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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
Malik Asif Humayun, Tristan Richardson, Augustin Brooks
A 17-year-old male presented with diarrhoea and malaise following his return from Kenya and Tunisia. He was managed as a case of traveller's diarrhoea. Stool cultures were negative for pathogenic bacterial growth. Two weeks later he presented with worsening lower back pain. MRI of lumbosacral spine suggested L1 osteomyelitis. CT-guided spinal aspirate grew no organisms and repeat viral serology and blood cultures (including tuberculosis screening) were negative. He was treated with a 6-week course of ceftriaxone...
September 30, 2016: BMJ Case Reports
David C Noriega, Francisco Ardura, Ruben Hernández-Ramajo, Miguel Angel Martín-Ferrero, Israel Sánchez-Lite, Borja Toribio, Mercedes Alberca, Veronica García, José Maria Moraleda, Ana Sánchez, Javier García-Sancho
BACKGROUND: Degenerative disc disease often causes severe low-back pain, a public health problem with huge economic and life quality impact. Chronic cases often require surgery, which may lead to biomechanical problems and accelerated degeneration of the adjacent segments. Autologous mesenchymal stromal cells (MSC) treatments have shown feasibility, safety and strong indications of clinical efficacy. We present here a randomized, controlled trial using allogeneic MSC, which are logistically more convenient than autologous cells...
September 21, 2016: Transplantation
Hendrik Schmidt, Sandra Reitmaier, Friedmar Graichen, Aboulfazl Shirazi-Adl
By maintaining a balance between external mechanical loads and internal osmotic pressure, fluid content of intervertebral discs constantly alters causing fluctuations in disc hydration, height, diameter and pressure that govern disc temporal response. This paper reviews and discusses the relevant findings of earlier studies on the disc fluid flow with the aim to understand and remedy discrepancies between in vivo and in vitro observations. New results of finite element model studies are also exploited in order to help identify the likely causes for such differences and underlying mechanisms observed in vitro...
September 14, 2016: Journal of Biomechanics
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
Yoon-Ho Kim, Sung-In Kim, Seongjun Park, Sung Hwan Hong, Sun G Chung
BACKGROUND: We theorized that active cervical extension should influence the position of the nucleus pulposus (NP) within the intervertebral disk (IVD) in the sagittal plane. Although several studies on the lumbar IVD have been conducted, there are no quantitative data for in vivo positional changes of the NP in the cervical IVD. OBJECTIVE: To evaluate the influence and mechanism of cervical extension on the deformation and migration of IVD and NP in the sagittal plane and understand underlying mechanisms of the extension maneuver...
September 6, 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
Shay Bess, Jeffrey E Harris, Alexander W L Turner, Virginie LaFage, Justin S Smith, Christopher I Shaffrey, Frank J Schwab, Regis W Haid
OBJECTIVE Proximal junctional kyphosis (PJK) remains problematic following multilevel instrumented spine surgery. Previous biomechanical studies indicate that providing less rigid fixation at the cranial aspect of a long posterior instrumented construct, via transition rods or hooks at the upper instrumented vertebra (UIV), may provide a gradual transition to normal motion and prevent PJK. The purpose of this study was to evaluate the ability of posterior anchored polyethylene tethers to distribute proximal motion segment stiffness in long instrumented spine constructs...
September 9, 2016: Journal of Neurosurgery. Spine
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
S E Gullbrand, N R Malhotra, T P Schaer, Z Zawacki, J T Martin, J R Bendigo, A H Milby, G R Dodge, E J Vresilovic, D M Elliott, R L Mauck, L J Smith
OBJECTIVE: The objective of this study was to establish a large animal model that recapitulates the spectrum of intervertebral disc degeneration that occurs in humans and which is suitable for pre-clinical evaluation of a wide range of experimental therapeutics. DESIGN: Degeneration was induced in the lumbar intervertebral discs of large frame goats by either intradiscal injection of chondroitinase ABC (ChABC) over a range of dosages (0.1U, 1U or 5U) or subtotal nucleotomy...
August 26, 2016: Osteoarthritis and Cartilage
Kazuhide Inage, Sumihisa Orita, Kazuyo Yamauchi, Takane Suzuki, Miyako Suzuki, Yoshihiro Sakuma, Go Kubota, Yasuhiro Oikawa, Takeshi Sainoh, Jun Sato, Kazuki Fujimoto, Yasuhiro Shiga, Koki Abe, Hirohito Kanamoto, Masahiro Inoue, Hideyuki Kinoshita, Kazuhisa Takahashi, Seiji Ohtori
STUDY DESIGN: Experimental animal study. PURPOSE: We aimed to determine the optimal dose of a single direct injection of the tumor necrosis factor (TNF)-α inhibitor, etanercept, by using the rat model of degenerative intervertebral disc from injury. OVERVIEW OF LITERATURE: The pain-related peptide expression was suppressed in the etanercept (100 µg and 1,000 µg)-administered groups in a dose-dependent manner. METHODS: The neurotracer FluoroGold (FG) was applied to the surfaces of L4/5 discs to label their innervating dorsal root ganglion (DRG) neurons (n=50)...
August 2016: Asian Spine Journal
Kieran Murphy, Gavin Elias, Jim Steppan, Chett Boxley, Kuberan Balagurunathan, Xylophone Victor, Thomas Meaders, Mario Muto
PURPOSE: To elucidate the mechanism of action of intradiscal oxygen-ozone therapy for herniated intervertebral disc therapy. METHODS: Ozone's mechanism of action was investigated using 3 approaches: mathematical models of intervertebral disc space to explore the relationship between disc pressure and volume; ozonolysis experiments using glycosaminoglycans (GAGs) from a Chinese hamster ovary cell line that were similar in composition to GAGs found in human nucleus pulposus; and experiments in which live Yucatan miniature pigs received various concentrations of percutaneous, image-guided intradiscal oxygen-ozone treatment and were examined (after sacrifice) with histology and semiquantitative analysis of disc cytokine concentrations...
August 2016: Journal of Vascular and Interventional Radiology: JVIR
Zhen Li, Gernot Lang, Lindsay S Karfeld-Sulzer, Kerstin T Mader, R Geoff Richards, Franz E Weber, Chris Sammon, Hagit Sacks, Avner Yayon, Mauro Alini, Sibylle Grad
Intervertebral disc (IVD) degeneration is the leading trigger of low back pain, which causes disability and leads to enormous healthcare toll worldwide. Biological treatment with growth factors has evolved as potential therapy for IVD regeneration. Bone morphogenetic protein 2 (BMP-2) and BMP-7 have shown promise in this regard. In the current study, we evaluated the effect of BMP-2/7 heterodimer for disc regeneration both in vitro and in organ culture. Nucleus pulposus (NP) cells isolated from bovine caudal disc were cultured in a fibrin-hyaluronan (FBG-HA) hydrogel for up to 14 days...
June 24, 2016: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
H-J Riesner, K Kiupel, P Lang, F Stuby, B Friemert, H-G Palm
BACKGROUND: Cement leakage is regarded as a typical complication of cement-based augmentation of vertebral fractures. The gold standard is balloon kyphoplasty (BK). Recent methods, such as radiofrequency kyphoplasty (RFK), must be compared with BK in terms of therapeutic success and complication rates. It is unclear whether the cement leakage rate in RFK is lower than with BK and whether this has any clinical relevance. Therefore, the aim of our prospective clinical study was to compare RFK with BK with respect to cement leakage rates and associated clinical complications...
August 2016: Zeitschrift Für Orthopädie und Unfallchirurgie
Graciosa Q Teixeira, Catarina Leite Pereira, Flávia Castro, Joana R Ferreira, Maria Gomez-Lazaro, Paulo Aguiar, Mário A Barbosa, Cornelia Neidlinger-Wilke, Raquel M Goncalves
UNLABELLED: Intervertebral disc (IVD) degeneration is one of the most common causes of low back pain (LBP), the leading disorder in terms of years lived with disability. Inflammation can play a role in LPB, while impairs IVD regeneration. In spite of this, different inflammatory targets have been purposed in the context of IVD regeneration. Anti-inflammatory nanoparticles (NPs) of Chitosan and Poly-(γ-glutamic acid) with a non-steroidal anti-inflammatory drug, diclofenac (Df), were previously shown to counteract a pro-inflammatory response of human macrophages...
September 15, 2016: Acta Biomaterialia
Agnieszka Saracen, Zbigniew Kotwica
Percutaneous vertebroplasty (PVP) is a minimally invasive procedure widely used for the treatment of pain due to vertebral fractures of different origins-osteoporotic, traumatic, or neoplastic. PVP is minimally invasive, but the complications are not rare; however, they are in most cases not significant clinically. The most frequent is cement leakage, which can occur onto veins, paravertebral soft tissue, into the intervertebral disk, or to the spinal canal, affecting foraminal area or epidural space. We analyzed results of treatment and complications of vertebroplasty performed with the use of polimethylomethylacrylate cement (PMMA) on 1100 vertebrae, with a special regard to the severity of complication and eventual clinical manifestation...
June 2016: Medicine (Baltimore)
Melodie F Metzger, Samuel T Robinson, Mark T Svet, John C Liu, Frank L Acosta
Study Design Biomechanical cadaveric study. Objective Clinical studies indicate that using less-rigid fixation techniques in place of the standard all-pedicle screw construct when correcting for scoliosis may reduce the incidence of proximal junctional kyphosis and improve patient outcomes. The purpose of this study is to investigate whether there is a biomechanical advantage to using supralaminar hooks in place of pedicle screws at the upper-instrumented vertebrae in a multilevel thoracic construct. Methods T7-T12 spines were biomechanically tested: (1) intact; (2) following a two-level pedicles screw fusion from T9 to T11; and after proximal extension of the fusion to T8-T9 with (3) bilateral supra-laminar hooks, (4) a unilateral hook + unilateral screw hybrid, or (5) bilateral pedicle screws...
June 2016: Global Spine Journal
F Ghezelbash, A Shirazi-Adl, N Arjmand, Z El-Ouaaid, A Plamondon
Development of a subject-specific computational musculoskeletal trunk model (accounting for age, sex, body weight and body height), estimation of muscle forces and internal loads as well as subsequent validation by comparison with measured intradiscal pressure in various lifting tasks are novel, important and challenging. The objective of the present study is twofold. First, it aims to update and personalize the passive and active structures in an existing musculoskeletal kinematics-driven finite element model...
May 12, 2016: Biomechanics and Modeling in Mechanobiology
Mamiko Noguchi, Chad E Gooyers, Thomas Karakolis, Kimihiro Noguchi, Jack P Callaghan
Approximately 40% of low back pain cases have been attributed to internal disc disruption. This disruption mechanism may be linked to intradiscal pressure changes, since mechanical loading directly affects the pressure and the stresses that the inner annulus fibrosus experiences. The objective of this study was to characterize cycle-varying changes in four dependent measures (intradiscal pressure, flexion-extension moments, specimen height loss, and specimen rotation angle) using a cyclic flexion-extension (CFE) loading protocol known to induce internal disc disruption...
June 14, 2016: Journal of Biomechanics
Richard Bostelmann, Hans-Jakob Steiger, Jan Frederick Cornelius
Background Integrity of intervertebral disks may influence, and be influenced by, the maintenance of hydrostatic pressures inside the nucleus pulposus. Disk degeneration causes decreased pressures, leading to overload and injury of the annulus fibrosus, increasing the risk of disk herniation. Diskectomies to treat disk herniation can cause further loss of hydrostatic pressures resulting in worsening degeneration. This study investigated the impact of opening the annulus on intradiscal pressure and whether implantation of an annular closure device (ACD) can restore physiologic pressures...
April 28, 2016: Journal of Neurological Surgery. Part A, Central European Neurosurgery
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