Journal of Back and Musculoskeletal Rehabilitation - Volume 36, issue 3

Authors: Yazici, Alikemal | Yerlikaya, Tuba | Oniz, Adile

Article Type: Research Article

Abstract: BACKGROUND: Although several studies have been conducted to determine the cause of low back pain (LBP), a sufficient correlation has not been found between research findings and symptoms. Therefore there seems to be a need for studies to explain the relationship between pain and morphological changes in the paraspinal muscles of patients with LBP through comparisons with healthy control subjects. OBJECTIVE: The aim of this study was to examine degeneration in the lumbar musculus multifidus (LMF) and lumbar musculus erector spinae (LES) muscles in patients with chronic LBP with non-radiculopathy lumbar disc herniation (LDH), patients with …mechanical LBP, and healthy individuals. METHODS: The study included 35 patients with mechanical LBP, 38 patients with non-radiculopathy LDH, and a control group of 36 healthy participants. In all patients and the control group, evaluations were made on axial magnetic resonance imaging slices at L3-S1 level of the LMF and LES cross-sectional areas (CSA), total CSA (TCSA = LMF+ LES), fat infiltrations and asymmetries. RESULTS: The mean CSA values of the right and left LMF and LES showed significant differences between the groups (p < 0.001, p = 0.002, p = 0.002, p = 0.010, respectively). Fat infiltrations showed a difference between the right-left LMF and left LES groups (p = 0.007, p < 0.001, p = 0.026, respectively). Asymmetry was not observed between the CSA and TCSA of the right and left sides. CONCLUSION: A correlation was found between fat infiltration in the LMF and mechanical LBP and LDH. However, no significant correlation was determined between LBP and the CSA and TCSA of the LMF and LES. This was thought to be due to an incorrect result of CSA and TCSA in the evaluation of muscle mass. Therefore, for a more accurate evaluation of muscle mass, it can be considered necessary to measure muscle atrophy associated with fat infiltration or functional CSA. Show more

Keywords: Low back pain, paraspinal muscles, intervertebral disc displacement, magnetic resonance imaging

DOI: 10.3233/BMR-220055

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 36, no. 3, pp. 637-650, 2023

Authors: Hinnekens, Simon | Bara, Julie | Scheen, Pauline | Hidalgo, Benjamin

Article Type: Research Article

Abstract: BACKGROUND: There is a sex-related difference in strength and endurance in trunk muscles: males have more strength while females have more endurance. OBJECTIVE: Investigate sex-related differences in motor control strategies in back muscles during isometric contractions (IC) in the Sorensen test posture. METHODS: Thirty-six healthy and young volunteers performed different tasks: three maximal voluntary contraction (MVC) tests recorded with a bio-feedback force sensor, and followed by five loaded IC (LIC) tests using bodyweight and loads of 0 to 8 kg with a 2-kg step. Surface electromyography was used to measure the activity of …bilateral lumbar paravertebral (LP) and quadratus lumborum (QL) muscles. RESULTS: Sex-related and load-related differences in EMG amplitudes were highlighted during LIC tests. Females showed significantly (p -value = 0.02) greater EMG amplitude for the highest load (8 kg) than males. Besides, significant differences between low (2 and 4 kg) and high (6 and 8 kg) loads for both LP and QL muscles and for both sexes were observed. Finally, for MVC tests, males produced significantly (p -value = 1.02e-4) greater strength during MVC tests (4.25 ± 1.37 N/kg vs 2.60 ± 0.78 N/kg). CONCLUSION: The results were clinically relevant to bring attention to load strategy during rehabilitation, particularly in females who seemed to recruit the QL muscle more. Show more

Keywords: Electromyography, motor control, back muscles, sexual dimorphism, sorensen test

DOI: 10.3233/BMR-220058

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 36, no. 3, pp. 651-660, 2023

Authors: Shin, Sun-Shil | An, Duk-Hyun | Yoo, Won-Gyu

Article Type: Research Article

Abstract: BACKGROUND: Sway-back posture in the sagittal profile is a commonly adopted poor standing posture. Although the terms, definitions, and adverse health problems of sway-back posture are widely used clinically, few studies have quantified sway-back posture. OBJECTIVE: To investigate spinal sagittal alignment in sway-back posture while standing based on global and regional angles using inertial measurement units (IMUs). METHODS: This cross-sectional study recruited 30 asymptomatic young adults. After measuring the sway angle while standing, the participants were divided into sway-back and non-sway-back groups (normal thoracic group). Each participant stood in a comfortable posture for …5 seconds with IMUs at the T1, T7, T12, L3, and S2 levels. Then, we measured the global and regional lumbar and thoracic angles and sacral inclination in the standing position. RESULTS: Although there was no difference in the global lumbar angle, there was a difference in regional lumbar angles between the two groups. The normal thoracic group had balanced lumbar lordosis between the upper and lower lordotic arcs, whereas the sway back group tended to have a flat upper lumbar angle and increased lower lumbar angle. CONCLUSION: It is useful to assess the global and regional angles in the spinal sagittal assessment of individuals with sway-back posture. Show more

Keywords: Assessment, lordosis, lumbar, posture, sway back

DOI: 10.3233/BMR-220072

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 36, no. 3, pp. 661-667, 2023

Authors: Takahiro, Fujimoto | Shigeharu, Tanaka

Article Type: Research Article

Abstract: BACKGROUND: The extent of asymmetry in the muscle tissue composition ratios with hip fractures has not been clarified. OBJECTIVE: To determine whether there is a difference in the muscle tissue composition ratios between the fractured and non-fractured sides of the trunk and thighs immediate measurement. METHODS: Forty-four patients (84.6 ± 7.0 years) were included. Computed tomography images were used for measurements. The muscle tissue composition ratio was measured using muscle cross-sectional area (CSA) and attenuation coefficient (Hounsfield units; HU). Defined each HU attenuation range as follows: low-density muscle (LDM), low-quality …muscle tissue with fat infiltration, normal-density muscle (NDM), muscle contractor tissue, and intramuscular adipose tissue (IMAT), fat infiltration tissue. The CSA of each muscle tissue was expressed as a percentage: %LDM, %NDM, and %IMAT. A paired t -test was performed for comparison. RESULTS: The %LDM on the fractured side was higher in the thigh and erector spinae. The %NDM on the fractured side was lower in the thigh. There was no significant difference in the %IMAT for all muscles. CONCLUSION: The thigh on the fractured side showed asymmetry with low %NDM and high %LDM. This characteristic captures a characteristic of muscle tissue that may have importance in hip fracture etiology. Show more

Keywords: Hip fractures, muscle tissue, adipose tissue, aged, computed tomography

DOI: 10.3233/BMR-220083

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 36, no. 3, pp. 669-676, 2023

Authors: El-Din Mahmoud, Lama Saad | El Meligie, Mohamed Magdy | Yehia, Radwa Mohammed

Article Type: Research Article

Abstract: BACKGROUND: The effectiveness of the muscle energy technique (MET) on postpartum meralgia paresthetica (MP) affecting the lateral femoral cutaneous nerve is unknown. OBJECTIVE: To investigate the effectiveness of the MET on postpartum MP affecting the lateral femoral cutaneous nerve. METHODS: In this randomized controlled trial, 30 patients with postpartum MP were randomly allocated to study and control groups. The study group received the MET with conventional therapeutic exercises and the control group received the conventional exercises alone for four weeks (thrice a week, for 30–40 minutes duration). Lateral femoral cutaneous nerve distal latency, …pain intensity, response to the prone knee bend (PKB) test and pelvic compression test were assessed. RESULTS: Patients allocated to the MET group had improvements compared to the controls in pain intensity (MD: - 1.66, 95%CI - 2.39 to - 0.94), distal latency (MD: - 0.66, 95%CI - 0.94 to - 0.36), and knee range of motion in the PKB test (MD: 19.5 ∘ , 95%CI 13 to 26.1) with high treatment effects, Cohen’s d –ES = 1.71 , 1.86 and 2.24 respectively. However, there was no between-group difference for the pelvic compression test (p = 0.41). CONCLUSION: The MET can reduce pain, distal latency, and increase the prone knee range of motion in women with MP affecting the lateral femoral cutaneous nerve. Show more

Keywords: Muscle energy technique, lateral femoral cutaneous nerve, distal latency, pain intensity, postpartum, pelvic compression test

DOI: 10.3233/BMR-220090

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 36, no. 3, pp. 677-684, 2023

Authors: Kim, Taegyu | Kim, Young Hoon | Park, Jae Myoung | Choi, Hokyung

Article Type: Research Article

Abstract: BACKGROUND: To maximize the ball velocity in the tennis sever, the shoulder plays a key role in the kinetic chain. But shoulder inefficiency leads to shoulder injuries such as shoulder impingement syndrome (SIS). Thus, to verify the scapular movements during the tennis serve could help prevent shoulder injury in tennis players. OBJECTIVE: This case-control study aimed to verify the scapular movements during flat first serve for elite tennis players with shoulder impingement syndrome compared to those without it. METHODS: Eight elite tennis players (4 males and 4 females) with SIS and 8 elite healthy …players (4 males and 4 females) performed flat first serves, and the three-dimensional scapular kinematic data was recorded using the Qualisys motion capture system through spherical reflective markers including the acromion marker cluster. RESULTS: The scapula was more internally rotated (median difference: 10.40 ∘ ) in the male players with SIS than in those without it at the maximally externally rotated humerothoracic joint during flat first serve, and female players with SIS (median difference: 7.16 ∘ and 11.28 ∘ , respectively) had more internally rotated scapula at the maximally externally rotated humerothoracic joint and ball impact. CONCLUSION: Increased scapular internal rotation may be something that affects shoulder injuries in the overhead sports, and it may help to prevent and rehabilitate overhead injuries including SIS. Show more

Keywords: Tennis, overhead activity, scapular, kinematic, shoulder injury

DOI: 10.3233/BMR-220096

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 36, no. 3, pp. 685-690, 2023

Authors: Paludo, Tatiane | Zardo, Franciele | de Mattos, Brenda Tubelo Pereira | Frata, Bruna | Ling, Chen Chai | de Castro Barroso, Gustavo | Cechetti, Fernanda

Article Type: Research Article

Abstract: BACKGROUND: In the motor rehabilitation of individuals with neurological disorders, including cerebral palsy (CP), Neurodevelopmental treatment (NDT) one of the most used approaches worldwide. OBJECTIVE: To verify muscle activation in NDT handling in individuals with severe CP using electromyography. METHODS: This was a controlled, cross-sectional, quantitative clinical trial. The individuals were evaluated using electromyography to analyze the muscular activation of the spinal erector, gluteus medius, rectus abdominis and multifidus during different NDT handling. We evaluated 59 individuals: 39 with spastic quadriparesis CP (Gross Motor Function Classification System, level IV–V) and 20 typically-developing individuals …(control group). These groups were homogeneous with respect to age and gender. RESULTS: There was a significant difference in muscle activation of the spinal erector, gluteus medius, rectus abdominis and multifidus in the six NDT handling used in this study: side-sitting for kneeling; supine for lateral decubitus, prone position for lateral decubitus, “sitting on horseback”, sitting on the roll, and proprioceptive stimulation sitting on the ball. CONCLUSION: The results show that all NDT handling analyzed in this study were effective for muscle activation of the spinal erector, gluteus medius, rectus abdominis and multifidus in individuals with severe spastic quadriparetic CP. Show more

Keywords: Cerebral palsy, electromyography, physical therapy, neurological rehabilitation, brain injury

DOI: 10.3233/BMR-220113

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 36, no. 3, pp. 691-700, 2023

Authors: Aicha, Ben Tekaya | Ahmed, Fendri | Seif, Boukriba | Ines, Mahmoud | Leila, Rouached | Selma, Bouden | Rawdha, Tekaya | Olfa, Saidane | Habiba, Mizouni | Leila, Abdelmoula

Article Type: Research Article

Abstract: BACKGROUND: A higher prevalence of cardiovascular risk was observed in spondyloarthritis (SpA). The relationship between disease-related factors structural damage and subclinical atherosclerosis is still unknown. OBJECTIVE: The aim of our study was to evaluate the association of subclinical atherosclerosis with radiographic structural damage in patients with SpA. METHODS: Forty-seven SpA patients who fulfilled the ASAS criteria were enrolled in a case-control study conducted over 12 months and compared with 47 age and sex-matched healthy controls. None of the subjects had a previous history of cardiovascular diseases or cardiovascular risk factors. Demographic and disease characteristics …were recorded. Structural lesions were evaluated using plain radiography, and two scoring tools were used to spine (BASRI and mSASSS). Subclinical atherosclerosis was assessed using ultrasound measurements of flow-mediated dilation (FMD) and carotid intima-media thickness (cIMT). RESULTS: The median age of patients was 36 years. The sex ratio was 2.35. The median BASRI total score was 3 (IQR 2–4), median mSASSS score was 10 (IQR 415). cIMT was significantly increased in SpA patients compared to controls (p < 0.0001), and FMD was significantly lower in patients than in healthy subjects (p = 0.008). cIMT was significantly associated with ankylosis of the facet joints (p = 0.035) and Romanus spondylitis (p = 005). FMD was negatively associated with vertebral squaring (p = 0049), bridging syndesmophytes (p = 0031) and mSASSS score (p = 0.047). CONCLUSION: Our result supports the association of radiographic structural damage and subclinical atherosclerosis assessed using cIMT and FMD. This finding highlights the importance of earlier treatment in order to prevent radiographic damage progression and atherosclerotic events. Show more

Keywords: Spondyloarthritis, atherosclerosis, carotid intima-media thickness, radiography

DOI: 10.3233/BMR-220141

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 36, no. 3, pp. 701-708, 2023

Authors: Qiu, Mei-Guang | Zhou, Shi-Guo | Lin, Shi-Shui | Hu, Xu | Lin, Cheng | Lin, Ke-Feng

Article Type: Research Article

Abstract: BACKGROUND: For the treatment of single-level lumbar degenerative disc disease (DDD), oblique lateral interbody fusion (OLIF) has clinical advantages. Whether internal fixation needs to be combined for treatment has been the subject of debate. OBJECTIVE: To compare the early clinical effects of standalone oblique lateral interbody fusion (S-OLIF) versus OLIF combined with lateral screw fixation of the vertebral body (F-OLIF) on single-level lumbar DDD. METHODS: A retrospective analysis was performed on the data of 34 patients for whom the OLIF technique was applied to treat single-level lumbar DDD from August 2018 to May …2021. Patients were divided into the S-OLIF (n = 18) and F-OLIF groups (n = 16). Intraoperative blood loss, operative time, and length of hospital stay were recorded. The pain visual analogue scale (VAS) and Oswestry disability index (ODI) before and after the operation were evaluated. The disc height (DH), foraminal height (FH), fused segment lordosis (FSL), lumbar lordosis (LL), cage subsidence, and fusion by CT examination were measured before and after the operation. RESULTS: The S-OLIF group experienced a shorter operative time and less intraoperative blood loss than the F-OLIF group, and the differences were statistically significant (p < 0.05), but the difference in the length of hospital stay was not statistically significant. The postoperative VAS score and ODI of the two groups were significantly lower than those before the operation, but the postoperative differences between the two groups were not statistically significant. Differences were not statistically significant in postoperative FH, DH, FSL and LL of the two groups. Both groups were followed up for no less than 12 months. In the two groups, fusion was achieved at the last follow-up visit. CONCLUSION: According to short-term follow-up results, both S-OLIF and F-OLIF can achieve reliable and stable fusion and good clinical effect in the treatment of single-level lumbar DDD. Show more

Keywords: Lumbar spine, lumbar degenerative disc, oblique lateral interbody fusion, minimally invasive, clinical effect

DOI: 10.3233/BMR-220156

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 36, no. 3, pp. 709-719, 2023

Authors: Jardim, Marco | Santos, Inês | da Silva, Madalena Gomes

Article Type: Research Article

Abstract: BACKGROUND: Gluteus medius (GM) is a segmented muscle involving three muscular subdivisions. Rehabilitation exercises has been suggested to strengthen specific subdivisions. OBJECTIVE: This study aimed to evaluate muscular activation of the anterior, middle, and posterior subdivisions of the GM during two different exercises. METHODS: A total of 28 healthy active subjects participated in this study. Muscle activity using surface electromyography was recorded for the three GM subdivisions during figure-of-four position (FFP) and wall press (WP). Non-parametric Kruskal-Wallis test was used to detect differences between GM subdivisions on each exercise and the Mann-Whitney U …test was used to compare muscular activation across exercises. RESULTS: There were statistically significant differences (P < 0.001) in all GM subdivision during FFP and WP exercises. Both exercises showed greater activation of the posterior subdivision than the middle and anterior subdivisions, with the WP causing highest activation of the posterior subdivision. CONCLUSION: In line with the WP exercise, the FFP produces sufficient activity to provide potential strength gains on the posterior subdivision and could be a viable option to include in the early stages of the rehabilitation process. Clinicians may use this information to make more informed decisions about exercise selection for strengthening specific GM subdivision. Show more

Keywords: Hip joint, gluteus medius, exercise, surface electromyography, muscular activity

DOI: 10.3233/BMR-220188

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 36, no. 3, pp. 721-729, 2023

Authors: Ersoy, Sedef | Paker, Nurdan | Kesiktaş, Fatma Nur | Bugdayci, Derya Soy | Karakaya, Ebru | Çetin, Mert

Article Type: Research Article

Abstract: BACKGROUND: Hemiplegic shoulder pain (HSP) is a common morbidity of stroke. Different treatment modalities can be used for optimizing the results and limiting the possible side effects. This research compares the effects of two therapies used to reduce the pain and improve the quality of life of the patients with HSP. OBJECTIVE: This study aimed to compare the effects of transcutaneous electrical nerve stimulation (TENS) and suprascapular nerve blockage (SSNB) in patients with HSP. METHODS: In this clinical research, 24 patients with HSP who participated in a conventional rehabilitation program were randomized into …TENS or SSNB treatment groups. A 100 mm visual analogue scale was used to assess the severity of pain. Passive range of motion (ROM) of the shoulder was measured. The Modified Ashworth Scale (MAS) was used to evaluate spasticity of the upper extremities, and the Modified Barthel Scale was used to assess activities of daily living (ADL). Quality of life was measured using the Stroke-specific Quality of Life (SS-QoL) questionnaire. RESULTS: The pain scores of the SSNB group decreased more significantly (p < 0.05) than in the TENS group. SS-QoL scores at the 3rd week in both groups were significantly higher than before treatment (p < 0.05). MAS scores and Barthel scores after treatment did not differ significantly between the groups. CONCLUSION: TENS and SSNB were beneficial in relieving pain and increasing passive shoulder ROM and ADL in all patients. The alleviating of pain was faster in patients who underwent SSNB. Show more

Keywords: Hemiplegia, shoulder pain, nerve block, electric stimulation therapy

DOI: 10.3233/BMR-220189

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 36, no. 3, pp. 731-738, 2023

Authors: Johnson, Marit E. | Karges-Brown, Joy R. | Brismée, Jean-Michel | Brenza, Timothy M. | Piper, Adam K.

Article Type: Research Article

Abstract: BACKGROUND: Lumbar intervertebral disc height loss has been associated with spinal height change (SHC) and low back pain (LBP), including stenosis. Non-invasive methods to improve disc height loss require forms of lying down, which are unconducive to computer work. OBJECTIVE: Intermittent vertical traction (VT) integrated with seated computer work may provide ergonomic alternatives for increasing SHC to promote LBP relief. The primary aim was to develop and introduce a safe VT prototype and dosage to induce and measure SHC. Prototype comfort and LBP ratings were exploratory secondary aims. METHODS: Forty-one participants were stadiometry-measured …for pre- and post-intervention SHC from seated VT at 35% body weight removed, supine lying (SL), and sitting at a computer (SIT) without VT. Pain ratings were recorded for those self-reporting LBP. VT prototype evaluations were compiled from a 3-question, 7-point Likert-style survey. RESULTS: SHC increased by 3.9 ± 3.4 mm in VT, 1.7 ± 3.4 mm in SIT, and 4.3 ± 3.1 mm in SL (P < 0.000). Post hoc findings were significant between VT and SIT (P < 0.000), and SL and SIT (P < 0.000). VT and SL LBP ratings both decreased, but not SIT. CONCLUSION: Intermittent seated VT is a promising alternative for postural relief during seated computer work, producing SHC similar to lying down without compromising workflow. Show more

Keywords: Spine, low back pain, traction, sitting position, work

DOI: 10.3233/BMR-220202

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 36, no. 3, pp. 739-749, 2023

Authors: Hisashiki, Ryota | Miyachi, Ryo | Miyazaki, Junya

Article Type: Research Article

Abstract: BACKGROUND: The effects of axial extension on pelvic floor displacement and abdominal muscle activity during pelvic floor muscle (PFM) exercises are not well known. OBJECTIVE: To clarify the effect of sitting axial extension on pelvic floor displacement and abdominal muscle activity during a PFM task. METHODS: Pelvic floor displacement, abdominal muscle activity, and subjective kinesthesia of the PFM were compared between the resting and axial-extended sitting positions during a pelvic floor task in 34 healthy young men. RESULTS: No significant difference in pelvic floor displacement was observed between the resting …and axial extension sitting position. Subjective kinesthesia was significantly easier to perform in axial extension than in resting sitting position during pelvic floor depression. Abdominal oblique muscle activity was higher in axial extension than in resting sitting position during pelvic floor depression. The changes in axial extension were significantly greater in the internal oblique muscles during elevation and in the internal and external oblique muscles during depression than in the lower rectus abdominis muscles. CONCLUSION: Axial extension in the sitting position does not change pelvic floor displacement during the PFM task. However, axial extension may be effective in facilitating subjective kinesthesia of PFM and in increasing oblique abdominal muscle activity. Show more

Keywords: Abdominal muscles, axial extension, pelvic floor muscle

DOI: 10.3233/BMR-220218

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 36, no. 3, pp. 751-757, 2023

Authors: Miyachi, Ryo | Madokoro, Sachiko | Ohno, Naoki | Miyati, Tosiaki | Yamazaki, Toshiaki

Article Type: Research Article

Abstract: BACKGROUND: Pelvic floor muscles (PFM) are important for lumbar stability. However, the relationship between lumbar and hip motion angle changes (MAC) caused by PFM contraction and each PFM’s function remains unclear. OBJECTIVE: To clarify the lumbar spine and hip motion changes produced by PFM contraction and the relationship between MAC and PFM function. METHODS: In 21 healthy females, motion angle was measured for prone hip extension movement using natural movement (NM), PFM contracting movement (PM), and reducing lumbar movement (RM) methods. The PFM functional indices were bladder base elevation distance, continuous bladder base …elevation time, and pelvic floor location. RESULTS: The PM showed no significant difference in lumbar motion angle but had significantly smaller hip motion than the NM (NM; 26.1 ± 8.3, PM; 29.2 ± 11.0). MAC was significantly greater in RM (lumbar spine; 4.4 ± 3.2, hip; 5.9 ± 8.7) than in PM (lumbar spine; 0.4 ± 4.4, hip; 3.1 ± 5.1) for both the lumbar spine and hip. Lumbar spine and hip MAC of PM was significantly correlated with pelvic floor location (lumbar spine; r = - 0.44, hip; r = 0.54). CONCLUSION: PFM contraction does not attenuate lumbar spine motion but reduces hip motion. MAC due to PFM contraction during lumbar movement tasks is related to the PFM functional index. Show more

Keywords: Lumbar spine, pelvic floor muscle, motion angle, hip joint

DOI: 10.3233/BMR-220240

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 36, no. 3, pp. 759-766, 2023

Authors: Mazerolle, Mylène | Babaei-Ghazani, Arash | Boudier-Revéret, Mathieu | Chang, Min Cheol

Article Type: Case Report

Abstract: BACKGROUND: Neck pain is a common complaint seen amongst patients from all ages. When common causes of neck pain have been ruled out, it is important to investigate further. A careful physical exam can help identify the painful structures. An ultrasound of the area can also be helpful to identify possible structures involved. Neuromas can be treated with oral medications as well as more invasive techniques, such as pulsed radiofrequency (PRF). CASE DESCRIPTION: In this case report, we discuss a 67-year-old female who presented with left anterior neck pain after developing a cervical mass who was …later diagnosed as non-Hodgkin lymphoma. A small neuroma of the left transverse cervical nerve was found on ultrasound and ultimately was treated with PRF with a complete resolution of her symptoms at two months follow-up. CONCLUSION: PRF seems to be a useful tool for controlling neuropathic pain caused by a neuroma. Show more

Keywords: Neuralgia, neuroma, pulsed radiofrequency treatment, ultrasonography

DOI: 10.3233/BMR-220114

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 36, no. 3, pp. 767-771, 2023

Authors: Zhang, Yi-Fei | Zhang, Li-Feng | Zhou, Ye-Jin

Article Type: Case Report

Abstract: BACKGROUND: Neer type II/bilateral distal clavicular fracture is an extremely rare injury combination, with few cases having been reported. CASE PRESENTATION: This paper reports a case of polytrauma in a 16-year-old female following a road traffic accident. The radiographs revealed distal fractures of the bilateral clavicles (Neer type II), and an open reduction and internal fixation procedure was performed. Initially, the distal fracture of the right clavicle was fixed with a six-hole hook plate before the fracture of the left clavicle was fixed using a pre-contoured lateral locking plate following reduction. At the two-year follow-up, the …patient had an excellent constant score in terms of the bilateral shoulder joints. CONCLUSION: It is important to achieve stability and to aim for excellence in terms of full shoulder function in this rare combination injury. Show more

Keywords: Distal fracture of the clavicle, Neer type, open reduction internal fixation, fracture, clavicle, hook plate, plate fixation, case report

DOI: 10.3233/BMR-220245

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 36, no. 3, pp. 773-777, 2023