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Herniated disc treatment

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https://www.readbyqxmd.com/read/28623897/altered-somatosensory-profile-according-to-quantitative-sensory-testing-in-patients-with-degenerative-lumbar-spine-disorders-scheduled-for-surgery
#1
Yvonne Lindbäck, Hans Tropp, Paul Enthoven, Björn Gerdle, Allan Abbott, Birgitta Öberg
BACKGROUND: Somatosensory profiling in affected and non-affected body regions can strengthen our insight regarding the underlying pain mechanisms, which can be valuable in treatment decision making and to improve outcomes, in patients with degenerative lumbar spine disorders pre-surgery. The aim was to describe somatosensory profiles in patients with degenerative lumbar spine disorders, to identify the proportion with altered somatosensory profile, and to analyze demographic characteristics, self-reported function, pain, and health pre- and 3 months post-surgery...
June 17, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28618737/effects-of-artcure-diffusional-patch-application-on-pain-and-functional-status-in-lumbar-disc-herniation-patients-a-prospective-randomized-controlled-study
#2
Mahmut Uğurlu, Mehmet Atıf Erol Aksekili, Berat Meryem Alkan, Halil Kara, Ceyhun Çağlar
BACKGROUND/AIM: The aim of this study was to assess the efficacy of the Artcure Diffusional Patch, which contains a mixture of 6 herbal oils (oleum thymi, oleum limonis, oleum nigra, oleum rosmarini, oleum chamomilla, oleum lauriexpressum) and has a hypoosmolar lipid structure, in the conservative treatment of lumbar disc herniation patients and to show the advantages and/or possibility of using this as an alternative method to surgery. MATERIALS AND METHODS: Of the 120 patients enrolled, 79 clinically diagnosed patients were included in the study...
June 12, 2017: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/28616747/criteria-for-failure-and-worsening-after-surgery-for-lumbar-disc-herniation-a-multicenter-observational-study-based-on-data-from-the-norwegian-registry-for-spine-surgery
#3
David A T Werner, Margreth Grotle, Sasha Gulati, Ivar M Austevoll, Greger Lønne, Øystein P Nygaard, Tore K Solberg
PURPOSE: In clinical decision-making, it is crucial to discuss the probability of adverse outcomes with the patient. A large proportion of the outcomes are difficult to classify as either failure or success. Consequently, cutoff values in patient-reported outcome measures (PROMs) for "failure" and "worsening" are likely to be different from those of "non-success". The aim of this study was to identify dichotomous cutoffs for failure and worsening, 12 months after surgical treatment for lumbar disc herniation, in a large registry cohort...
June 14, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28615337/accumulation-of-methylglyoxal-increases-the-advanced-glycation-end-products-levels-in-drg-and-contributes-to-lumbar-disc-herniation-induced-persistent-pain
#4
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 disc 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 and increased MG level in plasma and dorsal root ganglion (DRG) and enhanced the excitability of small DRG neurons (< 30μm in diameter)...
June 14, 2017: Journal of Neurophysiology
https://www.readbyqxmd.com/read/28604488/anterior-cervical-discectomy-and-fusion-outcomes-over-10-years-a-prospective-study
#5
Glenn R Buttermann
STUDY DESIGN: Prospective cohort study with >10-year follow-up. OBJECTIVE: To assess the long-term, >10-year, clinical outcomes of anterior cervical discectomy and fusion (ACDF) and to compare outcomes based on primary diagnosis of disc herniation; stenosis or advanced degenerative disc disease (DDD); number of levels treated; and preexisting adjacent level degeneration. SUMMARY OF BACKGROUND DATA: ACDF is a proven treatment for patients with stenosis and disc herniation and results in significantly improved short- and intermediate-term outcomes...
June 9, 2017: Spine
https://www.readbyqxmd.com/read/28590060/structure-function-relationships-at-the-human-spinal-disc-vertebra-interface
#6
Britta Berg-Johansen, Aaron J Fields, Ellen C Liebenberg, Alfred Li, Jeffrey C Lotz
Damage at the intervertebral disc-vertebra interface associates with back pain and disc herniation. However, the structural and biomechanical properties of the disc-vertebra interface remain underexplored. We sought to measure mechanical properties and failure mechanisms, quantify architectural features, and assess structure-function relationships at this vulnerable location. Vertebra-disc-vertebra specimens from human cadaver thoracic spines were scanned with micro-computed tomography (μCT), surface speckle-coated, and loaded to failure in uniaxial tension...
June 7, 2017: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/28588167/primary-and-revision-lumbar-discectomy-a-four-year-review-from-our-private-practice
#7
M R Islam, M A Majid, S Chowdhury, M M Rahman, M S Arefin
The surgical treatment of symptomatic lumbar disc herniation is now focused on nerve root decompression with preservation of the bony and ligamentous stabilizers of the spine. Various techniques of discectomy have been devised in accordance with this principle and irrespective of the technique used; primary disc surgeries have generally known to give good results. This retrospective study was done in different private clinics & hospitals of Dhaka city, Bangladesh from January 2012 to December 2015. Of the 105 lumbar discectomies performed during the study period, 95(90...
April 2017: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/28587362/effects-of-release-and-decompression-techniques-on-nerve-roots-through-percutaneous-transforaminal-endoscopic-discectomy-on-patients-with-central-lumbar-disc-herniation
#8
Qiangjun Kang, Ximing Li, Zishen Cheng, Chang'An Liu
The clinical effects and safety of release and decompression techniques on nerve roots through percutaneous transforaminal endoscopic discectomy (PTED) while treating patients with central lumbar disc herniation (CLDH) were explored. Patient cases of lumbar and leg pain treated in Bethune International Peace Hospital from July 2013 to October 2015 were collected retrospectively. The patients in these cases received imaging examinations such as computed tomography and magnetic resonance imaging. Among these cases, 37 CLDH patients with no other complications were selected for this study...
June 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28582905/a-comparative-study-on-the-mechanical-behavior-of-intervertebral-disc-using-hyperelastic-finite-element-model
#9
Feng Xie, Honghai Zhou, Wenju Zhao, Lixin Huang
BACKGROUND: Lumbar disc herniation may result in excruciating pain due to it being one of the most common diseases related to changes of intervertebral disc (IVD). In order to find a better clinical treatment and prevention scheme for relieving the pain caused by spine degeneration, the mechanical behavior analysis of IVD must be studied. OBJECTIVE: A finite element method (FEM) is used in this study to analyze the mechanical behaviors of healthy and herniated IVD...
May 19, 2017: Technology and Health Care: Official Journal of the European Society for Engineering and Medicine
https://www.readbyqxmd.com/read/28572152/temporal-evolution-of-disc-in-young-patients-with-low-back-pain-and-stress-reaction-in-lumbar-vertebrae
#10
A Sharma, K Sargar, A Salter
BACKGROUND AND PURPOSE: Although stress-induced bony changes often resolve with conservative treatment, the long-term effects of such mechanical stresses on intervertebral discs have not been studied. We aimed to assess the differences in the temporal evolution of disc in segments of the lumbar spine with and without signs of increased mechanical stresses. MATERIALS AND METHODS: Using MR imaging performed >6 months apart, 2 radiologists evaluated lumbar intervertebral discs for degenerative changes affecting the annulus fibrosus, the nucleus pulposus, and the endplates in 42 patients (22 male, 20 female; mean age, 16...
June 1, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28567591/ribosomal-pcr-assay-of-excised-intervertebral-discs-from-patients-undergoing-single-level-primary-lumbar-microdiscectomy
#11
Todd F Alamin, Marcus Munoz, Alicia Zagel, Agnes Ith, Eugene Carragee, Ivan Cheng, Gaetano Scuderi, Indre Budvytiene, Niaz Banei
PURPOSE: To determine the presence of infectious microorganisms in the herniated discs of immunocompetent patients, using methodology that we hoped would be of higher sensitivity and specificity than has been reported in the past. Recent studies have demonstrated a significant rate of positive cultures for low virulent organisms in excised HNP samples (range 19-53%). These studies have served as the theoretical basis for a pilot trial, and then, a well done prospective randomized trial that demonstrated that systemic treatment with antibiotics may yield lasting improvements in a subset of patients with axial back pain...
May 31, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28565778/value-of-a-new-pathological-classification-of-lumbar-intervertebral-disc-herniation-based-on-transforaminal-endoscopic-observations
#12
Lin Yang, Hong-Hui Lu
Removal of herniated disc materials based on an imaging only method may not relieve symptoms in many patients. Therefore, the aim of the present study was to develop a transforaminal endoscopic method of classifying the pathological type of lumber intervertebral disc herniation and to compare the outcomes of surgery based on the pathological type with those of conventional endoscopic disc removal. The records of patients who received endoscopic transforaminal nucleotomy with foraminoplasty for symptomatic lumbar disc herniation between 2009 and 2013 were retrospectively reviewed...
May 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28564667/rhode-island-hospital-s-contribution-to-the-field-of-endoscopic-spine-surgery
#13
Albert E Telfeian, Adetokunbo A Oyelese, Ziya L Gokaslan
The first academic program in endoscopic spine surgery in the United States opened its doors at Rhode Island Hospital in 2012. Published advances in the field since its inception have included treatments for a myriad of pathologies including lumbar and thoracic disc herniations, spondylolisthesis, spine tumors as well as treatments for complications of other spinal procedures including spinal fusion, kyphoplasty, and total disc replacement. In this issue of the Rhode Island Medical Journal we summarize the history of the procedure as well as some of the interesting progress going on in this field in Rhode Island...
June 1, 2017: Rhode Island Medical Journal
https://www.readbyqxmd.com/read/28557967/-the-assessment-of-the-impact-of-rehabilitation-on-the-pain-intensity-level-in-patients-with-herniated-nucleus-pulposus-of-the-intervertebral-disc
#14
Kamil Koszela, Sylwia Krukowska, Marta Woldańska-Okońska
Back pain may be caused by many factors. In many cases it is difficult to unambiguously determine a cause of the pathology, which can involve various structures in the spine. In this paper we will discuss the symptoms associated with the degenerative changes of the intervertebral disc, which involve, among others, its bulging, dislocation and pressure on the surrounding structures. These problems require an adequate clinical and imaging diagnostics in order to implement an appropriate treatment. In the first place, it should be based on the conservative methods (such as: pharmacotherapy, rehabilitation and lifestyle changes)...
May 23, 2017: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/28550071/tubular-discectomy-versus-conventional-microdiscectomy-for-the-treatment-of-lumbar-disc-herniation-long-term-results-of-a-randomised-controlled-trial
#15
Gijsbert M Overdevest, Wilco C Peul, Ronald Brand, Bart W Koes, Ronald Hma Bartels, Wee F Tan, Mark P Arts
BACKGROUND: The reference surgical procedure for the treatment of lumbar disc herniation is open microdiscectomy. Minimal invasive discectomy with tubular retractors is hypothesised to cause less tissue damage and result in lower blood loss, less postoperative pain and faster recovery. We previously reported our 1 and 2-year results, and found no better outcomes of tubular discectomy compared with open microdiscectomy. Until now, no studies on tubular discectomy have reported results with more than 2 years of follow-up...
May 26, 2017: Journal of Neurology, Neurosurgery, and Psychiatry
https://www.readbyqxmd.com/read/28546769/treatment-of-chronic-low-back-pain-new-approaches-on-the-horizon
#16
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/28545491/treatment-of-acute-sciatica-with-transforaminal-epidural-corticosteroids-and-local-anesthetic-design-of-a-randomized-controlled-trial
#17
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/28535642/-clinical-effects-of-dynesys-system-and-transfacet-decompression-through-wiltse-approach-in-the-treatment-of-lumbar-degenerative-diseases
#18
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
#19
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/28535556/feasibility-of-percutaneous-lumbar-discectomy-combined-with-percutaneous-cementoplasty-for-symptomatic-lumbar-disc-herniation-with-modic-type-i-endplate-changes
#20
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
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