Incidental vertebral lesions

2011 ◽  
Vol 31 (6) ◽  
pp. E17
Author(s):  
Jean-Valery C. E. Coumans ◽  
Brian P. Walcott
Keyword(s):  
Back Pain ◽  
Clinical Practice ◽  
Mr Imaging ◽  
Incidental Findings ◽  
Vertebral Column ◽  
Aging Population ◽  
Class Iii ◽  
Contributing Factors ◽  
Review Management ◽  
Practice Style

Incidental vertebral lesions on imaging of the spine are commonly encountered in clinical practice. Contributing factors include the aging population, the increasing prevalence of back pain, and increased usage of MR imaging. Additionally, refinements in CT and MR imaging have increased the number of demonstrable lesions. The management of incidental findings varies among practitioners and commonly depends more on practice style than on data or guidelines. In this article we review incidental findings within the vertebral column and review management of these lesions, based on available Class III data.

Role of Vaitarana Basti in the management of Gridhrasi w.s.r. to Sciatica

2018 ◽  
Vol 3 (5) ◽  
Author(s):  
Dr. Suresh N. Hakkandi ◽  
Dr. Manjunath Akki ◽  
Dr. Bhavana KS
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Clinical Practice ◽  
Routine Activity ◽  
Daily Routine ◽  
Low Back ◽  
Common Condition ◽  
Locomotor System

Vata Vyadhi is one of the most prevailing health problems in our day today clinical practice, Gridhrasi is one among them. Gridhrasi is Shoola Pradhana Nanatmaja Vatavyadhi, affecting the locomotor system and disable from daily routine activity. Gridhrasi the name itself indicates the way of gait shown by the patient due to extreme pain i.e. like Gridhra or Vulture. Gridhrasi is a condition characterized by Ruk, Toda, Stambha, Spandana in Sphik Pradesha and radiates downwards to Kati, Prusta, Uru, Janu, Jangha and Pada. Gridhrasi can be compared with Sciatica. Pain is the chief cause of person to visit a doctor. Although low back pain is a common condition that affects as many as 80 to 90 percent of people during their lifetime. Gridhrasi can be cured by the help of Vaitarana Basti. Hence in the case study of male patient of age 30 yrs presenting with cardinal clinical sign and symptoms of Gridhrasi are Ruka, Toda and Muhu Spandana in the Sphika, Kati, Uru, Janu, Jangha and Pada in order and Sakthikshepanigraha that is restricted lifting of the leg.

scholarly journals How to objectively assess and observe maladaptive pain behaviors in clinical rehabilitation: a systematic search and review

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Florian Naye ◽  
Chloé Cachinho ◽  
Annie-Pier Tremblay ◽  
Maude Saint-Germain Lavoie ◽  
Gabriel Lepage ◽  
...  
Keyword(s):  
Back Pain ◽  
Clinical Practice ◽  
Critical Appraisal ◽  
Inclusion Criteria ◽  
Clinical Criteria ◽  
Affective Factors ◽  
Pain Behaviors ◽  
Observation Methods ◽  
Critical Appraisal Tool ◽  
Secondary Objective

Abstract Background Cognitive-affective factors influence the perception of pain and disability. These factors can lead to pain behaviors (PB) that can persist and become maladaptive. These maladaptive PB will further increase the risk of chronicity or persistence of symptoms and disability. Thus, clinicians must be prepared to recognize maladaptive PB in a clinical context. To date, in the context of assessment in a rehabilitation setting, PB in clinical settings are poorly documented. The main objective of this study was to identify direct observation methods and critically appraise them in order to propose recommendations for practice. As a secondary objective, we explored and extracted the different observable PB that patients could exhibit and that clinicians could observe. Methods We conducted a comprehensive review on four databases with a generic search strategy in order to obtain the largest range of PB. For the first objective, a two-step critical appraisal used clinical criteria (from qualitative studies on barriers to implement routine measures) and psychometric criteria (from Brink and Louw critical appraisal tool) to determine which observation methods could be recommended for clinical practice. For the second objective, we extracted PB found in the literature to list potential PB that patients could exhibit, and clinicians could observe. Results From the 3362 retrieved studies, 47 met the inclusion criteria for the first objective. The clinical criteria allowed us to select three observation methods. After the psychometric step, two observation methods were retained and recommended for clinical practice: the Behavioral Avoidance Test-Back Pain (BAT-Back) and the Pain Behaviour Scale (PaBS). For the second objective, 107 studies met the inclusion criteria. The extraction of the PB allowed us to list a large range of PB and classify the data in 7 categories of PB. Conclusion Our results allowed us to recommend two observation methods for clinical practice. However, these methods have limitations and are validated only in chronic low back pain populations. With the extraction of PB presented in the literature, we contribute to better prepare clinicians to recognize PB in all patients who are experiencing pain.

Nonpharmacologic Therapies for Low Back Pain: A Systematic Review for an American College of Physicians Clinical Practice Guideline

2017 ◽  
Vol 166 (7) ◽  
pp. 493 ◽  
Author(s):  
Roger Chou ◽  
Richard Deyo ◽  
Janna Friedly ◽  
Andrea Skelly ◽  
Robin Hashimoto ◽  
...  
Keyword(s):  
Systematic Review ◽  
Low Back Pain ◽  
Back Pain ◽  
Clinical Practice ◽  
Clinical Practice Guideline ◽  
Practice Guideline ◽  
Low Back

Are Healthcare Providers Providing Appropriate Educational Material for People with Low Back Pain?

2021 ◽  
pp. 21
Author(s):  
Dalia Alemam
Keyword(s):  
Saudi Arabia ◽  
Low Back Pain ◽  
Back Pain ◽  
Healthcare Providers ◽  
Educational Material ◽  
Self Management ◽  
Low Back ◽  
Contributing Factors ◽  
Educational Materials ◽  
Military Hospitals

Introduction: One of the contributing factors to the burden of low back pain (LBP) is the failure to provide patients with appropriate education and advice about diagnosis and management. To date, no information exists about whether the content of patients’ information and educational material provided in physiotherapy clinics in Saudi Arabia is in line with the Clinical Practice Guidelines and contemporary practice. Therefore, the aim of this study was to investigate the content of educational material provided by physiotherapy clinics, hospitals, or distributed by healthcare associations to people with LBP in Saudi Arabia, to determine whether this information is adequate to reassure patients and inform self-management. This study also seeks to explore whether these materials are consistent with CPGs for people with LBP. Methodology: A sample of educational items (English or Arabic) in Saudi Arabia was collected. Content analysis was conducted to analyze data based on manifest content. Result: Seventeen educational materials were included, originating from diverse sources; the Ministry of Health hospitals (n = 10), military hospitals (n = 4), private hospitals (n = 2), and multidisciplinary healthcare association (n = 1). Six main sub-themes were identified: epidemiological/anatomical data about LBP (n = 6); causes/risk factors (n = 10); exercise (n = 14) and physical activity-related recommendations (n = 3); treatment-related recommendations (n = 2); general health and lifestyle-related recommendations (n = 8); and postural and ergonomics-related recommendations (n = 13). Ultimately, one theme was formulated, namely, the content of educational materials was hindering reassurance and self-management for people with LBP. The items reviewed were heavily influenced by the biomedical model of pain. Conclusion: The educational materials reviewed failed to properly report information about LBP from a biopsychosocial perspective and were inadequate to assure patients or inform self-management.

Treatment of low back pain in 2020: Monitoring clinical practice through audit

Physiotherapy ◽  
2021 ◽  
Vol 113 ◽  
pp. e193
Author(s):  
W.J. Gregory ◽  
K. Jeavons ◽  
G. Ford
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Clinical Practice ◽  
Low Back

scholarly journals Radical Dorsal Interventions in Treatment of Kyphotic Deformities (Literature Review)

2015 ◽  
Vol 22 (2) ◽  
pp. 66-75
Author(s):  
M. V Mikhailovskiy ◽  
V. V Novikov ◽  
I. G Udalov
Keyword(s):  
Clinical Practice ◽  
Literature Review ◽  
Vertebral Column ◽  
Surgical Techniques ◽  
Pedicle Subtraction Osteotomy ◽  
Treatment Results ◽  
Vertebral Column Resection ◽  
Surgical Interventions ◽  
Ponte Osteotomy ◽  
Spine Deformities

Widely used in clinical practice surgical interventions directed to the correction of severe kyphotic spine deformities, i.e. Ponte osteotomy, Smith-Peterson osteotomy, pedicle subtraction osteotomy and vertebral column resection are presented. Surgical techniques, surgery planning based on spinal and pelvic sagittal contour parameters, treatment results are described.

scholarly journals Presacral schwannoma. Case description

2015 ◽  
Vol 84 (4) ◽  
pp. 264-270
Author(s):  
Roman Jankowski ◽  
Jeremi Kościński ◽  
Bartosz Sokół ◽  
Stanisław Malinger ◽  
Janusz Szymaś
Keyword(s):  
Mr Imaging ◽  
Vertebral Column ◽  
Abdominal Cavity ◽  
Diagnostic Procedures ◽  
Precise Location ◽  
Pelvic Organs ◽  
Gynecological Examination ◽  
Giant Schwannoma ◽  
Vascular Structures ◽  
Anatomic Region

Schwannomas in the presacral region of vertebral column occur sporadically and are usually diagnosed incidentally during diagnostic procedures applied as a response to nonspecific complaints associated with vertebral column or abdominal cavity. This study focuses not only on the presentation of the case of the patient with giant schwannoma in the retrorectal area, but on the highlighting of the problems associated with diagnosis and treatment of tumours located in this anatomic region as well. The presented case involves a 23-year old woman. The diagnosis of the disease was made during gynecological examination accompanied by ultrasonography of pelvic organs. Neurological examination disclosed no deviations from the normal condition. MR imaging allowed to determine precise location of the tumour and its anatomic relations to pelvic visceral and vascular structures. The patient underwent a successful surgery using laparotomy. Histological examination revealed structures of schwannoma. Surgical radicality and the lack of relapse were confirmed by MR imaging taken five years after the surgery.

scholarly journals Optimizing management of low back pain through the pain and disability drivers management model: A feasibility trial

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0245689
Author(s):  
Christian Longtin ◽  
Simon Décary ◽  
Chad E. Cook ◽  
Marc O. Martel ◽  
Sylvie Lafrenaye ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Clinical Practice ◽  
Data Collection ◽  
Outcome Measures ◽  
Pragmatic Trial ◽  
Attrition Rate ◽  
Feasibility Trial ◽  
Clinical Settings ◽  
Low Back

Introduction Self-reported levels of disability in individuals with low back pain (LBP) have not improved in the last decade. A broader perspective and a more comprehensive management framework may improve disability outcomes. We recently developed and validated the Low Back Pain and Disability Drivers Management (PDDM) model, which aims to identify the domains driving pain and disability to guide clinical decisions. The objectives of this study were to determine the applicability of the PDDM model to a LBP population and the feasibility of conducting a pragmatic trial, as well as to explore clinicians’ perceived acceptability of the PDDM model’s use in clinical settings. Methods This study was an one-arm prospective feasibility trial. Participants included physiotherapists working with a population suffering from LBP and their patients aged 18 years or older presenting with a primary complaint of LBP that sought a new referral and deemed fit for rehabilitation from private and public clinical settings. Clinicians participated in a one-day workshop on the integration of the PDDM model into their clinical practice, and were asked to report various LBP-related outcomes via self-reported questionnaires (i.e., impact of pain on physical function, nervous system dysfunctions, cognitive-emotional factors, work disabilities) at baseline and at six-week follow-up. Physiotherapists’ acceptability of the use of the PDDM model and appreciation of the training were assessed via semi-structured phone interviews. Analyses focused on a description of the model’s applicability to a LBP population, feasibility outcomes and acceptability measures. Results Applicablity of the PDDM model was confirmed since it successfully established the profile of patients according to the elements of each categories, and each of the 5 domains of the model was represented among the study sample. Trial was deemed feasible contingent upon few modifications as our predefined success criteria for the feasibility outcomes were met but feasibility issues pertaining to data collection were highlighted. Twenty-four (24) clinicians and 61 patients were recruited within the study’s timeframe. Patient’s attrition rate (29%) and clinicians’ compliance to the study protocol were adequate. Clinicians’ perceived acceptability of the use of the model in clinical settings and their appreciation of the training and online resources were both positive. Recommendations to improve the model’s integration in clinical practice, content of the workshop and feasibility of data collection methods were identified for future studies. A positive effect for all patients’ reported outcome measures were also observed. All outcome measures except for the PainDetect questionnaire showed a statistically significant reduction post-intervention (p<0.05). Conclusion These findings provide preliminary evidence of the potential of the PDDM model to optimize LBP management as well as conducting a future larger-scale pragmatic trial to determine its effectiveness. Trial registration Clinicaltrial.gov: NCT03949179.

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