Purpose: This study aimed to investigate the application of quantitative magnetic resonance imaging of paraspinal muscles in assessing the young CNLBP with unilateral symptom.
Methods: This prospective study enrolled 107 young individuals with unilateral symptomatic CNLBP (56 cases) and a normal cohort (51 cases). All subjects underwent conventional lumbar sequences, T2 mapping, and IDEAL-IQ scans at 3T. T2 values and fat fraction (FF) of bilateral multifidus (mid-levels of L2-L5 vertebrae) and erector spinae (mid-levels of L1-L4 vertebrae) were measured. CNLBP severity, Japanese Orthopedic Association (JOA) score, and Visual Analogue Scale (VAS) score were recorded. Wilcoxon signed-rank tests were used to compare parameter differences between painful and non-painful sides in the case group. Mann-Whitney U tests were employed to evaluate differences between the case and normal group. Logistic regression analysis was conducted to identify predictive factors and to establish a combined model.
Results: In the case group, erector spinae FF values (L4 level), erector spinae T2 values (L1, L2, and L4 levels), and multifidus T2 values (L4 and L5 levels) were higher on the painful side (P<0.05). Multifidus T2 values (L5 level) and FF values (L2-L5 levels) were higher in the case group compared to the normal group (P<0.05). The optimal performance in differentiating young CNLBP was the combination of L5 level multifidus T2 value with FF (AUC = 91.81%). Negative correlation existed between T2 values and FF of multifidus at L5 level and JOA scores (r=-0.41, P < 0.05), and positive correlation with VAS scores (r = 0.46, P < 0.05).
Conclusion: The combination of T2 value and FF may provide deeper insights into the pathological alterations of paraspinal muscles in young CNLBP, providing an important imaging basis for clinical judgment and preventive treatment of non-painful side in unilateral symptomatic patients.
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http://dx.doi.org/10.1007/s00586-024-08535-9 | DOI Listing |
Orthop J Sports Med
December 2024
Department of Orthopaedic Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Background: The effects of the erector spinae plane (ESP) block and interscalene nerve block (ISNB) on arthroscopic rotator cuff repair (RCR) have been investigated separately.
Purpose: To evaluate whether additional catheterization for the ESP block can decrease acute postoperative pain and opioid consumption above the ISNB and multimodal oral analgesics in patients after arthroscopic RCR.
Study Design: Cohort study; Level of evidence, 3.
Clin Radiol
November 2024
School of Medicine, Cork University Hospital, Cork, Ireland; Department of Respiratory Medicine, Cork University Hospital, Cork, Ireland.
Aim: Idiopathic pulmonary fibrosis (IPF) is a debilitating and fatal lung disease. Changes in body composition potentially correlate with outcomes in patients with IPF.
Materials And Methods: Patients with IPF on antifibrotic treatment attending a single institution were identified and retrospectively evaluated (n=84).
Rev Esp Anestesiol Reanim (Engl Ed)
December 2024
Servicio de Anestesiología y Reanimación, Complejo Hospitalario Universitario Insular Materno Infantil de Gran Canaria.
Factor XI (FXI) deficiency is a rare bleeding disorder characterized by a quantitative or qualitative deficiency of FXI. The symptoms are highly variable, and the severity and site of bleeding is unpredictable and does not necessarily correlate with FXI levels. FXI deficiency is classified by phenotype: bleeding or non-bleeding, depending on the clinical manifestations.
View Article and Find Full Text PDFJ Surg Res
December 2024
University of Michigan Health, C.S. Mott Children's Hospital, Ann Arbor, Michigan.
Introduction: Regional anesthetic approach and surgical volume have been shown to outcomes in patients undergoing Nuss procedure for pectus excavatum. However, their independent relationship is not described. We investigated how regional anesthesia and surgical volume are associated with length of stay (LOS), postoperative opioid use, operating room utilization, and complications.
View Article and Find Full Text PDFCureus
December 2024
Gastroenterological Surgery, Tohoku Medical and Pharmaceutical University, Sendai, JPN.
Lumbar hernia (LH) is a rare abdominal wall hernia that occurs within the anatomic boundaries of the 12th rib, iliac crest, external oblique muscles, erector spinae muscles, and vertebral column. Secondary LH after urological surgery is rare, and the limited evidence hinders consensus on optimal surgical treatment. Here, we present a case of laparoscopic intraperitoneal onlay mesh (IPOM) repair for a large, symptomatic secondary LH after retroperitoneoscopic nephrectomy (RN) with mid-term postoperative outcomes.
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