1/24. The influence of a chiropractic manipulation on lumbar kinematics and electromyography during simple and complex tasks: a case study.OBJECTIVE: To investigate whether a more sophisticated and detailed analysis of both simple and complex tasks may yield more information regarding the short-term influence of an adjustment on spine biomechanics. methods: The study used a single-subject, before-after design. Three-dimensional spine kinematics and trunk muscle electromyography were assessed during a variety of tasks performed by a professional golfer exhibiting non-specific, chronic, low back pain. The patient received a right-to-left and left-to-right spinous pull adjustment. RESULTS: After the adjustment, changes were seen in all 3 axes of motion during a golf swing, with concomitant muscle responses. In addition, changes in the off axes of motion were seen during simple movement tasks. CONCLUSIONS: A more detailed spine kinematic analysis, specifically analysis of motion in the nonprincipled axes, yielded more information regarding the short-term influence of an adjustment on lumbar spine motion and muscle function.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
2/24. Case report: reduction of low back pain in a professional golfer.Previous research agrees that the majority of injuries that affect male golfers are located in the lower back and that they are related to improper swing mechanics and/or the repetitive nature of the swing. This study describes the trunk motion and paraspinal muscle activity during the swing of a golfer with related low back pain (LBP) and assesses the effect of a 3-month period of muscle conditioning and coaching on these variables. motion of the trunk was measured using three-dimensional video analysis and electromyograms (EMGs) were recorded from the same six sites of the erector spinae at the start and end of the 3-month period. At the end of the period, the golfer was able to play and practice without LBP. Coaching resulted in an increase in the range of hip turn and a decrease in the amount of shoulder turn, which occurred during the swing. In addition, a reduction in the amount of trunk flexion/lateral flexion during the downswing occurred in conjunction with less activity in the left erector spinae. These changes may serve to reduce the torsional and compressive loads acting on the thoracic and lumbar spine, which in turn may have contributed to the cessation of the LBP and would reduce the risk of reoccurrence in the future. In conclusion, further research with more subjects would now be warranted in order to test the findings of this program for the prevention of low back in golfers as piloted in this case report.- - - - - - - - - - ranking = 0.25keywords = motion (Clic here for more details about this article) |
3/24. VATER association: is it recognised by rheumatologists?The authors describe an adult patient with history of chronic low back pain and recurrent prostatitis, marked limitation of lumbar spine motion and a radiograph demonstrating fused lumbar vertebrae, which suggest a diagnosis of spondylarthropathy. However, the absence of radiographic evidence of sacroilitis, the nature of the vertebral defects and a history of imperforate anus pointed towards the diagnosis of VATER association, rather than a spondylarthropathy. Although most patients with VATER association are diagnosed during infancy, the musculoskeletal anomalies can be overlooked while the potentially life-threatening problems are under treatment. These anomalies may become evident later in life. Therefore, in a rheumatologic practice, when evaluating patients with back pain and vertebral anomalies, one should become familiar with the varied manifestations of VATER association.- - - - - - - - - - ranking = 0.25keywords = motion (Clic here for more details about this article) |
4/24. Management of multiple level spondylolysis of the lumbar spine in young males: a report of six cases.The most common procedure for surgical treatment of lumbar spondylolysis is intertransverse processes spinal arthrodesis with instrumentation. However, this procedure is associated with significant morbidity on long-term follow up. Direct repair of spondylolysis is an alternative method for preservation of motion segment and anatomic continuity in young adults with multiple level spondylolysis. From 1992 through 1998, six soldiers with a diagnosis of multiple level spondylolysis who complained of persistent low back pain were treated in our hospital. spondylolysis involved two levels in five cases and three levels in one case. All patients underwent serial roentgenography of the lumbar spine and a staged pars interarticularis infiltration test with bupivacain 0.5%. Five patients underwent direct repair of the pars interarticularis defects with hook screws, translaminar screws, and bone graft, while one patient received conservative treatment. All surgically treated patients had either good or excellent results at a mean of 34.4 months follow-up. One patient who was treated nonsurgically still complained of sport restriction at 16 months follow-up. Direct repair of multiple pars interarticularis defects after a positive staged pars infiltration test can restore anatomic stability, relieve back pain, and preserve a greater range of motion of the lumbar spine in young patients with intact disc height.- - - - - - - - - - ranking = 0.5keywords = motion (Clic here for more details about this article) |
5/24. Schwannoma: challenging diagnosis.OBJECTIVE: To discuss the presentation of a schwannoma in a 30-year-old man and to discuss the clincial features of this tumor. CLINICAL FEATURES: The patient had lower right back and abdominal pain that was made worse by any jarring motion. magnetic resonance imaging showed an intradural extramedullary mass of the thoracic spine behind the T10 vertebral body, which was found to be a schwannoma. INTERVENTION AND OUTCOME: A full laminectomy of T10 and partial laminectomies of T9 and T11 allowed removal of the tumor. CONCLUSION: When undiagnosed abdominal pain is present, spinal tumor should be considered one possible diagnosis.- - - - - - - - - - ranking = 0.25keywords = motion (Clic here for more details about this article) |
6/24. Disc herniation after lumbar fusion.STUDY DESIGN: Eight patients with a herniated disc after lumbar spinal fusion are reported. Their clinical features, imaging studies, and management are reported. OBJECTIVES: To identify the incidence and features of disc herniation above a spinal fusion, and to describe their management. SUMMARY OF BACKGROUND DATA: Late complications of lumbar spinal fusions have been reported in the literature, but disc herniation has not been specifically addressed in detail. The motion segment above a spinal fusion undergoes additional stresses, as documented by increased pressure and excessive motion, resulting in degenerative changes. These factors likely predispose to disc herniation. methods: Of 601 consecutive lumbar fusion cases over an 8-year period, herniated nucleus pulposus above the fusion was diagnosed in 8 patients. The clinical findings and imaging studies were reviewed, including a myelogram computed tomography scan, a magnetic resonance image with positive documentation of the herniation, or both. The management of these cases was reviewed. RESULTS: Eight patients (1.3%) (4 men and 4 women) were identified, whose average age was 56.4 years. Nonoperative treatment failed in six patients. Two of these patients underwent simple discectomy, and the remaining four underwent discectomy and fusion. All four patients went on to fusion. The average time from disc herniation onset to fusion was 28.4 months. CONCLUSIONS: Herniated disc after lumbar spinal fusion was found in approximately 1.3% of patients. Although rare, this entity that should be considered when patients complain of recurring back pain after a lumbar spinal fusion.- - - - - - - - - - ranking = 0.5keywords = motion (Clic here for more details about this article) |
7/24. A structural chiropractic approach to the management of diffuse idiopathic skeletal hyperostosis.OBJECTIVE: To discuss a unique method of treatment for a patient with diffuse idiopathic skeletal hyperostosis (DISH) and the long-term result of this treatment. CLINICAL FEATURES: The patient had a long-standing history of low back pain and stiffness caused by DISH. Coexisting conditions consisted of right-hand paresthesia because of a thalamic stroke, osteoporosis, Barrett's esophagus, thyroid and parathyroid disease, and hypercholesterolemia. INTERVENTION AND OUTCOME: The patient received chiropractic manipulation and drop table adjustments, along with range-of-motion exercise, extension exercise, and standing lumbar extension traction. The magnitude of lumbar lordotic alignment and Ferguson's angle improved with treatment. The patient's subjective perception of pain significantly improved, as documented with the use of numeric rating scales. Flexibility and activities of daily living were also improved. The effect was maintained for 19 months after termination of the active rehabilitative treatment period. CONCLUSION: A paucity of literature exists regarding the chiropractic management of patients with a diagnosis of DISH. Chiropractors should be encouraged to report on their clinical experiences in treating patients with varied conditions and disorders.- - - - - - - - - - ranking = 0.25keywords = motion (Clic here for more details about this article) |
8/24. A clinical guide to surface-EMG-assisted stretching as an adjunct to chronic musculoskeletal pain rehabilitation.Therapeutic stretching is a vital component of chronic musculoskeletal pain rehabilitation for increasing range of motion and counteracting the effects of physical deconditioning. Surface EMG biofeedback is currently being used to facilitate movement and to maximize effective stretching with patients in an interdisciplinary chronic pain rehabilitation program for disabled workers. A clinical protocol with case examples is presented.- - - - - - - - - - ranking = 0.25keywords = motion (Clic here for more details about this article) |
9/24. The use of an eclectic approach for the treatment of low back pain: a case study.The purposes of this case report are (1) to describe an examination approach that relates identification of an impairment to a disability and (2) to describe an eclectic treatment approach for an individual with low back pain (LBP). The individual described in this case report is an intercollegiate athlete who, because of chronic LBP, was unable to perform his sport of pole vaulting. The findings of the physical therapy examination suggested that an impairment of lumbar motion prevented the patient from assuming the spinal position necessary for pole vaulting. The goals of the treatment consisted of increasing the patient's lumbar motion to that required for pole vaulting and to have the patient pole vault without pain or stiffness. The treatment approach that was used combined procedures described by Maitland, McKenzie, and others. The rationale for the use of these procedures and their limitations are discussed.- - - - - - - - - - ranking = 0.5keywords = motion (Clic here for more details about this article) |
10/24. Bilateral pedicle stress fractures in a female athlete: case report and review of the literature.STUDY DESIGN: Clinical case report of bilateral stress fractures of the pedicle in a female athlete presenting with back pain. OBJECTIVES: To report this unusual case and surgical treatment and to review the relevant literature. SUMMARY OF BACKGROUND DATA: low back pain is a frequent complaint in athletes, with the majority of cases being related to muscular or soft tissue etiology. spondylolysis, or pars fracture, is the most common injury of the neural arch. Stress fracture of the pedicle is a much less common occurrence. Bilateral pedicle fractures in an otherwise healthy athlete has not been previously reported in the orthopedic literature. methods: A 19-year-old female athlete presented with low back pain limiting sports and daily activities. Radiographic workup revealed bilateral stress fractures of the pedicles of the L5 vertebra. Circumferential fusion of the L5-S1 segment was performed after failure of conservative treatment. Anterior interbody structural allograft and a vertical mesh cage were combined with instrumented posterolateral fusion using segmental pedicle screws and autogenous iliac crest bone graft. RESULTS: The patient achieved complete pain relief, solid fusion, and return to normal function. CONCLUSIONS: In this uncommon case of bilateral stress fractures of the pedicle, circumferential fusion assures full immobilization of the injured motion segment and assures a high probability of successful healing.- - - - - - - - - - ranking = 0.25keywords = motion (Clic here for more details about this article) |
| | Next -> |