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Herniated disc treatment

Korgün Ökmen, Burcu Metin Ökmen
This study aims to investigate the efficacy of three different percutaneous intradiscal therapies in patients with chronic low back pain (CLBP) due to lumbar disc herniation (LDH). Medical files of a total of 120 patients who received percutaneous intradiscal therapy were retrospectively analyzed. All patients were divided into three groups: group L: diode laser (n = 40), group R: radiofrequency (RF) (n = 40), and group P: pulsed radiofrequency (PRF) (n = 40). The visual analogue scale (VAS) and Oswestry Disability Index (ODI) scores were calculated at 1, 3, 6, and 12 months for all patients...
October 21, 2016: Lasers in Medical Science
Andrew J Hahne, Jon J Ford, Rana S Hinman, Matthew C Richards, Luke D Surkitt, Alexander Yp Chan, Sarah L Slater, Nicholas F Taylor
BACKGROUND CONTEXT: Physical therapy is commonly sought by people with lumbar disc herniation and associated radiculopathy. It is unclear whether physical therapy is effective for this population. PURPOSE: To determine the effectiveness of physical therapist delivered individualized functional restoration as an adjunct to guideline-based advice in people with lumbar disc herniation and associated radiculopathy. DESIGN: Pre-planned subgroup analysis of a multicenter parallel group randomized controlled trial...
October 17, 2016: Spine Journal: Official Journal of the North American Spine Society
Junichi Yokosuka, Yasushi Oshima, Takeshi Kaneko, Yuichi Takano, Hirohiko Inanami, Hisashi Koga
BACKGROUND: Percutaneous endoscopic lumbar discectomy (PELD) is one of the less invasive treatments for lumbar disc herniation (LDH), and has 3 different operative approaches. This study focused on the posterolateral approach (PLA) and investigated the appropriate operative indication. METHODS: PLA was performed in 29 patients with foraminal and extraforaminal LDH. The height and width of the foramen, LDH type, and positional relationship between LDH and the foramen were radiologically evaluated...
September 2016: J Spine Surg
Chang-Qing Zhao, Wei Ding, Kai Zhang, Jie Zhao
BACKGROUND: Large lumbar or lumbosacral (LS) disc herniations usually expand from the paramedian space to the neuroforamen and compress both the transversing (lower) and the exiting (upper) nerve roots, thus leading to bi-radicular symptoms. Bi-radicular involvement is a statistically significant risk factor for poor outcome in patients presenting with far lateral or foraminal disc herniation after facet preserving microdecompression. There is evidence showing that patients suffering from large lumbar disc herniations treated with interbody fusion have significant superior results in comparison with those who received a simple discectomy...
September 2016: Indian Journal of Orthopaedics
Martin Barth, Johann Fontana, Claudius Thomé, Gerrit J Bouma, Kirsten Schmieder
Sequestrectomy alone represents a procedure for the treatment of lumbar disc herniation. For selected cases, an anulus closure device (ACD) can be implanted which may result in lower reoperation rates. However, comparative magnetic resonance imaging (MRI) changes and their clinical relevance of both procedures are unclear and have not been reported so far. Clinical and MRI data of patients after limited discectomy with ACD implantation (group ACD; N=45) and patients after sequestrectomy alone (group S; N=40) with primary lumbar disc herniation were compared retrospectively...
October 11, 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Tae Hyun Kim, Jun Jae Shin, Woo Yong Lee
BACKGROUND: Percutaneous epidural neuroplasty with a Racz catheter is widely used to treat radicular pain caused by spinal stenosis or a herniated intervertebral disc. The breakage or shearing of an epidural catheter, particularly a percutaneous epidural neuroplasty catheter, is reported as a rare complication. There has been a controversy over whether surgical removal of a shorn epidural catheter is needed. Until now, only three cases related to sheared Racz neuroplasty catheters have been reported...
October 6, 2016: Journal of Medical Case Reports
J J Wong, P Côté, D A Sutton, K Randhawa, H Yu, S Varatharajan, R Goldgrub, M Nordin, D P Gross, H M Shearer, L J Carroll, P J Stern, A Ameis, D Southerst, S Mior, M Stupar, T Varatharajan, A Taylor-Vaisey
: We conducted a systematic review of guidelines on the management of low back pain (LBP) to assess their methodological quality and guide care. We synthesized guidelines on the management of LBP published from 2005 to 2014 following best evidence synthesis principles. We searched MEDLINE, EMBASE, CINAHL, PsycINFO, Cochrane, DARE, National Health Services Economic Evaluation Database, Health Technology Assessment Database, Index to Chiropractic Literature and grey literature. Independent reviewers critically appraised eligible guidelines using AGREE II criteria...
October 6, 2016: European Journal of Pain: EJP
B Eser, O Eser, Y Yuksel, H Aksit, E Karavelioglu, M Tosun, Z Sekerci
The aim of this study was to identify the possible correlation between polymorphisms in matrix metalloproteinase (MMP)-1 and MMP-3 and their corresponding protein levels in disc tissues obtained from patients with lumbar disc herniation (LDH) using biochemical and immunohistochemical analyses. Blood and disc samples were obtained from 100 patients with LDH who underwent a lumbar microdiscectomy. Based on the radiological degeneration, the patients were diagnosed with grade 2, 3, or 4 LDH. MMP-1 -1607 1G/2G and MMP-3 -1171 5A/6A were analyzed by real-time polymerase chain reaction...
September 9, 2016: Genetics and Molecular Research: GMR
Pablo Andrés-Cano, Tomás Vela, Claudio Cano, Gaspar García, Juan Carlos Vera, Jose Antonio Andrés-García
No abstract text is available yet for this article.
October 2016: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
Anna Maria Ierardi, Filippo Piacentino, Francesca Giorlando, Alberto Magenta Biasina, Alessandro Bacuzzi, Raffaele Novario, Gianpaolo Carrafiello
OBJECTIVE: To demonstrate the feasibility of percutaneous nucleoplasty procedures at L5/S1 level using cone beam CT (CBCT) and its associated image guidance technology for the treatment of lumbar disc herniation (LDH). MATERIALS AND METHODS: We retrospectively reviewed 25 cases (20 men, 5 women) of LDH at L5/S1 levels. CBCT as guidance imaging was chosen after a first unsuccessful fluoroscopy attempt that was related to complex anatomy (n = 15), rapid pathological changes due to degenerative diseases (n = 7) or both (n = 3)...
October 3, 2016: Skeletal Radiology
He-Ping Yin, Yu-Peng Wang, Zhi-Ye Qiu, Zhi-Cai Du, Yi-Min Wu, Shu-Wen Li
This study compares the safety and efficiency of two techniques in microendoscopic discectomy (MED) for lumbar disc herniation. The two techniques are MED with automatic nerve retractor and MED with nerve hook which had been widely used for many years. The former involves a newly developed MED device which contains three parts to protect nerve roots during operation. Four hundred and twenty-eight patients underwent MED treatments between October 2010 and September 2015 were recruited and randomized to either intraoperative utilization of automatic nerve retractor (n = 315, group A) or application of nerve hook during surgery (n = 113, group B)...
October 2016: Regenerative Biomaterials
G B Mahadewa Tjokorda, Golden Nyoman, Maliawan Sri, Mizuno Junichi
This report presents two cases of cervicobrachialgia and radiculopathy due to multiple cervical herniated discs and spur formation that dealt with anterior cervical discectomy and fusion (ACDF) using different titanium interbody cages. The description of the clinical presentation, magnetic resonance imaging (MRI) appearances and management strategy are discussed. Both cases showed chronic neck pain and radiating pain from the shoulder to the arm. They had a history of blurry vision, cluster head ache, weakness, and numbness on the shoulder for 2 years...
October 2016: Asian Journal of Neurosurgery
Hayri Kertmen, Bora Gürer, Erdal Resit Yilmaz, Zeki Sekerci
Endoscopic surgery for lumbar disc herniation has been available for more than 30 years. Transforaminal percutaneous endoscopic lumbar discectomy is a well-known, safe, and effective method used for the treatment of the lumbar disc herniation. The published complications of the transforaminal percutaneous endoscopic lumbar discectomy consist of infections, thrombophlebitis, dysesthesia, dural tear, vascular injury, and death. Seizure after transforaminal percutaneous endoscopic lumbar discectomy is an extremely rare complication...
October 2016: Asian Journal of Neurosurgery
Duygu Tecer, Emre Adiguzel, Arif Kenan Tan, Mehmet Ali Taskaynatan
OBJECTIVE:  To explore the outcome differences of lumbar transforaminal epidural steroid injection (TFESI) according to magnetic resonance imaging (MRI) findings in patients with lumbar radicular pain. DESIGN:  Retrospective study. SETTING:  Single university-based interventional pain management unit. PATIENTS:  Fifty-nine patients who had lumbar radicular pain with a recent lumbar MRI and three-month follow-up were included...
October 2, 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Amandeep Bhalla, Andrew J Schoenfeld, Jaiben George, Michael Moghimi, Christopher M Bono
BACKGROUND: Context: Understanding the influence of preoperative diagnosis on outcomes for lumbar fusion surgery improves the quality of research and outcomes data, and helps guide treatment decisions. PURPOSE: We sought to perform a systematic review of the literature published between 2000 and 2014 regarding lumbar fusion outcomes for degenerative disorders. An assessment of the influence of subgroup diagnosis on outcomes, as well as the quality of this body of literature was performed...
September 29, 2016: Spine Journal: Official Journal of the North American Spine Society
F C Heider, H M Mayer
OBJECTIVE: Herniated disc tissue removal to decompress the spinal nerve/cauda equina. Minimization of iatrogenic trauma and associated injuries. INDICATIONS: Conservative treatment did not sufficiently improve clinical symptoms. This is true for progressive or persisting neurological deficits, as well as for persisting pain which alters the quality of the patient`s life. Results of surgery are strongly dependent on the preoperative duration of symptoms. Paramount is the "timing" of surgery: poorer surgical results associated with increasing preoperative duration of symptoms...
September 29, 2016: Operative Orthopädie und Traumatologie
Gauri Tendulkar, Phillip Grau, Patrick Ziegler, Alfred Buck, Alfred Buck, Andreas Badke, Hans-Peter Kaps, Sabrina Ehnert, Andreas K Nussler
Intervertebral disc degeneration and disc herniation is one of the major causes of lower back pain. Depletion of extracellular matrix, culminating in nucleus pulposus (NP) extrusion leads to intervertebral disc destruction. Currently available surgical treatments reduce the pain but do not restore the mechanical functionality of the spine. In order to preserve mechanical features of the spine, total disc or nucleus replacement thus became a wide interest. However, this arthroplasty era is still in an immature state, since none of the existing products have been clinically evaluated...
2016: Journal of Visualized Experiments: JoVE
Güliz Acker, Ulf C Schneider, Zarko Grozdanovic, Peter Vajkoczy, Johannes Woitzik
BACKGROUND: Disc herniations are only reported in few case reports as a rare cause of acute spinal ischemia. A surgical treatment has not been described so far in these reports with analysis of diffusion weighted magnetic resonance imaging (DWI/MRI) before and after surgery. The aim of our study is to report a case of cervical spinal cord ischemia caused by cervical disc herniation and discuss the literature concerning diagnostic and treatment options. METHODS: A 72-year-old female patient developed an acute progressive tetraparesis with emphasis on the upper extremities...
June 2016: J Spine Surg
Kevin Phan, Alexander E Dunn, Prashanth J Rao, Ralph J Mobbs
Lumbar disc herniation arises when the annulus fibrosus of the vertebral disc fails, thus allowing displacement of the nucleus pulposus and other tissue. The term far lateral is used variably in the literature and usually refers to an extraforaminal displacement in the peridiscal zone peripheral to the sagittal plane of the most lateral part of the pedicle at the same level. Non-surgical treatments of far lateral disc herniation include physical therapy, anti-inflammatory medication, and corticosteroid injections...
March 2016: J Spine Surg
Darweesh O Al-Khawaja, Tamadur Mahasneh, Jonathan C Li
Lumbar discectomy is one of the most commonly performed neurosurgical procedure. Far lateral disc herniations (FLDH) make up a minor portion of the total discectomy workload for spine surgeons. Due to their lower incidence, as well as their different anatomical positioning compared to the more common para-median disc herniation, the surgical procedures involved in releasing the neural compression caused by FLDHs are often challenging and at times frustrating to most spine surgeons, resulting in suboptimal outcomes for the patient related to the higher risk of spinal instability from facet joint disruption and may even be associated with nerve root injury...
March 2016: J Spine Surg
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