Background: Center of pressure (CoP) trajectory is one of the gait parameters that is widely used for clinical assessments. Moreover, the CoP trajectory could be adversely affected by anatomic and mechanical factors that involve foot function, which was shown to be correlated with musculoskeletal diseases. The aim of this study is to compare angle-associated parameters of gait in patients with different Lumbar spinal disorders. Methods: The subjects suffered from the same levels of spine impairment, including patients with Lumbar spinal stenosis (LSS) and Lumbar intervertebral disc degeneration (LIDD) were recruited in this study. The spatio-temporal angular parameters associated with the CoP of the subjects during their gait were collected and examined. The measurements were used to calculate the CoP angle and symmetry angle (SA). Then the butterfly diagram (BD) intersection angle was introduced as a new potential parameter in gait assessment. Results: The results of the current study showed that CoPs and SAs did not vary between the two groups (P > 0. 05). The BD intersection angle, however, indicated some variations between patients with LSS and LIDD (P < 0. 05). Conclusion: While the results showed that CoP angles and SAs did not differ between the LSS and LIDD groups, it is hypothesized that such disorders that affect the gait could be reflected in the BD intersection angle. Therefore, the BD intersection angle is suggested as a clinical indicator in clarifying patients with Lumbar spinal disorders.

Obesity is a risk factor for severe, radicular, and debilitating lumbosacral pain. The use of non-surgical treatment methods in obese patients is important. Epidural steroid injection (ESI) is a common procedure that helps patients with low back pain and radicular symptoms. So far, using ESI in patients with Lumbar herniated discs remains to be controversial among physicians. Thus, the current study was carried out to compare the therapeutic effects of ESI's in obese and non-obese patients with spinal disc herniation. This prospective, clinical trial study was conducted among 124 patients (58=non-obese, 66=obese) with low back pain caused by a Lumbar herniated disc, who referred to our Pain Clinic from 2017 to 2018. The ESI was done using the parasagittal inter-laminar approach. The severity of pain was measured by the patients’ self-report of pain and using the visual analog scale (VAS) before the treatment and two and six weeks after the treatment. The Oswestry Disability Index (ODI) was also measured in the treatment groups. Patients were followed for 6 weeks (IRCT20131124015515N3). Overall, 58 (46. 8%) patients had a BMI of 20-25 kg/m2, 38 (30. 6%) had a BMI of 25-30 kg/m2, and 28 (22. 6%) patients had a BMI of >30 kg/m2. The changes in the pain scores and ODI at different time periods showed no statistically significant differences in the two groups (P=0. 685, P=0. 995), respectively. The ESI is an effective, safe, minimally invasive, and cost-effective method that can result in pain relief and improvements in patients' function after a short period of time. Hence, we suggested that this treatment be considered for all patients with acute/chronic low back pain as well as radiculopathy.

Low back pain (LBP) due to Lumbar disk herniation could collaborate with various risk factors. In this study, we focused on analysis of Lumbar disk herniation risk factors in patients with LBP. This comparative cross-sectional study was conducted in Hamedan-western Iran in 2014-2015. Overall, 58 cases with evidence of Lumbar disk hernia were classified as a case group and 47 cases without evidence of Lumbar disk herniation were classified as a control group. The data collection was performed by using a questionnaire and the statistical analysis was performed by using SPSS software. The analytic results indicated a meaningful correlation between demographic variables as body mass index (BMI) mean, occupation type and Lumbar disk hernia (P<0. 05). Furthermore, the abdominal circumference and the average heavy load carried by the participants throughout a day had a significant relationship with Lumbar disk herniation (P<0. 05). There are multiple risk factors for Lumbar disk hernia regarding a combination of genetics and acquired characteristics and lifestyle.

Purpose: The present study aimed to find reliability of magnetic resonance imaging (MRI) in patients with Lumbar disk herniation.Methods: In this cross-sectional study, 110 individuals aged 20-50 years with chronic low back pain (LBP) of more than 3 months were enrolled by nonprobability convenient sampling method. Only disk herniated patients of L4-L5 and L5-S1, diagnosed by physicians on the basis of MRI, were included in the study. Sagittal and axial MRI scans were taken and examined to rule out acute pathology. Two examiners interpreted the MRI results without knowing the results of clinical tests and questionnaires. Reliability at intra- and inter-level was done twice with the interval of 5 days. Reliabilities of findings such as affected disk level, extent of disk herniation, nerve root involvement, dehydration, and ligamentum flavum involvement were also assessed.Results: Intra- and inter-test values for disk level were 0.87 and 0.80, for disk grade were 0.81 and 0.76, for lateral canal stenosis were 0.81 and 0.75, for dehydration were 0.81 and 0.72, for spondylolisthesis were 0.88 and 0.81, and for ligamentum flavum involvement were 0.79 and 0.75.Conclusion: Repeatability of MRI results in patients with Lumbar disk herniation at intra- and inter-level was good to excellent.

Calcification of intervertebral disc (IVD) is an uncommon but well-defined clinical syndrome in children. Despite its benign nature, occasionally, calcified nucleus pulposus can herniate into the spinal canal. We report an interesting case of calcified disc herniation in the thoracic spine. Although it resulted in cord compression and syrinx formation, it well responded to conservative management. An 8-year-old girl presented with back pain and lower limbs hyperreflexia. The spinal imaging revealed that calcification within IVD, associated with huge calcified disc herniation on the T5/6, resulted in cord compression and syrinx formation within the spinal cord from T4/5 through T9/10. Despite cord compression and syrinx formation, the patient underwent conservative management. After a 6-month follow-up, the control imaging showed complete resolution of the calcified disc herniation and decreased syrinx size. In the patients with a calcified herniated IVD, in the absence of motor neurological deficit, conservative management consisting of bed rest, lifestyle adjustment, weight loss, and brace or collar wearing combined with a close follow-up can result in spontaneous regression of calcification, improvement of symptoms, and partial to complete resolution of the underlying pathology.