Lateral bending differentiates early-stage spondylolysis from nonspecific low back pain in adolescents
Shiro Sugiura1, Yasuchika Aoki2, Takeshi Toyooka3
1Nishikawa Orthopedics Clinic, Chiba, Japan; Department of Bioenvironmental Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan.
Background:
Early-stage spondylolysis (ESS) is one of the common causes of acute low back pain (LBP) in adolescents. Although accurate diagnosis of ESS is important for providing appropriate treatment, differentiating ESS from other low back disorders is difficult by physical signs alone.
Objectives:
To elucidate the most common characteristic, namely, motion-provoking LBP, in patients with ESS.
Design:
Retrospective comparative cohort study.
Method:
We included and categorized adolescents (n = 112; age, <18 years) with acute LBP (<1 month) into the ESS (n = 71) and nonspecific LBP (NS-LBP) (n = 41) groups based on magnetic resonance imaging (MRI) findings. Patients were evaluated using a visual analog scale (VAS), Oswestry Disability Index (ODI), and degree of pain using a numerical rating scale (NRS) provoked by hyperextension, hyperflexion, right and left rotations, and lateral bending in standing position.; the value were compared between the 2 groups. A cut-off value of significance was obtained using receiver operating characteristic (ROC) analysis.
Results:
The mean scores for VAS and ODI and NRS of each test were as follows (ESS/NS-LBP): VAS, 6.5/6.0; ODI, 19.7/24.6; hyperextension, 4.1/4.1; hyperflexion, 2.4/3.0; rotation, 2.1/2.2; and lateral bending, 2.9/2.2. The ESS group had a significantly greater number of LBP cases provoked by lateral bending than the NS-LBP group. A cut-off lateral bending of 3.5 yielded a diagnosis of ESS.
Conclusions:
Our results indicate that lateral bending is the greatest motion-provoking characteristic of LBP in patients with ESS.
More Related Videos
12:25C-arm-Free Simultaneous OLIF51 and Percutaneous Pedicle Screw Fixation in a Single Lateral Position
Published on: September 16, 2022
07:44Evaluation of Patients' Posture and Gait Profile After Lumbar Fusion Surgery by Video Rasterstereography and Treadmill Gait Analysis
Published on: March 23, 2019
Related Concept Videos
01:16Vertebral Column: Regions and Curvature
Regions of the Vertebral Column
In an adult, the spine is subdivided into five regions: the cervical, the thoracic, the lumbar, the sacral, and the coccygeal region. The spine initially develops as a series of 33 vertebrae; after 20 years of age, the nine bones in the sacral region, five sacral, and four coccygeal bones fuse to form...
01:27Muscles of the Vertebral Column
Superficial Layer:
The superficial layer consists primarily of the splenius muscles, which include the splenius capitis and splenius cervicis. These muscles are mainly responsible for the head and cervical spine movements, including extension, rotation, and lateral bending. The splenius capitis...
01:12General Case of Eccentric Axial Loading
Consider a member subjected to equal and opposite forces that are applied along a line that does not coincide with the member's neutral axis. In unsymmetrical...