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Discogenic Low Back Pain

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https://www.readbyqxmd.com/read/28491116/a-randomized-clinical-trial-comparing-the-effectiveness-of-electroacupuncture-versus-medium-frequency-electrotherapy-for-discogenic-sciatica
#1
Xue Zhang, Yang Wang, Zhao Wang, Chao Wang, Wentao Ding, Zhishun Liu
Objective. To investigate the short- and long-term effects of electroacupuncture (EA) compared with medium-frequency electrotherapy (MFE) on chronic discogenic sciatica. Methods. One hundred participants were randomized into two groups to receive EA (n = 50) or MFE (n = 50) for 4 weeks. A 28-week follow-up of the two groups was performed. The primary outcome measure was the average leg pain intensity. The secondary outcome measures were the low back pain intensity, Oswestry Disability Index (ODI), patient global impression (PGI), drug use frequency, and EA acceptance...
2017: Evidence-based Complementary and Alternative Medicine: ECAM
https://www.readbyqxmd.com/read/28486758/stimulation-of-the-l2-l3-dorsal-root-ganglia-induces-effective-pain-relief-in-the-low-back
#2
Frank Huygen, Liong Liem, William Cusack, Jeffery Kramer
INTRODUCTION: Chronic low back pain affects millions of people worldwide and can arise through a variety of clinical origins. In the case of Failed Back Surgery Syndrome (FBSS), previous surgical procedures can contribute to low back pain that is often unresponsive to intervention. Although spinal cord stimulation can be an effective treatment modality, it does not provide sufficient pain relief for some intractable cases. Recently, alternative neuromodulation options have been developed, including dorsal root ganglion (DRG) stimulation...
May 9, 2017: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/28486278/interventional-approaches-to-low-back-pain
#3
Ariana M Nelson, Geeta Nagpal
Chronic low back pain (LBP) places a tremendous economic burden on society due to both direct and indirect costs. Health care costs for adults with chronic LBP have steadily increased over the past 20 years, coinciding with a large increase in the utilization of spinal injections, surgical interventions, opioid medications, and physical therapy. The treatment of LBP is best approached by a multimodal and even multidisciplinary approach with a combination of physical rehabilitation, pharmacologic management, psychological intervention, spinal injections, and surgical intervention with a goal of improving the functional status of the patient...
May 8, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28430617/estrogen-receptors-involvement-in-intervertebral-discogenic-pain-of-the-elderly-women-colocalization-and-correlation-with-the-expression-of-substance-p-in-nucleus-pulposus
#4
Xiao-Xing Song, Sheng Shi, Zhen Guo, Xin-Feng Li, Bu-Wei Yu
Estrogenic modulation of pain is an exceedingly complex phenomenon. However, whether estrogen is involved in discogenic low back pain still remains unclear. Here, immunoreactivity staining technique was used to examine the expression level of the estrogen receptors (ERα and ERβ) and a pain related neuropeptide, Substance P in the lumbar intervertebral discs to analyze the relationship between the ERs and Substance P. Nucleus pulposus tissues of 23 elderly female patients were harvested during spinal surgeries and made to detect the immunoreactivity staining of ERα, ERβ and Substance P...
February 16, 2017: Oncotarget
https://www.readbyqxmd.com/read/28379575/no-transfer-of-pressure-to-adjacent-discs-during-human-low-pressure-controlled-discography-a-prospective-clinical-study
#5
Jan Willem Kallewaard, José W Geurts, Michel Terheggen, Chris Terwiel, Alfons Kessels, Maarten van Kleef, Paul C Willems
Background. : A substantial part of low back pain (LBP) originates from degeneration of the intervertebral disc. To confirm the diagnosis of discogenic pain, provocation discography seems the best available tool. However, provocation discography is also considered to be a controversial and subjective test because the patient's personal pain response is the most crucial for the result of the test. Recently, an in vivo porcine study and a study in nine human subjects showed passing of pressure to the adjacent discs during discography...
April 1, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28178999/the-correlation-between-the-high-intensity-zone-on-a-t2-weighted-mri-and-positive-outcomes-of-discography-a-meta-analysis
#6
Chunyang Fang, Wenbin Zhang, Liqiu Chen, Hongjie Li
BACKGROUND: This meta-analysis aimed to assess the correlation between the high-intensity zone (HIZ) of a lumbar MRI and discography. METHODS: We conducted an electronic search of the PubMed, MEDLINE, Embase, and ScienceDirect databases from their respective inceptions to October 2016 using the following search terms: "low back pain," "discogenic low back pain," "HIZ or high-intensity zone," and "discography". Relevant journals and conference proceedings were manually searched...
February 8, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28138783/issls-prize-in-basic-science-2017-intervertebral-disc-bone-marrow-cross-talk-with-modic-changes
#7
Stefan Dudli, David C Sing, Serena S Hu, Sigurd H Berven, Shane Burch, Vedat Deviren, Ivan Cheng, Bobby K B Tay, Todd F Alamin, Ma Agnes Martinez Ith, Eric M Pietras, Jeffrey C Lotz
STUDY DESIGN: Cross-sectional cohort analysis of patients with Modic Changes (MC). OBJECTIVE: Our goal was to characterize the molecular and cellular features of MC bone marrow and adjacent discs. We hypothesized that MC associate with biologic cross-talk between discs and bone marrow, the presence of which may have both diagnostic and therapeutic implications. BACKGROUND DATA: MC are vertebral bone marrow lesions that can be a diagnostic indicator for discogenic low back pain...
May 2017: European Spine Journal
https://www.readbyqxmd.com/read/27914651/individualised-functional-restoration-plus-guideline-based-advice-vs-advice-alone-for-non-reducible-discogenic-low-back-pain-a-randomised-controlled-trial
#8
Alexander Y P Chan, Jon J Ford, Luke D Surkitt, Matthew C Richards, Sarah L Slater, Megan Davidson, Andrew J Hahne
OBJECTIVES: To evaluate the effectiveness of individualised functional restoration plus guideline-based advice compared to advice alone in people with non-reducible discogenic pain (NRDP). DESIGN: Subgroup analysis within a multicentre, parallel group randomised controlled trial. SETTING: Fifteen primary care physiotherapy clinics. PARTICIPANTS: Ninety-six participants with clinical features indicative of NRDP (6 week to 6 month duration of injury)...
August 10, 2016: Physiotherapy
https://www.readbyqxmd.com/read/27906950/clinical-evaluation-and-magnetic-resonance-imaging-assessment-of-intradiscal-methylene-blue-injection-for-the-treatment-of-discogenic-low-back-pain
#9
XiaoJun Zhang, Jie Hao, Zhenming Hu, HaiTao Yang
BACKGROUND: Low back pain is a common worldwide health problem and has a significant socioeconomic impact on public health. Internal disc disruption has been considered as the most common cause of low back pain. Various therapies, including interbody fusion, disc replacement, injection therapies, and thermal annular procedures have been utilized for the treatment of discogenic low back pain. Recently, a new method of intradiscal methylene blue injection has been introduced to treat discogenic low back pain, but the clinical outcomes are controversial...
November 2016: Pain Physician
https://www.readbyqxmd.com/read/27875493/acute-lumbar-paraspinal-myonecrosis-in-football-players-with-sickle-cell-trait-a-case-series
#10
E Randy Eichner, Brock Schnebel, Scott Anderson, James R Clugston, Matthew Heath Hale, Charlie Michaudet, John M Small
We report six cases of a novel syndrome of acute, exertional low back pain in football players, five in college and one in the National Football League. All six are African Americans with sickle cell trait (SCT). The acute low back pain is severe and can be disabling, and the condition can be confused with muscle strain, discogenic pain, stress fracture, or other problems in athletes. Our evidence shows that this syndrome is caused by lumbar paraspinal myonecrosis (LPSMN), which likely often contributes to the lumbar paraspinal compartment syndrome...
April 2017: Medicine and Science in Sports and Exercise
https://www.readbyqxmd.com/read/27848245/inflammatory-mediators-and-signalling-pathways-controlling-intervertebral-disc-degeneration
#11
REVIEW
Stefania Elena Navone, Giovanni Marfia, Amedeo Giannoni, Matteo Beretta, Laura Guarnaccia, Roberta Gualtierotti, Daniele Nicoli, Paolo Rampini, Rolando Campanella
Intervertebral disc (IVD) degeneration (IDD) is one of the major causes of back pain, a condition that represents a serious socio-economic burden. Deeper knowledge of the complex and fine relationship between IVD degeneration, tissue inflammation and pain, appears to be critical to improve the current therapies, which have so far proven themselves ineffective. Upon degeneration, IVD tissues become inflamed, and this inflammatory microenvironment is associated with a cascade of degenerative events that may eventually cause discogenic pain...
November 16, 2016: Histology and Histopathology
https://www.readbyqxmd.com/read/27820861/diagnosing-discogenic-low-back-pain-associated-with-degenerative-disc-disease-using-a-medical-interview
#12
Juichi Tonosu, Hirohiko Inanami, Hiroyuki Oka, Junji Katsuhira, Yuichi Takano, Hisashi Koga, Yohei Yuzawa, Ryutaro Shiboi, Yasushi Oshima, Satoshi Baba, Sakae Tanaka, Ko Matsudaira
PURPOSES: To evaluate the usefulness of our original five questions in a medical interview for diagnosing discogenic low back pain (LBP), and to establish a support tool for diagnosing discogenic LBP. MATERIALS AND METHODS: The degenerative disc disease (DDD) group (n = 42) comprised patients diagnosed with discogenic LBP associated with DDD, on the basis of magnetic resonance imaging findings and response to analgesic discography (discoblock). The control group (n = 30) comprised patients with LBP due to a reason other than DDD...
2016: PloS One
https://www.readbyqxmd.com/read/27746559/a-comparative-study-of-continuous-versus-pulsed-radiofrequency-discectomy-for-management-of-low-backache-prospective-randomized-double-blind-study
#13
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
https://www.readbyqxmd.com/read/27744135/classification-characteristics-of-a-chronic-low-back-pain-population-using-a-combined-mckenzie-and-patho-anatomical-assessment
#14
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...
December 2016: Manual Therapy
https://www.readbyqxmd.com/read/27693825/transforaminal-endoscopic-system-technique-for-discogenic-low-back-pain-a-prospective-cohort-study
#15
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...
November 2016: International Journal of Surgery
https://www.readbyqxmd.com/read/27683679/the-outcome-of-pedicle-screw-instrumentation-removal-for-ongoing-low-back-pain-following-posterolateral-lumbar-fusion
#16
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: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/27683674/lumbar-interbody-fusion-techniques-indications-and-comparison-of-interbody-fusion-options-including-plif-tlif-mi-tlif-olif-atp-llif-and-alif
#17
REVIEW
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: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/27670140/quantitative-chemical-exchange-saturation-transfer-mri-of-intervertebral-disc-in-a-porcine-model
#18
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...
December 2016: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
https://www.readbyqxmd.com/read/27647190/fluoroscopy-guided-bipolar-radiofrequency-thermocoagulation-treatment-for-discogenic-low-back-pain
#19
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...
October 5, 2016: Chinese Medical Journal
https://www.readbyqxmd.com/read/27593796/patient-selection-and-efficacy-of-intradiscal-electrothermal-therapy-with-respect-to-dallas-discogram-score
#20
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
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