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Discogenic Low Back Pain

Bhagya Ranjan Jena, Anil Paswan, Yashpal Singh, Sandeep Loha, Anil Prasad Singh, Virendra Rastogi
BACKGROUND: Radiofrequency (RF) is a minimally invasive target-selective technique that has been used with success for many years in the treatment of different pathologies, such as low back pain, trigeminal neuralgia, and others. AIM: The aim of this study is to compare different mode of RF - continuous RF (CRF) versus pulsed RF (PRF) along with steroid in the management of low back pain of discogenic origin. SETTING AND DESIGN: Prospective, randomized, double-blind trial...
September 2016: Anesthesia, Essays and Researches
Carol Ann Flavell, Susan Gordon, Laurence Marshman
BACKGROUND: Physiotherapists use musculo-skeletal classification systems for patient assessment. Since its early development, the McKenzie lumbar spine assessment (MK) has been incorporated into examination algorithms and combined with a series of patho-anatomical diagnostic tests. No previous studies have used a MK and a combined examination (MK-C) to provide a detailed profile of patients, report and compare the classification characteristics of a chronic low back pain (CLBP) population...
October 5, 2016: Manual Therapy
Fumin Pan, Bin Shen, Surendra K Chy, Zhiyao Yong, Xiaoming Liu, Zhaoyu Ba, Zhonghan Liu, Jianguang Zhu, Desheng Wu
OBJECTIVE: To investigate the clinical outcomes of transforaminal endoscopic system(TESSYS) for discogenic low back pain(DLBP). METHODS: 62 consecutive patients with one-level DLBP applying to the including criteria underwent TESSYS from January 2010 to December 2013. These patients included 38 males and 24 females with a mean age of 42.7 ± 5.4 years (range, 18-73 yr) and a mean follow-up of 26.8 ± 4.2 months (range, 12-48 months). The visual analog scale (VAS) were used for back pain, the Oswestry Disability Index (ODI) for lumbar function, and the modified MacNab criteria for clinical global outcomes...
September 28, 2016: International Journal of Surgery
Mario G Zotti, Oscar P Brumby-Rendell, Ben McDonald, Tom Fisher, Christovalantis Tsimiklis, Wai Weng Yoon, Orso L Osti
BACKGROUND: Our aim was to determine whether patients derived benefit from removal of pedicle screw instrumentation for axial pain without other cause using our surgical technique and patient selection. A secondary aim was to investigate factors that were associated with poorer outcomes for this procedure as well as complication rate in this cohort. METHODS: Theater records from a single spinal surgeon's practice were reviewed to identify patients that had undergone lumbar fusion for discogenic back pain with subsequent pedicle screw instrumentation removal (Expedium, DePuy Synthes) in the preceding 3 years with a minimum of 18 months follow-up...
December 2015: J Spine Surg
Ralph J Mobbs, Kevin Phan, Greg Malham, Kevin Seex, Prashanth J Rao
Degenerative disc and facet joint disease of the lumbar spine is common in the ageing population, and is one of the most frequent causes of disability. Lumbar spondylosis may result in mechanical back pain, radicular and claudicant symptoms, reduced mobility and poor quality of life. Surgical interbody fusion of degenerative levels is an effective treatment option to stabilize the painful motion segment, and may provide indirect decompression of the neural elements, restore lordosis and correct deformity. The surgical options for interbody fusion of the lumbar spine include: posterior lumbar interbody fusion (PLIF), transforaminal lumbar interbody fusion (TLIF), minimally invasive transforaminal lumbar interbody fusion (MI-TLIF), oblique lumbar interbody fusion/anterior to psoas (OLIF/ATP), lateral lumbar interbody fusion (LLIF) and anterior lumbar interbody fusion (ALIF)...
December 2015: J Spine Surg
Zhengwei Zhou, Maxim Bez, Wafa Tawackoli, Joseph Giaconi, Dmitriy Sheyn, Sandra de Mel, Marcel M Maya, Barry D Pressman, Zulma Gazit, Gadi Pelled, Dan Gazit, Debiao Li
PURPOSE: Previous studies have associated low pH in intervertebral discs (IVDs) with discogenic back pain. The purpose of this study was to determine whether quantitative CEST (qCEST) MRI can be used to detect pH changes in IVDs in vivo. METHODS: The exchange rate ksw between glycosaminoglycan (GAG) protons and water protons was determined from qCEST analysis. Its dependence on pH value was investigated in GAG phantoms with varying pH and concentrations. The relationship between ksw and pH was studied further in vivo in a porcine model on a 3T MR scanner and validated using a pH meter...
September 26, 2016: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
Li Zhang, Xin-Li Ding, Xu-Li Zhao, Jun-Nan Wang, Yan-Ping Li, Ming Tian
BACKGROUND: The efficacy of percutaneous intradiscal radiofrequency thermocoagulation (PIRFT) for the treatment of discogenic low back pain (LBP) remains controversial. However, all the PIRFT studies utilized monopolar radiofrequency thermocoagulation (RFTC). The aim of this study was to investigate the safety and efficacy of bipolar RFTC for the treatment of discogenic LBP. METHODS: A total of 23 patients with discogenic LBP were treated with single-level bipolar RFTC...
2016: Chinese Medical Journal
Atilla Kircelli, İlker Çöven, Tufan Cansever, Erkin Sonmez, Cem Yilmaz
AIM: Intervertebral disc degeneration can cause severe low back pain. Intradiscal electrothermal therapy (IDET) is a minimally invasive treatment option for patients with symptomatic internal disc disruption unresponsive to conservative medical care. We aimed to evaluate 12-month pain and functional outcomes and predictors of clinical success in patients with discogenic back pain treated with IDET with respect to the Dallas Discogram Scale (DDS). MATERIAL AND METHODS: This was a retrospective analysis of patients undergoing IDET for low back pain from 2009 through 2014 at Baskent University department of Neurosurgery...
December 28, 2015: Turkish Neurosurgery
Mehul J Desai, Leonardo Kapural, Jeffrey D Petersohn, Ricardo Vallejo, Robert Menzies, Michael Creamer, Michael Gofeld
OBJECTIVE: This report conveys 12-month outcomes of subjects treated with intradiscal biacuplasty (IDB) and conservative medical management (CMM) for chronic low back pain of discogenic origin, and results for subjects who elected to receive IDB + CMM 6 months after CMM-alone. METHODS: Sixty-three subjects were originally randomized to the IDB + CMM group (N = 29) or CMM-alone (N = 34). Six months following continuous CMM-alone treatment, participants in this study group were permitted to "cross-over" to IDB + CMM (N = 25), and followed for an additional 6 months...
August 27, 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Luke D Surkitt, Jon J Ford, Alexander Y P Chan, Matthew C Richards, Sarah L Slater, Tania Pizzari, Andrew J Hahne
BACKGROUND: Low back disorders are prevalent and directional preference management is a common treatment with mixed evidence for effectiveness. OBJECTIVES: To determine the effectiveness of individualised directional preference management plus guideline-based advice versus advice alone in participants with reducible discogenic pain of 6-week to 6-month duration. DESIGN: Pre-planned secondary analysis of a multicentre, parallel group randomised controlled trial...
September 2016: Manual Therapy
Massimo Allegri, Silvana Montella, Fabiana Salici, Adriana Valente, Maurizio Marchesini, Christian Compagnone, Marco Baciarello, Maria Elena Manferdini, Guido Fanelli
Chronic low back pain (CLBP) is a chronic pain syndrome in the lower back region, lasting for at least 3 months. CLBP represents the second leading cause of disability worldwide being a major welfare and economic problem. The prevalence of CLBP in adults has increased more than 100% in the last decade and continues to increase dramatically in the aging population, affecting both men and women in all ethnic groups, with a significant impact on functional capacity and occupational activities. It can also be influenced by psychological factors, such as stress, depression and/or anxiety...
2016: F1000Research
Seiji Ohtori, Sumihisa Orita, Kazuyo Yamauchi, Yawara Eguchi, Yasuchika Aoki, Junichi Nakamura, Masayuki Miyagi, Miyako Suzuki, Gou Kubota, Kazuhide Inage, Takeshi Sainoh, Jun Sato, Yasuhiro Shiga, Koki Abe, Kazuki Fujimoto, Hiroto Kanamoto, Gen Inoue, Kazuhisa Takahashi
STUDY DESIGN: Retrospective case series. PURPOSE: To determine whether symptoms predict surgical outcomes for patients with discogenic low back pain (DLBP). OVERVIEW OF LITERATURE: Specific diagnosis of DLBP remains difficult. Worsening of pain on flexion is a reported symptom of DLBP. This study sought to determine whether symptoms predict surgical outcomes for patients with DLBP. METHODS: We investigated 127 patients with low back pain (LBP) and no dominant radicular pain...
June 2016: Asian Spine Journal
Chris Daly, Peter Ghosh, Graham Jenkin, David Oehme, Tony Goldschlager
Lower back pain is the leading cause of disability worldwide. Discogenic pain secondary to intervertebral disc degeneration is a significant cause of low back pain. Disc degeneration is a complex multifactorial process. Animal models are essential to furthering understanding of the degenerative process and testing potential therapies. The adult human lumbar intervertebral disc is characterized by the loss of notochordal cells, relatively large size, essentially avascular nature, and exposure to biomechanical stresses influenced by bipedalism...
2016: BioMed Research International
James J Yue, Rolando Garcia, Larry E Miller
Degeneration of the lumbar intervertebral discs is a leading cause of chronic low back pain in adults. Treatment options for patients with chronic lumbar discogenic pain unresponsive to conservative management include total disc replacement (TDR) or lumbar fusion. Until recently, only two lumbar TDRs had been approved by the US Food and Drug Administration - the Charité Artificial Disc in 2004 and the ProDisc-L Total Disc Replacement in 2006. In June 2015, a next-generation lumbar TDR received Food and Drug Administration approval - the activL(®) Artificial Disc (Aesculap Implant Systems)...
2016: Medical Devices: Evidence and Research
Nianhu Li, Camden Whitaker, Zhanwang Xu, Michael Heggeness, Shang-You Yang
BACKGROUND: Over half the population of the world will suffer moderate or severe low back pain (LBP) during their life span. Studies have shown that naringin, a major flavonoid in grapefruit and an active compound extracted from a Chinese herbal medicine (Rhizoma Drynariae) possesses many pharmacological effects. PURPOSE: To evaluate the influence of naringin on the growth of degenerative human nucleus pulposus (NP) cells, and its repair effects on protein and gene expressions of the cells...
May 18, 2016: Spine Journal: Official Journal of the North American Spine Society
Toshihiko Inui, Masahiro Murakami, Noriaki Nagao, Kouichi Miyazaki, Kou Matsuda, Yoshiko Tominaga, Masahiko Kitano, Hiroshi Hasegawa, Shinsuke Tominaga
STUDY DESIGN: Single-center retrospective case series OBJECTIVE.: To compare outcomes of instrumented fusion and two methods of decompression for degenerative spondylolisthesis. SUMMARY OF BACKGROUND DATA: There is no consensus on the surgical indications or optimum techniques for lumbar degenerative spondylolisthesis. METHODS: We analyzed the data of 140 patients treated by fusion (n = 80; mean follow-up, 77.9 months) or decompression (n = 60; mean follow-up, 38...
May 18, 2016: Spine
Niek Koenders, Alison Rushton, Nicola Heneghan, Martin L Verra, Paul Willems, Thomas Hoogeboom, J Bart Staal
BACKGROUND: Lumbar spinal fusion for degenerative disorders of the lumbar spine is frequently used, despite current research presenting inconclusive evidence. This study aims to systematically review and meta-analyse the natural course of pain and disability in patients with degenerative disorders of the lumbar spine such as spinal stenosis, spondylolisthesis, disc herniation, or discogenic low back pain to improve lumbar spinal fusion management. METHODS/DESIGN: An electronic database search will be conducted up to 30 September 2015 using MEDLINE, EMBASE, CINAHL, and ZETOC database...
2016: Systematic Reviews
Mary O'Keeffe, Kieran OʼSullivan, Peter OʼSullivan
No abstract text is available yet for this article.
July 1, 2016: Spine
Stefan Dudli, Ellen Liebenberg, Sergey Magnitsky, Steve Miller, Sibel Demir-Deviren, Jeffrey C Lotz
Modic type I change (MC1) are vertebral bone marrow lesions adjacent to degenerated discs that are specific for discogenic low back pain. The etiopathogenesis is unknown, but occult discitis, in particular with Propionibacteria acnes (P. acnes), has been suggested as a possible etiology. If true, antibiotic therapy should be considered for patients with MC1. However, this hypothesis is controversial. While some studies report up to 40% infection rate in herniated discs, others fail to detect infected discs and attribute reports of positive cultures to contamination during sampling procedure...
August 2016: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
Michael Monfett, Julian Harrison, Kwadwo Boachie-Adjei, Gregory Lutz
PURPOSE: The aim of this article is to provide an overview of clinical and translational research on intradiscal platelet-rich plasma (PRP) as a minimally invasive treatment for discogenic low back pain. METHODS: A literature review of in vitro, in vivo, and clinical studies was performed. RESULTS: There is strong in vitro evidence that supports the use of intradiscal PRP for discogenic low back pain. There are also promising findings in select preclinical animal studies...
June 2016: International Orthopaedics
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