A pair of functional radiographs, taken at each end of the range of motion, are used to determine spinal motions. Graphic construction and computer-assisted methods are available for the radiographic analysis. The later provides many more motion parameters. A study of lumbar spine lateral radiographs was conducted to determine errors in the motion parameters due to spinal level, radiographic quality, and errors in the two digitizing instruments. Significant differences were found in the errors due to the two digitizers when the same radiographic pair was redigitized several times. There were only minimal differences, however, between the digitizers when the radiographic films were remarked and redigitized. The error ranges (2 x SD) for the motion parameters were 1) rotation = +/- 1.25 degrees; 2) translation of the inferior posterior vertebral body corner = +/- 0.86 degrees; and 3) coordinates for the center of rotation = +/- 4.3 mm. Both the spinal level and radiographic quality affected the magnitude of errors in all motion parameters.

Objectives

Chronic low back pain (CLBP) affects millions of people worldwide, and appears to be increasing in prevalence. It is associated not only with pain, but also with increased disability, psychological symptoms, and reduced quality of life. There are various treatment options for CLBP, but no single therapy stands out as being the most effective. In the past 10 years, yoga interventions have been studied as a CLBP treatment approach. The objective of this paper is to review the current literature supporting the efficacy of yoga for CLBP.

Methods

A literature search through the beginning of 2015 was conducted in Pub Med for randomized control trials addressing treatment of CLBP with yoga.

Results

In this review we evaluate the use of yoga as a treatment for CLBP. Specifically we evaluate how yoga impacts physical functioning and disability, pain, and associated psychological symptoms. We also evaluate possible mediators of the effect of yoga and the safety of yoga.

Discussion

With few exceptions, previous studies and the recent randomized control trials (RCTs) indicate that yoga can reduce pain and disability, can be practiced safely, and is well received by participants. Some studies also indicate that yoga may improve psychological symptoms, but these effects are currently not as well established.

Synovial chondromatosis is a rare disease that causes disability and dysfunction of the involved synovial joint. We describe the second case in the literature of intraligamentous synovial chondromatosis involving the anterior cruciate ligament, confirmed by pathology after arthroscopic removal of the chondral bodies. We also describe associated magnetic resonance imaging findings which may be helpful for diagnosis of this very rare entity.

This report describes a severe injury to the proximal rectus femoris (RF) muscle in a 37-year-old recreational athlete. This injury is a relatively rare occurrence in both the general and elite athletic populations. Acute and long-term imaging and functional outcomes are described. This athlete was able to return to full activity without surgical intervention. Follow-up imaging demonstrated gross healing of both complete (or near complete) muscle and tendon tears. LEVEL OF EVIDENCE: V.

BACKGROUND: We aimed to provide information on whether or not the correlation between body tilt and the pulse amplitude of transcranial ultrasonic time-of-flight waveform can be observed in the anterior-posterior skull direction. Also, we asked the question whether or not the skull pulsation can be detected since the cranial bones involved are thicker. METHODS: The experimental model of body tilt that alters intracranial pressure by shifting body fluid headward was employed. Transcranial ultrasound waveforms were examined in 15 healthy volunteers positioned at five tilt angles of +30 degrees, 0 degrees, -30 degrees, -60 degrees, and -90 degrees from the horizontal body position. A pulse-echo transducer was placed on the middle forehead and ultrasound waveforms were recorded. Synchronized variations in the ultrasonic time-of-flight with heartbeats were monitored using the pulsed phase locked loop technique for the output voltage of the ultrasound transducer. Simultaneous effects of body tilt on cardiovascular parameters were also evaluated. RESULTS: Pulse amplitudes of ultrasonic time-of-flight waveforms were found to vary with body tilt. Repeated-measures ANOVA and regression analysis showed a negative correlation between body tilt angle and pulse amplitude. The regression line has the equation: pulse amplitude = (1.158-0.01023 x tilt angle) x 10(-4) voltage. There was no such relationship between head-down body tilt and altered mean blood pressure or heart rate. CONCLUSION: An increase in the pulse amplitude of the anterior-posterior transcranial ultrasonic time-of-flight waveform can be detected when the head-down body tilt angle increases.

Bone possesses a highly complex hierarchical structure comprised of mineral (~45% by volume), organic matrix (~35%) and water (~20%). Water exists in bone in two forms: as bound water (BW), which is bound to bone mineral and organic matrix, or as pore water (PW), which resides in Haversian canals as well as in lacunae and canaliculi. Magnetic resonance (MR) imaging has been increasingly used for assessment of cortical and trabecular bone. However, bone appears as a signal void on conventional MR sequences because of its short T2^*. Ultrashort echo time (UTE) sequences with echo times (TEs) 100-1,000 times shorter than those of conventional sequences allow direct imaging of BW and PW in bone. A series of quantitative UTE MRI techniques has been developed for bone evaluation. UTE and adiabatic inversion recovery prepared UTE (IR-UTE) sequences have been developed to quantify BW and PW. UTE magnetization transfer (UTE-MT) sequences have been developed to quantify collagen backbone protons, and UTE quantitative susceptibility mapping (UTE-QSM) sequences have been developed to assess bone mineral.

The human lumbar spine is uniquely adapted to the gravitational stress of upright posture. Using upright magnetic resonance imaging (uMRI), we characterized the adult lumbar spine's response to upright gravitational loading. We hypothesized that a gravitational load would compress the intervertebral discs (IVDs). Five volunteers underwent T2 weighted sagittal 0.6T uMRI scans of the lumbar spine while supine, upright, and upright with a 10% body weight (BW) backpack. While upright, the 10% BW load significantly compressed the L4‐L5 and L5‐S1 IVDs by about 10% relative to supine (p < 0.05). Upright posture and the 10% BW load significantly compressed the anterior L5‐S1 IVD relative to supine (p < 0.05). Gravitational loading of the lumbar spine plus an added 10% BW load compresses the caudal IVDs (L4‐L5 and L5‐S1), suggesting that these discs are either bearing more of the load or are more compliant than the other IVDs. This study is the first radiographic analysis to describe the adult lumbar spine in the upright position with added spinal load. This study was supported by the National Aeronautics and Space Administration Grant NNX10AM18G and the UCSD Clinical Translational Research Institute Fellowship Award.

Bone is comprised of mineral, collagenous organic matrix, and water. X-ray-based techniques are the standard approach for bone evaluation in clinics, but they are unable to detect the organic matrix and water components in bone. Magnetic resonance imaging (MRI) is being used increasingly for bone evaluation. While MRI can non-invasively assess the proton pools in soft tissues, cortical bone typically appears as a signal void with clinical MR techniques because of its short T2*. New MRI techniques have been recently developed to image bone while avoiding the ionizing radiation present in x-ray-based methods. Qualitative bone imaging can be achieved using ultrashort echo time (UTE), single inversion recovery UTE (IR-UTE), dual-inversion recovery UTE (Dual-IR-UTE), double-inversion recovery UTE (Double-IR-UTE), and zero echo time (ZTE) sequences. The contrast mechanisms as well as the advantages and disadvantages of each technique are discussed.