Response to Comments on "Correlation between Radiologic Sign of Lumbar Lordosis and Functional Status in Patients with Chronic Mechanical Low Back Pain"

No abstract available.

Response to "Commentary on Lumbar Lordosis in Chronic Mechanical Back Pain"

No abstract available.

Correlation between Degree of Radiologic Signs of Osteoarthritis and Functional Status in Patients with Chronic Mechanical Low Back Pain

Background: Osteoarthritis is the most intervening factors in producing mechanical low back pain (LBP). We aimed to evaluate the correlation between radiologic signs of osteoarthritis and functional status in patients with chronic mechanical LBP. Methods: Severity of osteoarthritis and disability were evaluated with Kellgren and Lawrence Grading Scale (K&L) by simple lumbar X-ray and Oswestry Disability Questionnaire (ODQ) respectively. Results: Although there was no significant correlation between ODQ and K&L score in general, the correlation was seen in female group (P = 0.024, r = 0.207). Conclusions: Mechanical LBP provides more disability in females suffering from more advanced osteoarthritis.

Correlation between Radiologic Sign of Lumbar Lordosis and Functional Status in Patients with Chronic Mechanical Low Back Pain

STUDY DESIGN: A cross-sectional study. PURPOSE: To describe the correlation between lumbar lordosis angle and functional status of patients with chronic mechanical low back pain (CMLBP). OVERVIEW OF LITERATURE: There are different and conflicting opinions regarding the relationship between the degree of lumbar lordosis and functional status of patients with low back pain. Nonetheless, the severity of lordosis is still one of the routine physical exams considered in rehabilitation clinics. METHODS: The degree of lumbar lordosis of 150 patients with CMLBP was measured by means of Cobb's method using sagittal standing spinal radiographs. Subjects with probable secondary causes of low back pain (trauma, congenital anomaly, spinal infection, rheumatologic problems and history of spinal surgery) were excluded. Besides recording demographic data, their score of functional disability was estimated using Oswestry Disability Questionnaire, one of the most useful and reliable questionnaires. Comparison between these data was made regarding different age and gender groups. RESULTS: In this study, 119 subjects were female and 31 male, with an age range of 19-85 years. The average degree of lumbar lordosis was 44.69+/-11.43 and that of Oswestry disability index (ODI) 30.52%. Although we found a significant direct relationship between age and degree of lumbar lordosis (Pearson's correlation coefficient, p=0.016, r=0.197), while insignificant correlation was seen between the degree of lumbar lordosis and ODI (p=0.129). CONCLUSIONS: There was no significant correlation between the degree of lumbar lordosis and the score of functional disability with regards to different age groups and gender.

Diagnostic accuracy of magnetic resonance angiography for detection of intracranial aneurysms in patients with acute subarachnoid hemorrhage; a comparison to digital subtraction angiography

Objectives: To determine the diagnostic accuracy of magnetic resonance angiography [MRA] compared to intra-arterial digital subtraction angiography [DSA] in detection of intracranial aneurysms in those suffering from acute subarachnoid hemorrhage [SAH]

Methods: This observational diagnostic study was performed at a tertiary teaching hospital and reference center in Shiraz, Iran. We included 55 patients who presented to our center with the diagnosis of acute SAH. All the patients underwent MRA and DSA during their hospital course in order to detect the intracranial aneurysms. The time-of-flight MRA protocol was used and the results were compared to the results of DSA as the gold standard test. Sensitivity, specificity, positive predictive value [PPV] and negative predictive value [NPV] were calculated for MRA

Results: The mean age of the patients was 46.3 +/- 7.9 including 26 [47.3%%] men and 29 [52.7%] women. In 46 patients, 51 intracranial aneurysms were diagnosed by DSA [5 patients had two aneurysms]. No evidence of intracranial aneurysm was found in 9 patients with subarachnoid hemorrhage. MRA correctly identified 42 of the 51 aneurysms [sensitivity 82%] and missed 9 small aneurysms [less than 10 mm]. MRA revealed one false-positive finding, resulting in a specificity of 88.8%. The PPG and NPV for MRA were 97% and 47%, respectively. The diagnostic accuracy per aneurysm was 0.83 for MRA

Conclusion: High sensitivity and specificity of MRA compared to DSA in diagnosis of intracranial aneurysms in those with acute SAH indicate that MRA could be reliably used as a diagnostic tool for this purpose. However we cannot recommend it as a routine substitute for DSA before surgery