Austria.

Three-column osteotomy (3-CO) is a powerful technique in adult deformity surgery, and pedicle subtraction osteotomy (PSO) is the workhorse to correct severe kyphotic spinal deformities. Aging of the population, increasing cases of iatrogenic flat back deformities and understanding the importance of sagittal balance have led to a dramatic increase of this surgical technique. Surgery, however, is demanding and associated with high complication rates so that every step of the procedure requires meticulous technique. Read More

Spine (Phila Pa 1976) 2021 May 6. Epub 2021 May 6.

School of Mechanical Engineering and Automation, Northeastern University, Shenyang, China.

Study Design: A biomechanical comparison study using finite element (FE) method.

Objective: To investigate effects of different dynamic stabilization devices, including pedicle-based dynamic stabilization system (PBDSS) and interspinous process spacer (ISP), used for topping-off implants on biomechanical responses of human spine after lumbar interbody fusion.

Summary Of Background Data: Topping-off stabilization technique has been proposed to prevent adjacent segment degeneration following lumbar spine fusion. Read More

Neurodiagn J 2021 May 5:1-14. Epub 2021 May 5.

Axis Neuromonitoring, Richardson, Texas.

Lateral lumbar interbody fusion procedures are performed with multimodality neuromonitoring of the femoral nerve to prevent lumbosacral plexus and peripheral nerve injury from positioning, dilation, retraction, and hardware implantation. The integrity of the femoral nerve can be continuously assessed during these procedures by Somatosensory Evoked Potentials of the Saphenous nerve (Sn-SSEPs). Sn-SSEPs are technically challenging to acquire and necessitate advanced troubleshooting skills with a more rigid anesthetic regimen and physiological parameters. Read More

Acta Neurol Belg 2021 May 4. Epub 2021 May 4.

Department of Neurosurgery, Beijing Jishuitan Hospital, No 31, Xinjiekou East Street, Xicheng, Beijing, 100035, China.

To discuss the clinical features and surgical outcomes of spinal epidural angiolipomas. We retrospectively analyzed the medical records of patients with spinal epidural angiolipomas who were performed microsurgery between January 2003 and December 2017. The diagnosis of spinal angiolipomas was based on pathological criteria. Read More

Neurodiagn J 2021 Mar;61(1):27-36

Medical Department, SpecialtyCare, Brentwood, Tennessee.

MEPs are recommended for patients undergoing lumbar and lumbosacral procedures in which intraoperative neuromonitoring (IONM) is being utilized. While electromyography (EMG) provides critical nerve root proximity information, spontaneous EMG discharges are relatively poor at reliably diagnosing spinal nerve root dysfunction. In contrast, research indicates that MEPs are both sensitive and specific in diagnosing evolving spinal nerve root dysfunction. Read More

Orthop Surg 2021 May 4. Epub 2021 May 4.

Department of Spine Surgery and Orthopaedics, Xiangya Hospital, Central South University, Changsha, China.

Objective: This study aimed to investigate the clinical effects of surgically treating lumbosacral tuberculosis with a modified posterior unilateral limited laminectomy method for debridement.

Methods: This retrospective study enrolled a total of 26 patients who were administered in our institution from January 2010 to December 2016, diagnosed with lumbosacral tuberculosis at the L5/S1 level, and underwent one-stage posterior unilateral limited laminectomy as surgical treatment for debridement, allograft of cortical bone grafting, and fixation. The erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) level, visual analog scale (VAS) score, Oswestry Disability Index (ODI), and lumbosacral angle (LA, Cobb's method) were statistically compared, and the American Spinal Injury Association Impairment (ASIA) Scale was compared between the preoperative and postoperative time points to evaluate the clinical outcomes. Read More

J Back Musculoskelet Rehabil 2021 Apr 30. Epub 2021 Apr 30.

Department of Physical Medicine and Rehabilitation, Marmara University Faculty of Medicine, Division of Rheumatology, Istanbul, Turkey.

Background: Lumbosacral radiculopathy is associated with a broad range of complaints; therefore, specific disability measurements should be validated for this condition.

Objectives: The aim of this study was to investigate the validity and reliability of the Istanbul Low Back Pain Disability Index (ILBPDI) in lumbosacral radiculopathy.

Methods: Patients diagnosed with radiculopathy caused by a disc herniation were included. Read More

Spine J 2021 Apr 29. Epub 2021 Apr 29.

London Health Science Centre, Victoria Hospital, London, N6A 5W9, Canada; Dept. of Surgery (Div. of Orthopaedic Surgery), Western University, London, N6A 3K7, Canada.

Background Context: There are several options for the stabilization of high-grade lumbosacral spondylolisthesis including transdiscal screws, the Bohlman technique (transdiscal fibular strut) and the modified Bohlman technique (transdiscal titanium mesh cage). The choice of an optimum construct remains controversial; therefore, we endeavoured to study and compare the biomechanical performance of these 3 techniques.

Purpose: The aim of this study was to compare 3 types of transdiscal fixation biomechanically in an in vitro porcine lumbar-sacral spine model. Read More

Arch Phys Med Rehabil 2021 Apr 29. Epub 2021 Apr 29.

Faculty of Kinesiology, University of New Brunswick, Canada; School of Psychology and Exercise Science, Murdoch University, Australia. Electronic address:

Objective: To investigate the effectiveness of conservative non-pharmacologic therapies on pain-related, physical capacity, and physical activity outcomes in patients with degenerative lumbar spinal stenosis (LSS).

Data Sources: Systematic search of MEDLINE, EMBASE, CENTRAL, and PsycINFO from inception to November 4, 2019 without language restrictions.

Study Selection: Pairs of review authors independently identified randomized clinical trials published in peer-reviewed scientific journals reporting on the effects of rehabilitation interventions on pain intensity (back or leg), disability, symptom severity, physical capacity, physical activity behavior, or adverse events (secondary outcome) in adults with LSS. Read More

Int J Environ Res Public Health 2021 Apr 23;18(9). Epub 2021 Apr 23.

Department of Physical Therapy, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan.

The abdominal expansion (AE) strategy, involving eccentric contraction of the abdominal muscles, has been increasingly used in clinical practices; however, its effects have not been rigorously investigated. This study aimed to investigate the immediate effects of the AE versus abdominal drawing-in (AD) strategy on lumbar stabilization muscles in people with nonspecific low back pain (LBP). Thirty adults with nonspecific LBP performed the AE, AD, and natural breathing (NB) strategies in three different body positions. Read More

Diagnostics (Basel) 2021 Apr 22;11(5). Epub 2021 Apr 22.

Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul 135-896, Korea.

Lumbar spinal stenosis (LSS) is a common neurodegenerative condition. However, how neurogenic claudication develops with severe leg pain has not yet been clearly elucidated. Moreover, cerebrospinal fluid (CSF) physiology at the lumbosacral level is poorly understood because of the difficulties involved in quantification and visualization. Read More

Asian Spine J 2021 May 3. Epub 2021 May 3.

Department of Orthopedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.

Study Design: This study is a retrospective analysis of a case.

Purpose: The purpose of this study is to investigate the fracture patterns and risk factors of sacral insufficiency fractures (SIFs) to improve their diagnosis in clinical practice.

Overview Of Literature: SIFs occur when normal stresses are applied to a bone with decreased density, most often due to osteoporosis. Read More

Radiol Case Rep 2021 Jun 10;16(6):1428-1432. Epub 2021 Apr 10.

Department of Oncology, Tai'an City Cancer Prevention Hospital, Taian City Shandong, China.

Angioleiomyoma is a solitary smooth muscle cell tumor that originates from the tunical media of arteries and veins. Its origin in the sacrum is rare, only one case has been recorded in the literature to date, but cases with bone destruction are even rarer. We present a 49-year-old woman with lumbosacral pain, unsteady gait and right lower extremity pain for two years, accompanied by radiation pain. Read More

Zhongguo Zhen Jiu 2021 Apr;41(4):395-9

Department of Obstetrics and Gynecology, Second Affiliated Hospital of Liaoning University of TCM.

Objective: To observe the effect of electroacupuncture (EA) on chronic pelvic pain in patients with sequelae of pelvic inflammatory disease.

Methods: A total of 144 patients with chronic pelvic pain were randomly divided into an observation group (72 cases, 10 cases dropped off) and a control group (72 cases, 9 cases dropped off). The patients in the control group were treated with ibuprofen sustained-release capsules 10 days before menstruation, 0. Read More

Clin Anat 2021 Apr 28. Epub 2021 Apr 28.

The Spine Clinic of Oklahoma City, Oklahoma City, Oklahoma, USA.

The latest development in the anterior lumbar interbody fusion (ALIF) procedure is its application in the lateral position to allow for simultaneous posterior percutaneous screw placement. The technical details of the lateral ALIF technique have not yet been described. To describe the surgical anatomy relevant to the lateral ALIF approach we performed a comprehensive anatomical study. Read More

Medicine (Baltimore) 2021 Apr;100(17):e25698

Department of Neurology, Washington University School of Medicine, Saint Louis, MO.

Rationale: Peripheral nerve injury related to vascular complications associated with extracorporeal membrane oxygenation (ECMO) is perhaps underappreciated. Compared to the well-described central nervous system complications of ECMO, brachial plexopathy and lumbosacral plexopathy have rarely been reported. We report this case to heighten awareness of lumbosacral plexus injury due to pelvic hematoma formation after ECMO. Read More

J Korean Neurosurg Soc 2021 Apr 29. Epub 2021 Apr 29.

Neuro-oncology Clinic, Center for Rare Cancers, National Cancer Center, Goyang, Korea.

Recent advancements in basic research on the process of secondary neurulation and increased clinical experience with caudal spinal anomalies with associated abnormalities in the surrounding and distal structures shed light on further understanding of the pathoembryogenesis of the lesions and led to the new classification of these dysraphic entities. We summarized the changing concepts of lesions developed from the disordered secondary neurulation shown during the last decade. In addition, we suggested our new pathoembryogenetic explanations for a few entities based on the literature and the data from our previous animal research. Read More

Clin Biomech (Bristol, Avon) 2021 Apr 3;85:105347. Epub 2021 Apr 3.

Human Movement Biomechanics Research Group, Department of Movement Sciences, KU Leuven, Belgium.

Background: There is currently little insight in lumbar spine loading during activities of daily living in patients with axial spondyloarthritis. Furthermore, it is unclear how inflammation or ankylosis-related mobility limitations in patients with axial spondyloarthritis affect lumbosacral loading, and if lumbar movement profiles have an effect on lumbosacral loading as well. Therefore, the aim of this study is to get more insight in the differences in peak and cumulative lumbosacral loading in patients with axial spondyloarthritis during activities of daily living. Read More

PLoS One 2021 26;16(4):e0250456. Epub 2021 Apr 26.

Chair of Product Development, Department of Mechanical Engineering, Ruhr-University Bochum, Bochum, Germany.

In computational biomechanics, two separate types of models have been used predominantly to enhance the understanding of the mechanisms of action of the lumbosacral spine (LSS): Finite element (FE) and musculoskeletal multibody (MB) models. To combine advantages of both models, hybrid FE-MB models are an increasingly used alternative. The aim of this paper is to develop, calibrate, and validate a novel passive hybrid FE-MB open-access simulation model of a ligamentous LSS using ArtiSynth. Read More

Int J Spine Surg 2021 Apr 1;15(2):359-367. Epub 2021 Apr 1.

Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi, India.

Background: Abnormal anatomy is a contributory factor to wrong-level surgery. Variations in the number of vertebrae in populations from different races and geographical regions have been described. A ∼10% prevalence of variations in number of thoracic and lumbar vertebrae in adolescent idiopathic scoliosis (AIS) patients has been previously reported. Read More