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Objective：The Japanese Orthopaedic Association Low Back Pain Evaluation Questionnaire (JOABPEQ) consists of 25 questions, which allows for the multifaceted evaluation of patients with low back pain. In this study, we aimed to investigate whether the JOABPEQ could be used to construct a regression model to quantify low back pain, lower limb symptoms, and hip range of motion (ROM) in patients with lumbar spinal stenosis.Methods：We evaluated 115 patients with lumbar spinal stenosis scheduled to undergo surgery at our hospital. We measured the degrees of low back pain, lower leg pain, and lower leg numbness using the visual analog scale before the surgery. In addition, we measured the ROM of the hip joint during flexion, external rotation, and internal rotation. All responses of the JOABPEQ and physical function data were subjected to a partial least-squares (PLS) regression analysis.Results：Low back pain, lower limb pain, lower limb numbness, and hip ROM during flexion could each be used for significant regression models with JOABPEQ items. However, the hip ROMs during external and internal rotation could not be used for regression models with the JOABPEQ.Conclusion：On the basis of the results of the PLS regression analysis in this study, the degree of pain symptoms in patients with lumbar spinal stenosis may be quantified with the JOABPEQ items. Furthermore, the flexion angle of the hip ROM was quantified using the JOABPEQ items. The results of this study may indicate an effective means for establishing treatment plans for physical therapy.
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Objective：The Japanese Orthopaedic Association Low Back Pain Evaluation Questionnaire (JOABPEQ) consists of 25 questions, which allows for the multifaceted evaluation of patients with low back pain. In this study, we aimed to investigate whether the JOABPEQ could be used to construct a regression model to quantify low back pain, lower limb symptoms, and hip range of motion (ROM) in patients with lumbar spinal stenosis.Methods：We evaluated 115 patients with lumbar spinal stenosis scheduled to undergo surgery at our hospital. We measured the degrees of low back pain, lower leg pain, and lower leg numbness using the visual analog scale before the surgery. In addition, we measured the ROM of the hip joint during flexion, external rotation, and internal rotation. All responses of the JOABPEQ and physical function data were subjected to a partial least-squares (PLS) regression analysis.Results：Low back pain, lower limb pain, lower limb numbness, and hip ROM during flexion could each be used for significant regression models with JOABPEQ items. However, the hip ROMs during external and internal rotation could not be used for regression models with the JOABPEQ.Conclusion：On the basis of the results of the PLS regression analysis in this study, the degree of pain symptoms in patients with lumbar spinal stenosis may be quantified with the JOABPEQ items. Furthermore, the flexion angle of the hip ROM was quantified using the JOABPEQ items. The results of this study may indicate an effective means for establishing treatment plans for physical therapy.
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BACKGROUND: Blood oxygenation level dependent functional MRI (BOLD-fMRI) has proven to be a powerful tool for studying the functional change of the brain. In task-state fMRI study, the functional reorganization of sensory and motor cortex has been observed in patients with cervical spondylotic myelopathy. OBJECTIVE: To discuss the correlations between task-state fMRI measurements with clinical symptoms and surgical outcomes of cervical spondylotic myelopathy. METHODS: Eighty-two patients with cervical spondylotic myelopathy undergoing posterior cervical decompression (cervical spondylotic myelopathy group) and forty-five healthy volunteers (normal group) were recruited from January 2018 to January 2019. All subjects underwent fMRI and performed a finger-tapping paradigm with the right hand. The Japanese Orthopaedic Association score was used to evaluate the function of the spinal cord. Japanese Orthopaedic Association score recovery rate less than 50% was defined as a poor result. RESULTS AND CONCLUSION: (1) Japanese Orthopaedic Association score was significantly improved after surgery in the cervical spondylotic myelopathy group compared with that before surgery (P 0.05). Before surgery, VOA ratio (left precentral gyrus/left postcentral gyrus) was significantly higher in the cervical spondylotic myelopathy group than in normal group (P 0.05). VOA ratio was significantly decreased compared with that preoperatively (P < 0.05). (4) Correlation analysis revealed that the VOA in the left precentral gyrus and left postcentral gyrus and VOA ratio were significantly correlated with preoperative Japanese Orthopaedic Association score and postoperative Japanese Orthopaedic Association score recovery rate (P < 0.05). The absolute value of correlation coefficient of VOA ratio with preoperative Japanese Orthopaedic Association score and postoperative recovery rate was largest. (5) Receiver operating characteristic curve analysis showed that the area under the curve value for the VOA ratio was 0.803, indicating strong predictive discrimination, and the cut-off value was 3.621. The area under the curve value for Japanese Orthopaedic Association score was 0.751, and the cut-off value was 8. The predictive effect of VOA ratio was higher than Japanese Orthopaedic Association score. (6) The results indicate that the VOA in the left precentral gyrus and left postcentral gyrus was negatively correlated with severity of clinical symptoms (Japanese Orthopaedic Association score). Preoperative VOA ratio can effectively predict the recovery of spinal cord function after operation in patients with cervical spondylotic myelopathy.
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Objective To observe the clinical efficacy of acupuncture plus activator method chiropractic technique (AMCT) in treating lumbar facet joint disorders.Method A total of 40 patients with lumbar facet joint disorders were randomized into a treatment group and a control group, 20 cases in each group. The treatment group was intervened by acupuncture plus AMCT, while the control group was treated with AMCT alone. The Visual Analogue Scale (VAS) and Japanese Orthopaedic Association (JOA) were observed in the two groups before and after 3 treatment sessions, and the clinical efficacies were compared between the two groups.Result The VAS score and JOA score were significantly changed right after the 1st treatment and after 3 treatment sessions in the two groups (P<0.05). Right after the 1st treatment and after 3 treatment sessions, there were statistically significant differences in the VAS score and JOA score between the two groups (P<0.05). The total effective rate was 90.0% in the treatment group versus 60.0% in the control group, and the difference was statistically significant (P<0.05). The relapse rate was 22.2% in the treatment group versus 50.0% in the control group 3 months after the treatment, and the difference was statistically significant (P<0.05).Conclusion Acupuncture plus AMCT is an effective approach in treating lumbar facet joint disorders.
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OBJECTIVE: It is important to develop an easy means of diagnosing lumbar foraminal stenosis (LFS) in a general practice setting. We investigated the use of the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ) to diagnose LFS in symptomatic patients. METHODS: Subjects included 13 cases (mean age, 72 years) with LFS, and 30 cases (mean age, 73 years) with lumbar spinal canal stenosis (LSCS) involving one intervertebral disc. The visual analogue scale score for low back pain and leg pain, the JOABPEQ were evaluated. RESULTS: Those with LFS had a significantly lower JOA score (p<0.001), while JOABPEQ scores (p<0.05) for lumbar dysfunction and social functioning impairment (p<0.01) were both significantly lower than the scores in LSCS. The following JOABPEQ questionnaire items (LFS vs. LSCS, p-value) for difficulties in: sleeping (53.8% vs. 16.6%, p<0.05), getting up from a chair (53.8% vs. 6.6%, p<0.001), turning over (76.9% vs. 40%, p<0.05), and putting on socks (76.9% vs. 26.6%, p<0.01) such as pain during rest, and signs of intermittent claudication more than 15 minutes (61.5% vs. 26.6%, p<0.05) were all significantly more common with LFS than LSCS. CONCLUSION: Results suggest that of the items in the JOABPEQ, if pain during rest or intermittent claudication is noted, LFS should be kept in mind as a cause during subsequent diagnosis and treatment. LFS may be easily diagnosed from LSCS using this established patient-based assessment method.
Subject(s)
Humans , Asian People , Back Pain , Constriction, Pathologic , Diagnosis , General Practice , Intermittent Claudication , Intervertebral Disc , Leg , Low Back Pain , Methods , Spinal CanalABSTRACT
10.3969/j.issn.2095-4344.2013.26.014
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BACKGROUND:Navigation assisted minimal y invasive posterior lumbar interbody fusion and pedicle screw fixation can precisely real-time guide a variety of operation under minimal y invasive sleeve, and implant the pedicle screws and interbody fusion cage and other implants safely and accurately, thus can determine the decompression parts. Minimal y invasive transforaminal lumbar interbody fusion is the typical approach in recent years for the successful application of minimal y invasive spine surgery techniques with the advantages of smal incision, less bleeding, slight tissue damage and faster recovery. OBJECTIVE:To evaluate the short-term effect of minimal y invasive transforaminal lumbar interbody fusion with real-time three-dimensional navigation system and open posterior transforaminal lumbar interbody fusion. METHODS:Forty cases with single-level lumbar disc herniation were retrospectively analyzed. The patients were treated with minimal y invasive transforaminal lumbar interbody fusion with real-time three-dimensional navigation system (20 cases) and open posterior transforaminal lumbar interbody fusion (20 cases) respectively for the comparative analysis. The fusion duration, intraoperative blood loss, postoperative drainage volume, the length of postoperative hospital stay and the length of hospital stay were compared between two groups. The wound pain and function were evaluated after treatment with visual analogue scale score and Japanese Orthopaedic Association score. RESULTS AND CONCLUSION:Al patients were fol owed-up for 7.7 months. The operative duration in the minimal y invasive transforaminal lumbar interbody fusion group was longer than that in the open posterior transforaminal lumbar interbody fusion group, and the difference was significant (P0.05).The results indicate that minimal y invasive transforaminal lumbar interbody fusion with real-time three-dimensional navigation system is an effective method for lumbar disc herniation with the advantages of less intraoperative blood loss, less postoperative drainage volume, smal trauma, short hospital stay and short-term efficacy.
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Progressive myelopathies can be secondary to inborn errors of metabolism (IEM) such as mucopolysaccharidosis, mucolipidosis, and adrenomyeloneuropathy. The available scale, Japanese Orthopaedic Association (JOA) score, was validated only for degenerative vertebral diseases. Our objective is to propose and validate a new scale addressing progressive myelopathies and to present validating data for JOA in these diseases. A new scale, Severity Score System for Progressive Myelopathy (SSPROM), covering motor disability, sphincter dysfunction, spasticity, and sensory losses. Inter- and intra-rater reliabilities were measured. External validation was tested by applying JOA, the Expanded Disability Status Scale (EDSS), the Barthel index, and the Osame Motor Disability Score. Thirty-eight patients, 17 with adrenomyeloneuropathy, 3 with mucopolysaccharidosis I, 3 with mucopolysaccharidosis IV, 2 with mucopolysaccharidosis VI, 2 with mucolipidosis, and 11 with human T-cell lymphotropic virus type-1 (HTLV-1)-associated myelopathy participated in the study. The mean ± SD SSPROM and JOA scores were 74.6 ± 11.4 and 12.4 ± 2.3, respectively. Construct validity for SSPROM (JOA: r = 0.84, P < 0.0001; EDSS: r = -0.83, P < 0.0001; Barthel: r = 0.56, P < 0.002; Osame: r = -0.94, P < 0.0001) and reliability (intra-rater: r = 0.83, P < 0.0001; inter-rater: r = 0.94, P < 0.0001) were demonstrated. The metric properties of JOA were similar to those found in SSPROM. Several clinimetric requirements were met for both SSPROM and JOA scales. Since SSPROM has a wider range, it should be useful for follow-up studies on IEM myelopathies.
Subject(s)
Adolescent , Adult , Child , Female , Humans , Male , Middle Aged , Young Adult , Disability Evaluation , Severity of Illness Index , Spinal Cord Diseases/diagnosis , Observer Variation , Spinal Cord Diseases/etiologyABSTRACT
@#Objective To explore the relationship between the somatosensory evoked potential (SEP) diversification during operation and the short term outcome of ossification of posterior longitudinal ligament (OPLL) of cervical spine. Methods 70 OPLL inpatients from February 2008 to February 2011were included in this study. All patients received anterior cervical operation. According to the diversification of the SEP during surgery, the patients were divided into 2 groups. The preoperative and postoperative JOA scores of the OPLL patients were collected. Results There were 35 patients in the SEP no change group and 30 in SEP improved group. There was no difference in the preoperative JOA scores between them (P>0.05), but was significantly different in the postoperative JOA scores (P>0.05). Conclusion There is some relationship between the SEP diversification during operation and the short term outcome of OPLL of cervical spine.