scholarly journals The outcome of decompression surgery for lumbar herniated disc is influenced by the level of concomitant preoperative low back pain

2011 ◽  
Vol 20 (7) ◽  
pp. 1166-1173 ◽  
Author(s):  
F. S. Kleinstueck ◽  
T. Fekete ◽  
D. Jeszenszky ◽  
A. F. Mannion ◽  
D. Grob ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Herniated Disc ◽  
Decompression Surgery ◽  
Low Back

scholarly journals SubclinicalPropionibacterium acnesinfection estimation in the intervertebral disc (SPInE-ID): protocol for a prospective cohort

BMJ Open ◽  
2017 ◽  
Vol 7 (11) ◽  
pp. e017930 ◽  
Author(s):  
Nelson Astur ◽  
Delio E Martins ◽  
Marcelo Wajchenberg ◽  
Mario Ferretti ◽  
Fernando G Menezes ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Intervertebral Disc ◽  
Prospective Cohort ◽  
Lumbar Disc ◽  
Herniated Disc ◽  
Decompression Surgery ◽  
Low Back ◽  
Informed Consent Form ◽  
Study Results

IntroductionLow back pain and vertebral endplate abnormalities are common conditions within the population. Subclinical infection caused by indolent pathogens can potentially lead to these findings, with differentiation between them notably challenging from a clinical perspective. Progressive infection of the intervertebral disc has been extensively associated with increasing low back pain, withPropionibacterium acnesspecifically implicated with in relation to sciatica. The main purpose of this study is to identify if the presence of an infective pathogen within the intervertebral disc is primary or is a result of intraoperative contamination, and whether this correlates to low back pain.Methods and analysisAn open prospective cohort study will be performed. Subjects included within the study will be between the ages of 18 and 65 years and have a diagnosis of lumbar disc herniation requiring open decompression surgery. Excised herniated disc fragments, muscle and ligamentum flavum samples will be collected during surgery and sent to microbiology for tissue culture and pathogen identification. Score questionnaires for pain, functionality and quality of life will be given preoperatively and at 1, 3, 6 and 12 months postoperatively. A MRI will be performed 12 months after surgery for analysis of Modic changes and baseline comparison. The primary endpoint is the rate of disc infection in patients with symptomatic degenerative disc disease. The secondary endpoints will be performance scores, Modic incidence and volume.Ethics and disseminationThis study was approved by our Institutional Review Board and was only initiated after it (CAAE 65102617.2.0000.0071). Patients agreeing to participate will sign an informed consent form before entering the study. Results will be published in a peer reviewed medical journal irrespective of study findings. If shown to be the case, this would have profound effects on the way physicians treat chronic low back pain, even impacting health costs.Trials registration numberNCT0315876; Pre-results.

scholarly journals Guideline update for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 8: Lumbar fusion for disc herniation and radiculopathy

2014 ◽  
Vol 21 (1) ◽  
pp. 48-53 ◽  
Author(s):  
Jeffrey C. Wang ◽  
Andrew T. Dailey ◽  
Praveen V. Mummaneni ◽  
Zoher Ghogawala ◽  
Daniel K. Resnick ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Lumbar Fusion ◽  
Signs And Symptoms ◽  
Herniated Disc ◽  
Spinal Instability ◽  
Low Back ◽  
Low Level ◽  
Disc Herniations

Patients suffering from a lumbar herniated disc will typically present with signs and symptoms consistent with radiculopathy. They may also have low-back pain, however, and the source of this pain is less certain, as it may be from the degenerative process that led to the herniation. The surgical alternative of choice remains a lumbar discectomy, but fusions have been performed for both primary and recurrent disc herniations. In the original guidelines, the inclusion of a fusion for routine discectomies was not recommended. This recommendation continues to be supported by more recent evidence. Based on low-level evidence, the incorporation of a lumbar fusion may be considered an option when a herniation is associated with evidence of spinal instability, chronic low-back pain, and/or severe degenerative changes, or if the patient participates in heavy manual labor. For recurrent disc herniations, there is low-level evidence to support the inclusion of lumbar fusion for patients with evidence of instability or chronic low-back pain.

scholarly journals Management Options for Patients with Chronic Back Pain without an Etiology

2013 ◽  
Vol 6 ◽  
pp. HSI.S10469 ◽  
Author(s):  
Lenny D. Salzberg ◽  
Eron G. Manusov
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Chronic Back Pain ◽  
Lifetime Prevalence ◽  
Herniated Disc ◽  
Evidence Based ◽  
Low Back ◽  
Management Options ◽  
Evidence Based Guidelines

The treatment and management of low back pain is complex when there is no specific etiology such as cancer, fracture, or herniated disc. An organized approach to management that follows evidence based guidelines will facilitate care in a problem that reflects a lifetime prevalence of over 70 percent. The purpose of this review is to present a guideline to care for a common disabling process with a very heterogeneous etiology.

scholarly journals Can decompression surgery relieve low back pain in patients with lumbar spinal stenosis combined with degenerative lumbar scoliosis?

2013 ◽  
Vol 22 (9) ◽  
pp. 2010-2014 ◽  
Author(s):  
Shunji Tsutsui ◽  
Ryohei Kagotani ◽  
Hiroshi Yamada ◽  
Hiroshi Hashizume ◽  
Akihito Minamide ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Decompression Surgery ◽  
Degenerative Lumbar Scoliosis ◽  
Low Back ◽  
Lumbar Scoliosis ◽  
Lumbar Spinal

scholarly journals Short-term comparison of preoperative and postoperative pain after indirect decompression surgery and direct decompression surgery in patients with degenerative spondylolisthesis

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Akihiko Hiyama ◽  
Hiroyuki Katoh ◽  
Daisuke Sakai ◽  
Masahiro Tanaka ◽  
Masato Sato ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Interbody Fusion ◽  
Rating Scale ◽  
Degenerative Spondylolisthesis ◽  
Operation Time ◽  
Decompression Surgery ◽  
Low Back ◽  
Short Term ◽  
Indirect Decompression

Abstract The purpose of this study was to compare the short-term clinical outcomes between extreme lateral interbody fusion (XLIF) and minimally invasive surgery (MIS)–transforaminal interbody fusion (TLIF) in patients with degenerative spondylolisthesis with stenosis. One hundred-six patients were enrolled; 44 were treated with MIS–TLIF (direct decompression group; DP), and 62 were treated with XLIF (indirect decompression group; IDP). Perioperative indexes included operation time and intraoperative bleeding. Perioperative indexes preoperative and postoperative numeric rating scale (NRS) scores for low back pain (NRS-BP), leg pain (NRS-LP), and leg numbness (NRS-LN), and the preoperative score on the Japanese version of the painDETECT questionnaire (PDQ-J) were also assessed. The average follow-up period for the collection of NRS scores was 12.6 months. The operation time was significantly shorter in the IDP than in the DP group (109.9 ± 35.4 vs. 153.3 ± 50.9 min; p < 0.001). Intraoperative blood loss was also significantly less in the IDP group than in the DP group (85.4 ± 125.4 vs. 258.3 ± 220.4 mL; p < 0.001). The PDQ-J score and preoperative NRS scores (NRS-BP, NRS-LP, and NRS-LN) did not differ significantly between groups. Less improvement in the NRS-BP (ΔNRS-BP) was observed in the DP group than in the IDP group (p < 0.05). Although pain improved after surgery in both groups, IDP surgery was advantageous in minimizing bleeding and preserving posterior support elements such as the facet joints, lamina, and paraspinal muscles. These findings suggest that this may have contributed to the higher rate of improvement in low back pain compared with DP surgery.

scholarly journals Comparison of muscle activation of the transversus abdominis and muscle strength between individuals with low back pain, herniated disc and healthy individuals: a cross-sectional study.

2020 ◽  
Author(s):  
Clecio Souza ◽  
Sanderson Assis ◽  
Karinna Costa ◽  
Yago Medeiros ◽  
Liane Macedo
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Muscle Activation ◽  
Cross Sectional Study ◽  
Transversus Abdominis ◽  
Herniated Disc ◽  
World Population ◽  
Low Back ◽  
Sectional Study ◽  
Cross Sectional

Abstract BACKGROUND: Low back pain and disc herniation are common problems in the world population, being characterized by discomfort in the region of the spine, resulting in functional capacity and quality of life reduced. Some of the causes of these conditions seem to be associated with the biomechanical imbalance of the muscles that act in the spine. There are methods to assess the level of activation and strength of the stabilizing muscles of the spine, such as the Pressure Biofeedback Unit (PBU). This study aims to compare the level of activation of the transverse abdomen muscle and back strength in healthy, low back pain and herniated disc individuals. METHODOS: a cross-sectional study was carried out with 30 men that were homogeneously distributed in three groups: healthy (HG), with low back pain (LBPG) and with herniated disc (HDG). The primary outcomes were the level of activation of the transversus abdominis, assessed by PBU, and back strength, assessed by dynamometry. Pain, flexibility and disability were evaluated as secondary outcomes.RESULTS: The mean age of the participants in this study was 30.47 ± 9.74 years. Regarding the activation of the transversus abdominis, no differences were found between groups (p = 0.155). For strength, LBPG and HDG were different compared to HG (p = 0.028 and p = 0.045, respectively). Pain was different between the HG and both LBPG and HDG (all p < 0.001). Regarding flexibility, no differences (p > 0.05) were found. The HDG had the highest disability score and was statistically different of the HG (p = 0.005), but with no difference from LBPG (p = 0.087).CONCLUSION: the activation of the tranversus abdominis is similar between healthy, non-specific back pain and herniated disc individuals; however, the latter presents a reduced level of strength and more disability.

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