| 1. |
- Aasa, Ulrika, et al.
(författare)
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Physical Activity Might Be of Greater Importance for Good Spinal Control Than If You Have Had Pain or Not : A Longitudinal Study
- 2015
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Ingår i: Spine. - 0362-2436 .- 1528-1159. ; 40:24, s. 1926-1933
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Tidskriftsartikel (refereegranskat)abstract
- STUDY DESIGN: Longitudinal design. A cohort followed in 3 waves of data collection.OBJECTIVE: The aim of the study was to describe the relationships between the performance of 2 tests of spinal control at the age of 52 years and low back pain, physical activity level, and fitness earlier in life, as well as to describe the cross-sectional relationships between these measures.SUMMARY OF BACKGROUND DATA: Altered spinal control has been linked to pain; however, other stimuli may also lead to inability to control the movements of the spine.METHODS: Participants answered questions about physical activity and low back pain, and performed physical fitness tests at the age of 16, 34, and 52 years. The fitness test battery included tests of endurance in the back and abdominal muscles, a submaximal bicycle ergometer test to estimate maximal oxygen uptake, and measurements of hip flexion, thoracic spine flexibility, and anthropometrics. Two tests were aggregated to a physical fitness index. At the age of 52, also 2 tests of spinal control, the standing Waiter's bow (WB) and the supine double leg lower (LL) were performed.RESULTS: Logistic regression analyses showed that higher back muscle endurance at the age of 34 years could positively predict WB performance at 52 years and higher physical fitness at the age of 34 could positively predict LL performance at 52 years. Regarding cross-sectional relationships, an inability to perform the WB correctly was associated with lower physical fitness, flexibility and physical activity, and larger waist circumference. An inability to correctly perform the LL was associated with lower physical fitness. One-year prevalence of pain was not significantly associated with WB or LL test performance.CONCLUSION: An active life resulting in higher physical fitness is related to better spinal control in middle-aged men and women. This further strengthens the importance of physical activity throughout the life span.LEVEL OF EVIDENCE: 3.
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| 2. |
- Berglund, Lars, et al.
(författare)
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Effects of low-load motor control exercises and a high-load lifting exercise on lumbar multifidus thickness : a randomized controlled trial
- 2017
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Ingår i: Spine. - : Wolters Kluwer. - 0362-2436 .- 1528-1159. ; 42:15, s. E876-E882
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Tidskriftsartikel (refereegranskat)abstract
- Study Design: Randomized controlled trialObjective: The aim of this study was to compare the effects of low-load motor control exercises and a high-load lifting exercise on lumbar multifidus thickness among patients with nociceptive mechanical low back pain.Summary of Background Data: There is evidence that patients with low back pain may have a decreased size of the lumbar multifidus muscles with an asymmetry between left/right sides in the lower back. It has also been shown that low-load motor control training can affect this asymmetry; essentially, it is effective in equalizing side differences in lumbar multifidus muscle size. It is, however, not known whether a high-load exercise has the same effect.Methods: Sixty-five participants diagnosed with nociceptive mechanical low back pain were included and randomized into low-load motor control exercises or a high-load lifting exercise, the deadlift. The lumbar multifidus thickness at the fifth lumbar vertebra was measured, using rehabilitative ultrasound imaging, at baseline and after a 2-month training period.Results: There were no differences between interventions regarding effect on lumbar multifidus muscle thickness. However, the linear mixed model analysis showed a significant effect for asymmetry. The thickness of the lumbar multifidus muscle on the small side increased significantly compared to the large side in both intervention groups.Conclusions: There was a difference in thickness of the lumbar multifidus muscles between sides. It seems that exercises focusing on spinal alignment may increase the thickness of the lumbar multifidus muscles on the small side, irrespective of exercise load.
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| 3. |
- Bergmann, Annekatrin, et al.
(författare)
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Do occupational risks for low back pain differ from risks for specific lumbar disc diseases? : Results of the German Lumbar Spine Study (EPILIFT)
- 2017
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Ingår i: Spine. - 0362-2436 .- 1528-1159. ; 42:20, s. E1204-E1211
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Tidskriftsartikel (refereegranskat)abstract
- Study design: A multicenter, population based, case-control study.Objective: The aim of the present analysis is to clarify potential differences in the "occupational risk profiles" of structural lumbar disc diseases on the one hand, and low back pain (LBP) on the other hand.Summary of background data: Physical workplace factors seem to play an important etiological role.Methods: We recruited 901 patients with structural lumbar disc diseases (disc herniation or severe disc space narrowing) and 233 control subjects with "low-back-pain." Both groups were compared with 422 "low-back pain free" control subjects. Case history, pain data, neurological deficits, and movement restrictions were documented. LBP was recorded by the Nordic questionnaire on musculoskeletal symptoms. All magnetic resonance imaging, computed tomography, and X-rays were inspected by an independent study radiologist. The calculation of cumulative physical workload was based on a computer-assisted interview and a biomechanical analysis by 3-D-dynamic simulation tool. Occupational exposures were documented for the whole working life.Results: We found a positive dose-response relationship between cumulative lumbar load and LBP among men, but not among women. Physical occupational risks for structural lumbar disc diseases [odds ratio (OR) 3.7; 95% confidence interval (95% CI) 2.3-6.0] are higher than for LBP (OR 1.9; 95% CI 1.0-3.5).Conclusion: Our finding points to potentially different etiological pathways in the heterogeneous disease group of LBP. Results suggest that not all of the structural disc damage arising from physical workload leads to LBP.
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| 4. |
- Crnalic, Sead, et al.
(författare)
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Predicting survival for surgery of metastatic spinal cord compression in prostate cancer : a new score
- 2012
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Ingår i: Spine. - 0362-2436 .- 1528-1159. ; 37:26, s. 2168-2176
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Study design. We retrospectively analyzed prognostic factors for survival in prostate cancer patients operated for metastatic spinal cord compression.Objective. The aim was to obtain a clinical score for prediction of survival after surgery.Summary of background data. Survival prognosis is important when deciding about treatment of patients with metastatic spinal cord compression. The criteria for identifying prostate cancer patients who may benefit from surgical treatment are unclear.Patients and methods The study comprised 68 consecutive patients with prostate cancer operated for metastatic spinal cord compression at Umeå University Hospital, Sweden. The indication for surgery was neurological deficit; 53 patients had hormone-refractory prostate cancer, and 15 patients had previously untreated, hormone-naïve prostate cancer. In 42 patients posterior decompression was performed and 26 patients were operated with posterior decompression and stabilization.Results A new score for prediction of survival was developed based on the results of survival analyses. The score includes: hormone status of prostate cancer, Karnofsky performance status, evidence of visceral metastasis, and preoperative serum PSA. The total scores ranged from 0 to 6. Three prognostic groups were formulated: group A (n = 32) with scores 0-1; group B (n = 23) with scores 2-4, and group C (n = 12) with scores 5-6. The median overall survival was 3 (0.3 - 20) months in group A, 16 (1.8 - 59) months in group B, and in group C more than half (7 of 12) of patients were still alive.Conclusion We present a new prognostic score for predicting survival of prostate cancer patients after surgery for metastatic spinal cord compression. The score is easy to apply in clinical practice and may be used as additional support when making decision about treatment.
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| 5. |
- Karppinen, Jaro, et al.
(författare)
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Effects of tiaprofenic acid and indomethacin on proteoglycans in the degenerating porcine intervertebral disc.
- 1995
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Ingår i: Spine. - : Wolters Kluwer. - 0362-2436 .- 1528-1159. ; 20:10, s. 1170-1177
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Tidskriftsartikel (refereegranskat)abstract
- STUDY DESIGN: Eighteen pigs were stabbed with a scalpel in the anterior part of the anulus fibrosus of a lumbar disc. After surgery, the pigs received either tiaprofenic acid or indomethacin daily, and a third group did not receive any medication.OBJECTIVES: Nonsteroidal anti-inflammatory agents are widely used in the treatment of low back patients, but their long-term effects on the matrix molecules in the degenerate disc are unknown.SUMMARY OF BACKGROUND DATA: Several in vitro and in vivo studies on articular cartilage have suggested that tiaprofenic acid may not have adverse effects on matrix metabolism, whereas indomethacin probably does.METHODS: Uronic acid, DNA, and water contents were determined from five different locations in each injured disc. Transport and incorporation of sulfate were examined by in vivo radioactive tracer analysis, and proteoglycan structures were analyzed by gel electrophoresis.RESULTS: Morphologically, there were no differences between the treatments. Tiaprofenic acid maintained a higher uronic acid content in the nucleus pulposus and outer anulus compared with that of the nonmedicated animals. Tiaprofenic acid decreased the incorporation of sulfate in the injured area and the water content at most sites. Indomethacin had no adverse effects compared with the nonmedicated group, and it increased water content in the posterior anulus fibrosus.CONCLUSIONS: Long-term administration of tiaprofenic acid and indomethacin did not have harmful effects on matrix metabolism after disc injury. On the contrary, tiaprofenic acid may slightly protect proteoglycans in the degenerating disc.
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| 6. |
- Knutsson, Björn, et al.
(författare)
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Body mass index and risk for clinical lumbar spinal stenosis : a cohort study
- 2015
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Ingår i: Spine. - : Wolters Kluwer. - 0362-2436 .- 1528-1159. ; 40:18, s. 1451-1456
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Tidskriftsartikel (refereegranskat)abstract
- STRUCTURED ABSTRACT: Study Design. A prospective cohort study that used a Swedish nationwide occupational surveillance program for construction workers (period of registration from 1971-1992). In all, 364 467 participants (mean age at baseline 34 years) were included in the study.OBJECTIVE: To determine whether overweight and obesity are associated with a higher risk of lumbar spinal stenosis (LSS).SUMMARY OF BACKGROUND DATA: During recent decades, LSS has become the most common indication for spine surgery, a change that coincides with a higher prevalence of obesity.METHODS: A diagnosis of LSS was collected through individual linkage to the Swedish National Patient Register through December 31, 2011. Poisson regression models were employed to estimate multivariable-adjusted incidence rate ratios (IRRs) for LSS.RESULTS: At baseline, 65% had normal weight (BMI 18.5 to 24.99 kg/m), 29% were overweight (BMI 25 to 29.99 kg/m), 5% were obese (BMI≥30 kg/m) and 2% were underweight (BMI<18.5 kg/m). During 11,190,944 person-years of follow-up, with a mean of 31 years, 2381 participants were diagnosed with LSS. Compared with normal weight individuals, obese workers had an IRR of 2.18 (95% confidence interval (CI), 1.87 to 2.53) for LSS and overweight workers had an IRR of 1.68 (95% CI, 1.54 to 1.83). Workers who were underweight halved their risk of LSS (IRR 0.52, 95% CI 0.30 to 0.90).CONCLUSION: Obese and overweight persons are at a higher risk of developing LSS. Further, our results indicate that obesity might be a novel explanation for the increased number of patients with clinical LSS.
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| 7. |
- Lampa, Ewa, et al.
(författare)
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The Course of Orofacial Pain and Jaw Disability after Whiplash Trauma : A 2-year Prospective Study
- 2020
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Ingår i: Spine. - : Wolters Kluwer. - 0362-2436 .- 1528-1159. ; 45:3, s. E140-E147
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Tidskriftsartikel (refereegranskat)abstract
- Study Design: Prospective cohort study.Objective: To evaluate the course of orofacial pain and jaw disability in relation to neck pain, neck disability and psychosocial factors at the acute stage and the chronic stage after whiplash trauma.Summary of Background Data: Many individuals report chronic pain in the orofacial region after whiplash trauma. The possible association between whiplash trauma and orofacial pain is debated. Prospective studies are therefore needed to evaluate the development of orofacial pain after whiplash trauma.Methods: Within one month following a whiplash trauma, 176 cases were examined and compared to 116 controls with questionnaires concerning neck and jaw pain and related disability, non-specific physical symptoms and depression. At the 2-year follow-up, 119 cases (68%) and 104 controls (90%) were re-examined.Results: Compared to controls, cases reported more jaw and neck pain, both at baseline and follow-up. A majority (68%) of cases with pain in the jaw region in the acute stage also reported jaw pain at the follow-up. The intensity of jaw and neck pain was correlated both at baseline and follow-up. Both neck pain and jaw pain was correlated to non-specific physical symptoms and to depression.Conclusion: Orofacial pain and jaw disability related to neck pain is often present already at the acute stage after whiplash trauma and persist into the chronic stage for most individuals. Assessment following whiplash trauma should therefore include both the neck and the orofacial regions. More studies are needed to further evaluate risk factors for development of orofacial pain after whiplash trauma.Level of Evidence: 3
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| 8. |
- Leijon, Ola, et al.
(författare)
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Prevalence of self-reported neck-shoulder-arm pain and concurrent low back pain or psychological distress : time-trends in a general population, 1990-2006.
- 2009
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Ingår i: Spine. - 0362-2436 .- 1528-1159. ; 34:17, s. 1863-1868
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Tidskriftsartikel (refereegranskat)abstract
- STUDY DESIGN: Analysis of repeated cross-sectional surveys. OBJECTIVE: To investigate the prevalence of neck-shoulder-arm pain and concurrent low back pain and psychological distress in a geographical area over a 16-year period. SUMMARY OF BACKGROUND DATA: A large number of studies have shown that nonspecific neck, shoulder, and arm pain is a very common symptom in the general population. However, few studies have followed the prevalence of neck-shoulder-arm pain within a geographical area, in order to investigate time-trends. METHODS: This study provides an analysis of questionnaire data collected every 4 years between 1990 and 2006 on the prevalence of neck-shoulder-arm pain and concurrent low back pain or psychological distress in the County of Stockholm, Sweden (response rate: 61%-69%). All individuals aged 21 to 64 years (n = 1976-26,611) were included in the study. RESULTS: Over the 16-year period, the prevalence of self-reported neck-shoulder-arm pain rose slightly, from 22.8% to 25.0% among females (prevalence rate ratio [PRR]: 1.10) and from 12.8% to 15.4% among males (PRR: 1.21). The prevalence of neck-shoulder-arm pain with concurrent low back pain also rose slightly, from 8.4% to 10.8% among females (PRR: 1.28) and from 5.3% to 6.6% among males (PRR: 1.24). In contrast, the prevalence of neck-shoulder-arm pain with concurrent psychological distress rose more substantially, from 4.4% to 8.5% among females (PRR: 1.91) and from 2.0% to 4.3% among males (PRR: 2.18). All prevalence rates rose between 1990 and 2002, and decreased in 2006 compared to 2002. The gender gap in prevalence did not change over time. CONCLUSION: Although the prevalence of neck-shoulder-arm pain and concurrent symptoms decreased in 2006 compared to 2002, it is still too early to conclude that we have reached and passed the peak of the "epidemic" of neck-shoulder-arm pain.
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| 9. |
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| 10. |
- Sahlman, Janne, et al.
(författare)
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Premature vertebral endplate ossification and mild disc degeneration in mice after inactivation of one allele belonging to the Col2a1 gene for Type II collagen.
- 2001
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Ingår i: Spine. - : Lippincott Williams & Wilkins. - 0362-2436 .- 1528-1159. ; 26:23, s. 2558-2565
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Tidskriftsartikel (refereegranskat)abstract
- STUDY DESIGN: Skeletal tissues of mice with an inactivated allele of the Col2a1 gene for Type II collagen ("heterozygous knockout") were studied.OBJECTIVE: To determine whether a heterozygous inactivation of the Col2a1 gene has a role in the etiology of spine disorders such as disc degeneration.SUMMARY OF BACKGROUND DATA: Mutations in the COL2A1, COL11A1, COL11A2, and COL9A2 genes have been linked to spine disorders. However, the mechanism by which genetic factors lead to disc degeneration still are largely unknown.METHODS: Spine tissues were studied using radiograph analyses; conventional, quantitative, and polarized light microscopy; immunohistochemistry for the major extracellular components, and in situ hybridization for procollagens alpha1(I) and alpha1(II). Voluntary running activity also was monitored in half of the mice.RESULTS: As the findings showed, 1-month-old heterozygous knockout mice had shorter limb bones, skulls, and spines, as well as thicker and more irregular vertebral endplates, which calcified earlier than in the control mice. They also had a lower concentration of glycosaminoglycans in the anulus fibrosus, in the endplates, and in the vertebral bone than the controls. These features in the heterozygous knockout mice were compensated by the age of 15 months. However, the long bones and skulls of the mature heterozygous mice remained shorter than those of the controls. Gene-deficient mice used the running wheel less. However, physical exercise did not induce any marked structural changes in the skeleton.CONCLUSION: Mice with heterozygous knockout of Col2a1 show subtle early skeletal manifestations that bear some resemblance to those of human spine disorders.
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