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Discogenic back pain

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https://www.readbyqxmd.com/read/28898530/a-cost-effectiveness-analysis-of-intradiscal-electrothermal-therapy-idet-compared-with-circumferential-lumbar-fusion
#1
Eugena Stamuli, Withawin Kesornsak, Michael P Grevitt, John Posnett, Karl Claxton
STUDY DESIGN: Cost-effectiveness analysis. OBJECTIVE: To evaluate the cost-effectiveness of intradiscal electrothermal therapy (IDET) relative to circumferential lumbar fusion with femoral ring allograft (FRA) in UK. SUMMARY OF BACKGROUND DATA: Circumferential lumbar fusion is an established treatment for discogenic low back pain. However, IDET could be a cost-effective treatment alternative as it can be carried out as a day case. METHODS: Patient-level data were available for patients with discogenic low back pain treated with FRA (n=37) in a randomized trial of FRA vs titanium cage, and for patients recruited to a separate study evaluating the use of IDET (n=85)...
September 12, 2017: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/28874973/inhibiting-vascular-endothelial-growth-factor-in-injured-intervertebral-discs-attenuates-pain-related-neuropeptide-expression-in-dorsal-root-ganglia-in-rats
#2
Jun Sato, Kazuhide Inage, Masayuki Miyagi, Yoshihiro Sakuma, Kazuyo Yamauchi, Masao Koda, Takeo Furuya, Junichi Nakamura, Miyako Suzuki, Go Kubota, Yasuhiro Oikawa, Takeshi Sainoh, Kazuki Fujimoto, Yasuhiro Shiga, Koki Abe, Hirohito Kanamoto, Masahiro Inoue, Hideyuki Kinoshita, Masaki Norimoto, Tomotaka Umimura, Kazuhisa Takahashi, Seiji Ohtori, Sumihisa Orita
STUDY DESIGN: An experimental animal study. PURPOSE: To evaluate effects of anti-vascular endothelial growth factor (VEGF) on the content and distribution of the calcitonin gene-related peptide (CGRP) in the dorsal ganglia in a rat model. OVERVIEW OF LITERATURE: Increased expression of VEGF in degenerative disc disease increases the levels of inflammatory cytokines and nerve ingrowth into the damaged discs. In animal models, increased levels of VEGF can persist for up to 2 weeks after an injury...
August 2017: Asian Spine Journal
https://www.readbyqxmd.com/read/28866262/groin-pain-associated-with-sacroiliac-joint-dysfunction-and-lumbar-disorders
#3
Daisuke Kurosawa, Eiichi Murakami, Toshimi Aizawa
OBJECTIVE: We investigated the prevalence of groin pain in patients with sacroiliac joint (SIJ) dysfunction, lumbar spinal canal stenosis (LSS), and lumbar disc herniation (LDH) who did not have hip disorders, and evaluated the clinical features that distinguished SIJ dysfunction from LSS and LDH. PATIENT AND METHODS: We evaluated 127 patients (57 men, 70 women, average age 55 years) with SIJ dysfunction, 146 (98 men, 48 women, average age 71 years) with LSS, and 124 (83 men, 41 women, average age 50 years) with LDH...
October 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28797134/looking-beyond-the-intervertebral-disc-the-need-for-behavioral-assays-in-models-of-discogenic-pain
#4
REVIEW
Grace E Mosley, Thomas W Evashwick-Rogler, Alon Lai, James C Iatridis
Orthopedic research into chronic discogenic back pain has commonly focused on aging- and degeneration-related changes in intervertebral disc structure, biomechanics, and biology. However, the primary spine-related reason for physician office visits is pain. The ambiguous nature of the human condition of discogenic low back pain motivates the use of animal models to better understand the pathophysiology. Discogenic back pain models must consider both emergent behavioral changes following pain induction and changes in the nervous system that mediate such behavior...
August 10, 2017: Annals of the New York Academy of Sciences
https://www.readbyqxmd.com/read/28748380/autologous-bone-marrow-concentrate-intradiscal-injection-for-the-treatment-of-degenerative-disc-disease-with-three-year-follow-up
#5
Kenneth A Pettine, Richard K Suzuki, Theodore T Sand, Matthew B Murphy
PURPOSE: The purpose of this study is to assess safety and feasibility of intradiscal bone marrow concentrate (BMC) injections to treat low back discogenic pain as an alternative to surgery with three year minimum follow-up. METHODS: A total of 26 patients suffering from degenerative disc disease and candidates for spinal fusion or total disc replacement surgery were injected with 2 ml autologous BMC into the nucleus pulposus of treated lumbar discs. A sample aliquot of BMC was characterized by flow cytometry and CFU-F assay to determine progenitor cell content...
July 26, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28746177/correlation-between-high-intensity-zone-on-mri-and-discography-in-patients-with-low-back-pain
#6
Huadong Wang, Zhonghai Li, Chunli Zhang, Weisheng Zhang, Li Li, Jidong Guo, Wenwen Wu, Shuxun Hou
The aim of this study was to analyze the correlation between high-intensity zone (HIZ) on magnetic resonance imaging (MRI) of a lumbar disc and positive pain response assessed by discography for the diagnosis and treatment of discogenic low back pain (LBP). Thirty-seven patients aged 21 to 59 years with chronic LBP but without any neurological symptoms or lumbar disc herniation who underwent MRI and subsequent discography were included in this study. During discography, concordant pain was regarded as positive, whereas discordant pain and no pain were regarded as negative...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28697031/epidural-injections-contraindicated-for-lumbar-radiculopathy-in-may-thurner-syndrome-a-case-report
#7
Michael Sniderman
A 59-year-old patient presented to the chronic pain clinic with a 6-week history of worsening lumbar back pain, bilateral thigh pain, and unilateral radiculopathy. Magnetic resonance imaging revealed mild discogenic and facetogenic disease, but significant epidural venous plexus engorgement compressing the thecal sac. The patient reported previous treatment by a vascular surgeon for May-Thurner Syndrome, a type of inferior vena caval obstruction, yet had not experienced these specific complaints. A discussion with the radiologist confirmed worsening of the patient's May-Thurner Syndrome was the likely cause of the patient's symptoms...
July 10, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28670405/intradiscal-injection-of-autologous-platelet-rich-plasma-releasate-to-treat-discogenic-low-back-pain-a-preliminary-clinical-trial
#8
Koji Akeda, Kohshi Ohishi, Koichi Masuda, Won C Bae, Norihiko Takegami, Junichi Yamada, Tomoki Nakamura, Toshihiko Sakakibara, Yuichi Kasai, Akihiro Sudo
STUDY DESIGN: Preliminary clinical trial. PURPOSE: To determine the safety and initial efficacy of intradiscal injection of autologous platelet-rich plasma (PRP) releasate in patients with discogenic low back pain. OVERVIEW OF LITERATURE: PRP, which is comprised of autologous growth factors and cytokines, has been widely used in the clinical setting for tissue regeneration and repair. PRP has been shown in vitro and in vivo to potentially stimulate intervertebral disc matrix metabolism...
June 2017: Asian Spine Journal
https://www.readbyqxmd.com/read/28666263/the-value-of-radiographic-indexes-in-the-diagnosis-of-discogenic-low-back-pain-a-retrospective-analysis-of-imaging-results
#9
Jian Song, Hong-Li Wang, Xiao-Sheng Ma, Xin-Lei Xia, Fei-Zhou Lu, Chao-Jun Zheng, Jian-Yuan Jiang
To explore value of different radiographic indexes in the diagnosis of discogenic low back pain (LBP). A total number of 120 cases (60 patients diagnosed with discogenic LBP and 60 healthy people) were retrospectively analysed to identify factors in the diagnosis of discogenic LBP by using univariate and multivariate analyses. A receiver operating characteristic (ROC) curve was drew to show the predictive accuracy of the finally enrolled factors. Among all the included patients, 60 were strictly admitted in the discogenic LBP group while the other 60 were enrolled in the control group...
June 27, 2017: Oncotarget
https://www.readbyqxmd.com/read/28655123/mechanical-low-back-pain-in-elite-track-and-field-athletes-an-observational-cohort-study
#10
Nikolaos Malliaropoulos, Georgios Bikos, Maria Meke, Ioannis Tsifountoudis, Dev Pyne, Vasileios Korakakis
OBJECTIVE: The aim of the study was to gain information about the incidence of mechanical Low Back Pain (MLBP) injuries etiology in elite track and field athletes and to assess the recurrence rate. BACKGROUND: The prevalence and the etiology of Low Back Pain (LBP) in athletic populations at the elite level of competition lack of longitudinal studies focused on certain sport fields. The present study evaluates MLBP incidents in elite track and field athletes visiting National Track and Field Centre in Thessaloniki, Greece and classifies MLBP according to etiology...
August 3, 2017: Journal of Back and Musculoskeletal Rehabilitation
https://www.readbyqxmd.com/read/28648909/clinical-efficacy-and-its-prognostic-factor-of-percutaneous-endoscopic-lumbar-annuloplasty-and-nucleoplasty-for-the-treatment-of-patients-with-discogenic-low-back-pain
#11
Jung Hwan Lee, Sang-Ho Lee
OBJECTIVE: The choice of appropriate treatment of discogenic low back pain (DLBP) frequently is difficult. This study sought to identify the clinical efficacy of percutaneous endoscopic lumbar annuloplasty and nucleoplasty (PELAN) to treat patients with DLBP and to investigate prognostic clinical or radiologic variables. METHODS: Eighty-nine patients with a diagnosis of DLBP who underwent PELAN were included. Numeric Rating Scale (NRS) for back pain, Oswestry Disability Index % (ODI%), and modified Macnab criteria were measured at short-term (3-4 weeks) and long-term follow-up period (at least 12 months) to investigate clinical efficacy of PELAN...
September 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28645219/pullulan-microbeads-si-hpmc-hydrogel-injectable-system-for-the-sustained-delivery-of-gdf-5-and-tgf-%C3%AE-1-new-insight-into-intervertebral-disc-regenerative-medicine
#12
Nina Henry, Johann Clouet, Audrey Fragale, Louise Griveau, Claire Chédeville, Joëlle Véziers, Pierre Weiss, Jean Le Bideau, Jérôme Guicheux, Catherine Le Visage
Discogenic low back pain is considered a major health concern and no etiological treatments are today available to tackle this disease. To clinically address this issue at early stages, there is a rising interest in the stimulation of local cells by in situ injection of growth factors targeting intervertebral disc (IVD) degenerative process. Despite encouraging safety and tolerability results in clinic, growth factors efficacy may be further improved. To this end, the use of a delivery system allowing a sustained release, while protecting growth factors from degradation appears of particular interest...
November 2017: Drug Delivery
https://www.readbyqxmd.com/read/28617390/-pathopsychological-aspects-of-low-back-pain
#13
A I Krupatkin, A A Kuleshov, T V Sokolova, A O Gospod
Low back pain is one of the most common causes of disability in the world. Discogenic process is the leading component of the disease. A significant part of these pain syndromes become chronic that leads to disability and social maladjustment. Chronic low back pain is hard to treat due to the several types of pathogenesis. The paper analyzes the etiology, mechanisms of development, clinical features, specific characteristics, pathomorphology of the formation of psychogenic component of pain. A role of comorbid psychogenic states involved in the chronization of low back pain is considered...
2017: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
https://www.readbyqxmd.com/read/28615337/accumulation-of-methylglyoxal-increases-the-advanced-glycation-end-product-levels-in-drg-and-contributes-to-lumbar-disk-herniation-induced-persistent-pain
#14
Cui-Cui Liu, Xin-Sheng Zhang, Yu-Ting Ruan, Zhu-Xi Huang, Su-Bo Zhang, Meng Liu, Hai-Jie Luo, Shao-Ling Wu, Chao Ma
Lumbar disk herniation (LDH) with discogenic low back pain and sciatica is a common and complicated musculoskeletal disorder. The underlying mechanisms are poorly understood, and there are no effective therapies for LDH-induced pain. In the present study, we found that the patients who suffered from LDH-induced pain had elevated plasma methylglyoxal (MG) levels. In rats, implantation of autologous nucleus pulposus (NP) to the left lumbar 5 spinal nerve root, which mimicked LDH, induced mechanical allodynia, increased MG level in plasma and dorsal root ganglion (DRG), and enhanced the excitability of small DRG neurons (<30 μm in diameter)...
August 1, 2017: Journal of Neurophysiology
https://www.readbyqxmd.com/read/28535546/cost-utility-analysis-of-lumbar-interlaminar-epidural-injections-in-the-treatment-of-lumbar-disc-herniation-central-spinal-stenosis-and-axial-or-discogenic-low-back-pain
#15
Laxmaiah Manchikanti, Vidyasagar Pampati, Ramsin M Benyamin, Joshua A Hirsch
BACKGROUND: Cost utility or cost effective analysis continues to take center stage in the United States for defining and measuring the value of treatments in interventional pain management. Appropriate cost utility analysis has been performed for caudal epidural injections, percutaneous adhesiolysis, and spinal cord stimulation. However, the literature pertaining to lumbar interlaminar epidural injections is lacking, specifically in reference to cost utility analysis derived from randomized controlled trials (RCTs) with a pragmatic approach in a practical setting...
May 2017: Pain Physician
https://www.readbyqxmd.com/read/28491116/a-randomized-clinical-trial-comparing-the-effectiveness-of-electroacupuncture-versus-medium-frequency-electrotherapy-for-discogenic-sciatica
#16
Xue Zhang, Yang Wang, Zhao Wang, Chao Wang, Wentao Ding, Zhishun Liu
Objective. To investigate the short- and long-term effects of electroacupuncture (EA) compared with medium-frequency electrotherapy (MFE) on chronic discogenic sciatica. Methods. One hundred participants were randomized into two groups to receive EA (n = 50) or MFE (n = 50) for 4 weeks. A 28-week follow-up of the two groups was performed. The primary outcome measure was the average leg pain intensity. The secondary outcome measures were the low back pain intensity, Oswestry Disability Index (ODI), patient global impression (PGI), drug use frequency, and EA acceptance...
2017: Evidence-based Complementary and Alternative Medicine: ECAM
https://www.readbyqxmd.com/read/28486758/stimulation-of-the-l2-l3-dorsal-root-ganglia-induces-effective-pain-relief-in-the-low-back
#17
Frank Huygen, Liong Liem, William Cusack, Jeffery Kramer
INTRODUCTION: Chronic low back pain affects millions of people worldwide and can arise through a variety of clinical origins. In the case of Failed Back Surgery Syndrome (FBSS), previous surgical procedures can contribute to low back pain that is often unresponsive to intervention. Although spinal cord stimulation can be an effective treatment modality, it does not provide sufficient pain relief for some intractable cases. Recently, alternative neuromodulation options have been developed, including dorsal root ganglion (DRG) stimulation...
May 9, 2017: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/28486278/interventional-approaches-to-low-back-pain
#18
Ariana M Nelson, Geeta Nagpal
Chronic low back pain (LBP) places a tremendous economic burden on society due to both direct and indirect costs. Health care costs for adults with chronic LBP have steadily increased over the past 20 years, coinciding with a large increase in the utilization of spinal injections, surgical interventions, opioid medications, and physical therapy. The treatment of LBP is best approached by a multimodal and even multidisciplinary approach with a combination of physical rehabilitation, pharmacologic management, psychological intervention, spinal injections, and surgical intervention with a goal of improving the functional status of the patient...
May 8, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28430617/estrogen-receptors-involvement-in-intervertebral-discogenic-pain-of-the-elderly-women-colocalization-and-correlation-with-the-expression-of-substance-p-in-nucleus-pulposus
#19
Xiao-Xing Song, Sheng Shi, Zhen Guo, Xin-Feng Li, Bu-Wei Yu
Estrogenic modulation of pain is an exceedingly complex phenomenon. However, whether estrogen is involved in discogenic low back pain still remains unclear. Here, immunoreactivity staining technique was used to examine the expression level of the estrogen receptors (ERα and ERβ) and a pain related neuropeptide, Substance P in the lumbar intervertebral discs to analyze the relationship between the ERs and Substance P. Nucleus pulposus tissues of 23 elderly female patients were harvested during spinal surgeries and made to detect the immunoreactivity staining of ERα, ERβ and Substance P...
June 13, 2017: Oncotarget
https://www.readbyqxmd.com/read/28379575/no-transfer-of-pressure-to-adjacent-discs-during-human-low-pressure-controlled-discography-a-prospective-clinical-study
#20
Jan Willem Kallewaard, José W Geurts, Michel Terheggen, Chris Terwiel, Alfons Kessels, Maarten van Kleef, Paul C Willems
Background. : A substantial part of low back pain (LBP) originates from degeneration of the intervertebral disc. To confirm the diagnosis of discogenic pain, provocation discography seems the best available tool. However, provocation discography is also considered to be a controversial and subjective test because the patient's personal pain response is the most crucial for the result of the test. Recently, an in vivo porcine study and a study in nine human subjects showed passing of pressure to the adjacent discs during discography...
April 1, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
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