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Biomedical subjects

Tom Bendix

Publications and source records attributed to Tom Bendix.

9 recordsLinked to original sources
PubMed2006

Modic changes and their associations with clinical findings.

It is believed that disc degeneration (DD) is, in general, only mildly associated with low back pain (LBP). MRI-identified Modic changes (MC), probably a late stage of DD, are relatively strongly associated with LBP but it is not known if people with MC also have a specific clinical profile. The purpose of this study was to investigate if the clinical findings differ in people with Modic changes (MC) as compared to those with only degenerative disc findings or none at all. In a population-based sample of 412 40-year-old Danes, information was collected independently with MRI, questionnaires and clinical examination. Three subgroups of people were created: those with both DD and MC, those with only DD, and those with neither DD nor MC. The clinical pattern was investigated for each subgroup in order to test the assumption that the clinical picture differs in the three groups. It was expected that people with both DD and MC would have a more pronounced clinical profile than those with only DD who, in turn, would differ from those with neither of these two MRI findings. Our findings were generally in concordance with our expectations. MC constitutes the crucial element in the degenerative process around the disc in relation to LBP, history, and clinical findings. People with DD and no MC only vaguely differ from those without. People with LBP and MC may deserve to be diagnosed as having specific LBP.

Activities of Daily Living↗
PubMed2006

[Back pain].

Low back pain created a dramatic increase in sick leave from 1970-95 despite of no pain-relevant biological changes of the back. An update of several disc-related pathologies is presented. Especially discovering the significance of Modic changes and a new muscle-function understanding contribute to a modernized view on pain mechanisms. Generally, traditional treatment modalities have an effect wise sparse influence on natural history over time. Subgroup identification is a central issue in modern research, because the effect of treatment can be very different across such groups.

Humans↗
PubMed2005

Magnetic resonance imaging and low back pain in adults: a diagnostic imaging study of 40-year-old men and women.

STUDY DESIGN: Cross-sectional cohort study of a general population. OBJECTIVE: To investigate "abnormal" lumbar spine magnetic resonance imaging (MRI) findings, and their prevalence and associations with low back pain (LBP). SUMMARY OF BACKGROUND DATA: The clinical relevance of various "abnormal" findings in the lumbar spine is unclear. Distinguishing between inevitable age-related findings and degenerative findings with deleterious consequences is a challenge. METHODS: Lumbar spine MRI was obtained in 412, 40-year-old individuals. Predefined "abnormal" MRI findings were interpreted without any knowledge of patient symptoms. Associations between MRI abnormalities and LBP were calculated using odds ratios. The "overall picture" of each MRI finding was established on the basis of the frequencies, diagnostic values, and the strength and consistency of associations. RESULTS: Most "abnormal" MRI findings were found at the lowest lumbar levels. Irregular nucleus shape and reduced disc height were common (>50% of individuals). Relatively common (25% to 50%) were hypointense disc signal, anular tears, high intensity zones, disc protrusions, endplate changes, zygapophyseal joint degeneration, asymmetry, and foraminal stenosis. Nerve root compromise, Modic changes, central spinal stenosis, and anterolisthesis/retrolisthesis were rare (<25%). Most strongly associated with LBP were Modic changes and anterolisthesis (odds ratios >4). Significantly positive associations with all LBP variables were seen for hypointense disc signals, reduced disc height, and Modic changes. All disc "abnormalities" except protrusion were moderately associated with LBP during the past year. CONCLUSION: Most degenerative disc "abnormalities" were moderately associated with LBP. The strongest associations were noted for Modic changes and anterolisthesis. Further studies are needed to define clinical relevance.

Adult↗
PubMed2005

An epidemiologic study of MRI and low back pain in 13-year-old children.

STUDY DESIGN: Cross-sectional cohort study of a general population. OBJECTIVE: To describe associations between "abnormal" lumbar magnetic resonance imaging (MRI) findings and low back pain (LBP) in 13-year old children. SUMMARY AND BACKGROUND DATA: Very little is known about the distribution of lumbar MRI findings and how they are associated with LBP in youngsters. METHODS: Disc abnormalities, as well as nerve root compromise, endplate changes, and anterolisthesis were identified from MRI studies of 439 children. LBP was identified from structured interviews. Associations are presented as odds ratios (OR). RESULTS: Signs of disc degeneration were noted in approximately 1/3 of the subjects. Reduced signal intensity and irregular nucleus shape in the upper 3 lumbar discs were significantly associated with LBP within the last month (OR, 2.5-3.6), whereas reduced signal intensity and disc protrusion at L5-NS1 were associated with seeking care (OR, 2.8 and 7.7, respectively). Endplate changes in relation to the L3 discs were associated with LBP month and seeking care (OR, between 9.7 and 22.2). Anterolisthesis at L5 was associated with seeking care (OR, 4.3). There were obvious differences between genders: degenerative disc changes in the upper lumbar spine were more strongly associated with LBP in boys, while disc abnormalities in the lower lumbar spine were more strongly associated with seeking care in girls. CONCLUSIONS: In children, degenerative disc findings are relatively common, and some are associated with LBP. There appears to be a gender difference. Disc protrusions, endplate changes, and anterolisthesis in the lumbar spine were strongly associated with seeking care for LBP.

Adolescent↗
PubMed2004

A combination of gestalt therapy, Rosen Body Work, and Cranio Sacral therapy did not help in chronic whiplash-associated disorders (WAD)--results of a randomized clinical trial.

The chronic state of whiplash-associated disorder (WAD) might be understood as a somatization of existential pain. Intervention aimed to improve quality of life (QOL) seemed to be a solution for such situations. The basic idea behind the intervention was holistic, restoring quality of life and relationship with self, in order to diminish tension in the locomotion system, especially the neck. A psychosomatic theory for WAD is proposed. Our treatment was a short 2-day course with teachings in philosophy of life, followed by 6-10 individual sessions in gestalt psychotherapy and body therapy (Rosen therapy and Cranio Sacral therapy), followed by a 1-day course approximately 2 months later, closing the intervention. Two independent institutions did the intervention and the assessments. In a randomized, clinically controlled setting, 87 chronic WAD patients were included with a median duration of 37 months from their whiplash accidents. One patient never started. Forty-three had the above intervention (female/male = 36/7, ages 22-49, median 37 years) and another 43 were assigned to a nontreated control group (female/male = 35/8, ages 18-48, median 38). Six had disability pension and 27 had pending medicolegal issues in each group. Effect variables were pain in neck, arm, and/or head; measures of quality of life and daily activities; as well as general physical or mental health. Wilcoxon test for between-groups comparisons with intention-to-treat analyses was conducted; the square curve paradigm testing for immediate improvements of health and quality of life was also used. The groups were comparable at baseline. From the intervention group, 11 dropped out during the intervention (4 of those later joined the follow-up investigation), 22 of the remaining 32 graduated the course, and 35 of the 43 controls did as well. Approximately 3 months later, we found no clinically relevant or significant increase in any effect measure. The above version of a quality of life intervention based on alternative therapy had no effect on patients with chronic WAD.

Adolescent↗
PubMed2002

Motion palpation findings and self-reported low back pain in a population-based study sample.

BACKGROUND: Although the clinical usefulness of motion palpation has not been established, it is one of the most commonly used diagnostic methods by chiropractors. Notably, its sensitivity, specificity, and validity in general have not been adequately studied, and most study samples have consisted of student volunteers. OBJECTIVE: To determine the prevalence of positive motion-palpation findings (so-called fixations and spontaneous pain response) in relation to self-reported low back pain status and to determine the sensitivity and specificity of the motion-palpation technique carried out on the sacroiliac and lumbar joints. DESIGN: Study subjects were examined by 1 examiner (out of 7 possible), who was unaware of their low back pain status. Information on low back pain was then collected in a self-report questionnaire. SETTING: Research laboratory at the Odense University Hospital, Denmark. PARTICIPANTS: One hundred eighty-four twins, consisting of a subset of healthy twins taken from a panel of population-generated twins aged 19 to 42 years, made up the study sample. Examiners consisted of 7 biomechanics (chiropractic) students from the University of Southern Denmark who were proficient in motion palpation. MAIN OUTCOME MEASURES: The prevalence rates of motion palpation-determined fixations and of spontaneous pain reactions in response to motion palpation were studied in relation to anatomic area, self-reported low back pain status, and each other. RESULTS: The point period prevalence of low back pain was 14%. Fixations were found in 43% of the study sample, and 25% appeared to have a painful reaction to motion palpation. There was no logical pattern of fixations and spontaneous pain reactions in relation to the low back pain status. The sensitivity was generally low (always below 60%) for fixations and pain, whereas the specificity was higher, significantly so for pain in the mid lumbar area. There was no strong association between fixations and the examiners' interpretation of a spontaneous pain reaction in response to motion palpation. CONCLUSION: Motion palpation does not appear to be a good method to differentiate persons with or without low back pain. It is possible to dissociate the findings of fixations and those of pain reactions.

Adult↗