The annular closure device - panacea of lumbar disc herniation: how closed is closed enough for the intervertebral disc space?

2021 ◽  
Author(s):  
Arthur R. Kurzbuch ◽  
Jean-Yves Fournier ◽  
Constantin Tuleasca
Keyword(s):  
Intervertebral Disc ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Closure Device ◽  
Intervertebral Disc Space ◽  
Disc Space ◽  
Annular Closure Device

scholarly journals OUTCOMES OF SURGICAL TREATMENT OF LUMBAR DISK HERNIATION USING AN ANNULAR CLOSURE DEVICE

2018 ◽  
Vol 17 (3) ◽  
pp. 188-194 ◽  
Author(s):  
Abdugafur Jabborovich Sanginov ◽  
Aleksandr Vladimirovich Krutko ◽  
Evgenii Sergeevich Baykov ◽  
Anatoliy Andreevich Lutsik
Keyword(s):  
High Risk ◽  
Nucleus Pulposus ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Intraoperative Complications ◽  
Case Series ◽  
Reoperation Rate ◽  
Closure Device ◽  
Annular Closure Device

ABSTRACT Objective: The aim of the study was to investigate the clinical and radiological results of using the annular closure device in patients with lumbar disc herniation (LDH). Methods: The study involved 120 patients with LDH operated on by limited discectomy and annular closure using the Barricaid device. A literature review was conducted to evaluate the effectiveness of the annuloplasty. Results: All patients showed postoperative regression of the radicular pain syndrome and were mobilized on the day of surgery. The correlation between the removed nucleus pulposus and changes in DHI was studied by linear regression. The results revealed that disc height loss is directly correlated with the volume of removed nucleus pulposus (p <0.05). Modic changes were present in 22 (22%) patients. Endplate changes (resorption and erosion) were present in 25 patients (20.7%). We found that these changes in MR and CT images have no effect on the clinical presentation of the disease. No intraoperative complications, such as severe hemorrhage requiring blood transfusion, or injury to the dura mater or nerve roots, were observed in our case series. Postoperative complications occurred in 3 (2.5%) patients. The reoperation rate was 4.2%. Conclusions: The use of the Barricaid annular closure device in 120 patients with lumbar disc herniation and high risk of recurrent herniation showed good clinical and radiographic outcomes. The reoperation rate in our study was 2.5%; disc reherniation at the operated level was observed in 1.7% of patients. This is a good outcome compared to the data reported for patients having a high risk of disc reherniation. Level of Evidence IV; Case series.

scholarly journals Effectiveness of an Annular Closure Device to Prevent Recurrent Lumbar Disc Herniation

2021 ◽  
Vol 4 (12) ◽  
pp. e2136809
Author(s):  
Claudius Thomé ◽  
Adisa Kuršumović ◽  
Peter Douglas Klassen ◽  
Gerrit J. Bouma ◽  
Richard Bostelmann ◽  
...  
Keyword(s):  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Closure Device ◽  
Annular Closure Device ◽  
Recurrent Lumbar Disc Herniation

scholarly journals Three-Dimensional Biomechanical Finite Element Analysis of Lumbar Disc Herniation in Middle Aged and Elderly

2022 ◽  
Vol 2022 ◽  
pp. 1-11
Author(s):  
Shiyuan Wan ◽  
Bin Xue ◽  
Yanhao Xiong
Keyword(s):  
Finite Element ◽  
Intervertebral Disc ◽  
Lumbar Disc Herniation ◽  
Vertebral Body ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Three Dimensional ◽  
Surgical Methods ◽  
Left And Right ◽  
The Impact

Lumbar intervertebral disc protrusion disease refers to the degeneration of intervertebral disc, rupture of fibrous ring, nucleus pulpous protrusion and stimulation or compression of nerve root. The import command in Mimics medical 3D reconstruction software was used to erase the irrelevant image data and obtain vertebral body images. The original 3D model of each vertebral body was built by 3D computing function. A three-dimensional finite element model was established to analyze the effect of different surgical methods on the mechanical distribution of the spine after disentomb. The stress distribution of the spine, intervertebral disc, and left and right articular cartilage at L4/L5 stage and the position shift of the fourth lumbar vertebra were analyzed under 7 working conditions of vertical, forward flexion, extension, left and right flexion, and left and right rotation. The results showed that the established model was effective, and the smaller the area of posterior laminar decompression was, the lesser the impact on spinal stability was. The PELD treatment of lumbar disc herniation had little impact on spinal biomechanics and could achieve good long-term biomechanical stability. Combining the clinical experiment method and finite element simulation, using the advantages of finite element software to optimize the design function can provide guidance for the design and improvement of medical devices and has important significance for the study of clinical mechanical properties and biomechanics.

Intervertebral bone implants following excision of protruded lumbar discs

1975 ◽  
Vol 42 (4) ◽  
pp. 401-405 ◽  
Author(s):  
Lee A. Christoferson ◽  
Bradford Selland
Keyword(s):  
Conservative Treatment ◽  
Intervertebral Disc ◽  
Lumbar Disc ◽  
Leg Pain ◽  
Intervertebral Disc Space ◽  
Disc Space ◽  
Disc Protrusion ◽  
Content Type ◽  
Back Surgery ◽  
Fine Print

✓ The authors describe a technique whereby a portion of the lamina removed during exposure of an intervertebral lumbar disc protrusion is implanted in the intervertebral disc space following disc excision. An analysis of 456 consecutive cases operated on by this technique and followed from 1 to 10 years is presented. Of the 418 patients followed, 92% indicated they were able to return to their normal activities and were satisfied with the result. Thirty percent of the patients indicated they had required some conservative treatment for recurrent episodes of back or leg pain. Ten patients had subsequent back surgery; only one implant has dislocated.

scholarly journals The Clinical Diagnostic Value of Lumbar Intervertebral Disc Herniation Based on MRI Images

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Kangxing Zheng ◽  
Zihuan Wen ◽  
Dehuai Li
Keyword(s):  
Intervertebral Disc ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Facet Joint ◽  
Lumbar Disc ◽  
Herniated Disc ◽  
Intervertebral Disc Herniation ◽  
Facet Joints ◽  
Lumbar Intervertebral Disc ◽  
Lumbar Intervertebral Disc Herniation

MRI was used to measure the changes in the angle of the facet joints of the lumbar spine and analyze the relationship between it and the herniated lumbar intervertebral disc. Analysis of the causes of lumbar disc herniation from the anatomy and morphology of the spine provides a basis for the early diagnosis and prevention of lumbar disc herniation. There is a certain correlation between the changes shown in MRI imaging of lumbar disc herniation and the TCM syndromes of lumbar intervertebral disc herniation. There is a correlation between the syndromes of lumbar disc herniation and the direct signs of MRI: pathological type, herniated position, and degree of herniation. Indirect signs with MR, nerve root compression and dural sac compression, are related. The MRI examination results can help syndrome differentiation to improve its accuracy to a certain extent. MRI has high sensitivity for the measurement of the angle of the facet joints of the lumbar spine and can be used to study the correlation between the changes of the facet joint angles and the herniated disc. Facet joint asymmetry is closely related to lateral lumbar disc herniation, which may be one of its pathogenesis factors. The herniated intervertebral disc is mostly on the sagittal side of the facet joint, and the facet joint angle on the side of the herniated disc is more sagittal. The asymmetry of the facet joints is not related to the central lumbar disc herniation, and the angle of the facet joints on both sides of the central lumbar disc herniation is partial sagittal.

scholarly journals 843 Annular Closure Device for Disc Herniation: Meta-Analysis of Clinical Outcome and Complications

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
C S Ong ◽  
W J Choy ◽  
K Phan ◽  
A Diwan ◽  
R Mobbs
Keyword(s):  
Disc Herniation ◽  
Weighted Mean Difference ◽  
Lumbar Disc ◽  
Meta Analysis ◽  
Control Group ◽  
Closure Device ◽  
Complication Rates ◽  
Early Results ◽  
Annular Closure Device

Abstract Aim To assist surgeons to determine a potential approach to reduce incidences of recurrent lumbar disc herniation and assess the current devices regarding their outcomes and complications. Method Four electronic full-text databases were systematically searched through September 2017. All results were pooled utilising meta-analysis with weighted mean difference and odds ratio as summary statistics. Results Four studies met inclusion criteria. Three studies reported the use of Barricaid (ACD) while one study reported the use of Anulex (AR). A total of 24 symptomatic reherniation were reported among 811 discectomies with ACD/AR as compared to 51 out of 645 in the control group (OR: 0.34; 95% CI: 0.20,0.56; I2 = 0%; P &lt; 0.0001). Durotomies were lower among the ACD/AR patients with only 3 reported cases compared to 7 in the control group (OR: 0.54; 95% CI: 0.13, 2.23; I2 = 11%; P = 0.39). Similar outcomes for post-operative Oswestry Disability Index and visual analogue scale were obtained when both groups were compared. Conclusions Early results showed the use of Barricaid and Anulex devices are beneficial for short term outcomes demonstrating a reduction in symptomatic disc reherniation with low post-operative complication rates. Long-term studies are required to further investigate the efficacy of such devices.

scholarly journals Evaluation of the effectiveness of surgical methods for the treatment of recurrent lumbar disc herniation: a cohort retrospective study

2021 ◽  
Vol 18 (2) ◽  
pp. 34-43
Author(s):  
M. N. Kravtsov ◽  
I. A. Kruglov ◽  
S. D. Mirzametov ◽  
A. S. Seleznev ◽  
N. P. Alekseyeva ◽  
...  
Keyword(s):  
Intervertebral Disc ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Interbody Fusion ◽  
Lumbar Disc ◽  
Disc Replacement ◽  
Single Level ◽  
Surgical Methods ◽  
Endoscopic Discectomy ◽  
Recurrent Lumbar Disc Herniation

Objective. To compare the effectiveness of surgical methods for treating patients with recurrent lumbar disc herniation.Material and Methods. The sample consisted of 160 patients operated on in 2014–2019 for recurrent lumbar disc herniation by percutaneous endoscopic discectomy (Group 1), microsurgical discectomy (Group 2), single-level transforaminal interbody fusion (Group 3) and single-level total intervertebral disc replacement (Group 4). The effectiveness of surgical treatment was evaluated using the NRS-11, ODI, and MacNab questionnaires.Results. Assessment of the pain syndrome severity and the vital activity level of patients revealed significant (p < 0.05) differences in favor of total intervertebral disc replacement. Excellent and good outcomes after arthroplasty according to MacNab criteria were noted in all patients in this group. Similar outcomes were reported in 77.5 % (31/40) of patients in the TLIF group, in 75.1 % (24/32) of patients in the percutaneous endoscopic discectomy group and in 72.6 % (45/62) of patients in the microdiscectomy group. The operation time and length of hospital stay were shorter in the endoscopic and microsurgical discectomy groups (p < 0.001). However, the lower incidence of complications and reoperations was observed in groups of posterior interbody fusion and arthroplasty (p > 0.05).Conclusion. Arthroplasty with the M6-L implant expands the possibilities of surgery for recurrent lumbar disc herniation. Total intervertebral disc replacement and posterior interbody fusion for recurrent lumbar disc herniation are more effective in comparison with decompressive operations, which is reflected in the improvement of clinical treatment outcomes, reduction of perioperative complications and frequency of repeated interventions.

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