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https://www.readbyqxmd.com/read/28546769/treatment-of-chronic-low-back-pain-new-approaches-on-the-horizon
#1
REVIEW
Nebojsa Nick Knezevic, Shane Mandalia, Jennifer Raasch, Ivana Knezevic, Kenneth D Candido
Back pain is the second leading cause of disability among American adults and is currently treated either with conservative therapy or interventional pain procedures. However, the question that remains is whether we, as physicians, have adequate therapeutic options to offer to the patients who suffer from chronic low back pain but fail both conservative therapy and interventional pain procedures before they consider surgical options such as discectomy, disc arthroplasty, or spinal fusion. The purpose of this article is to review the potential novel therapies that are on the horizon for the treatment of chronic low back pain...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28546122/cauda-equina-syndrome-due-to-dural-sac-shift-with-engorgement-of-the-epidural-venous-plexus-rare-complication-after-lumbar-microdiscectomy
#2
Yoshinori Maki, Motohiro Takayama, Hideki Hayashi, Yohei Yokoyama, Yuji Agawa
BACKGROUND: Several postoperative complications related to lumbar microdisectomy have been reported, including cauda equina syndrome. However, to the best of our knowledge, postoperative cauda equina syndrome resulting from dural sac shift with engorgement of the epidural venous plexus is yet to be reported. CASE DESCRIPTION: A 71-year-old male patient was referred to our hospital with a chief complaint of pain and sensory disturbance due to the lumbar disc herniation of L5-S1...
May 22, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28545560/influences-of-lumbar-disc-herniation-on-the-kinematics-in-multi-segmental-spine-pelvis-and-lower-extremities-during-five-activities-of-daily-living
#3
Shengzheng Kuai, Wenyu Zhou, Zhenhua Liao, Run Ji, Daiqi Guo, Rui Zhang, Weiqiang Liu
BACKGROUND: Low back pain (LBP) is a common problem that can contribute to motor dysfunction. Previous studies reporting the changes in kinematic characteristics caused by LBP present conflicting results. This study aimed to apply the multisegmental spinal model to investigate the kinematic changes in patients with lumbar disc herniation (LDH) during five activities of daily living (ADLs). METHODS: Twenty-six healthy subjects and 7 LDH patients participated in this study and performed level walking, stair climbing, trunk flexion, and ipsilateral and contralateral pickups...
May 25, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28545491/treatment-of-acute-sciatica-with-transforaminal-epidural-corticosteroids-and-local-anesthetic-design-of-a-randomized-controlled-trial
#4
Bastiaan C Ter Meulen, Esther T Maas, Amrita Vyas, Marinus van der Vegt, Koo de Priester, Michiel R de Boer, Maurits W van Tulder, Henry C Weinstein, Raymond W J G Ostelo
BACKGROUND: Transforaminal epidural injections with steroids (TESI) are used increasingly for patients with sciatica. However there is much debate about their safety and effectiveness. It is important to identify patients that benefit most from TESI and only few trials have yet evaluated the effects in patients with acute sciatica. METHODS: We describe a prospective, randomized controlled trial (RCT), with the aim to evaluate the hypothesis that TESI plus Levobupivacaine (TESI-plus) added to oral pain medication is more effective compared to pain medication alone or compared to transforaminal injection with a local anesthetic of short duration among patients with acute sciatica...
May 25, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28542104/reduced-spinal-cord-movement-with-the-straight-leg-raise-test-in-patients-with-lumbar-intervertebral-disc-herniation
#5
Marinko Rade, Janne Pesonen, Mervi Könönen, Jarkko Marttila, Michael Shacklock, Ritva Vanninen, Markku Kankaanpää, Olavi Airaksinen
STUDY DESIGN: Controlled radiological study. OBJECTIVE: To explore whether impairment of neural excursion during the straight leg raise test occurs in patients with sciatic symptoms secondary to lumbar intervertebral disc herniation (LIDH). SUMMARY OF BACKGROUND DATA: Earlier studies have shown that during the SLR test in asymptomatic volunteers tensile forces are consistently transmitted throughout the neural system and the thoracolumbar spinal cord slides distally...
May 25, 2017: Spine
https://www.readbyqxmd.com/read/28542101/clinical-impact-of-t1-slope-minus-cervical-lordosis-following-multilevel-posterior-cervical-fusion-surgery-a-minimum-2-year-follow-up-data
#6
Seung-Jae Hyun, Ki-Jeong Kim, Tae-Ahn Jahng, Hyun-Jib Kim
STUDY DESIGN: Retrospective study. OBJECTIVE: To assess the longer term relationship between sagittal alignment of the cervical spine and patient-reported health-related quality-of-life (HRQOL) scores following multilevel posterior cervical fusion, and to explore whether an analog of T1 slope - C2-C7 lordosis ('T1S-CL') impacts on patients' clinical outcomes. SUMMARY OF BACKGROUND DATA: A 6-month follow-up study demonstrated that, similar to the thoracolumbar spine, the severity of disability increases with sagittal malalignment following cervical reconstruction surgery...
May 25, 2017: Spine
https://www.readbyqxmd.com/read/28535642/-clinical-effects-of-dynesys-system-and-transfacet-decompression-through-wiltse-approach-in-the-treatment-of-lumbar-degenerative-diseases
#7
K Shang, M J Chen, D G Wang
Objective: To investigate the early clinical effects of Dynesys system and transfacet decompression by Wiltse approach in the treatment of lumbar degenerative diseases. Methods: From January 2010 to December 2013, 48 patients suffering from lumbar degenerative diseases were treated with Dynesys system in addition to transfacet decompression through Wiltse approach.There were 28 males and 20 females with age of (51.8±6.8). The preoperative diagnosis included lumbar spinal stenosis(10 cases); lumber intervertebral disc herniation (38 cases)...
May 23, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28535570/a-novel-combination-of-percutaneous-endoscopic-lumbar-discectomy-and-epiduroscopic-laser-neural-decompression-for-down-migrated-disc-herniation
#8
Kyung-Chul Choi, Dong Chan Lee, Choon-Keun Park
Although percutaneous endoscopic lumbar discectomy (PELD) is an effective treatment for herniated discs, its application in a disc with extensive migration is still challenging. As such, epiduroscopic laser neural decompression (ELND) provides a new view of the epidural space as well as an alternative treatment for a herniated disc and epidural fibrosis. In this paper the authors introduce the novel combination of PELD and ELND for high grade down-migrated disc herniation.An 87-year old woman presented with severe pain radiating down her leg due to high grade down-migrated disc herniation at L4-5...
May 2017: Pain Physician
https://www.readbyqxmd.com/read/28535559/initial-clinical-outcomes-of-percutaneous-full-endoscopic-lumbar-discectomy-using-an-interlaminar-approach-at-the-l4-l5
#9
Jun-Ichiro Nakamura, Kiyoshi Yoshihara
BACKGROUND: Percutaneous full-endoscopic discectomy (PED) is being increasingly used because of its potential to minimalize soft-tissue damage and decrease hospital stay. PED using the interlaminar approach (PED-IL) at L4-L5 is performed by only a few surgeons. To the best of our knowledge, the safety and efficacy of PED-IL at L4-L5, without experience in PED via a transforaminal approach (PED-TF) has not been previously reported. OBJECTIVE: This study aimed to evaluate initial clinical outcomes and complications of PED-IL at L4-L5 without experience in PED-TF...
May 2017: Pain Physician
https://www.readbyqxmd.com/read/28535556/feasibility-of-percutaneous-lumbar-discectomy-combined-with-percutaneous-cementoplasty-for-symptomatic-lumbar-disc-herniation-with-modic-type-i-endplate-changes
#10
Qing-Hua Tian, Ying-Ying Lu, Xi-Qi Sun, Tao Wang, Chun-Gen Wu, Ming-Hua Li, Sheng Cheng-Ying
BACKGROUND: Treatment of symptomatic lumbar disc herniation with Modic type I endplate changes is complex and challenging, requiring systemic and local therapies which include conservative therapy, epidural infiltrations, percutaneous therapeutic techniques, and surgical options. The clinical management of symptomatic lumbar disc herniation involving Modic type I endplate changes is uniquely challenging because it requires alleviating pain caused by both the herniated disc and the endplate osteochondritis...
May 2017: Pain Physician
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
#11
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/28534073/surgical-treatment-of-intraforaminal-extraforaminal-lumbar-disc-herniations-many-approaches-for-few-surgical-routes
#12
REVIEW
Giorgio Lofrese, Lorenzo Mongardi, Francesco Cultrera, Giorgio Trapella, Pasquale De Bonis
BACKGROUND: Several disc disease nomenclatures and approaches for LDH exist. The traditional midline bone-destructive procedures together with approaches requiring extreme muscular retraction are being replaced by muscle sparing, targeted, stability-preserving surgical routes. The increasing speculation on LDHs and the innovative corridors described to treat them have lead to an extensive production of papers frequently treating the same topic but adopting different terminologies and reporting contradictory results...
May 22, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28528480/full-endoscopic-treatment-of-dural-tears-in-lumbar-spine-surgery
#13
Joachim M Oertel, Benedikt W Burkhardt
PURPOSE: An incidental durotomy is a common complication of spinal surgery. Its treatment remains challenging, especially in endoscopic procedures. The objective of this study is to describe a technique for endoscopic dural closure which is safe and effective. METHODS: From a prospective database all endoscopic spinal procedures with incidental durotomy were identified. Retrospectively, video recordings were analysed with a special reference to the applied technique of dural closure...
May 20, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28525292/comparison-of-adjacent-segment-degeneration-after-nonrigid-fixation-system-and-posterior-lumbar-interbody-fusion-for-single-level-lumbar-disc-herniation-a-new-method-of-mri-analysis-of-lumbar-nucleus-pulposus-volume
#14
Shaofeng Yang, Yanan Liu, Zhaohua Bao, Jun Zou, Huilin Yang
PURPOSE: To evaluate the influence of a nonrigid fixation system and posterior lumbar interbody fusion on adjacent intervertebral disc degeneration by using MRI analysis of lumbar nucleus pulposus volume for single-level lumbar disc herniation. MATERIALS AND METHODS: We selected 112 patients who underwent nonrigid fixation (17 men and 44 women) or posterior lumbar interbody fusion (13 men and 38 women) for this retrospective study. Based on the T2-weighted magnetic resonance imaging (MRI) scans taken preoperatively, and 6, 12, and 24 months after surgery, the nucleus pulposus in the upper segments of the operated level was considered an ellipsoid, and their volumes were measured respectively and then compared between the two groups...
May 19, 2017: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
https://www.readbyqxmd.com/read/28520505/early-blockade-of-matrix-metalloproteinases-in-spinal-cord-injured-dogs-results-in-a-long-term-increase-in-bladder-compliance
#15
Jonathan Michael Levine, Noah D Cohen, Thomas Fandel, Gwendolyn Joan Levine, Joseph M Mankin, John F Griffin, Sharon C Kerwin, C Elizabeth Boudreau, Alpa Trivedi, Linda Noble-Haeusslein
Spinal cord injury (SCI) is often accompanied by reduced bladder compliance, which contributes to adverse conditions including urinary tract infections and vesicoureteral reflux. Reduced compliance is, in part, attributed to extensive remodeling of the bladder wall including the extracellular matrix (ECM). Here we tested the hypothesis that blockade of matrix metalloproteinases (MMPs), known for their ability to remodel the ECM, improves bladder compliance in dogs with SCI. We first evaluated dogs with naturally occurring SCIs resulting from intervertebral disc herniation (IVDH)...
May 18, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28511972/a-matched-cohort-comparison-of-cervical-disc-arthroplasty-versus-anterior-cervical-discectomy-and-fusion-evaluating-perioperative-outcomes
#16
Pavan S Upadhyayula, John K Yue, Erik I Curtis, Reid Hoshide, Joseph D Ciacci
OBJECTIVE: Cervical disc arthroplasty (CDA) is a recent alternative to anterior cervical discectomy and fusion (ACDF) in patients suffering cervical disc herniation and degeneration. To date, a systematic analysis of their comparative advantages and risks following elective surgery remains elusive. METHODS: Adult patients undergoing elective CDA or ACDF were extracted from the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database years 2011-2014...
May 13, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28507882/aquaporin-1-expression-in-herniated-human-lumbar-intervertebral-discs
#17
Haydn Hoffman, Aaron W Choi, Victor Chang, Jon Kimball, Alan S Verkman, Rubeen Virani, Brian Kim, Tianyi Niu, Daniel C Lu
STUDY DESIGN: Case series. OBJECTIVE: Intervertebral disc (IVD) degeneration is the cause of spondylosis. The pathogenesis is poorly understood, but disc dehydration often plays a role. In this study, we aim to identify and quantify aquaporin-1 (AQP1) in ex vivo human degenerated IVDs obtained intraoperatively and to investigate the relationship between AQP1 levels and magnetic resonance imaging (MRI) T2 intensity of the disc. METHODS: Ex vivo samples of nucleus pulposus (NP) tissue from lumbar IVDs were obtained from 18 consecutive patients who underwent surgery for disc herniation at L4/5 and L5/S1 level...
April 2017: Global Spine Journal
https://www.readbyqxmd.com/read/28507834/clinical-and-radiological-improvement-following-ozone-disc-nucleolysis-a-case-report
#18
Sharad Ghatge, Pranav D Modi, Dhaval B Modi
The results of traditional open surgery for herniated intervertebral disc are often limited by complications and failed back surgery syndrome (FBSS). Over the past few decades, a considerable amount of research has been done in the field of minimally invasive procedures as a treatment option for herniated intervertebral disc disease. Ozone disc nucleolysis is one such procedure which has results equal to or better than traditional surgery with virtually no complications. A 27-year-old post-partum female presented to the clinic with acute onset of severe lower back pain radiating to the left lower limb for one month...
April 13, 2017: Curēus
https://www.readbyqxmd.com/read/28505956/regression-of-lumbar-disc-herniation-by-physiotherapy-does-non-surgical-spinal-decompression-therapy-make-difference-double-blind-randomized-controlled-trial
#19
Aynur Demirel, Mehmet Yorubulut, Nevin Ergun
BACKGROUND AND OBJECTIVES: The aim of the study determining whether or not Non-invasive Spinal Decompression Therapy (NSDT) was effective in resorption of herniation, increasing disc height in patients with lumbar disc herniation (LHNP). METHODS: A total of twenty patients diagnosed as LHNP and suffering from pain at least 8 weeks were enrolled to the study. Patients were allocated in study (SG) and control groups (CG) randomly. Both groups received combination of electrotherapy, deep friction massage and stabilization exercise for fifteen session...
May 5, 2017: Journal of Back and Musculoskeletal Rehabilitation
https://www.readbyqxmd.com/read/28505030/association-between-neurotrophic-factor-expression-and-pain-related-behavior-induced-by-nucleus-pulposus-applied-to-rat-nerve-root
#20
Shinobu Seki, Miho Sekiguchi, Shin-Ichi Konno
STUDY DESIGN: An experimental animal study OBJECTIVE.: To investigate the relationship between pain-related behavior and the expression of neurotrophic factors in the dorsal root ganglion (DRG) and spinal cord (SC) using a nucleus pulposus (NP) rat model. SUMMARY OF BACKGROUND DATA: Neurotrophic factors are released from activated glial cells and are associated with pain-related behavior. Nerve growth factor (NGF) is a neurotrophic factor that is induced by inflammation...
April 12, 2017: Spine
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