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Herniated disc treatment

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https://www.readbyqxmd.com/read/28097245/consideration-of-proper-operative-route-for-interlaminar-approach-for-percutaneous-endoscopic-lumbar-discectomy
#1
Juichi Tonosu, Yasushi Oshima, Ryutaro Shiboi, Akihiko Hayashi, Yuichi Takano, Hirohiko Inanami, Hisashi Koga
BACKGROUND: Percutaneous endoscopic lumbar discectomy (PELD) is one of the less invasive treatments of lumbar disc herniation (LDH), and has three different operative approaches. This study focused on the interlaminar approach (ILA) and investigated the appropriate operative route for this approach. METHODS: ILA was performed in 41 patients with LDH. The width of the interlaminar space, LDH size, and positional relation between LDH and the corresponding nerve root were radiologically evaluated...
December 2016: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/28072806/endoscopic-spine-surgery-distance-patients-will-travel-for-minimally-invasive-spine-surgery
#2
Albert E Telfeian, Menno Iprenburg, Ralf Wagner
BACKGROUND: Transforaminal lumbar endoscopic discectomy is a minimally invasive spine surgery procedure performed principally for the treatment of lumbar herniated discs. Endoscopic spine surgeons around the world have noted how far patients will travel to undergo this minimally invasive spine surgery, but the actual distance patients travel has never been investigated. OBJECTIVE: We present here our analysis of how far patients will travel for endoscopic spine surgery by studying the referral patterns of patients to 3 centers in 3 different countries...
January 2017: Pain Physician
https://www.readbyqxmd.com/read/28072800/modified-percutaneous-lumbar-foraminoplasty-and-percutaneous-endoscopic-lumbar-discectomy-instrument-design-technique-notes-and-5-years-follow-up
#3
Zhen-Zhou Li, Shu-Xun Hou, Wei-Lin Shang, Ke-Ran Song, Hong-Liang Zhao
BACKGROUND: Conventional percutaneous endoscopic lumbar discectomy (PELD) with an "inside-outside" technique has 4.3% - 10.3% surgical failure rate, especially in central herniated discs (HDs), migrated HDs, and axillary type HDs. PELD with foraminoplasty has been used for complex HDs. Percutaneous lumbar foraminoplasty (PLF), which is performed with a trephine or bone reamer introduced over a guidewire without a protective working cannula in the original Tessys technique, can quickly cut the hypertrophied bony structure under fluoroscopic guidance, and risk injury to the exiting and traversing nerve roots...
January 2017: Pain Physician
https://www.readbyqxmd.com/read/28072799/percutaneous-endoscopic-lumbar-discectomy-for-highly-migrated-lumbar-disc-herniation
#4
Chao Liu, Lei Chu, Hao-Chuan Yong, Liang Chen, Zhong-Liang Deng
BACKGROUND: Percutaneous endoscopic lumbar discectomy (PELD) has been growing in popularity for the treatment of lumbar disc herniation (LDH) due to its irreplaceable advantages over conventional open surgery. Compared with common lumbar disc herniations, discectomy of highly migrated LDH by PELD is known to be very difficult. Highly migrated lumbar disc herniation has long been a challenge for its specific characteristics. Three approaches for PELD have been applied to access a highly migrated LDH, including an interlaminar approach (IL), transforaminal approach (TF), and contralateral transforaminal approach (CTF)...
January 2017: Pain Physician
https://www.readbyqxmd.com/read/28072796/incidence-of-spontaneous-resorption-of-lumbar-disc-herniation-a-meta-analysis
#5
Ming Zhong, Jin-Tao Liu, Hong Jiang, Wen Mo, Peng-Fei Yu, Xiao-Chun Li, Rui Rui Xue
BACKGROUND: Lumbar disc herniation (LDH), a common disease, is often treated conservatively, frequently resulting in spontaneous resorption of the herniated disc. The incidence of this phenomenon, however, remains unknown. OBJECTIVE: To analyze the incidence of spontaneous resorption after conservative treatment of LDH using computed tomography and magnetic resonance imaging. STUDY DESIGN: Meta-analysis and systematic review of cohort studies...
January 2017: Pain Physician
https://www.readbyqxmd.com/read/28050537/spinopelvic-balance-evaluation-of-patients-with-degenerative-spondylolisthesis-l4l5-and-l4l5-herniated-disc-who-underwent-surgery
#6
Viviane Regina Hernandez Nunes, Charbel Jacob, Igor Machado Cardoso, José Lucas Batista, Marcus Alexandre Novo Brazolino, Thiago Cardoso Maia
OBJECTIVE: To correlate spinopelvic balance with the development of degenerative spondylolisthesis and disk herniation. METHODS: This was a descriptive retrospective study that evaluated 60 patients in this hospital, 30 patients with degenerative spondylolisthesis at the L4-L5 level and 30 with herniated disk at the L4-L5 level, all of whom underwent Surgical treatment. RESULTS: Patients with lumbar disk herniation at L4-L5 level had a mean tilt of 8...
November 2016: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/28045705/nonsurgical-treatment-choices-by-individuals-with-lumbar-intervertebral-disc-herniation-in-the-united-states-associations-with-long-term-outcomes
#7
Anne Thackeray, Julie M Fritz, Jon D Lurie, Wenyan Zhao, James N Weinstein
OBJECTIVES: The objectives of this study were to (1) evaluate differences between patients with lumbar intervertebral disc herniation who received physical therapy (PT) and those who did not; (2) identify factors associated with receiving PT; and (3) examine the influence of PT on clinical outcomes over the course of 1 yr. DESIGN: An observational cohort study using data from the Spine Patient Outcomes Research Trial was conducted. This study included 363 patients with intervertebral disc herniation who received nonsurgical management within 6 wks of enrollment...
December 31, 2016: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/28043884/risk-factors-for-the-recurrent-herniation-after-percutaneous-endoscopic-lumbar-discectomy
#8
Yuan Yao, Huan Liu, Huiyu Zhang, Honggang Wang, Chao Zhang, Zhengfeng Zhang, Junlong Wu, Yu Tang, Yue Zhou
BACKGROUND: Percutaneous endoscopic lumbar discectomy (PELD) has been widely used for treating lumbar disc herniation (LDH). Recurrence after PELD has been reported, but few studies have focused on the risk factors responsible for PELD recurrence. METHODS: From March 2005 to March 2016, 116 patients suffering from recurrent herniation after successful PELD were enrolled in this retrospective study. Kaplan-Meier methods and Cox regression analysis were employed to identify the significant risk factors predicting PELD recurrence...
December 30, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/28042726/hybrid-cervical-disc-arthroplasty
#9
Tsung-Hsi Tu, Jau-Ching Wu, Henrich Cheng, Praveen V Mummaneni
For patients with multilevel cervical stenosis at nonadjacent segments, one of the traditional approaches has included a multilevel fusion of the abnormal segments as well as the intervening normal segment. In this video we demonstrate an alternative treatment plan with tailored use of a combination of anterior cervical discectomy and fusion (ACDF) and cervical disc arthroplasty (CDA) with an intervening skipped level. The authors present the case of a 72-year-old woman with myeloradiculopathy and a large disc herniation with facet joint degeneration at C3-4 and bulging disc at C5-6...
January 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28042725/stepwise-illustration-of-teeth-fixation-semi-constrained-cervical-disc-arthroplasty
#10
Chih-Chang Chang, Jau-Ching Wu, Peng-Yuan Chang, Mei-Yin Yeh, Yi-Hsuan Kuo, Li-Yu Fay, Tsung-Hsi Tu, Wen-Cheng Huang, Henrich Cheng
There are many kinds of artificial discs available for cervical disc arthroplasty (CDA), with various designs of fixation and articulation mechanisms. Each of these designs has different features and theoretically fits most optimally in selected types of patients. However, there has been insufficient literature to guide individualized selection among these CDA devices. Since CDA aims to restore the joint function rather than arthrodesis, tailor-made size, shape, and mechanical properties should be taken into account for each candidate's target disc...
January 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28028952/mastalgia-due-to-degenerative-changes-of-the-spine
#11
Okay Pirti, Aziz M Barlas, Serdar Kuru, Selim Temel, Mustafa K Urhan, Kemal Kismet, Adnan Hasanoglu, Osman Guler
BACKGROUND: Mastalgia is a common and enigmatic condition; the cause and optimal treatment are still inadequately defined. Cervical radiculopathy, which is the result of cervical nerve root pathology often caused by spaceoccupying lesions such as cervical disc herniation, spondylosis, or osteophytosis, is frequently encountered in physical therapy. OBJECTIVES: The aim of the study was to evaluate the incidence of vertebral pathologies in patients with non-cyclic mastalgia and the efficacy of conservative treatment of these pathologies on relieving breast pain...
September 2016: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
https://www.readbyqxmd.com/read/28012973/methotrexate-prevents-epidural-fibrosis-through-endoplasmic-reticulum-stress-signalling-pathway
#12
Hui Chen, Lianqi Yan, Jingcheng Wang, Yu Sun, Xiaolei Li, Shuai Zhao, Daxin Wang, Gengyao Zhu, Yuan Liang
Lumbar laminectomy is one of the most common treatments for lumbar disc herniation and other lumbar disorders with serious complications, such as failed back surgery syndrome, mainly caused by epidural fibrosis (EF). The developing fibrosis causes radicular pain after the laminectomy or discectomy. Methotrexate (MTX) is a folic acid antagonist that has shown anti-proliferative effects in previous studies. The aim of our experiment is to study whether MTX has positive effects on the outcome of the laminectomy in rats...
December 21, 2016: European Journal of Pharmacology
https://www.readbyqxmd.com/read/28004244/gender-differences-after-lumbar-sequestrectomy-a-prospective-clinical-trial-using-quantitative-sensory-testing
#13
Anja Tschugg, Wolfgang N Löscher, Sara Lener, Matthias Wildauer, Sebastian Hartmann, Sabrina Neururer, Claudius Thomé
BACKGROUND: Quantitative sensory testing (QST) gained popularity to evaluate the time course of recovery in sensory dysfunction and the results of different treatment options. Concerning sex differences in lumbar spine surgery, female gender seems to play a major role as a negative prognostic factor in different spinal disorders. For this purpose, we hypothesised that there are also comparable differences in pain patterns in men and women after lumbar sequestrectomy using QST. METHODS: We applied the QST protocol of the German Research Network on Neuropathic Pain in 53 patients (21 women and 32 men) with a single lumbar disc herniation confirmed on MRI treated by a lumbar sequestrectomy...
December 21, 2016: European Spine Journal
https://www.readbyqxmd.com/read/28003290/surgical-versus-conservative-treatment-for-lumbar-disc-herniation-a-prospective-cohort-study
#14
Marinella Gugliotta, Bruno R da Costa, Essam Dabis, Robert Theiler, Peter Jüni, Stephan Reichenbach, Hans Landolt, Paul Hasler
OBJECTIVES: Evidence comparing the effectiveness of surgical and conservative treatment of symptomatic lumbar disc herniation is controversial. We sought to compare short-term and long-term effectiveness of surgical and conservative treatment in sciatica symptom severity and quality of life in patients with lumbar disc herniation in a routine clinical setting. METHODS: A prospective cohort study of a routine clinical practice registry consisting of 370 patients...
December 21, 2016: BMJ Open
https://www.readbyqxmd.com/read/27994790/a-nationwide-retrospective-study-of-opioid-management-patterns-in-2-468-patients-with-spinal-pain-in-korea
#15
Sung-Soo Chung, Chun-Kun Park, Kyu-Jung Cho, Kyoung Hyo Choi, Jin-Hyok Kim, Sung-Bum Kim, Sung-Uk Kuh, Jae Chul Lee, Jae Hyup Lee, Kyu-Yeol Lee, Sun-Ho Lee, Seong-Hwan Moon, Si-Young Park, Jae Hang Shim, Byung-Chul Son, Myung Ha Yoon, Hye-Jeong Park
STUDY DESIGN: Retrospective patient data collection and investigator survey. PURPOSE: To investigate patterns of opioid treatment for pain caused by spinal disorders in Korea. OVERVIEW OF LITERATURE: Opioid analgesic prescription and adequacy of consumption measures in Korea have markedly increased in the past decade, suggesting changing patterns in pain management practice; however, there is lack of integrated data specific to Korean population...
December 2016: Asian Spine Journal
https://www.readbyqxmd.com/read/27994783/closed-drainage-versus-non-drainage-for-single-level-lumbar-disc-surgery-relationship-between-epidural-hematoma-and-fibrosis
#16
Kadir Kotil
STUDY DESIGN: A prospective clinical series with prospectively collected data. PURPOSE: The efficacy of using closed suction drains (CSD) after single-level lumbar disc surgery was evaluated. Postoperative CSD are regularly fitted to prevent postoperative epidural hematomas (EH) after multilevel lumbar decompression, although it remains unclear whether CSD also reduces postoperative EH following single-level lumbar disc surgery. OVERVIEW OF LITERATURE: Few articles have addressed the clinical outcome in patients with single-level lumbar disc disease who were treated by two different operative methods (with and without drainage)...
December 2016: Asian Spine Journal
https://www.readbyqxmd.com/read/27924416/endoscope-assisted-oblique-lumbar-interbody-fusion-for-the-treatment-of-cauda-equina-syndrome-a-technical-note
#17
Jin-Sung Kim, Ji-Hoon Seong
OBJECTIVE: The goal of this paper was to describe how endoscope-assisted oblique lumbar interbody fusion (OLIF) could remove huge lumbar disc herniation (HLDH) manifested with cauda equina syndrome (CES). METHODS: In this study, the authors made an attempt to treat CES with a direct endoscopic decompression through the OLIF corridor and performed OLIF in two patients with HLDH. RESULTS: Two patients with HLDH were successfully treated using OLIF with spinal endoscopic discectomy...
December 7, 2016: European Spine Journal
https://www.readbyqxmd.com/read/27922167/cost-effectiveness-of-primarily-surgical-versus-primarily-conservative-treatment-of-acute-and-subacute-radiculopathies-due-to-intervertebral-disc-herniation-from-the-swiss-perspective
#18
Zanfina Ademi, Viktoria Gloy, Dominik Glinz, Heike Raatz, Joris Van Stiphout, Heiner C Bucher, Matthias Schwenkglenks
AIMS OF THE STUDY: To assess the cost-effectiveness of primarily surgical treatment (PST) versus primarily conservative treatment (PCT) in adults with intermediate severity, acute or subacute, lumbar radicular syndrome due to intervertebral disc herniation. METHODS: A decision analytic model from healthcare system and societal perspectives was used to compare outcomes and costs of PST with those of PCT (physiotherapy, epidural injection and medication). Treatment pathways and quality of life were obtained from published clinical trials...
2016: Swiss Medical Weekly
https://www.readbyqxmd.com/read/27913961/prediction-of-postoperative-clinical-recovery-of-drop-foot-attributable-to-lumbar-degenerative-diseases-via-a-bayesian-network
#19
Shota Takenaka, Hiroyuki Aono
BACKGROUND: Drop foot resulting from degenerative lumbar diseases can impair activities of daily living. Therefore, predictors of recovery of this symptom have been investigated using univariate or/and multivariate analyses. However, the conclusions have been somewhat controversial. Bayesian network models, which are graphic and intuitive to the clinician, may facilitate understanding of the prognosis of drop foot resulting from degenerative lumbar diseases. QUESTIONS/PURPOSES: (1) To show a layered correlation among predictors of recovery from drop foot resulting from degenerative lumbar diseases; and (2) to develop support tools for clinical decisions to treat drop foot resulting from lumbar degenerative diseases...
December 2, 2016: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/27906945/ganglion-cyst-at-the-proximal-tibiofibular-joint-in-a-patient-with-painless-foot-drop
#20
Abdulmuhsen Alsahhaf, Waleed Renno
Entrapment neuropathies of the fibular nerve and its branches are often underdiagnosed due to the lack of reliable diagnosis using clinical examination and electrophysiologic evaluation. Most fibular nerve compressions may be classified into 2 broad categories: (a) mechanical causes, which occur at fibrous or fibro-osseous tunnels, and (b) dynamic causes related to nerve injury during specific limb positioning. Foot drop resulting from weakness of the dorsiflexor muscles of the foot is a relatively uncommon presentation and closely related to L5 neuropathy caused by a disc herniation...
November 2016: Pain Physician
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