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Lumbar disc

Jack Zigler, Nicole Ferko, Chris Cameron, Leena Patel
AIM: To compare the efficacy and safety of total disc replacement, lumbar fusion, and conservative care in the treatment of single-level lumbar degenerative disc disease (DDD). MATERIALS & METHODS: A network meta-analysis was conducted to determine the relative impact of lumbar DDD therapies on Oswestry Disability Index (ODI) success, back pain score, patient satisfaction, employment status, and reoperation. Odds ratios or mean differences and 95% credible intervals were reported...
March 2018: Journal of Comparative Effectiveness Research
Catherine E Ferland, Diana-Luk Ye, Jean A Ouellet
This case report illustrates the value of a comprehensive perioperative pain assessment composed of quantitative sensory testing and self-reported measures that highlight the impact of pain experienced by a 14-year-old boy suffering from chronic low back pain and sciatica. Before surgery, the pain assessment revealed inefficient endogenous inhibitory pain control with presence of temporal summation of pain. The severe pain was constant and lasted for 18 months. The patient was in a high-anxiety state, and reported significant functional disability and poor sleep quality...
March 12, 2018: Journal of Pediatric Health Care
Xiaoming Liu, Fumin Pan, Zhaoyu Ba, Shanjin Wang, Desheng Wu
BACKGROUND: Diabetes mellitus (DM) and low back pain which is mainly caused by degeneration of the intervertebral discs (IVDs) both are major public health problem worldwide. The present study was designed to investigate the association between type 2 diabetes mellitus (T2D) and severity of lumbar disc degeneration (LDD). METHODS: We retrospectively reviewed patients with low back pain visiting our spine clinic in 2014. Low back pain patients all have the lumbar MRI imaging and no previous treatment...
March 14, 2018: Journal of Orthopaedic Surgery and Research
Oliver P Gautschi, Martin N Stienen, Marco V Corniola, Granit Molliqaj, Enrico Tessitore
No abstract text is available yet for this article.
April 2018: Journal of Neurosurgical Sciences
Gang Wang, Jing Liang, Zishan Jia, Lei Wan, Mingxia Yang
RATIONALE: Spinal cord infarction is one of the complications of epidural steroid injections (ESIs), but has only been reported in cervical vertebra by transforaminal injection and lumbar vertebra by transforaminal injection; and up to now, there is no reporting about spinal cord infarction caused by caudal injection. Here, we report a case. PATIENT CONCERNS: A 52-year-old man was admitted to our hospital. He was diagnosed as lumbar disc herniation in other hospital, and the patient suffered bilateral lower limb motor and sensory disorders after administration of caudal ESI...
March 2018: Medicine (Baltimore)
Feng Xie, Jun Bian, Zhi-Wei Wang, Wei-Shan Chen
OBJECTIVE: To study the difference of spino-pelvic sagittal alignment between lumbar disc herniation(LDH) and lumbar canal stenosis(LCS) in adults. METHODS: The integrated imaging data of 88 patients with lumbar disc herniation (42 cases) or lumbar canal stenosis(46 cases) were searched from January 1, 2015 to September 10, 2016 in our hospital.Twenty-two cases were excluded because of age factor, 36 cases of LDH (LDH group) and 30 cases of LCS (LCS group) were internalized in the study...
January 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Víctor Rodrigo, Marta Claramonte, Mónica Martín, Juan B Calatayud
BACKGROUND: Intradural disc herniation is a rare phenomenon in spine surgery. Diagnosis is difficult despite current neuroradiologic imaging techniques. METHOD: We present a case of a 59-year-old man with lumbar and radicular pain and a recurrent lumbar herniation. A laminectomy was performed after no clear disc herniation in the epidural space was found and an intradural mass was palpable. A durotomy showed an intradural disc fragment that was removed, followed by an arthrodesis...
March 12, 2018: Acta Neurochirurgica
Rafet Ozay, Torel Ogur, Hasan Ali Durmaz, Erhan Turkoglu, Yusuf Sukru Caglar, Zeki Sekerci, Mehmet Sorar, Sahin Hanalioglu
OBJECTIVE: Preserving the ligamentum flavum (LF) during lumbar spine surgery may help limit the extent of postoperative epidural fibrosis (EF), a potential cause of persistent leg pain. We present a retrospective analysis of microdiscectomy with preservation of the LF in order to evaluate the effects of the two LF mobilizing techniques (reflecting inferiorly or medially vs. removing completely) on EF and clinical outcomes. METHODS: Microdiscectomy was performed through a unilateral laminotomy in 93 patients (52 male, 41 female; mean age 46; range 25-65 years) with L3-L4 (n=3), L4-L5 (n=40), and L5-S1 (n=50) lumbar disc herniation...
March 9, 2018: World Neurosurgery
Yidan Zhang, Wei Guo, Xiaodong Tang, Rongli Yang, Taiqiang Yan, Sen Dong, Shidong Wang, Nikolas Zaphiros
BACKGROUND: Although aortic balloon occlusion has been shown to reduce blood loss during sacral tumor resections, it has not been validated in larger sacral tumors involving the lower lumbar spine. If such an approach were shown to be associated with less blood loss, it might aid the tumor surgeon in resecting these difficult tumors. QUESTIONS/PURPOSES: (1) Is the use of aortic balloon occlusion associated with reduced blood loss in sacral tumor resections when the lower lumbar spine is also involved? (2) Does the use of the aortic balloon prolong total operating time? (3) What complications are associated with the use of a balloon? METHODS: We retrospectively studied all 56 patients diagnosed with sacral tumors involving the lower lumbar spine (L4, L5) who were treated surgically between 2004 and 2015 at our institute...
March 2018: Clinical Orthopaedics and related Research
John P Kleimeyer, Ivan Cheng, Todd F Alamin, Serena S Hu, Thomas Cha, Vijay Yanamadala, Kirkham B Wood
STUDY DESIGN: This is a retrospective cohort study. OBJECTIVE: To evaluate the long-term outcomes of selective one- to two-level anterior lumbar interbody fusions (ALIFs) in the lower lumbar spine versus continued nonsurgical management. SUMMARY OF BACKGROUND DATA: Low back pain associated with lumbar intervertebral disc degeneration is common with substantial economic impact, yet treatment remains controversial. Surgical fusion has previously provided mixed results with limited durable improvement of pain and function...
March 9, 2018: Spine
Salah G Aoun, Nicole Bedros, Tarek Y El Ahmadieh, Jake Kreck, Nikhil Mehta, Mazin Al Tamimi
BACKGROUND: Venous thromboembolism can be a significant cause of morbidity in the trauma population. Medical and surgical specialties have been pushing the indication for prophylactic filter placement. CASE DESCRIPTION: A 36-year-old man presented with axial lower back pain with a radicular right L2 component after lifting a heavy object. He had a history of penetrating brain trauma 3 years prior, with placement of a prophylactic inferior vena cava filter. His x-ray, computed tomography, and magnetic resonance imaging of the lumbar spine showed fracture of his filter, with migration of the fractured fragment through the inferior vena cava and into the L2-L3 disc space, and surrounding bony lysis and severe osteodiscitis...
March 7, 2018: World Neurosurgery
Xinxin Miao, Dingwen He, Tianlong Wu, Xigao Cheng
BACKGROUND: Percutaneous endoscopic technique via interlaminar approach is one of the prevalent minimal invasive procedures in the treatment of lumbar disc herniation even lumbar spinal stenosis. The aim of this report is to perform complete decompressions for the cases with thoracic ossification of the ligamentum flavum using percutaneous endoscopic technique. CASE DESCRIPTION: We experienced surgical decompressions of two patients with thoracic myelopathy caused by OLF using percutaneous endoscopic surgery via interlaminar approach...
March 7, 2018: World Neurosurgery
P Elkan, T Lagerbäck, H Möller, Paul Gerdhem
PURPOSE: Quality registers give unique possibilities to achieve information from large groups of patients, but outcome must be interpreted carefully due to less stringent data collection and lower follow-up rates than in research projects. We tried to quantify any outcome differences between a national spine quality register and a prospective observational study. METHODS: Adult patients treated with lumbar discectomy between 2004 and 2010 were retrieved from the Swedish Spine register (Swespine) (n = 7791) and from the single center lumbar disc herniation study (LDHS) in Stockholm (n = 177)...
March 9, 2018: European Spine Journal
Yang Meng, Xiaofei Wang, Beiyu Wang, Tingkui Wu, Hao Liu
RATIONALE: Cervical open-door laminoplasty can enlarge the volume of the cervical vertebral canal and thus has become an effective and safe treatment for multilevel cervical disc herniation and cervical stenosis. Some post-surgery complications exist, such as reduction of cervical alignment and local kyphosis. However, aggravation of cervical disc herniation at the surgical level during short-term follow-up has not been discussed. Additionally, spontaneous disappearance of herniated disc pulposus is a common phenomenon in the lumbar region but is relatively rare in the cervical region...
March 2018: Medicine (Baltimore)
Zhenjun Zhang, Guy R Fogel, Zhenhua Liao, Yitao Sun, Weiqiang Liu
Inappropriate lordotic angle of lumbar fusion cage could be associated with cage damage or subsidence. The biomechanical influence of cage lordotic angle on lumbar spine has not been fully investigated. Four surgical finite element models were constructed by inserting cages with various lordotic angles at L3-L4 disc space. The four motion modes were simulated. The range of motion (ROM) decreased with increased lordotic angle of cage in flexion, extension, and rotation, whereas it was not substantially changed in bending...
March 7, 2018: Computer Methods in Biomechanics and Biomedical Engineering
Xuanqi Xiong, Zhengwei Zhou, Matteo Figini, Junjie Shangguan, Zhuoli Zhang, Wei Chen
Objective: To quantitatively evaluate lumbar disc degeneration with recently-developed quantitative magnetic resonance imaging (MRI) techniques. A series of MRI parameters, including T2*, T1rho relaxation time, apparent diffusion coefficient and gagCEST, were compared and correlated with the Pfirrmann semi-quantitative classification of lumbar intervertebral disc degeneration; the most accurate and relevant MRI parameters of lumbar disc degeneration were identified. Materials and Methods: Thirty-seven subjects (age range, 18-74 years) with non-specific low back pain (LBP) for more than 6 months were enrolled...
2018: American Journal of Translational Research
Huihong Wu, Siting Wang, Weiyou Chen, Xinli Zhan, Zengming Xiao, Hua Jiang, Qingjun Wei
BACKGROUND: An increasing number of studies have investigated associations between collagen IX alpha 2 chain (COL9A2) and collagen IX alpha 3 chain (COL9A3) gene polymorphisms and the risk of lumbar disc degeneration (LDD). However, these studies have yielded contradictory results. The purpose of this meta-analysis is to investigate the association between the collagen IX gene polymorphisms (rs12077871, rs12722877, rs7533552 in COL9A2; rs61734651 in COL9A3) and LDD. METHODS: All relevant articles were collected from PubMed, Web of Science, and China National Knowledge Infrastructure (CNKI)...
March 5, 2018: Journal of Orthopaedic Surgery and Research
Gilles Norotte, Carlos Barrios
OBJECTIVE: Recent improvements in cage designs with integral fixation and screw attachments have made stand-alone ALIF a viable option with several possible advantages. The aim of this study was to confirm the efficacy and safety of a PEEK cage filled with hydroxyapatite nanoparticles without adding a bone graft for stand-alone ALIF in the treatment of L5-S1 isolated degenerative disc discopathy (DDD). PATIENTS AND METHODS: Sixty-five patients who required surgery for DDD were evaluated...
January 31, 2018: Clinical Neurology and Neurosurgery
Faris A Alodaibi, Julie M Fritz, Anne Thackeray, Shane L Koppenhaver, Jeffrey J Hebert
OBJECTIVE: To examine the prognostic value of the Fear Avoidance Model (FAM) variables when predicting pain intensity and disability 10-weeks postoperative following lumbar disc surgery. METHODS: We recruited patients scheduled for first-time, single level lumbar disc surgery. The following aspects of the FAM were assessed at preoperative baseline and after 10 postoperative weeks: numeric pain rating scale (0-10) for leg and back pain intensity separately, Pain Catastrophizing Scale (PCS), Fear Avoidance Beliefs Questionnaire (FABQ), Beck Depression Inventory (BDI), Oswestry Disability Questionnaire (ODI), and the International Physical Activity Questionnaire (IPAQ)...
2018: PloS One
Feng-Kai Chan, Chien-Chin Hsu, Hung-Jung Lin, Jhi-Joung Wang, Shih-Bin Su, Chien-Cheng Huang, Shih-Feng Weng
Physicians in Taiwan have long working hours and are at risk for inappropriate posture when handling patients, which may contribute to lumbar herniated intervertebral disc (L-HIVD). This study was conducted to delineate this issue, which is still unknown. This nationwide population-based cohort study was based on Taiwan National Health Insurance Research Database. We identified 25,428 physicians, 32,316 nonphysician health care professionals (HCPs), and an identical number of age- and sex-matched individuals from the general population...
January 2018: Medicine (Baltimore)
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