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Herniated disc treatment

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https://www.readbyqxmd.com/read/28727718/quantity-of-disc-removal-and-radiological-outcomes-of-percutaneous-endoscopic-lumbar-discectomy
#1
Ji Han Heo, Chi Heon Kim, Chun Kee Chung, Yunhee Choi, Young-Geun Seo, Dong Hoi Kim, Sung Bae Park, Jung Hyeon Moon, Won Heo, Jong-Myung Jung
BACKGROUND: Herniated intervertebral disc disease (HIVD) is a common cause of lower back and leg pain. Percutaneous endoscopic lumbar discectomy (PELD) is indicated when non-surgical treatments such as medication and interventions are intractable. Ruptured discs and loose fragments inside discs are removed during PELD. Nerve root decompression is usually assessed by visualizing the free movement of the traversing nerve root or epidural fat, the free passage of a probe into the epidural space, the depression of the annulus, and the removal of the expected ruptured discs and loose fragments based on preoperative magnetic resonance images (MRI)...
July 2017: Pain Physician
https://www.readbyqxmd.com/read/28727709/transforaminal-percutaneous-endoscopic-discectomy-and-foraminoplasty-after-lumbar-spinal-fusion-surgery
#2
Jian-Jun Wu, Hui-Zhen Chen, Changkun Zheng
BACKGROUND: The most common causes of pain following lumbar spinal fusions are residual herniation, or foraminal fibrosis and foraminal stenosis that is ignored, untreated, or undertreated. The original surgeon may advise his patient that nothing more can be done in his opinion that the nerve was visually decompressed by the original surgery. Post-operative imaging or electrophysiological assessment may be inadequate to explain all the reasons for residual or recurrent symptoms. Treatment of failed lumbar spinal fusions by repeat traditional open revision surgery usually incorporates more extensive decompression causing increased instability and back pain...
July 2017: Pain Physician
https://www.readbyqxmd.com/read/28727705/activation-of-the-rage-stat3-pathway-in-the-dorsal-root-ganglion-contributes-to-the-persistent-pain-hypersensitivity-induced-by-lumbar-disc-herniation
#3
Xin-Sheng Zhang, Xiao Li, Hai-Jie Luo, Zhu-Xi Huang, Cui-Cui Liu, Qing Wan, Shu-Wei Xu, Shao-Ling Wu, Song-Jian Ke, Chao Ma
BACKGROUND: Clinically, chronic low back pain and sciatica associated with lumbar disc herniation (LDH) is a common musculoskeletal disorder. Due to the unawareness of detailed mechanisms, it is difficult to get an effective therapy. OBJECTIVE: The aim of the present study was to identify the role of the RAGE/STAT3 pathway in the dorsal root ganglion (DRG) on the formation and development of persistent pain hypersensitivity induced by LDH. STUDY DESIGN: Controlled animal study...
July 2017: Pain Physician
https://www.readbyqxmd.com/read/28723772/anatomic-investigation-of-lumbar-transforaminal-fenestration-approach-and-its-clinical-application-in-far-lateral-disc-herniation
#4
Baoshan Xu, Haiwei Xu, Jean Destandau, Xinlong Ma, Jian He, Qun Xia, Ning Ji, Qiang Yang, Yue Liu, Hongfeng Jiang
Treating lumbar disease at the intervertebal foramina is controversial because we lack an approach providing sufficient exposure and preserving spinal stability. The primary objective of this study was to investigate the feasibility of the transforaminal fenestration (TFF) approach for treating lumbar disease involving the intervertebal foramina.In the anatomic study of 30 adult cadaveric lumbar spine specimens, the TFF approach was used from L1 to S1. The scope of resection was measured manually and on 3D CT images...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28719550/does-an-annular-puncture-influence-the-herniation-path-an-in-vitro-mechanical-and-structural-investigation
#5
Vonne M van Heeswijk, Ashvin Thambyah, Peter A Robertson, Neil D Broom
STUDY DESIGN: A study of mechanically-induced herniation in punctured ovine discs followed by structural analysis. OBJECTIVE: To investigate whether an annular puncture influences the path that herniation takes by providing direct passage for nucleus through the annulus and therefore whether it increases the risk of acute herniation from overload at the site of damage independent of any longer-term degeneration. SUMMARY OF BACKGROUND DATA: 10 years after treatment with discography both degenerative changes and frequency of herniation have been shown to increase compared to untreated discs...
July 17, 2017: Spine
https://www.readbyqxmd.com/read/28715939/surgical-versus-non-operative-treatment-for-lumbar-disc-herniation-a-systematic-review-and-meta-analysis
#6
Bing-Lin Chen, Jia-Bao Guo, Hong-Wei Zhang, Ya-Jun Zhang, Yi Zhu, Juan Zhang, Hao-Yu Hu, Yi-Li Zheng, Xue-Qiang Wang
OBJECTIVE: To investigate the effects of surgical versus non-operative treatment on the physical function and safety of patients with lumbar disc herniation. DATA SOURCES: PubMed, Cochrane Library, Embase, EBSCO, Web of Science, China National Knowledge Infrastructure and Chinese Biomedical Literature Database were searched from initiation to 15 May 2017. METHODS: Randomized controlled trials that evaluated surgical versus non-operative treatment for patients with lumbar disc herniation were selected...
July 1, 2017: Clinical Rehabilitation
https://www.readbyqxmd.com/read/28709837/what-are-the-possibilities-of-spontaneous-resorption-of-a-thoracic-disc-herniation-occupying-more-than-20-of-the-spinal-canal-in-the-asymptomatic-subject-comparative-study
#7
David Brauge, Rachid Madkouri, Robert Clément, Vincent Reina, Thomas Brauge, Stephan Gaillard
Thoracic disc herniation is a rare pathology for which surgical treatment is difficult. The discovery of asymptomatic or only slightly symptomatic lesions can be problematic, especially in cases of marked canal stenosis. The possibility of spontaneous resorption has been documented by a few case reports but there is no study on this subject. Our objective was to compare the clinical and radiological data for two groups of patients with significant thoracic herniation (occupying more than 20% of the spinal canal): one showing spontaneous resorption (group 1) and the other persistence of the lesion during follow up (group 2)...
July 11, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28708040/anterior-lumbar-discectomy-and-fusion-for-acute-cauda-equina-syndrome-caused-by-recurrent-disc-prolapse-report-of-3-cases
#8
Kimberly-Anne Tan, Mathew D Sewell, Yma Markmann, Andrew J Clarke, Oliver M Stokes, Daniel Chan
There is a lack of information and consensus regarding the optimal treatment for recurrent disc herniation previously treated by posterior discectomy, and no reports have described an anterior approach for recurrent disc herniation causing cauda equina syndrome (CES). Revision posterior decompression, irrespective of the presence of CES, has been reported to be associated with significantly higher rates of dural tears, hematomas, and iatrogenic nerve root damage. The authors describe treatment and outcomes in 3 consecutive cases of patients who underwent anterior lumbar discectomy and fusion (ALDF) for CES caused by recurrent disc herniations that had been previously treated with posterior discectomy...
July 14, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28700387/treatment-of-recurrent-lumbar-disc-herniation-with-or-without-fusion-in-workers-compensation-subjects
#9
Jeffrey A O'Donnell, Joshua T Anderson, Arnold R Haas, Rick Percy, Stephen T Woods, Uri M Ahn, Nicholas U Ahn
STUDY DESIGN: Retrospective cohort study. OBJECTIVE: To determine outcomes after reoperation discectomy with or without fusion surgery for recurrent lumbar disc herniation (RLDH) in the workers' compensation (WC) population. SUMMARY OF BACKGROUND DATA: RLDH is estimated to occur in 7% to 24% of patients after discectomy. There are two main surgical options after reherniation: a revision discectomy (RD), or an RD combined with fusion (RDF)...
July 15, 2017: Spine
https://www.readbyqxmd.com/read/28694597/management-of-cervical-monoradiculopathy-due-to-prolapsed-intervertebral-disc-an-institutional-experience
#10
Amresh S Bhaganagare, S A Nagesh, B G Shrihari, Vikas Naik, M N Nagarjun, Balaji S Pai
BACKGROUND: Cervical radiculopathy is the common clinical entity, often caused by "wear and tear" changes that occur in the spine. In the younger population, cervical radiculopathy is a result of a disc herniation or an acute injury causing foraminal impingement of an exiting nerve, whereas in the older individuals, it is due to foraminal narrowing from osteophyte formation, decreased disc height, and degenerative changes of the uncovertebral joints anteriorly and of the facet joints posteriorly...
April 2017: Journal of Craniovertebral Junction and Spine
https://www.readbyqxmd.com/read/28688062/giant-thoracic-discs-treatment-outcome-and-follow-up-of-33-patients-in-a-single-centre
#11
Saurabh Kapoor, Meriem Amarouche, Farah Al-Obeidi, Jean Marie U-King-Im, Nick Thomas, David Bell
PURPOSE: To help guide treatment strategies and create insight into functional outcomes in patients with Giant herniated thoracic discs (GHTD), which are defined as occupying more than 40% of spinal canal. METHODS: Authors did a retrospective analysis of prospective cohort of 33 cases of GHTD, using clinical letters, notes, and telephonic questionnaires to determine their pre and postoperative functional status, surgical details, and complication rates. 16 males and 17 females operated between 2006 and 2014 were included in the study...
July 7, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28676461/cervical-burst-fracture-in-a-patient-with-contiguous-two-level-cervical-stand-alone-cages-a-case-report
#12
Rui Feng, Joshua Loewenstern, John Caridi
BACKGROUND: Cervical stand-alone interbody cages have seen increasingly wider use over the plate-and-screw construct in single-level anterior cervical discectomy and fusion (ACDF) in the treatment of cervical disc herniation and degenerative spondylotic conditions. Despite positive clinical outcomes, the efficacy and safety of using these devices in contiguous multi-level ACDF, however, has remained controversial. CASE DESCRIPTION: This report discusses a burst fracture seen as a complication in multi-level cervical stand-alone cage use...
July 1, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28669725/mir-21-promotes-fibrosis-and-hypertrophy-of-ligamentum-flavum-in-lumbar-spinal-canal-stenosis-by-activating-il-6-expression
#13
Chao Sun, Jiwei Tian, Xinhui Liu, Guoping Guan
The molecular mechanism underlying the fibrosis of ligamentum flavum(LF) in patients with lumbar spinal canal stenosis(LSCS) remains unknown. MicroRNAs are reported to play important roles in regulating fibrosis in different organs. The present study aimed to identify fibrosis related miR-21 expression profile and investigate the pathological process of miR-21 in the fibrosis of LF hypertrophy and associated regulatory mechanisms. 15 patients with LSCS underwent surgical treatment were enrolled in this study...
June 29, 2017: Biochemical and Biophysical Research Communications
https://www.readbyqxmd.com/read/28669721/initial-investigation-of-individual-and-combined-annulus-fibrosus-and-nucleus-pulposus-repair-ex-vivo
#14
Stephen R Sloan, Devis Galesso, Cynthia Secchieri, Connor Berlin, Roger Hartl, Lawrence J Bonassar
Novel tissue engineered and biomaterial approaches to treat intervertebral disc (IVD) degeneration focus on single aspects of the progressive disease and hence are insufficient repair strategies. In this study, annulus fibrosus (AF) and nucleus pulposus (NP) biomaterial repair strategies were used individually and combined to treat IVD degeneration modeled in ex vivo rat-tail motion segments by annulotomy and nucleotomy. An injectable riboflavin cross-linked high-density collagen gel patched defects in the AF, while NP repair consisted of injections of a modified hyaluronic acid (HA) hydrogel...
June 29, 2017: Acta Biomaterialia
https://www.readbyqxmd.com/read/28665378/-the-application-of-general-magnetic-therapy-for-the-rehabilitation-of-the-patients-following-the-surgical-treatment-of-herniated-intervertebral-discs
#15
D D Voronina, A G Kulikov, I A Luppova, O V Yarustovskaya
AIM: The objective of the present work was to rehabilitate more efficiently the patients who had undergone the surgical treatment for herniated discs in the lumbosacral spine by applying general magnetic therapy during the combined treatment. MATERIAL AND METHODS: A total of 73 patients underwent the medical examination and treatment. The patients matched for age and sex presenting with similar clinical symptoms were divided into two groups. All of them received initial therapy that included medication, therapeutic physical exercises, and aquatic therapy...
2017: Voprosy Kurortologii, Fizioterapii, i Lechebnoĭ Fizicheskoĭ Kultury
https://www.readbyqxmd.com/read/28662011/-the-assessment-of-the-impact-of-rehabilitation-on-the-pain-intensity-level-in-patients-with-herniated-nucleus-pulposus-of-the-intervertebral-disc
#16
Kamil Koszela, Sylwia Krukowska, Marta Woldańska-Okońska
Back disorders are very common phenomena in modern society. One of the methods of spinal pain treatment is performing surgery. Unfortunately, this method is not one hundred percent effective. Some patients show no improvement after surgery, the pain persists and even increases. In these cases, it is reasonable to use the term Failed Back Surgery Syndrome (FBSS), i.e. back pain syndrome after unsuccessful spine surgery. AIM: The aim of the study is to assess the impact of rehabilitation on the pain intensity level in patients with FBSS...
June 23, 2017: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/28658870/failed-back-surgery-syndrome-evaluation-with-magnetic-resonance-imaging
#17
Peeyush Kumar Dhagat, Megha Jain, Satyendra Narayan Singh, Sumeet Arora, Kasukarthi Leelakanth
INTRODUCTION: Failed Back Surgery Syndrome (FBSS) is a generalized term used to describe varied spinal symptoms of patients who have had unsuccessful results after spinal surgery. The treatment of FBSS is challenging and varies from conservative management to reoperation. Imaging plays a crucial role in identifying the cause and helps to guide the appropriate therapy. Contrast enhanced Magnetic Resonance Imaging (MRI) with its superior resolution is the imaging modality of choice. AIM: To evaluate the spectrum of imaging findings on postoperative MRI in FBSS...
May 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28658038/immediate-versus-delayed-surgical-treatment-of-lumbar-disc-herniation-for-acute-motor-deficits-the-impact-of-surgical-timing-on-functional-outcome
#18
Ondra Petr, Bernhard Glodny, Konstantin Brawanski, Johannes Kerschbaumer, Christian Freyschlag, Daniel Pinggera, Rafael Rehwald, Sebastian Hartmann, Martin Ortler, Claudius Thomé
STUDY DESIGN: A retrospective cohort study. OBJECTIVE: The aim of the study was to assess the impact of time to surgery in patients with MDs on their functional outcome. The current single-center study presents results of emergency surgery for LDH in a group of patients with acute paresis in a "real-world" setting. SUMMARY OF BACKROUND DATA: Motor deficits (MDs) are a frequent symptom of lumbar disc herniation (LDH). While surgery within 48 hours has been recommended for cauda-equina syndrome, the best timing of surgery for acute MDs continues to be debated...
June 27, 2017: Spine
https://www.readbyqxmd.com/read/28646343/clinical-outcome-following-anterior-cervical-discectomy-and-fusion-with-and-without-anterior-cervical-plating-for-the-treatment-of-cervical-disc-herniation-a-25-year-follow-up-study
#19
Benedikt W Burkhardt, Moritz Brielmaier, Karsten Schwerdtfeger, Joachim M Oertel
Extreme long-term clinical outcome studies following anterior cervical discectomy and fusion (ACDF) with an autologous iliac crest with and without Caspar plating (ACDF + CP) for the treatment of radiculopathy caused by cervical disc herniation (CDH) are extremely rare. Hospital records of patients who underwent ACDF or ACDF + CP for the treatment of CDH at least 17 years ago were reviewed. Information about diagnosis, surgery, pre- and postoperative clinical process, and repeated procedure was analyzed...
June 23, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28645675/anatomical-considerations-of-the-iliac-crest-on-percutaneous-endoscopic-discectomy-using-a-transforaminal-approach
#20
Fumitake Tezuka, Toshinori Sakai, Mitsunobu Abe, Kazuta Yamashita, Yoichiro Takata, Kosaku Higashino, Akihiro Nagamachi, Takashi Chikawa, Koichi Sairyo
BACKGROUND CONTEXT: Percutaneous endoscopic discectomy (PED) is a minimally invasive procedure for the surgical treatment of lumbar disc herniation (LDH). It can be performed under local anesthesia and requires a skin incision of only 8 mm, with minimal disruption of the spinal structures including ligaments and muscles. However, performing PED with a transforaminal approach (TF-PED) for the lower lumbar spine is associated with some anatomical problems such as interference from the iliac crest...
June 20, 2017: Spine Journal: Official Journal of the North American Spine Society
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