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Fulltext Codfish vertebra sign

Amin OS

BMJ Case Rep, 2017 Feb 28;2017.
PMID: 28246115 DOI: 10.1136/bcr-2016-219119
Matched MeSH terms: Low Back Pain/etiology
Fulltext Osteopoikilosis--a case report

Pan KL, Ibrahim S

Med J Malaysia, 2000 Sep;55 Suppl C:107-8.
PMID: 11200037

Osteopoikilosis is a rare, inheritable, sclerosing bone dysplasia; sometimes mistaken for osteoblastic bone metastases. We report a case in a 25 year-old lady.

Matched MeSH terms: Back Pain/etiology
Fulltext Anterior sacral meningocele

Samuel D, Puvaneswary M

Med J Malaysia, 1989 Sep;44(3):243-7.
PMID: 2533960

Anterior sacral meningocele is a rare congenital meningeal cyst herniating through a bony defect in the sacrum. Since its description by Bryant in 1837, only 154 cases have been reported in the world literature. The application of ultrasound and C.T. scan following myelography is discussed.

Matched MeSH terms: Back Pain/etiology
Myelopathy and Reactive Microgliosis and Astrogliosis in Equine Back Pain

Mayaki AM, Abdul Razak IS, Mohd Adzahan N, Mazlan M, Abdullah R

J Equine Vet Sci, 2020 07;90:103019.
PMID: 32534783 DOI: 10.1016/j.jevs.2020.103019

Equine chronic back pain (CBP) has been linked to different pathologic processes, which directly or indirectly involve spinal structures. Thus, making diagnosis and management very challenging with most horses with the condition recommended for early retirement from athletic activity. This study described the spinal cord lesions and the development of reactive microgliosis and astrocytosis in the spinal cords of horse with CBP. Thoracolumbar spinal cord segments from three horses euthanized because of unresolved CBP were dissected and grossly and histopathologically examined. The expression of activated microglia and astrocytes were demonstrated immunohistochemically using polyclonal rabbit anti-Iba-1 and anti-glial fibrillary acidic protein antibodies, respectively. All horses had radiological evidence of varying degrees of kissing spine involving six to nine vertebrae with the majority of the lesions graded between 2 and 5. Grossly, there was myelomalacia with intramedullary hemorrhages. The gray matters of the spinal cords were characterized by hemorrhagic malacic lesions with medullary disintegration. Reactive microgliosis and astrocytosis were evident in the spinal dorsal horns. White matter lesions include axonal swollen and/or loss, satellitosis, and varying degrees of dilation of myelin sheaths with some containing macrophages. In conclusion, the presence of reactive microgliosis and astrogliosis in the spinal dorsal horn indicates that they are possible precipitating factors in the development of equine CBP.

Matched MeSH terms: Back Pain/etiology
Backpack-back pain complexity and the need for multifactorial safe weight recommendation

Adeyemi AJ, Rohani JM, Abdul Rani MR

Appl Ergon, 2017 Jan;58:573-582.
PMID: 27132042 DOI: 10.1016/j.apergo.2016.04.009

The study analysed backpack-related back pain in school children by investigating the possibility of multiple interactions among causative factors, which may be responsible for the non-conclusive findings on the issue. Using data from 444 prepubescent schoolchildren, a mixed method design combining survey, observation and direct measurement strategies was implemented. Using a multivariate structural equation modelling approach, the study investigated interactions among anthropometry, posture, backpack volume, rating and back pain constructs, with each construct made of 2-4 indicators. Additionally, regression analysis was used to determine the feasibility of considering the two additional factors of age and body mass index along with the globally accepted recommendation of a load of 10-15% of body weight. Our model demonstrated an acceptable model fit and revealed direct and indirect effects of the factors. Obese children were recommended to carry a one-third lighter load than other children. The application of systematic/multiple strategies provided an explanation for some of the issues associated with school children's backpack-related back pain.

Matched MeSH terms: Back Pain/etiology*
Histoplasmosis presenting with progressively worsening backache--a case report

Lachmanan SR, Haniza O, Hisham AN, Subramaniam J, Merican I

Ann Acad Med Singap, 2001 Nov;30(6):656-8.
PMID: 11817299

INTRODUCTION: Bilateral adrenal enlargement is often the result of disseminated malignant disease, and this diagnosis is particularly likely in a patient with severe weight loss. We describe a case with bilateral adrenal enlargement presenting with progressively worsening backache as a prominent symptom.
CLINICAL PICTURE: A 55-year-old man presented with intermittent low back pain which was progressively worsening, fever, anorexia, low back pain and a 10-kg weight loss. He had underlying diabetes mellitus and ischaemic heart disease. He gave a history of travel to caves for worship. Clinically, the most significant findings included nodular lesions in the anterior fauces and left palatoglossal region. Computed tomographic scan revealed bilateral adrenal masses. Biopsies were taken from the palatal nodules, which revealed histiocytes with numerous histoplasma organisms.
TREATMENT: He was commenced on itraconazole 200 mg daily for a period of 9 months. There was a dramatic initial response with settling of his fever and this was followed by subjective improvement in his well-being.
OUTCOME: He is presently on follow-up and has completed 9 months of itraconazole therapy with resolution of all his symptoms and has gained about 10 kg of weight.

Matched MeSH terms: Low Back Pain/etiology*
Fulltext The surgical outcome of degenerative lumbar spinal stenosis

Razak MA, Ong KP, Hyzan Y

Med J Malaysia, 1998 Sep;53 Suppl A:12-21.
PMID: 10968178

A retrospective study was conducted to assess the surgical outcomes of degenerative lumbar spinal stenosis. Twenty-five patients treated with decompressive surgery in Hospital Kuala Lumpur between January 1992 and August 1996 were reviewed. There were seven males and eighteen females. The average age was 51 years old (range 33 to 64 years old). The diagnosis of degenerative spinal stenosis was made based on the clinical features and was confirmed by radiographic findings. Ninety two percent of the patients had moderate to severe symptoms preoperatively. The types of surgery consisted of laminectomy (n = 15), laminotomy (n = 10), and laminoplasty (n = 1). The surgical outcomes were assessed based on patients' own assessment of symptoms relieved and functional returned to daily activities at least six months after the surgery. The average follow-up period was fifteen months (range 6 months to 42 months). Of these twenty-five patients, 4 (16%) claimed to have excellent results, 11 (44%) had good results, 8 (32%) reported fair, and 2 (8%) judged their surgical treatment as poor with little or no use. There was no anaesthetic, cardiovascular, or thromboembolic complications seen in this study. Four patients had recurrent claudication, one demonstrated localised arachnoiditis, and two had lumbar instability which were not documented preoperatively. One patient had L4 nerve root avulsion with dura torn and another patient had superficial wound infection. We concluded in this study that decompressive surgery offers satisfactory results in patients with moderate to severe degenerative spinal stenosis in short term follow-up.

Matched MeSH terms: Low Back Pain/etiology
Fulltext Incidence of back pain after lumbar epidural anaesthesia for non-obstetric surgery--a preliminary report

Chan ST

Med J Malaysia, 1995 Sep;50(3):241-5.
PMID: 8926902

This prospective survey attempt to study the incidence of post-operative back pain after lumbar epidural anesthesia for non-obstetric patterns and the correlation of this symptom with various contributing factors. One hundred and five patients who were given lumbar epidural anaesthesia as the sole anaesthesia for non-obstetric surgery were studied. The choice of equipment, number of attempts at giving the injection, duration of surgery and position of patient during surgery were documented. One week post-operatively, the patients were asked whether they recalled any back pain. The nature, duration and severity of the back pain was documented. Statistical analysis was achieved by using Chi-squared test. Twenty-eight patients recalled "injection site tenderness" post-operatively. The pain was mild to moderate in severity and lasted up to 4 days. None of the studied patients had post-operative "backache". The pain showed no significant correlation with needle size, technique of injection, use of epidural catheter, patient's position during surgery, duration and number of attempts made during epidural injection.

Matched MeSH terms: Back Pain/etiology
Fulltext Spinal tuberculosis: a five-year review of cases at the National Tuberculosis Centre

Jalleh RD, Kuppusamy I, Mahayiddin AA, Yaacob MF, Yusuf NA, Mokhtar A

Med J Malaysia, 1991 Sep;46(3):269-73.
PMID: 1839924

We reviewed 31 cases (19 males and 12 females) of spinal tuberculosis seen at the National Tuberculosis Centre from 1985 to 1989. The mean age was 35.4 years. The predominant clinical feature was backache (90.3%), while neurological features were found in 30.9%. An elevated erythrocyte sedimentation rate (in 80.0%) and a positive Mantoux test (in 70.9%) served as useful investigations. Spinal x-ray was abnormal in all cases, the lumbar spine being most commonly involved. Bacteriological or histopathological confirmation was obtained in only 29.0% of cases. The mainstay of treatment was anti-tuberculous chemotherapy with surgery being performed in 41.9% of patients.

Matched MeSH terms: Back Pain/etiology
Fulltext Low back pain and association with whole body vibration among military armoured vehicle drivers in Malaysia

Rozali A, Rampal KG, Shamsul Bahri MT, Mohd Sidik S, Shamsul Azhar S, Khairuddin H, et al.

Med J Malaysia, 2009 Sep;64(3):197-204.
PMID: 20527267 MyJurnal

A cross sectional study was conducted among military armoured vehicle drivers in the two largest mechanized battalions with the objective to determine the prevalence of low back pain (LBP), and its association with whole body vibration (WBV) and other associated factors. A self-administered questionnaire and Human Vibration Meter were used in this study. A total of 159 respondents participated in this study and 102 (64.2%) of them were subjected to WBV measurement. One-hundred-and-seventeen respondents complained of LBP for the past 12 months giving a prevalence of 73.6%. The prevalence of LBP among tracked armoured vehicle drivers was higher (81.7%) as compared to wheeled armoured vehicle drivers (67.0%). The mean acceleration at Z-axis in tracked armoured vehicles (1.09 +/- 0.26 ms(-2)) and wheeled armoured vehicles (0.33 +/- 0.07 ms) were the dominant vibration directions. The mean estimated vibration dose value (eVDV) for eight-hour daily exposure at Z-axis (19.86 +/- 4.72 ms(-1.75)) in tracked armoured vehicles showed the highest estimation. Based on the European Vibration Directive (2002), the mean eVDV at Z-axis in tracked armoured vehicles exceeded exposure action value (EAV) (> 9.1 ms(-1.75), but did not exceed exposure limit value (ELV) (<21.0 ms(-1.75)). Logistic regression analysis revealed that only driving in forward bending sitting posture (OR = 3.63, 95% CI 1.06-12.42) and WBV exposure at X-axis (OR = 1.94, 95% CI 1.02-3.69) were significant risk factors to LBP. Preventive measures should be implemented to minimize risk of WBV and to improve ergonomic postures among drivers.

Matched MeSH terms: Low Back Pain/etiology*
Fulltext Haemorrhagic lumbar synovial cyst

Soon CK, Razak M

Med J Malaysia, 2001 Dec;56 Suppl D:57-60.
PMID: 14569769

Hemorrhagic lumbar synovial cysts are not commonly reported in English literature. Post-resection recurrence of synovial cyst is unusual and therefore recurrence symptoms required repeat MRI or CT scan. We reported a case of hemorrhagic lumbar synovial cyst presented with neurological deficit that recovered initially after surgery but subsequently developed recurrent of symptoms at a higher level due to fibrous tissue.

Matched MeSH terms: Back Pain/etiology
Recovery of H-Reflex with Transforaminal Epidural Steroid Injection in S1 Radiculopathy

Gunduz OH, Sencan S, Ercalik T, Suhaimi A

Pain Med, 2017 08 01;18(8):1594-1597.
PMID: 28087843 DOI: 10.1093/pm/pnw303
Matched MeSH terms: Back Pain/etiology
Fulltext Psycho-behavioural risks of low back pain in railway workers

Ganasegeran K, Perianayagam W, Nagaraj P, Al-Dubai SA

Occup Med (Lond), 2014 Jul;64(5):372-5.
PMID: 24727561 DOI: 10.1093/occmed/kqu039

BACKGROUND:
Low back pain (LBP) is the most costly ailment in the work force. Risky work behaviour and psychological stress are established risk factors.

AIMS:
To explore the associations between workplace risk factors, psychological stress and LBP among Malaysian railway workers.

METHODS:
A cross-sectional study was carried out on railway workers in Malaysia. Socio-demographics, workplace risk factors for LBP, perceived psychological stress and history of LBP over the previous month were obtained by direct interviews using a structured closed-ended questionnaire. Descriptive, bivariate and logistic regression analyses were conducted.

RESULTS:
There were 513 study participants (70% response rate). The prevalence of LBP in the previous month was 69%. Multivariate analysis yielded four significant predictors of LBP: employment of ≥ 10 years, lifting and lowering heavy loads, prolonged standing posture and psychological stress.

CONCLUSIONS:
The high prevalence of LBP and its significant associations with physical and psychological stress factors in railway workers points to an urgent need for preventive measures, particularly among workers in high-risk occupations.

Matched MeSH terms: Low Back Pain/etiology*
The Association between risk factors and low back pain among commercial vehicle drivers in peninsular Malaysia: a preliminary result

Tamrin SB, Yokoyama K, Jalaludin J, Aziz NA, Jemoin N, Nordin R, et al.

Ind Health, 2007 Apr;45(2):268-78.
PMID: 17485871

To determine the risk factors associated with complain of low back pain. A cross sectional study was done from June 2004 until August 2005. Seven hundred and sixty commercial vehicle drivers from 11 bus companies in central, northern and eastern regions in Malaysia participated in this study. Modified Nordic questionnaire was used to determine the prevalence of low back pain; Maestro human vibration meter was used to measure the personal R.M.S values of lateral, anterior-posterior and vertical axes. Modified Owas was used to assess the awkward posture of the driver torso namely, bending forward movement, leaning, sitting straight and twisting. Profile of Mood States (POMS) was used to evaluate the mood states of bus drivers with complain of low back pain. A high prevalence of low back pain (60.4%) among Malaysian commercial vehicle drivers was found. Logistic regression analysis controlling for age, income, education level and non occupational activities revealed that the following factors were related to low back pain: Tension-anxiety [1.080, 95% CI 1.041-1.121], depression dejection [1.047, 95% CI 1.023-1.072], anger-hostility [1.053, 95% CI 1.027-1.081], fatigue [1.132, 95% CI 1.089-1.177] and confusion [1.114, 95% CI 1.061-1.169] of POMS, length of employment [1.001, 95% CI 1.0-1.003], steering wheel adjustment [1.521, 95% CI 1.101-2.101], perception of exposing to vibration [1.943, 95% CI 1.389-2.719]. In conclusion, combinations of risks lead to high increase of low back pain complain among Malaysian bus drivers.

Matched MeSH terms: Low Back Pain/etiology
Fulltext The management of psoas abscess

Bajaj HN, Choong LT

Med J Malaysia, 1998 Sep;53 Suppl A:95-8.
PMID: 10968189

The presentation and management of psoas abscess was studied prospectively in 5 patients and retrospectively in 4. 3 patients had bilateral abscesses. All patients had back pain and a mass in loin or iliac fossa. 7 patients had no hip findings. One patient had a perinephric abscess and another had radiological features of tuberculosis of the spine. In the other seven no cause for the abscess could be identified. Ultrasonography demonstrated the abscess in all patients; CT scanning done in 5 patients was confirmatory. Drainage was done by an extraperitoneal route. Biopsy of the abscess wall in 2 patients demonstrated tuberculosis. They, the patient with TB spine and 3 others put empirically on anti-tuberculosis chemotherapy responded well. The perinephric abscess grew Pseudomonas sensitive to gentamycin, but she and two other patients died due to multiorgan failure.

Matched MeSH terms: Back Pain/etiology
Fulltext A rare cause of back pain and radiculopathy - spinal tophi: a case report

Wan SA, Teh CL, Jobli AT, Cheong YK, Chin WV, Tan BB

J Med Case Rep, 2019 Jan 08;13(1):8.
PMID: 30626451 DOI: 10.1186/s13256-018-1940-4

BACKGROUND: Gout is a monosodium urate deposition disease which is prevalent worldwide. The usual manifestations are crystal arthropathy and tophi deposition in the soft tissues. Spinal tophi may also occur and are rarely reported, resulting in various clinical manifestations such as back pain, spinal cord compression, radiculopathy, and even mimicking epidural abscess and spondylodiscitis.

CASE PRESENTATION: We report a case of a 42-year-old Chinese man with underlying gout who presented with back pain and radiculopathy. The diagnosis of spinal tophi was unsuspected and he was initially treated for epidural abscess and spondylodiscitis. He underwent a laminectomy and posterolateral fusion during which tophus material was discovered. He recovered and medications for gout were started.

CONCLUSION: Spinal tophi are rare. The diagnosis is difficult and spinal tophi may be mistaken for epidural abscess, spondylodiscitis, or neoplasm.

Matched MeSH terms: Back Pain/etiology*
Pregnancy-associated osteoporosis: a UK case series and literature review

Hardcastle SA, Yahya F, Bhalla AK

Osteoporos Int, 2019 May;30(5):939-948.
PMID: 30671611 DOI: 10.1007/s00198-019-04842-w

Mini Abstract: Pregnancy-associated osteoporosis (PAO) is a rare syndrome affecting women during late pregnancy and the early postpartum period. We set out to review the clinical features of ten cases of PAO from a single UK centre. Patients had attended the Royal National Hospital for Rheumatic Diseases, Bath (RNHRD) between January 2000 and June 2016. The principal criterion for inclusion was the occurrence of low trauma fractures either during pregnancy or the immediate post-partum period. Data were obtained from retrospective review of medical notes. Bone mineral density (BMD) was measured using dual-energy X-ray absorptiometry (Hologic ®Discovery system) at the lumbar spine and hip. Data pertaining to the pregnancy, as well as type and duration of treatment received, were reviewed. All ten cases presented with vertebral fractures. In four patients, no risk factors for fracture other than pregnancy or breastfeeding could be identified. Four patients were found to have vitamin D insufficiency at the time of diagnosis, and a further two patients had received treatment with low molecular weight heparin (LMWH). In one case, further investigation led to a diagnosis of osteogenesis imperfecta (OI) confirmed on genetic testing. In terms of treatment, eight out of the ten patients in this series received a bisphosphonate, most commonly risedronate due to its relatively short skeletal retention time. Clinicians should be aware of PAO, a rare but recognised complication of pregnancy. The condition should be especially considered in women presenting with new onset back pain in pregnancy or the postpartum period.

Matched MeSH terms: Back Pain/etiology

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