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Article
Low Back Pain and Obesity (Review Article)

Author: Mohammed Sh. Al- Edanni
Journal: Al-Kindy College Medical Journal مجلة كلية الطب الكندي ISSN: 18109543 Year: 2018 Volume: 14 Issue: 2 Pages: 1-6
Publisher: Baghdad University جامعة بغداد

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Abstract

Low back pain a major causes of morbidity throughout the world and it is a most debilitating condition ,and can lead to decreased physical function ,compromised quality of life, and psychological distress. Obesity is nowadays a pandemic condition. Obese subjects are commonly characterized by musculoskeletal disorders and particularly by non-specific LBP. However, the relationship between obesity and LBP remain to date unsupported by objective measurements of mechanical behavior of spine and it is morphology in obese subjects.


Article
Role of MRI in acute lower back pain

Author: Najat Adel Hashim
Journal: Muthanna Medical Journal مجلة المثنى الطبية ISSN: 2226146x Year: 2017 Volume: 4 Issue: 2 Pages: 147-157
Publisher: Al-Muthanna University جامعة المثنى

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Abstract

A group of 501 patient who referred unit from orthopedic were subjected to MRI examination and the MRI results were evaluated. All patients with radicular pain, neurological signs or traumatic patients were excluded from this study. A 501 patients complain from acute lower back pain , mean age 33.49+8.38 range (20-70), 229 (46%) male and 272 (54%) female, in combined MRI finding with age of patients, we found large number of patient have disk prolapsed (191), with mean age 36.50, while patient with normal MRI or just muscles spasm were mean age (31.79), so the MRI not effect in outcome of young patient (below 31 years old ) with a lower back pain. In conclusion; lumbo-sacral MRI exam have minimal effect in outcome of young patient with acute lower back pain (less than 3wks).


Article
Low Level Laser Irradiation Effects on Joint Movements

Authors: Ziad T. Al-Dahan زياد طارق الدهان --- Ali S. Mahmood علي شكر محمود --- Ghassan H. Farhan غسان حامد فرحان
Journal: AL-NAHRAIN JOURNAL FOR ENGINEERING SCIENCES مجلة النهرين للعلوم الهندسية ISSN: 25219154 / eISSN 25219162 Year: 2016 Volume: 19 Issue: 2 Pages: 407-411
Publisher: Al-Nahrain University جامعة النهرين

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Abstract

This study tried to show an approach for joints process healing based on using of low level laser therapy (LLLT), in order to enhance the healing rate. The effect is not thermal, but rather related to photochemical reactions in the cells. This study included 26 patients with low back pain (LBP) in range of 20-50 years old were randomly divided to the laser treatment group and laser placebo group (control group). Both of two groups were treated twice weekly for 6 weeks. The treated group exposed group to pulse infrared with diode laser (BEAM 3K00) with 904nm wavelength and 230mJ (energy) for one point, and was irradiated on the vertebral column. The same process was performed on control group but with off laser. The laser placebo group did not complete their treatment because there was no improvement or decrease pain. The treated group divided into three subgroups according to the treatment period: the first showed improvement and decrease pain where dispersed to (4) in end of the three-week treatment, and (4) in a five-week treatment, and (5) valuable six weeks treatment. Visual analogue scale (VAS), Schober test and Roland Disability Questionnaire (RDQ) were used in the clinical and functional evaluations pre and post therapeutic periods. Significant improvements were noted in all groups with respect to all outcome parameters, in comparison to placebo laser group. Efficacies of treatment were evaluated using pain relief between treated groups by the statistical significance of the differences between the three feature sets for the LBP was tested with a Bonferroni corrected analysis of variance (ANOVA) test with a significance level of 0.05. Statistically significant differences were found in all outcomes measured (p<0.05).

تظهر هذه الدراسة عملية علاج المفاصل باستخدام الليزر واطئ المستوى يكون تأثير الليزر غير حراري لكن من التفاعلات الكيميائية الضوئية في الخلايا ويكون العلاج بدون تدخل جراحي.استخدم 26 مريض مصابون بألم أسفل الظهر بعمر مابين 20-50 سنه قسمت بشكل عشوائي إلى مجموعة عولجت بالليزر ومجموعة بعلاج ليزر مموه .كلا المجموعتين تم معالجتها مرتين بالأسبوع ولمدة ستة أسابيع. في هذا العمل تم استخدام الدايود الليزري ذو الأشعة النبضية بطول موجي 904 نانو متر على مجموعة الليزر.أما مجموعة الليزر المموه فقد تم إطفاء جهاز الليزر أثناء المعالجة .طبق الليزر على أجسام الفقرات المصابة .وبعد المباشرة بالعلاج في كلا المجموعتين لم تكمل العلاج مجموعة الليزر المموه وذلك لكونهم لم يشعروا بتحسن أو انخفاض بمستوى الألم أما مجموعة العلاج بالليزر فقد انقسموا إلى ثلاثة مجموعات حسب فترة العلاج وذلك لشعورهم بالتحسن وانخفاض مستوى الألم لديهم .استخدمت ثلاث متغيرات للتقييم هي (مقياس مستوى الألم , واستبيان العجز رولاند, واختبار شوبر).لوحظت تحسينات في مجموعات الليزر بكل المتغيرات ماعدا مجموعة الليزر المموه وقد تم استخدام التحليلات الإحصائية لمعرفة أهمية التحسن (الكفاءة)بين المجموعات التي عولجت بالليزر واستخدم لذلك اختبار بونفيروني في برنامج الماتلاب مع مستوى أهميه 0.05.من النتائج وجدنا فروق ذات دلالة إحصائية في جميع نتائج المتغيرات (P<0.05).


Article
Evaluation of obesity, smoking, and sedentary lifestyle associations with low back pain in young adults

Authors: Dalia Ahmed Braisem --- Nawras Alaa-Aldeen Hussein, --- Laith Thamer Al-Ameri ,
Journal: Al-Kindy College Medical Journal مجلة كلية الطب الكندي ISSN: 18109543 Year: 2019 Volume: 15 Issue: 1 Pages: 56-60
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: low back pain is one of the most common public health problems and of the most common musculoskeletal complaint. Many risk factors have been considered for developing low back pain include smoking, obesity and sedentary lifestyle.Aim of study: To evaluate smoking, obesity, and sedentary lifestyle associations with low back pain in young adults aged (18 – 39 years).Methods: a comparative cross sectional study for young adults aged 18 – 39 years, participants with low back pain as a symptom constitutes the first group, others free of this symptom considered as the control group. Age and gender matched in both groups. Smoking, obesity and sedentary life style variables collected and analyzed statistically using odd ratio and chi-square Results: One hundred patients were enrolled in the study after 12 patients being removed due to our exclusion criteria. 45 patients were with low back pain, 2:1 male to female ratio, For LBP group; data show 30:15 obese to none obese ratio, 23:22 smokers to none smoker ratio, and ratio of 35:10 with sedentary lifestyle compared to active one. While in the control group, data show 22:33 obese to none obese ratio, 16:39 smokers to none smoker ratio, and ratio of 23:32 with sedentary lifestyle compared to active one. Using Chi-square test, the P- value was of 0.0079, 0.025 and 0.0003 for obesity, smoking, and sedentary lifestyle, respectively. The odds ratio was 3, 2.55 and 4.86 for obesity, smoking, and sedentary lifestyle, respectively. All above results were statistically significant.Conclusion: Each of smoking, obesity and sedentary lifestyle is statistically correlated with low back pain in young adults' age group.


Article
Antibiotic Treatment in Patients with Chronic Low Back Pain and Vertebral Bone Edema (Modic Type I Changes): A Randomized Clinical Controlled Trial of Efficacy

Authors: Mohanned A. Al-Falahi --- Mohammed H. Salal --- Dhiaa M. Abdul-Wahab
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2014 Volume: 13 Issue: 3 Pages: 390-397
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND: Modic type I changes/bone edema in the vertebrae are present in 6 % of the general population and 35–40 % of the low back pain population. It is strongly associated with low back pain. Chronic Low back pain (CLBP) is a leading cause of disability. It occurs in similar proportions in all cultures, interferes with quality of life and work performance, and is the most common reason for medical consultations.A new method of treatment included the use of antibiotic in management of CLBP with Modic type I changes has proved to be effective in some cases.OBJECTIVE: The aim was to test the efficacy of antibiotic treatment in patients with chronic low back pain (>6 months) and Modic type I changes (bone edema).PATIENTS AND METHODS:The study was a randomized clinical trial(RCT) with 71 patients whose only known illness was chronic LBP of greater than 6 months duration occurring after a previous disc herniation and who also had bone edema demonstrated as Modic type I changes in the vertebrae adjacent to the previous herniation. Patients were randomized to either 100 days of antibiotic treatment or placebo and were evaluated at baseline, and end of treatment.Outcome measures: are the disease-specific disability Questionnaire, which is Roland Morris Disability Questionnaire (RMDQ) and lumbar pain.RESULTS:43 of the 71 original patients were evaluated at baseline and at end of treatment follow-up. The two groups were similar at baseline. The antibiotic group had better improvement on the outcome measures and improvement continued after end of treatment. At baseline, 100 days follow-up the means of the disease specific disability-RMDQ changed: antibiotic 15.5, 12; placebo: 15, 14.8. For Lumbar pain: antibiotics 6.4, 4.8; placebo 6.1, 6.0.CONCLUSION:The antibiotic protocol in this study was more effective for this group of patients (CLBP associated with Modic changes type I) than placebo in the outcomes.


Article
Associated Factors of Low Back Pain in a Sample of Patients Attending Hawler Teaching Hospital/Erbil City A Case Control Group

Authors: Burhan Izzaddin Sabir --- Vian A Naqshbandi
Journal: Journal of University of Babylon مجلة جامعة بابل ISSN: 19920652 23128135 Year: 2018 Volume: 26 Issue: 6 Pages: 45-55
Publisher: Babylon University جامعة بابل

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Abstract

Background and objective: Low back pain (LBP) is an important clinical, social,economic,andpublichealthproblemaffectingthepopulationerraticallyandrandom.Theaim of the study was to determine the factors associated with low back pain among patients attendingphysiotherapydepartmentatHawlerteachinghospitalinErbilCity.Methods: the study was carried out from November 3rd, 2014 to November 3rd 2015.Thestudyinvolvedof100casesdiagnosedwithlowbackpaininthephysiotherapydepart- mentatHawlerteachinghospitalsubjectsincontrolgroupareofthesameageandgender ofthoseintheexperimentgroup,and100participantsasa100ascontrolgroupfreefrom low backpain.Result:Multiplelogisticregressionofriskfactorsoflowbackpainrevealedthatbody massindex7.55,nonusinglumbarsupportinsittingchairduringwork31.81,non-practice exercise 5.58, standing erect 34.836, sitting on a high backrest chair 27.986, sitting on a lowbackrestchair65.167,drinkingwaterperday18.989,emotionalstress14.636timehave riskyeffectonlowbackaffectlowbackpainrespectively.Conclusion: The study concluded that most of the participants in the study were employers and they perform different types of positions such as bending, squatting and sittingduringworktime,therewerestatisticalsignificantassociationbetweenbodymass index,liftingheavyobjects,drivingandemotionalstresswithdevelopmentoflowbackpain.

الخلفية والهدف:آلام أسفل الظهر هو مشكلة سريرية, اجتماعية واقتصادية هامة وهو بالتأكيد مشكلة صحية عامة تؤثر على الانسان بطريقة متقطعة وبشكل عشوائي. الهدف من هذه الدراسة هو تحديد العوامل المرتبطة بآلام أسفل الظهر بين المرضى الذين يراجعون قسم العلاج الطبيعي في مستشفى هوليرالتعليمي في مدينة أربيل بهدف العلاج. الطريقة والمنهاج: أجريت الدراسة واستمرت لعام كامل بدءا من ال 3 من شهر تشرين الثاني 2014 إلى ال 3 من شهر تشرين الثاني من 2015. وشملت الدراسة 100 حالة تم تشخيصها بآلام أسفل الظهر في قسم العلاج الطبيعي في مستشفى هوليرالتعليمي مع عدد مماثل من الاشخاص الاصحاء لا يعانون من نفس المشكلة كمجموعة ضابطة و مراعاة التطابق في العمر والجنس لكلا المجموعتين.النتائج: اظهرت نتائج التحليل الاحصائي للانحدار المنطقي المتعدد للعوامل المرتبطة بالام اسفل الظهر ان مؤشر كتلة الجسم7.55, عدم استخدام دعم المنطقة القطنية في حالة الجلوس31.81, عدم ممارسة الرياضة 5.58, الوقوف بشكل منتصب 34.836, الجلوس على الكرسي بمسند عالي للظهر 27.986, والجلوس على الكرسي بمسند منخفض للظهر 65.167, عدم شرب كمية كافية من الماء يوميا 18.989, التوتر النفسي والعاطفي 14.636 مرة لها تأثير الخطورة على الاصابة بالام اسفل الظهر بشكل متوالي لكل عامل. الاستنتاجات: توصلت الدراسة الى ان معظم المشاركين في البحث هم من الموظفين و اصحاب الاعمال و هم يؤدون اوضاع مختلفة اثناء العمل مثل: الانحناء, جلوس القرفصاء والجلوس اثناء العمل لفترات طويلة. واكد ان هناك ارتباط ذات دلالات احصائية عالية بين مؤشر كتلة الجسم, رفع الاشياء الثقيلة, قيادة السيارات والتوترات العاطفية والنفسية و بين تطور حالات الام اسفل الظهر.


Article
MRI Finding of Cartilaginous Endplates Herniation of Lumbar Spine in Patient with Low Back Pain

Author: Mohammed Abd Kadhim* , Mansour Eidan Dawood Al – Zubaidi**, Firas Mahmood Yaqub
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2018 Volume: 17 Issue: 4 Pages: 328-334
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND:Magnetic resonance imaging (MRI) provides a noninvasive assessment of the lumbar spine. Little isthought about the MRI characteristics of cartilaginous endplate (CEP) and CEP herniation on theground that their normal thickness is only 0.6mm, making it hard to perceive at routine MRIexaminationsOBJECTIVE :To study the reliable magnetic resonance imaging findings suggested cartilage endplate herniation inlumbar spine.PATIENTS AND METHODS:This prospective study was conducted on 46 patients with low back pain in the MRI unit of Al-Imamein Alkadhmein Medical City, Baghdad, Iraq between September, 2016 and August 2017.Inclusion criteria: adult patients with lumbar disc herniation proved by MRI with surgical prove ofcartilage end plates herniation. Exclusion criteria include: patients with previous back surgery,history of spinal tumor and the general contraindications to MRI. Sagittal and axial T1-weightedspino-echo image and sagittal and axial T2 weighted spine echo images were obtained. Statisticalanalysis using SPSS version 23, the level of significance (p value) was set as ≤ 0.05.RESULT:Forty six patients with low back pain were included in this study, the mean age of 44±9 years, 26patients were females and 20 patients were males.The CEP herniation was detected by MRI among52.2% of patients with back pain. There was a highly significant association between CEP andincreased age of the patients, back pain radiated to both limbs, L4-5 defect site, modic changes andlumbar posterior marginal nodes (p value 0.01, 0.004, 0.02, 0.03 and <0.001 respectively). Nosignificant differences between patients with CEP herniation and those without CEP herniationregarding posterior osteophytes, dorsal vertebral cornal defect, heterogeneous signal intensity andposterior corner and mid endplate irregularities. There was a highly significant association betweenlumbar posterior marginal nodes and CEP herniation (p<0.001).CONCLUSION:CEP herniation is more prevalent among advanced age and at lower lumbar level. The most commonMRI signs related to CEP herniation were modic changes in mid endplate and lumbar posteriormarginal nodes..


Article
Disability Measurement in Patients with Low Back Pain Using Roland-Morris Questionnaire as a Model and Studying Possible Modifications
قياس الإعاقة عند مرضى الم أسفل الظهر باستعمال مقياس رولاند- مورس كقالب ودراسة حاجته إلى تحوير

Authors: Dr. Ismail D. Saeeda د. اسماعيل داود سعيدأ --- Dr. Ali F. Y. Al-Barodchib د. علي فاروق البارودجي ب
Journal: Annals of the College of Medicine Mosul مجلة طب الموصل ISSN: 00271446 23096217 Year: 2019 Volume: 41 Issue: 1 Pages: 18-27
Publisher: Mosul University جامعة الموصل

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Abstract

Background: Self-reported questionnaires have become popular measures in assessing disability in patients with low back pain (LBP). Roland-Morris Questionnaire (RMQ) is one of the internationally accepted, self-reporting questionnaire which demonstrates good psychometric properties.Objectives: The present study intended to evaluate a face to face interview applying Arabic version of the RMQ, and comparing it with a modified version of RMQ (RMQV), and whether the purely subjective RMQ scores correlate with symptoms and signs which have predictive or prognostic values.Design: case-series studyMethods and materials: Case-series study conducted on seventy-two patients with chronic LBP at Ibn-Sina Teaching Hospital in Mosul city. Physical examination at rheumatology outpatient clinic performed for every patient, and the patients are allowed to answer the questions of RMQ through a direct investigator-patient Arabic conversation. The disability measured by the RMQ subdivided into: mild (0-8), moderate (9-16) and severe (17-24). An individualized literature review performed for clinical features which have predictive or prognostic values in LBP, and including these features in the clinical evaluation of patients in the current study.Results: The results showed that the Arabic conversational RMQ have acceptable reliability and RMQV have excellent reliability (Cronbach’s alpha values=0.72 and 0.94 respectively). There was a significant direct correlation between these two questionnaires (r=0.861; p-value<0.001). However, we found a significant difference between them (p-value<0.01). The scores of the RMQ and RMQV correlate moderately with a score of the predictive features (r=0.503; p-value < 0.01 and 0.530; p-value<0.01 respectively).Conclusion: The study found that the modified version (RMQV) has higher reliability than the original one. Also, the RMQV showed a better correlation with the narrow-angle straight leg raising test, and its mild and moderate subgroups have significant differences regarding the duration and pain intensity of the current episode of LBP. Other measured properties look similar between the two questionnaires.

الخلفية: أصبحت الإستبيانات ذاتية التحرير من المقاييس الشائعة جدا في تقييم العجز عند مرضى ألم أسفل الظهر. يعتبر إستبيان رولاند-مورس أحد هذه المقاييس المستخدمة دوليا كونه يمتلك خصائص قياسية جيدة.الأهداف: تهدف الدراسة الى تقييم إستبيان "رولاند- مورس بنسخته العربية الحوارية" عن طريق الحديث وجها لوجه مع المريض، ومقارنته مع إستبيان "رولاند- مورس المُحَوَر" بحيث تكون أجوبته مدرجة على مقياس تناظري بصري بدلاً من الإجابة الثنائية الاعتيادية، كذلك حاولت الدراسة البحث فيما إذا كان إستبيان "رولاند- مورس الذاتية البحتة" يرتبط مع الأعراض والعلامات ذات القيم التنبؤية. التصميم: دراسة سلسلة حالات.الطرائق: أجريت الدراسة على إثنين وسبعين مريضا ممن يعانون ألم أسفل الظهر المزمن وذلك في مستشفى ابن سينا التعليمي في مدينة الموصل. جميع المرضى خضعوا لتقييم سريري متكامل بواسطة الباحث، وكان قد جرى بحث خاص عن المواد المطبوعة المختصة بالأعراض السريرية ذات القيم التنبؤية أو التكهنية لألم أسفل الظهر، وذلك لتضمين هذه الأعراض في التقييم ألسريري . النتائج: أظهرت النتائج بأن النسخة العربية الحوارية لإستبيان رولاند-مورس تمتلك قيمة عِول مقبولة، مقارنة بقيمة عِول ممتازة بالنسبة للاستبيان المُحَور (قيمة كرونباخ الفا = 0.72 و 0.94 على التوالي). هنالك إرتباط خطي معنوي بين الاستبيانين (r = 0.861 عند مستوى معنوية < 0.001). لكن وجدت الدراسة بأنه يوجد فرق معنوي بينهما عند مستوى معنوية أقل من 0.01 بإستعمال إختبار الفرضية (اختبار t). مجموع النقاط لكل من إستبيان رولاند-مورس الأصلي والمحور ترتبط بشكل متوسط مع مجموعة نقاط مكونة من الأعراض التنبؤية (r = 0.503 و 0.530 عند مستوى معنوية <0.01 على التعاقب). الإستنتاج: خلصت الدراسة بأن النسخة المحورة من إستبيان رولاند-مورس تمتلك عِولا أكثر من النسخة الأصلية للإستبيان. إضافة إلى ذلك فان النسخة المحورة من إستبيان رولاند-مورس أظهرت إرتباطاً خطياً أفضل مع إختبار رفع الساق المستقيمة ذي الزاوية الضيقة، وكذلك يوجد فرق معنوي بين مجموعتيها الفرعيتين الضعيفة والمتوسطة بالنسبة لمدة وشدة ألم النوبة الحالية من ألم أسفل الظهر. أما الخصائص المُقاسة الأخرى فقدت بدت متشابهة بين كلا الإستبيانين.


Article
Comparison between Somatosensory‑Evoked Potential Parameters in Patients with Nonspecific versus Specific Chronic Low Back Pain

Author: Jumana Sami Khudhair, Ali F. Al Hashimi1, Yasir M. Hamandi2
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2019 Volume: 16 Issue: 4 Pages: 325-330
Publisher: Babylon University جامعة بابل

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Abstract

Background: Modern pain neuroscience has revolutionized our understanding about pain, including the role of central sensitization in amplifyingpain experiences with increased neuronal response to central nervous system stimuli. During external upper and lower limb perturbation, it hasbeen shown that Chronic low back pain (CLBP) was associated with longer reflex response latencies of trunk muscles. One theoretic but rarelyexamined possibility for longer reflex latencies is related to modulated somatosensory information processing. Objectives: The objective of thestudy was to compare the somatosensory‑evoked potential (SSEP) parameters of the right median and left tibial nerves between patients withnonspecific and specific CLBP. Materials and Methods: The study includes 102 CLBP patients, clinically and radiologically confirmed anddivided into two groups: 48 patients with nonspecific pathology and 54 patients with specific pathology. During this SSEP study the right medianand left tibial nerves of all patients were examined. Recorded parameters include the latency and amplitudes. Results: The means of the latenciesof all the SSEP waves of the right median and left tibial nerves were only significant in the peripheral SSEP waves in the upper and lower limbs (N9and N10, respectively) and highly significant in cortical right median N20 SSEP wave. Regarding the central sensory conduction time values,both in the median and tibial SSEP study, The significant differences was noted only in the median nerve SSEP study. Regarding the means of theamplitudes of differently studied SSEP components of the right median and left tibial nerves, it was only significant in the peripheral SSEP (N9)wave of the right median nerve and in the subcortical and cortical (P37 and N45) waves in the tibial nerve SSEP study. Conclusions: Resultsshowed a significantly higher SSEP amplitude and latency in nonspecific CLBP patients as compared to their counterpart CLBP patients. This couldreflect a higher excitability of sensory cortex and sensory pathways in patients with nonspecific CLBP as compared to their counterpart patients.


Article
Do low back pain changes correlate with sagittal lumbar alignment changes after total hip replacement arthroplasty?
هل ان التغيرات في الالام اسفل الظهر ترتبط بتغيرات الوضع الجانبي للفقرات القطنية بعد عملية تبديل مفصل الورك الكامل ؟

Author: Firas Abdalhadi Alobidi فراس العبيدي
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 / 24108057 Year: 2015 Volume: 57 Issue: 2 Pages: 125-128
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: The hip joint and lumbar spine are both anatomically and functionally closely related as had shown by many authors. So the abnormality in one area can affect the other e.g. hip joint osteoarthritis can cause lumbar sagittal malalignment and backache. Objectives: is to see if there is significant improvement in backache after total hip replacement? And which degree of backache improvement is associated with significant changes in lumbar lordosis? Methods and patients: a prospective open trial study was performed on 30 patients who had severe hip osteoarthritis and chronic low back pain. Total hip replacement was performed to all patients. Backache and lumbar lordosis were measured by visual analogue scale and Cobb's angle respectively both before and 6 months after surgery. Patients were divided into 3 groups according to grade of improvement in backache after surgery. Results: The improvement in low back pain after surgery was statistically significant for all patients and for each group separately, while the changes in lumbar lordosis were not statistically significant neither for all patients nor for any group separately. Conclusions: total hip replacement surgery has significant positive effect on backache. There is no significant correlation between improvement in backache and changes in lumbar lordosis. Key words: low back pain+lumbar lordosis+hip replacement.

الخفية : ان مفصل الورك والفقرات القطنية مرتبطين من حيث الوضع التشريحي والوظيفي كما اثبته الكثير من المؤلفين.وان اي خلل بمنطقة معينة سيؤدي الى خلل بالمنطقة الاخرى فمثلا سوفان مفصل الورك قد يؤدي الى تغيير بالوضع الجانبي للفقرات والالام الظهر.الهدف : هو معرفة هل يحصل تحسن مهم احصائيا في الالام الظهر بعد عملية تبديل مفصل الورك الكامل ؟ واي درجة من التحسن بالالام الظهر تكون مرتبطة بتغييرات مهمة احصائيا في الوضع الجانبي للفقرات القطنية ؟المرضى والطرق: اجريت هذه الدراسة المستقبلية على 30 مريض كانوا يعانون من سوفان مفصل الورك المتقدم والالام اسفل الظهر المزمنة,تم اجراء عملية تبديل مفصل الورك الكامل لكل المرضى, وتم قياس درجة الالام الظهر وزاوية الانحناء الجانبي للفقرات القطنية قبل العملية وبعد 6 اشهر من العملية , وتم تقسيم المرضى الى ثلاث مجاميع حسب درجات التحسن بالالام الظهر.النتائج : التحسن بالالام اسفل الظهر بعد العملية كان مهم احصائيا لكل المرضى ولكل المجاميع, بينما التغيير بزاوية الانحناء الجانبي للفقرات القطنية بعد العملية لم يكن مهم احصائيا لكل المرضى ولكل المجاميع.الاستنتاجات : عملية تبديل مفصل الورك الكامل لها تاثيرات ايجابية مهمة احصائيا على الالام اسفل الظهر. لاتوجد علاقة مهمة احصائيا بين التحسن بالالام الظهر والتغييرات بزاوية الانحناء الجانبي للفقرات القطنية.مفتاح الكلمات: الالام اسفل الظهر، انحراف الفقرات القطنية في الوضع الجانبي ، تبديل مفصل الورك الكامل

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