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https://www.readbyqxmd.com/read/28934777/effectiveness-of-thermal-annular-procedures-in-treating-discogenic-low-back-pain
#1
Standiford Helm Ii, Thomas T Simopoulos, Milan Stojanovic, Salahadin Abdi, Mohamed Ahamed El Terany
BACKGROUND: Discogenic low back is a distinct clinic entity characterized by pain arising from a damaged disc. The diagnosis is clouded by the controversy surrounding discography. The treatment options are limited, with unsatisfactory results from both conservative treatment and surgery. Multiple interventional therapies have been developed to treat discogenic pain, but most have not yet been validated by high quality studies.The best studied treatment for discogenic pain is the use of heat, which has been labeled as thermal intradiscal procedures (TIPs) by the Centers for Medicare and Medicaid Services (CMS)...
September 2017: Pain Physician
https://www.readbyqxmd.com/read/28898530/a-cost-effectiveness-analysis-of-intradiscal-electrothermal-therapy-idet-compared-with-circumferential-lumbar-fusion
#2
Eugena Stamuli, Withawin Kesornsak, Michael P Grevitt, John Posnett, Karl Claxton
STUDY DESIGN: Cost-effectiveness analysis. OBJECTIVE: To evaluate the cost-effectiveness of intradiscal electrothermal therapy (IDET) relative to circumferential lumbar fusion with femoral ring allograft (FRA) in UK. SUMMARY OF BACKGROUND DATA: Circumferential lumbar fusion is an established treatment for discogenic low back pain. However, IDET could be a cost-effective treatment alternative as it can be carried out as a day case. METHODS: Patient-level data were available for patients with discogenic low back pain treated with FRA (n=37) in a randomized trial of FRA vs titanium cage, and for patients recruited to a separate study evaluating the use of IDET (n=85)...
September 12, 2017: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/28874973/inhibiting-vascular-endothelial-growth-factor-in-injured-intervertebral-discs-attenuates-pain-related-neuropeptide-expression-in-dorsal-root-ganglia-in-rats
#3
Jun Sato, Kazuhide Inage, Masayuki Miyagi, Yoshihiro Sakuma, Kazuyo Yamauchi, Masao Koda, Takeo Furuya, Junichi Nakamura, Miyako Suzuki, Go Kubota, Yasuhiro Oikawa, Takeshi Sainoh, Kazuki Fujimoto, Yasuhiro Shiga, Koki Abe, Hirohito Kanamoto, Masahiro Inoue, Hideyuki Kinoshita, Masaki Norimoto, Tomotaka Umimura, Kazuhisa Takahashi, Seiji Ohtori, Sumihisa Orita
STUDY DESIGN: An experimental animal study. PURPOSE: To evaluate effects of anti-vascular endothelial growth factor (VEGF) on the content and distribution of the calcitonin gene-related peptide (CGRP) in the dorsal ganglia in a rat model. OVERVIEW OF LITERATURE: Increased expression of VEGF in degenerative disc disease increases the levels of inflammatory cytokines and nerve ingrowth into the damaged discs. In animal models, increased levels of VEGF can persist for up to 2 weeks after an injury...
August 2017: Asian Spine Journal
https://www.readbyqxmd.com/read/28859858/obesity-and-spinal-loads-a-combined-mr-imaging-and-subject-specific-modeling-investigation
#4
M H Akhavanfar, H Kazemi, A H Eskandari, N Arjmand
Epidemiological studies have identified obesity asa possible risk factor for low back disorders. Biomechanical models can help test such hypothesis and shed light on the mechanism involved. A novel subject-specific musculoskeletal-modelling approach is introduced to estimate spinal loads during static activities in five healthy obese (BMI>30kg/m(2)) and five normal-weight (20<BMI<25kg/m(2)) individuals. Subjects underwent T1 through S1 MR imaging thereby measuring cross-sectional-area (CSA) and moment arms of trunk muscles together with mass and center of mass (CoM) of T1-L5 segments...
August 20, 2017: Journal of Biomechanics
https://www.readbyqxmd.com/read/28853606/impact-of-the-quantity-of-intradiscal-cement-leak-on-the-progression-of-intervertebral-disc-degeneration
#5
B Jamjoom, S Patel, R Bommireddy, Z Klezl
Introduction We aim to assess the impact of the quantity of intradiscal cement leak during kyphoplasty on the rate of progression of degenerative changes in the affected disc. Methods Of 316 kyphoplasty procedures, we identified 32 episodes of intradiscal cement leak in 26 patients. The quantity of cement leaked was graded from I to IV. Disc degenerative changes were assessed at presentation and follow-up using radiographical scoring and magnetic resonance imaging (MRI) grading systems. Data for low-grade leaks (grade I) were compared with the medium- and high-grade leaks (grades II-IV) using a chi-squared test...
September 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28839324/nosocomial-spondylodiscitis-after-intradiscal-electrothermal-therapy-case-series
#6
Vuslat Kecik Bosnak, Ilkay Karaoglan, Ibrahim Erkutlu, Mustafa Namiduru
Intradiscal electrothermal therapy (IDET) is a method applied for treatment of pain caused by the disc and involves reaching spinal disc through a catheter under fluoroscopy and solidifying disc interior by heating. We retrospectively evaluated ten patients treated and followed up with diagnosis of nosocomial spondylodiscitis after IDET. Ten patients, to whom IDET was applied for low back pain treatment in a tertiary healthcare organization, came with complaints of fever and low back pain during postoperative process...
August 2017: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/28828753/reduction-of-intradiscal-pressure-by-the-use-of-polycarbonate-urethane-rods-as-compared-to-titanium-rods-in-posterior-thoracolumbar-spinal-fixation
#7
Eva Jacobs, Alex K Roth, Jacobus J Arts, Lodewijk W van Rhijn, Paul C Willems
Loss of sagittal alignment and balance in adult spinal deformity can cause severe pain, disability and progressive neurological deficit. When conservative treatment has failed, spinal fusion using rigid instrumentation is currently the salvage treatment to stop further curve progression. However, fusion surgery is associated with high revision rates due to instrumentation failure and proximal junctional failure, especially if patients also suffer from osteoporosis. To address these drawbacks, a less rigid rod construct is proposed, which is hypothesized to provide a more gradual transition of force and load distribution over spinal segments in comparison to stiff titanium rods...
August 21, 2017: Journal of Materials Science. Materials in Medicine
https://www.readbyqxmd.com/read/28805297/mesenchymal-stem-cells-deliver-exogenous-mir-21-via-exosomes-to-inhibit-nucleus-pulposus-cell-apoptosis-and-reduce-intervertebral-disc-degeneration
#8
Xiaofei Cheng, Guoying Zhang, Liang Zhang, Ying Hu, Kai Zhang, Xiaojiang Sun, Changqing Zhao, Hua Li, Yan Michael Li, Jie Zhao
Although mesenchymal stem cells (MSCs) transplantation into the IVD (intervertebral disc) may be beneficial in inhibiting apoptosis of nucleus pulposus cells (NPCs) and alleviating IVD degeneration, the underlying mechanism of this therapeutic process has not been fully explained. The purpose of this study was to explore the protective effect of MSC-derived exosomes (MSC-exosomes) on NPC apoptosis and IVD degeneration and investigate the regulatory effect of miRNAs in MSC-exosomes and associated mechanisms for NPC apoptosis...
August 14, 2017: Journal of Cellular and Molecular Medicine
https://www.readbyqxmd.com/read/28797595/effects-of-motion-segment-simulation-and-joint-positioning-on-spinal-loads-in-trunk-musculoskeletal-models
#9
F Ghezelbash, A H Eskandari, A Shirazi-Adl, N Arjmand, Z El-Ouaaid, A Plamondon
Musculoskeletal models represent spinal motion segments by spherical joints/beams with linear/nonlinear properties placed at various locations. We investigated the fidelity of these simplified models (i.e., spherical joints with/without rotational springs and beams considering nonlinear/linear properties) in predicting kinematics of the ligamentous spine in comparison with a detailed finite element (FE) model while considering various anterior-posterior joint placements. Using the simplified models with different joint offsets in a subject-specific musculoskeletal model, we computed local spinal forces during forward flexion and compared results with intradiscal pressure measurements...
July 25, 2017: Journal of Biomechanics
https://www.readbyqxmd.com/read/28796755/the-effect-of-lumbar-disc-herniation-on-musculoskeletal-loadings-in-the-spinal-region-during-level-walking-and-stair-climbing
#10
Shengzheng Kuai, Zhenhua Liao, Wenyu Zhou, Xinyu Guan, Run Ji, Rui Zhang, Daiqi Guo, Weiqiang Liu
BACKGROUND People with low back pain (LBP) alter their motion patterns during level walking and stair climbing due to pain or fear. However, the alternations of load sharing during the two activities are largely unknown. The objective of this study was to investigate the effect of LBP caused by lumbar disc herniation (LDH) on the muscle activities of 17 main trunk muscle groups and the intradiscal forces acting on the five lumbar discs. MATERIAL AND METHODS Twenty-six healthy adults and seven LDH patients were recruited to perform level walking and stair climbing in the Gait Analysis Laboratory...
August 10, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28782368/analysis-of-risk-factors-causing-short-term-cement-leakages-and-long-term-complications-after-percutaneous-kyphoplasty-for-osteoporotic-vertebral-compression-fractures
#11
Chang Gao, Min Zong, Wen-Tao Wang, Lei Xu, Da Cao, Yue-Fen Zou
Background Percutaneous kyphoplasty (PKP) is a common treatment modality for painful osteoporotic vertebral compression fractures (OVCFs). Pre- and postoperative identification of risk factors for cement leakage and follow-up complications would therefore be helpful but has not been systematically investigated. Purpose To evaluate pre- and postoperative risk factors for the occurrence of short-term cement leakages and long-term complications after PKP for OVCFs. Material and Methods A total of 283 vertebrae with PKP in 239 patients were investigated...
January 1, 2017: Acta Radiologica
https://www.readbyqxmd.com/read/28748380/autologous-bone-marrow-concentrate-intradiscal-injection-for-the-treatment-of-degenerative-disc-disease-with-three-year-follow-up
#12
Kenneth A Pettine, Richard K Suzuki, Theodore T Sand, Matthew B Murphy
PURPOSE: The purpose of this study is to assess safety and feasibility of intradiscal bone marrow concentrate (BMC) injections to treat low back discogenic pain as an alternative to surgery with three year minimum follow-up. METHODS: A total of 26 patients suffering from degenerative disc disease and candidates for spinal fusion or total disc replacement surgery were injected with 2 ml autologous BMC into the nucleus pulposus of treated lumbar discs. A sample aliquot of BMC was characterized by flow cytometry and CFU-F assay to determine progenitor cell content...
July 26, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28735027/translation-of-an-injectable-triple-interpenetrating-network-hydrogel-for-intervertebral-disc-regeneration-in-a-goat-model
#13
Sarah E Gullbrand, Thomas P Schaer, Prateek Agarwal, Justin R Bendigo, George R Dodge, Weiliam Chen, Dawn M Elliott, Robert L Mauck, Neil R Malhotra, Lachlan J Smith
Degeneration of the intervertebral discs is a progressive cascade of cellular, compositional and structural changes that is frequently associated with low back pain. As the first signs of disc degeneration typically arise in the disc's central nucleus pulposus (NP), augmentation of the NP via hydrogel injection represents a promising strategy to treat early to mid-stage degeneration. The purpose of this study was to establish the translational feasibility of a triple interpenetrating network hydrogel composed of dextran, chitosan, and teleostean (DCT) for augmentation of the degenerative NP in a preclinical goat model...
September 15, 2017: Acta Biomaterialia
https://www.readbyqxmd.com/read/28713050/the-biomechanical-impact-of-facet-tropism-on-the-intervertebral-disc-and-facet-joints-in-the-cervical-spine
#14
Xin Rong, Beiyu Wang, Chen Ding, Yuxiao Deng, Hua Chen, Yang Meng, Weijie Yan, Hao Liu
BACKGROUND CONTEXT: Facet tropism is defined as the angular difference between the left and the right facet orientation. Facet tropism was suggested to be associated with the disc degeneration and facet degeneration in the lumbar spine. However, little is known about the relationship between facet tropism and pathologic changes in the cervical spine and the mechanism behind. PURPOSE: This study was conducted to investigate the biomechanical impact of facet tropism on the intervertebral disc and facet joints...
July 13, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28670405/intradiscal-injection-of-autologous-platelet-rich-plasma-releasate-to-treat-discogenic-low-back-pain-a-preliminary-clinical-trial
#15
Koji Akeda, Kohshi Ohishi, Koichi Masuda, Won C Bae, Norihiko Takegami, Junichi Yamada, Tomoki Nakamura, Toshihiko Sakakibara, Yuichi Kasai, Akihiro Sudo
STUDY DESIGN: Preliminary clinical trial. PURPOSE: To determine the safety and initial efficacy of intradiscal injection of autologous platelet-rich plasma (PRP) releasate in patients with discogenic low back pain. OVERVIEW OF LITERATURE: PRP, which is comprised of autologous growth factors and cytokines, has been widely used in the clinical setting for tissue regeneration and repair. PRP has been shown in vitro and in vivo to potentially stimulate intervertebral disc matrix metabolism...
June 2017: Asian Spine Journal
https://www.readbyqxmd.com/read/28660372/a-finite-element-study-of-traditional-chinese-cervical-manipulation
#16
Zhen Deng, Kuan Wang, Huihao Wang, Tianying Lan, Hongsheng Zhan, Wenxin Niu
PURPOSE: Traditional Chinese cervical manipulation (TCCM) has been claimed as an effective treatment for diseases of the cervical spine, but its biomechanical effects on the vertebral body and intervertebral discs remain unclear. The aim of this study was to develop and validate a detailed finite element model of cervical spine, which was then used to investigate the biomechanical response of the cervical spine to TCCM. METHODS: The model of a C2-T1 cervical spine was constructed based on CT images of a healthy male volunteer and validated against published in vitro studies under different loading conditions...
June 28, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28594131/optimization-of-puncture-injury-to-rat-caudal-disc-for-mimicking-early-degeneration-of-intervertebral-disc
#17
Ming-Hsiao Hu, Kai-Chiang Yang, Yeong-Jang Chen, Yuan-Hui Sun, Feng-Huei Lin, Shu-Hua Yang
The caudal discs of rats have been proposed as a puncture model in which intervertebral disc (IVD) degeneration can be induced and novel therapies can be tested. For biological repair, treatments for ongoing IVD degeneration are ideally administered during the earlier stages. The purpose of this study was to elucidate the optimal puncture needle size for creating a model that mimicked the earlier stages of IVD degeneration. According to the disc height index, histologic score, and MRI grading, a puncture needle sized 21G or larger induced rapid degenerative processes in rat caudal discs during the initial 2-4 weeks...
June 8, 2017: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/28549604/effects-of-eight-different-ligament-property-datasets-on-biomechanics-of-a-lumbar-l4-l5-finite-element-model
#18
S Naserkhaki, N Arjmand, A Shirazi-Adl, F Farahmand, M El-Rich
Ligaments assist trunk muscles in balancing external moments and providing spinal stability. In absence of the personalized material properties for ligaments, finite element (FE) models use dispersed data from the literature. This study aims to investigate the relative effects of eight different ligament property datasets on FE model responses. Eight L4-L5 models distinct only in ligament properties were constructed and loaded under moment (15Nm) alone or combined with a compressive follower load (FL). Range of motions (RoM) of the disc-alone model matched well in vitro data...
May 16, 2017: Journal of Biomechanics
https://www.readbyqxmd.com/read/28546769/treatment-of-chronic-low-back-pain-new-approaches-on-the-horizon
#19
REVIEW
Nebojsa Nick Knezevic, Shane Mandalia, Jennifer Raasch, Ivana Knezevic, Kenneth D Candido
Back pain is the second leading cause of disability among American adults and is currently treated either with conservative therapy or interventional pain procedures. However, the question that remains is whether we, as physicians, have adequate therapeutic options to offer to the patients who suffer from chronic low back pain but fail both conservative therapy and interventional pain procedures before they consider surgical options such as discectomy, disc arthroplasty, or spinal fusion. The purpose of this article is to review the potential novel therapies that are on the horizon for the treatment of chronic low back pain...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28544701/intradiscal-application-of-a-pcla-peg-pcla-hydrogel-loaded-with-celecoxib-for-the-treatment-of-back-pain-in-canines-what-s-in-it-for-humans
#20
Anna R Tellegen, Nicole Willems, Martijn Beukers, Guy C M Grinwis, Saskia G M Plomp, Clemens Bos, Maarten van Dijk, Mike de Leeuw, Laura B Creemers, Marianna A Tryfonidou, Björn P Meij
Chronic low back pain is a common clinical problem in both the human and canine population. Current pharmaceutical treatment often consists of oral anti-inflammatory drugs to alleviate pain. Novel treatments for degenerative disc diseases focus on local application of sustained released drug formulations. The aim of this study was to determine safety and feasibility of intradiscal application of a PCLA-PEG-PCLA hydrogel releasing celecoxib, a COX-2 inhibitor. Biocompatibility was evaluated after subcutaneous injection in mice and safety of intradiscal injection of the hydrogel was evaluated in experimental dogs with early spontaneous intervertebral disc (IVD) degeneration...
May 19, 2017: Journal of Tissue Engineering and Regenerative Medicine
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