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Lumbar disc

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
Evgenii Belykh, Alexander V Krutko, Evgenii S Baykov, Morgan B Giers, Mark C Preul, Vadim A Byvaltsev
BACKGROUND CONTEXT: Recurrence of lumbar disc herniation (rLDH) is one of the unfavorable outcomes after microdiscectomy. Prediction of the patient population with increased risk of rLDH is important because patients may benefit from preventive measures or other surgical options. PURPOSE: The study assessed preoperative factors associated with rLDH after microdiscectomy and created a mathematical model for estimation of chances for rLDH. STUDY DESIGN/SETTING: This is a retrospective case-control study...
October 17, 2016: Spine Journal: Official Journal of the North American Spine Society
Enrico Tessitore, Granit Molliqaj, Karl Schaller, Oliver Pascal Gautschi
Extreme lateral interbody fusion (XLIF) is an alternative to standard posterior approaches for achieving fusion in the lumbar spine. It allows exposure of the lateral aspect of the lumbar disc through a lateral approach with the possibility to insert a wide footprint interbody cage as a stand-alone procedure or associated with a uni- or bilateral percutaneous fixation. This is a retrospective series of 20 consecutive patients operated with a XLIF procedure from 2014 to 2015. N=10 women and N=10 men with a mean age of 67...
October 17, 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Andrew J Teichtahl, Donna M Urquhart, Yuanyuan Wang, Anita E Wluka, Richard O'Sullivan, Graeme Jones, Flavia M Cicuttini
BACKGROUND: Degenerative disc disease of the lumbar spine is common, with severe disease increasing the risk for chronic low back pain. This cross-sectional study examined whether disc degeneration is representative of a 'whole-organ' pathology, by examining its association with bone (vertebral endplate) and soft tissue (paraspinal muscle fat) abnormalities. METHODS: Seventy-two community-based individuals unselected for low back pain, had Magnetic Resonance Imaging (MRI)...
October 21, 2016: BMC Musculoskeletal Disorders
Y-C Huang, J Xiao, W Y Leung, W W Lu, Y Hu, K D Luk
Previous human study suggested that fresh-frozen intervertebral disc allograft transplantation can relieve neurological symptoms and restore segmental kinematics. Before wide clinical application, research into the pathophysiology of the postoperative disc allograft is needed. One important question that remains to be answered in disc allografting is the healing process of the host-graft interface and the subsequent change of the endplates. With the goat model for lumbar disc allografting, histology, micro-computed tomography analysis, scanning electron microscopy and energy-dispersive X-ray spectroscopy mapping were applied to evaluate the healing of the host-graft interfaces, the remodelling of subchondral bone, and the changes of the bony and cartilaginous endplates after transplantation...
October 19, 2016: European Cells & Materials
Ru-Sen Zhu, Yi-Ming Ren, Jian-Jun Yuan, Zi-Jian Cui, Jun Wan, Bao-You Fan, Wei Lin, Xian-Hu Zhou, Xue-Li Zhang
Lumbar disc herniation (LDH) is a common disease and lumbar discectomy is the most common surgical procedure carried out for patients with low back pain and leg symptoms. Although most researchers are focusing on the surgical techniques during operation, the aim of this study is to evaluate the effect of local intervertebral lavage during microdiscectomy.In this retrospective study, 410 patients were operated on by microdiscectomy for LDH during 2011 to 2014. Retrospectively, 213 of them (group A) accepted local intervertebral irrigation with saline water before wound closure and 197 patients (group B) only had their operative field irrigated with saline water...
October 2016: Medicine (Baltimore)
Brett T Allaire, M Clara DePaolis Kaluza, Alexander G Bruno, Elizabeth J Samelson, Douglas P Kiel, Dennis E Anderson, Mary L Bouxsein
PURPOSE: Current standard methods to quantify disc height, namely distortion compensated Roentgen analysis (DCRA), have been mostly utilized in the lumbar and cervical spine and have strict exclusion criteria. Specifically, discs adjacent to a vertebral fracture are excluded from measurement, thus limiting the use of DCRA in studies that include older populations with a high prevalence of vertebral fractures. Thus, we developed and tested a modified DCRA algorithm that does not depend on vertebral shape...
October 18, 2016: European Spine Journal
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
Mohammed Rigi, Khurrum Khan, Stacy V Smith, Ayman O Suleiman, Andrew G Lee
Cryptococcal meningitis (CM) is the most common and severe form of cryptococcal infection. In addition to infiltrative and inflammatory mechanisms, intracranial hypertension commonly complicates CM and may cause significant visual and neurological morbidity and mortality. The mainstays of treatment for CM include standard antifungal therapy, management of intracranial hypertension, and treatment of underlying immunosuppressive conditions. Early and aggressive management of intracranial hypertension in accordance with established guidelines reduces the risk of long term visual and neurological complications and death...
October 14, 2016: Survey of Ophthalmology
Weifei Wu, Jie Liang, Ying Chen, Aihua Chen, Bin Wu, Zong Yang
To investigate the microstructural changes in compressed nerves using diffusion tensor imaging (DTI) of herniated disc treated with percutaneous transforaminal endoscopic discectomy.Diffusion tensor imaging has been widely used to visualize peripheral nerves, and the microstructure of compressed nerve roots can be assessed using DTI. However, the microstructural changes after surgery are not well-understood in patients with lumbar disc herniation.Thirty-four consecutive patients with foraminal disc herniation affecting unilateral sacral 1 (S1) nerve roots were enrolled in this study...
October 2016: Medicine (Baltimore)
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
Arvind G Kulkarni, Hussain Bohra, Abhilash Dhruv, Abhishek Sarraf, Anupreet Bassi, Vishwanath M Patil
BACKGROUND: The aim of the present prospective study is to evaluate whether the touted advantages of minimal invasive-transforaminal lumbar interbody fusion (MI-TLIF) translate into superior, equal, or inferior outcomes as compared to open-transforaminal lumbar interbody fusion (O-TLIF). This is the first study from the Indian subcontinent prospectively comparing the outcomes of MI-TLIF and O-TLIF. MATERIALS AND METHODS: All consecutive cases of open and MI-TLIF were prospectively followed up...
September 2016: Indian Journal of Orthopaedics
Brandon Miles, Ismail Ben Ayed, Seyed-Parsa Hojjat, Michael H Wang, Shuo Li, Aaron Fenster, Gregory J Garvin
This study investigates a fast integral-kernel algorithm for classifying (labeling) the vertebra and disc structures in axial magnetic resonance images (MRI). The method is based on a hierarchy of feature levels, where pixel classifications via non-linear probability product kernels (PPKs) are followed by classifications of 2D slices, individual 3D structures and groups of 3D structures. The algorithm further embeds geometric priors based on anatomical measurements of the spine. Our classifier requires evaluations of computationally expensive integrals at each pixel, and direct evaluations of such integrals would be prohibitively time consuming...
October 1, 2016: Computerized Medical Imaging and Graphics: the Official Journal of the Computerized Medical Imaging Society
A Spallone, M Çelniku
A 49 years-old man came to our attention with severe flaccid paraparesis occurring 10 days before, almost immediately after he had immerged his legs in boiling water for treating his severe left lombo-crural pain. This was known to be due to a right L3-L4 herniated disk diagnosed by MRI. At the examination he showed severe motor paresis and absent reflexes of his lower limbs, whilst crural pain was very mild and sensation and urinary function were unaffected. The results of his neurological examination led us to suspect an acute motor axon degeneration related to the heating shock...
October 11, 2016: World Neurosurgery
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
Abolfazl Rahimizadeh, Housain Soufiani, Valliolah Hassani, Ava Rahimizadeh
In this study the authors report the first example of spinal pseudarthrosis in a patient with ochronosis, and they describe the application of posterior-only 360° surgery as an alternative approach to combined anterior-posterior surgery in the management of pseudarthrosis of an ankylosed spine, regardless of its etiology. Spinal involvement in ochronosis produces loss of flexibility and ankylosis of thoracic and lumbar segments. Pseudarthrosis is a serious complication of the diseases that present with ankylosis of the spine...
October 14, 2016: Journal of Neurosurgery. Spine
C W J van Tilburg, D L Stronks, J G Groeneweg, F J P M Huygen
BACKGROUND: Investigate the effect of percutaneous radiofrequency compared to a sham procedure, applied to the ramus communicans for treatment of lumbar disc pain. METHODS: Randomized sham-controlled, double-blind, crossover, multicenter clinical trial. Multidisciplinary pain centres of two general hospitals. Sixty patients aged 18 or more with medical history and physical examination suggestive for lumbar disc pain and a reduction of two or more on a numerical rating scale (0-10) after a diagnostic ramus communicans test block...
October 13, 2016: European Journal of Pain: EJP
Jonathan M Weimer, Martin Marinov, Rafi Avitsian
A 58-year old male with grade II L4-L5 spondylolisthesis and degenerative changes presented for single level transforaminal lumbar interbody fusion. During decompression of the L4 foramina, distraction of the disc space, and placement of the interbody cage and pedicle screws, episodes of extreme bradycardia with up to 5 seconds of asystole were detected on both EKG and invasive hemodynamic monitoring. The events correlated with and could possibly be a result of traction on the dura. Lumbar spinal surgery may be associated with electrophysiological and hemodynamic abnormalities, and anesthesia providers should be aware of such possibilities and the need to respond appropriately with sympathomimetic or vagolytic interventions...
October 7, 2016: World Neurosurgery
Rebecca Wilson, Richard Kendall
Low back pain and obesity are both rising epidemics. This article will examine global trends in obesity, contributory lifestyle and societal factors, and morbidity and mortality associated with cardiovascular disease. With this background information, this article will explore the complex physiological process of atherosclerosis and the association between impaired lumbar perfusion and low back pain. It also will provide specific guidance on exercise and nutrition to help treat these potential underlying and contributory mechanisms of spine pathology...
October 6, 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
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