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Non-Spesifik Bel Ağrılı Hastalarda Lumbal Lordoz Açısı ve Lumbal Kas Kalınlıklarının MRG Analizi

Year 2023, Volume: 15 Issue: 3, 294 - 301, 20.10.2023
https://doi.org/10.18521/ktd.1210087

Abstract

Amaç: Karbapenem dirençli Enterobacterales (CRE) enfeksiyonlarının tedavi seçenekleri sınırlıdır ve bu enfeksiyonlar yüksek mortalite oranları ile ilişkilidir. CRE ile kolonize olan asemptomatik taşıyıcılar, CRE'nin hastanelerde yayılmasına katkıda bulunur. Bu çalışmada merkezimizde saptanan CRE izolatlarının sıklığının, bu suşlardaki karbapenemaz oranlarının, karbapenemaz genlerinin, antibiyotik direnç profillerinin, rektal CRE kolonizasyon oranlarının belirlenmesi ve CRE enfeksiyonlarının çeşitli klinik özelliklerinin değerlendirilmesi amaçlandı.
Gereç ve Yöntem: Çeşitli örneklerden izole edilen Enterobacterales türleri ve kolonizasyon taraması için gönderilen rektal sürüntü örneklerinden izole edilen Enterobacterales türleri incelenmiştir. Rektal sürüntü örneklerinde CRE kolonizasyonu olan hastalar daha sonra CRE enfeksiyonu gelişimi açısından incelendi. CRE izolatları karbapenemaz üretimi ve karbapenemaz geni varlığı açısından incelenmiştir.
Bulgular: 14521 Enterobacterales (10.161 E. coli ve 4195 K. pneumoniae, 165 Citrobacter) izolatı incelendi. Bu suşların %8.9'unda karbapenem direnci saptanmıştır. Kolonizasyon için değerlendirilen 15695 rektal sürüntü örneğinin %4,7'sinde CRE saptanmıştır. CRE kolonizasyonu olan hastaların %23,4'ünde ilerleyen dönemde rektal sürüntü dışında diğer örneklerde de CRE üremesi saptandı. CRE enfeksiyonlarının
kolonizasyondan ortalama 21 gün sonra geliştiği gözlendi.
Sonuç: CRE enfeksiyonları sadece hastanede yatan hastalarda değil toplum kökenli enfeksiyonlarda da bir etken olarak karşımıza çıkmaya başlamıştır. Çalışmamız ayrıca CRE kolonizasyonunun enfeksiyon gelişimi için önemli bir risk faktörü olabileceğini göstermiştir. Bu nedenle, kolonizasyonu saptamak için erken tarama tespiti, uygun izolasyon yöntemleriyle CRE enfeksiyonlarını önlemeye veya sınırlamaya yardımcı olabilir.

References

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  • 2. Hoy D, March L, Brooks P, Blyth F, Woolf A, Bain C, et al. The global burden of low back pain: Estimates from the Global Burden of Disease 2010 study. Ann Rheum Dis. 2014; 73:968-74.
  • 3. Hoy D, Brooks P, Blyth F, Buchbinder R. The Epidemiology of low back pain. Best Pract Res Clin Rheumatol. 2010; 24(6):769–81.
  • 4. Vos T, Allen C, Arora M, Barber RM, Brown A, Carter A, et al. Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015. The Lancet. 2016; 388(10053): 1545-602.
  • 5. Tavee JO, Levin KH. Low Back Pain. CONTINUUM Lifelong Learning in Neurology. 2017; 23(2): 467–86.
  • 6. Roussouly P, Pinheiro-Franco JL. Sagittal parameters of the spine: biomechanical approach. European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society. 2011; 20(5):578.
  • 7. Cho I, Jeon C, Lee S, Lee D, Hwangbo G. Effects of lumbar stabilization exercise on functional disability and lumbar lordosis angle in patients with chronic low back pain. J Phys Ther Sci. 2015; 27(6):1983-5.
  • 8. Chun SW, Lim CY, Kim K, Hwang J, Chung SG. The relationships between low back pain and lumbar lordosis: a systematic review and meta-analysis. Spine Journal. 2017; 17(8):1180–91.
  • 9. Lim JH. Correlations of Symmetry of the Trunk Muscle Thickness by Gender with the Spinal Alignment in Healthy Adults. The Journal of Korean Society of Physical Therapy. 2013; 25(6):405-10.
  • 10. Koppenhaver S, Gaffney E, Oates A, Eberle L, Young B, Hebert J, et al. Lumbar muscle stiffness is different in individuals with low back pain than asymptomatic controls and is associated with pain and disability, but not common physical examination findings. Musculoskelet Sci Pract. 2020; 45:102078.
  • 11. Masaki M, Aoyama T, Murakami T, Yanase K, Ji X, Tateuchi H, et al. Association of low back pain with muscle stiffness and muscle mass of the lumbar back muscles, and sagittal spinal alignment in young and middle-aged medical workers. Clinical Biomechanics. 2017; 49:128–33.
  • 12. Reeves NP, Cholewicki J, Silfies SP. Muscle activation imbalance and low-back injury in varsity athletes. Journal of Electromyography and Kinesiology. 2006; 16(3): 264-72.
  • 13. Singh R, Yadav SK, Sood S, Yadav RK, Rohilla R. Magnetic resonance imaging of lumbar trunk parameters in chronic low backache patients and healthy population: a comparative study. European Spine Journal. 2016; 25(9):2864–72.
  • 14. Goubert D, De Pauw R, Meeus M, Willems T, Cagnie B, Schouppe S, et al. Lumbar muscle structure and function in chronic versus recurrent low back pain: a cross-sectional study. Spine Journal. 2017; 17(9):1285–96.
  • 15. Menezes-Reis R, Bonugli GP, Salmon CEG, Mazoroski D, Da Silva Herrero CFP, Nogueira-Barbosa MH. Relationship of spinal alignment with muscular volume and fat infiltration of lumbar trunk muscles. PLoS One. 2018; 13(7): e0200198.
  • 16. Ghamkhar L, Kahlaee AH. Trunk Muscles Activation Pattern During Walking in Subjects With and Without Chronic Low Back Pain: A Systematic Review. PM and R. 2015; 7(5):519-526.
  • 17. Jun HS, Kim JH, Ahn JH, Chang IB, Song JH, Kim TH, et al. The Effect of Lumbar Spinal Muscle on Spinal Sagittal Alignment: Evaluating Muscle Quantity and Quality. Neurosurgery. 2016; 79(6):847-55.
  • 18. Tatsumi M, Mkoba EM, Suzuki Y, Kajiwara Y, Zeidan H, Harada K, et al. Risk factors of low back pain and the relationship with sagittal vertebral alignment in Tanzania. BMC Musculoskelet Disord. 2019; 20(1):1–5.
  • 19. Wallwork TL, Stanton WR, Freke M, Hides JA. The effect of chronic low back pain on size and contraction of the lumbar multifidus muscle. Man Ther. 2009; 14(5):496-500.
  • 20. Masaki M, Aoyama T, Murakami T, Yanase K, Ji X, Tateuchi H, et al. Association of low back pain with muscle stiffness and muscle mass of the lumbar back muscles, and sagittal spinal alignment in young and middle-aged medical workers. Clinical Biomechanics. 2017; 49:128–33.
  • 21. Yakut E, Düger T, Öksüz C, Yörükan S, Ureten K, Turan D, et al. Validation of the Turkish version of the Oswestry Disability Index for patients with low back pain. Spine (03622436). 2004; 29(5): 581-5.
  • 22. Ling W. Physical Therapy Research: Principles and Applications, ed 2. Phys Ther. 2001; 81(11):1843.
  • 23. ShahAli S, Shanbehzadeh S, ShahAli S, Ebrahimi Takamjani I. Application of Ultrasonography in the Assessment of Abdominal and Lumbar Trunk Muscle Activity in Participants with and Without Low Back Pain: A Systematic Review. J Manipulative Physiol Ther. 2019; 42(7):541–50.
  • 24. Seyedhoseinpoor T, Taghipour M, Dadgoo M, Sanjari MA, Takamjani IE, Kazemnejad A, et al. Alteration of lumbar muscle morphology and composition in relation to low back pain: a systematic review and meta-analysis. Spine Journal. 2022; 22(4):660-76.
  • 25. Vlaeyen JWS, Maher CG, Wiech K, Van Zundert J, Meloto CB, Diatchenko L, et al. Low back pain. Nat Rev Dis Primers. 2018; 4(1):1–18.
  • 26. Palacios-Ceña D, Albaladejo-Vicente R, Hernández-Barrera V, Lima-Florencio L, Fernández-de-Las-Peñas C, Jimenez-Garcia R, et al. Female Gender Is Associated with a Higher Prevalence of Chronic Neck Pain, Chronic Low Back Pain, and Migraine: Results of the Spanish National Health Survey, 2017. Pain Med. 2021;22(2):382–95.
  • 27. Ferrari S, Vanti C, Pellizzer M, Dozza L, Monticone M, Pillastrini P. Is there a relationship between self-efficacy, disability, pain and sociodemographic characteristics in chronic low back pain? A multicenter retrospective analysis. Arch Physiother. 2019;9(1):1–9.
  • 28. Oddsson LIE, De Luca CJ. Activation imbalances in lumbar spine muscles in the presence of chronic low back pain. J Appl Physiol. 2003;94(4):1410–20.
  • 29. Smyers Evanson A, Myrer JW, Eggett DL, Mitchell UH, Johnson AW. Multifidus Muscle Size and Symmetry in Ballroom Dancers with and without Low Back Pain. Int J Sports Med. 2018; 39(08): 630-5.
  • 30. Kamaz M, Kireşi D, Oǧuz H, Emlik D, Levendoǧlu F. CT measurement of trunk muscle areas in patients with chronic low back pain. Diagnostic and Interventional Radiology. 2007;13(3):144–8.
  • 31. Christophy M, Senan NAF, Lotz JC, O’Reilly OM. A Musculoskeletal model for the lumbar spine. Biomech Model Mechanobiol. 2012;11(1–2):19–34.

An MRI Analysis of The Lumbar Lordosis Angle and Lumbar Muscle Thicknesses in Patients with Non-Specific Low Back Pain

Year 2023, Volume: 15 Issue: 3, 294 - 301, 20.10.2023
https://doi.org/10.18521/ktd.1210087

Abstract

Objective: This study aimed to examine the relationship of lumbar lordosis angle and lumbar muscle thickness with non-specific low back pain (LBP) through magnetic resonance imaging (MRI) images.
Methods: The study included 96 individuals (43 men/53 women) with non-specific LBP, aged between 18-65 years and had no disc pathology in MRI, who applied to affiliated Training and Research Hospital with the complaint of LBP between March-June 2019. Sociodemographic information was recorded using an LBP assessment form. The Oswestry LBP Disability Questionnaire was used for LBP disability. The thicknesses of muscle (m.) psoas major, m. multifidus, m. quadratus lumborum and m. erector spinae were measured corresponding to the L3-L4 vertebral level by using Radiant DICOM viewer program. The Cobb Angle method was used for lumbar lordosis angle determination. Measurements were made in three repetitions using the Radiant DICOM viewer program.
Results: The results showed that an inverse relationship was found between the Oswestry Disability Index (ODI) and m. psoas major thickness (p<0.05). Given the comparison of right-left side muscle thicknesses, left side muscles were thicker (p<0.05). Comparing LMT between genders, muscle thicknesses were higher in males except for the right m. quadratus lumborum and left m. erector spinae transverse measurements (p<0.05).
Conclusions: In regard to inverse relationship between m. psoas major thickness and ODI, m. psoas major should be taken into consideration to alleviate the disability caused by LBP. Additionally, the difference on both sides is likely one of the causes of muscle imbalance, and this might be one of the reasons for LBP, thereby causing disability in daily tasks due to LBP.

References

  • 1. Bento TPF, Genebra CV dos S, Maciel NM, Cornelio GP, Simeão SFAP, Vitta A de. Low back pain and some associated factors: is there any difference between genders? Braz J Phys Ther. 2020; 24(1):79-87.
  • 2. Hoy D, March L, Brooks P, Blyth F, Woolf A, Bain C, et al. The global burden of low back pain: Estimates from the Global Burden of Disease 2010 study. Ann Rheum Dis. 2014; 73:968-74.
  • 3. Hoy D, Brooks P, Blyth F, Buchbinder R. The Epidemiology of low back pain. Best Pract Res Clin Rheumatol. 2010; 24(6):769–81.
  • 4. Vos T, Allen C, Arora M, Barber RM, Brown A, Carter A, et al. Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015. The Lancet. 2016; 388(10053): 1545-602.
  • 5. Tavee JO, Levin KH. Low Back Pain. CONTINUUM Lifelong Learning in Neurology. 2017; 23(2): 467–86.
  • 6. Roussouly P, Pinheiro-Franco JL. Sagittal parameters of the spine: biomechanical approach. European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society. 2011; 20(5):578.
  • 7. Cho I, Jeon C, Lee S, Lee D, Hwangbo G. Effects of lumbar stabilization exercise on functional disability and lumbar lordosis angle in patients with chronic low back pain. J Phys Ther Sci. 2015; 27(6):1983-5.
  • 8. Chun SW, Lim CY, Kim K, Hwang J, Chung SG. The relationships between low back pain and lumbar lordosis: a systematic review and meta-analysis. Spine Journal. 2017; 17(8):1180–91.
  • 9. Lim JH. Correlations of Symmetry of the Trunk Muscle Thickness by Gender with the Spinal Alignment in Healthy Adults. The Journal of Korean Society of Physical Therapy. 2013; 25(6):405-10.
  • 10. Koppenhaver S, Gaffney E, Oates A, Eberle L, Young B, Hebert J, et al. Lumbar muscle stiffness is different in individuals with low back pain than asymptomatic controls and is associated with pain and disability, but not common physical examination findings. Musculoskelet Sci Pract. 2020; 45:102078.
  • 11. Masaki M, Aoyama T, Murakami T, Yanase K, Ji X, Tateuchi H, et al. Association of low back pain with muscle stiffness and muscle mass of the lumbar back muscles, and sagittal spinal alignment in young and middle-aged medical workers. Clinical Biomechanics. 2017; 49:128–33.
  • 12. Reeves NP, Cholewicki J, Silfies SP. Muscle activation imbalance and low-back injury in varsity athletes. Journal of Electromyography and Kinesiology. 2006; 16(3): 264-72.
  • 13. Singh R, Yadav SK, Sood S, Yadav RK, Rohilla R. Magnetic resonance imaging of lumbar trunk parameters in chronic low backache patients and healthy population: a comparative study. European Spine Journal. 2016; 25(9):2864–72.
  • 14. Goubert D, De Pauw R, Meeus M, Willems T, Cagnie B, Schouppe S, et al. Lumbar muscle structure and function in chronic versus recurrent low back pain: a cross-sectional study. Spine Journal. 2017; 17(9):1285–96.
  • 15. Menezes-Reis R, Bonugli GP, Salmon CEG, Mazoroski D, Da Silva Herrero CFP, Nogueira-Barbosa MH. Relationship of spinal alignment with muscular volume and fat infiltration of lumbar trunk muscles. PLoS One. 2018; 13(7): e0200198.
  • 16. Ghamkhar L, Kahlaee AH. Trunk Muscles Activation Pattern During Walking in Subjects With and Without Chronic Low Back Pain: A Systematic Review. PM and R. 2015; 7(5):519-526.
  • 17. Jun HS, Kim JH, Ahn JH, Chang IB, Song JH, Kim TH, et al. The Effect of Lumbar Spinal Muscle on Spinal Sagittal Alignment: Evaluating Muscle Quantity and Quality. Neurosurgery. 2016; 79(6):847-55.
  • 18. Tatsumi M, Mkoba EM, Suzuki Y, Kajiwara Y, Zeidan H, Harada K, et al. Risk factors of low back pain and the relationship with sagittal vertebral alignment in Tanzania. BMC Musculoskelet Disord. 2019; 20(1):1–5.
  • 19. Wallwork TL, Stanton WR, Freke M, Hides JA. The effect of chronic low back pain on size and contraction of the lumbar multifidus muscle. Man Ther. 2009; 14(5):496-500.
  • 20. Masaki M, Aoyama T, Murakami T, Yanase K, Ji X, Tateuchi H, et al. Association of low back pain with muscle stiffness and muscle mass of the lumbar back muscles, and sagittal spinal alignment in young and middle-aged medical workers. Clinical Biomechanics. 2017; 49:128–33.
  • 21. Yakut E, Düger T, Öksüz C, Yörükan S, Ureten K, Turan D, et al. Validation of the Turkish version of the Oswestry Disability Index for patients with low back pain. Spine (03622436). 2004; 29(5): 581-5.
  • 22. Ling W. Physical Therapy Research: Principles and Applications, ed 2. Phys Ther. 2001; 81(11):1843.
  • 23. ShahAli S, Shanbehzadeh S, ShahAli S, Ebrahimi Takamjani I. Application of Ultrasonography in the Assessment of Abdominal and Lumbar Trunk Muscle Activity in Participants with and Without Low Back Pain: A Systematic Review. J Manipulative Physiol Ther. 2019; 42(7):541–50.
  • 24. Seyedhoseinpoor T, Taghipour M, Dadgoo M, Sanjari MA, Takamjani IE, Kazemnejad A, et al. Alteration of lumbar muscle morphology and composition in relation to low back pain: a systematic review and meta-analysis. Spine Journal. 2022; 22(4):660-76.
  • 25. Vlaeyen JWS, Maher CG, Wiech K, Van Zundert J, Meloto CB, Diatchenko L, et al. Low back pain. Nat Rev Dis Primers. 2018; 4(1):1–18.
  • 26. Palacios-Ceña D, Albaladejo-Vicente R, Hernández-Barrera V, Lima-Florencio L, Fernández-de-Las-Peñas C, Jimenez-Garcia R, et al. Female Gender Is Associated with a Higher Prevalence of Chronic Neck Pain, Chronic Low Back Pain, and Migraine: Results of the Spanish National Health Survey, 2017. Pain Med. 2021;22(2):382–95.
  • 27. Ferrari S, Vanti C, Pellizzer M, Dozza L, Monticone M, Pillastrini P. Is there a relationship between self-efficacy, disability, pain and sociodemographic characteristics in chronic low back pain? A multicenter retrospective analysis. Arch Physiother. 2019;9(1):1–9.
  • 28. Oddsson LIE, De Luca CJ. Activation imbalances in lumbar spine muscles in the presence of chronic low back pain. J Appl Physiol. 2003;94(4):1410–20.
  • 29. Smyers Evanson A, Myrer JW, Eggett DL, Mitchell UH, Johnson AW. Multifidus Muscle Size and Symmetry in Ballroom Dancers with and without Low Back Pain. Int J Sports Med. 2018; 39(08): 630-5.
  • 30. Kamaz M, Kireşi D, Oǧuz H, Emlik D, Levendoǧlu F. CT measurement of trunk muscle areas in patients with chronic low back pain. Diagnostic and Interventional Radiology. 2007;13(3):144–8.
  • 31. Christophy M, Senan NAF, Lotz JC, O’Reilly OM. A Musculoskeletal model for the lumbar spine. Biomech Model Mechanobiol. 2012;11(1–2):19–34.
There are 31 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Articles
Authors

Ali Cihan Dağlı 0000-0003-2442-0520

Serkan Öner 0000-0002-7802-880X

Zülal Öner 0000-0003-0459-1015

Beyza Yazgan Dağlı 0000-0001-6169-1800

Publication Date October 20, 2023
Acceptance Date August 15, 2023
Published in Issue Year 2023 Volume: 15 Issue: 3

Cite

APA Dağlı, A. C., Öner, S., Öner, Z., Yazgan Dağlı, B. (2023). An MRI Analysis of The Lumbar Lordosis Angle and Lumbar Muscle Thicknesses in Patients with Non-Specific Low Back Pain. Konuralp Medical Journal, 15(3), 294-301. https://doi.org/10.18521/ktd.1210087
AMA Dağlı AC, Öner S, Öner Z, Yazgan Dağlı B. An MRI Analysis of The Lumbar Lordosis Angle and Lumbar Muscle Thicknesses in Patients with Non-Specific Low Back Pain. Konuralp Medical Journal. October 2023;15(3):294-301. doi:10.18521/ktd.1210087
Chicago Dağlı, Ali Cihan, Serkan Öner, Zülal Öner, and Beyza Yazgan Dağlı. “An MRI Analysis of The Lumbar Lordosis Angle and Lumbar Muscle Thicknesses in Patients With Non-Specific Low Back Pain”. Konuralp Medical Journal 15, no. 3 (October 2023): 294-301. https://doi.org/10.18521/ktd.1210087.
EndNote Dağlı AC, Öner S, Öner Z, Yazgan Dağlı B (October 1, 2023) An MRI Analysis of The Lumbar Lordosis Angle and Lumbar Muscle Thicknesses in Patients with Non-Specific Low Back Pain. Konuralp Medical Journal 15 3 294–301.
IEEE A. C. Dağlı, S. Öner, Z. Öner, and B. Yazgan Dağlı, “An MRI Analysis of The Lumbar Lordosis Angle and Lumbar Muscle Thicknesses in Patients with Non-Specific Low Back Pain”, Konuralp Medical Journal, vol. 15, no. 3, pp. 294–301, 2023, doi: 10.18521/ktd.1210087.
ISNAD Dağlı, Ali Cihan et al. “An MRI Analysis of The Lumbar Lordosis Angle and Lumbar Muscle Thicknesses in Patients With Non-Specific Low Back Pain”. Konuralp Medical Journal 15/3 (October 2023), 294-301. https://doi.org/10.18521/ktd.1210087.
JAMA Dağlı AC, Öner S, Öner Z, Yazgan Dağlı B. An MRI Analysis of The Lumbar Lordosis Angle and Lumbar Muscle Thicknesses in Patients with Non-Specific Low Back Pain. Konuralp Medical Journal. 2023;15:294–301.
MLA Dağlı, Ali Cihan et al. “An MRI Analysis of The Lumbar Lordosis Angle and Lumbar Muscle Thicknesses in Patients With Non-Specific Low Back Pain”. Konuralp Medical Journal, vol. 15, no. 3, 2023, pp. 294-01, doi:10.18521/ktd.1210087.
Vancouver Dağlı AC, Öner S, Öner Z, Yazgan Dağlı B. An MRI Analysis of The Lumbar Lordosis Angle and Lumbar Muscle Thicknesses in Patients with Non-Specific Low Back Pain. Konuralp Medical Journal. 2023;15(3):294-301.