Macrophage Tissue Infiltration, Clinical Symptoms, and Signs in Patients with Lumbar Disc Herniation. A Clinicopathological Study on 179 Patients

1998 ◽  
Vol 140 (12) ◽  
pp. 1245-1248 ◽  
Author(s):  
R. Rothoerl ◽  
C. Woertgen ◽  
M. Holzschuh ◽  
K. Brehme ◽  
J. Rüschoff ◽  
...  
1995 ◽  
Vol 4 (4) ◽  
pp. 202-205 ◽  
Author(s):  
B. J�nsson ◽  
B. Str�mqvist

2002 ◽  
Vol 398 ◽  
pp. 131-135 ◽  
Author(s):  
Takeshi Kanamiya ◽  
Hiroshi Kida ◽  
Masahiro Seki ◽  
Toshitake Aizawa ◽  
Shiro Tabata

2019 ◽  
Vol 28 (11) ◽  
pp. 2579-2587 ◽  
Author(s):  
Niek Djuric ◽  
Xiaoyu Yang ◽  
Raymond W. J. G. Ostelo ◽  
Sjoerd G. van Duinen ◽  
Geert J. Lycklama à Nijeholt ◽  
...  

Abstract Purpose To study the interaction between Modic changes (MC) and inflammation by macrophages in the disc, in relation to clinical symptoms before and after discectomy for lumbar disc herniation. Methods Disc tissue was embedded in paraffin and stained with haematoxylin and CD68. Subsequently, tissue samples were categorized for degree of inflammation. Type of MC was scored on MRI at baseline. Roland Disability Questionnaire (RDQ) score and visual analogue scale for back pain and leg pain separately were considered at baseline and 1-year follow-up post-surgery. Main and interaction effects of MC and inflammation were tested against clinical outcome questionnaires. In addition, this analysis was repeated in bulging and extruded discs separately. Results Disc material and MRI’s of 119 patients were retrieved and analysed. Forty-eight patients demonstrated mild inflammation, 45 showed moderate inflammation, and 26 showed considerable inflammation. In total, 49 out of 119 patients demonstrated MC. Grade of disc inflammation did not associate with the presence of MC. At baseline, no main or interaction effects of MC and inflammation were found on the clinical scores. However, during follow-up after discectomy, significant interaction effects were found for RDQ score: Only in patients with MC at baseline, patients remained significantly more disabled (3.2 points p = 0.006) if they showed considerable disc inflammation compared to patients with mild inflammation. The additional analysis showed similar results in extruded discs, but no significant effects in bulging discs. Conclusions An interaction effect of MC and disc inflammation by macrophages is present. Only in patients with MC, those with considerable inflammation recover less satisfactory during follow-up after surgery. Graphic abstract These slides can be retrieved under Electronic Supplementary Material.


Spine ◽  
1985 ◽  
Vol 10 (1) ◽  
pp. 88-92 ◽  
Author(s):  
PEKKA KORTELAINEN ◽  
JAAKKO PURANEN ◽  
ERKKI KOIVISTO ◽  
SEPPO LÄHDE

2010 ◽  
Vol 4 ◽  
pp. 617-622 ◽  
Author(s):  
Hamit Selim Karabekir ◽  
Ahmet YIldIzhan ◽  
Elmas K. Atar ◽  
Soner YaycIoglu ◽  
Nuket Gocmen-Mas ◽  
...  

2020 ◽  
Author(s):  
Shitong Feng ◽  
Zihan Fan ◽  
Xiang Li ◽  
Jisheng Lin ◽  
Yong Yang ◽  
...  

Abstract Background. It is commonly recognized that interspinous spacers were not generally suitable for the application in L5-S1 level due to the short S1 spinous process.In this retrospective study, the feasibility and validity of the IntraSpine interlaminar device in the treatment of lumbar disc herniation on the L5/S1 level were evaluated.Methods. During the January 2018 and December 2018, a total of 30 patients, who were hospitalized in our hospital due to lumbar disc herniation (LDH) on the L5/S1 level, were included in the current study. The clinical symptoms before surgery, post-operation (3 days after surgery), 6 months after surgery, 12 months after surgery, and final follow-up were assessed using the back and leg visual analog scale (VAS), Oswestry disability index (ODI). Sagittal diameter of the lumbar spinal canal (SD), posterior disc height (PDH), left and right foramina height (LFH and RFH), left and right foramina width (LFW and RFW) were measured by sagittal reconstructions of CT scans. The range of motion (ROM) of L5-S1 level was estimated by lumbar dynamic X-ray images.Results. The back VAS, leg VAS, ODI, were significantly improved after surgery(P<0.05). The SD, PHD, LFH, RFH, LFW, and RFW after the operation and in the follow-up period were statistically different from those before surgery (P<0.05). The ROM of L5/S1 level at final follow-up was not statistically different from that before surgery (P = 0.299). 93.3% of patients demonstrated successful outcomes.Conclusions. The combination of IntraSpine interlaminar device with lumbar discectomy is an effective minimally invasive procedure for the treatment of L5/S1 disc herniation, which can delay and prevent the reduction of the disc height after discectomy in L5/S1 segment.


2021 ◽  
Vol 12 ◽  
pp. 353
Author(s):  
George Fotakopoulos ◽  
Alexandros Brotis ◽  
Kostas Andreas Fountas

Background: Lumbar disc herniation (LDH) usually presents with lower extremity symptoms and signs, but rarely with bladder and bowel complaints. Here, we present a 61-year-old female who suffered solely from fecal incontinence (FI) attributed to a large LDH. Case Description: The patient presented with FI, but had a normal neurological examination. When the lumbar magnetic resonance imaging of showed a large central L5S1 LDH, the patient underwent an urgent diskectomy. Six months later, her symptoms had improved. Conclusion: Patients with large central LDHs may present with FI alone warranting urgent/emergent disc removal.


2017 ◽  
Vol 7 (3) ◽  
pp. 230-238 ◽  
Author(s):  
Madan Mohan Sahoo ◽  
Sudhir Kumar Mahapatra ◽  
Sheetal Kaur ◽  
Jitendra Sarangi ◽  
Manoranjan Mohapatra

Study Design: Prospective cohort study. Objective: Endplate lesions though have been implicated in the genesis of lumbar disc herniation (LDH), very little is known regarding their clinical course. Thus, the present study is aimed to investigate the incidence and types of endplate failure (EPF) in LDH and its correlation with the clinical symptoms and prognosis. Methods: Clinical and magnetic resonance imaging (MRI) features of 66 patients with isolated single level LDH were studied. Three-dimensional fast spoiled gradient (3D FSPGR) MRI and computed tomography scans were used to identify the bony and cartilaginous EPF. Twenty-five patients were operated on and 41 patients were treated conservatively. Changes in the pain score, function and neurology were noted at 3, 6, 12, 24, and 36 weeks. Results: Endplate lesions were observed in 64 patients (96.9%), including bony endplate failure (bony failure) in 47 patients (71.2%) and isolated cartilaginous endplate lesions in 17 patients (25.7%). Bony failure group had similar pain and functional scores but more severe neurological deficit at the initial evaluation. Clinical parameters improved in all groups, but the recovery was lesser in conservatively treated bony failure patients. Conclusion: Endplate lesions are commonly associated with symptomatic LDH. Presence of bony failure can increase neurological deficit and reduce the chance of recovery with conservative management. The 3D FSPGR sequence of MRI can be successfully used for detection of the endplate lesions in the herniated disc.


2020 ◽  
Author(s):  
Zenan Wu ◽  
Jun Xiong ◽  
Guixing Xu ◽  
Zhengyun Zuo ◽  
Yi Yang ◽  
...  

Abstract Background: Lumbar disc herniation (LDH) refers to lumbar disc degeneration or external pressure, resulting in annulus fibrosus rupture, nucleus pulposus protrusion or bulging, compression of nerve roots, cauda equina nerve, and then some clinical symptoms of a clinical syndrome, clinical symptoms are often manifested as unilateral or bilateral lumbar pain, leg numbness. L3/L4,L4/L5, and L5/S1 intervertebral disc herniations are common in the lesion sites of lumbar disc herniations, and the incidence rate is as high as 90%. Typical manifestations are tenderness at the corresponding surface of the body. This disease is a common and frequently-occurring disease in the department of rehabilitation and acupuncture of the hospital, and is a common cause of lumbago and leg pain. At present, the common external treatment for LDH includes many methods,mostly acupuncture and moxibustionMethods: We're going to use systematic electronic search, including PubMed,MEDLINE, Cochrane library, SinoMed,CNKI,WF,VIPand checked references of retrieved articles. Randomized controlled trials (RCTs) on acupotomy treatment in LDH patients will be searched for independently by 2 reviewers in the databases from their inception to August 2020. We will combine data from clinically homogenous studies in a fixed effect meta-analysis using RevManV.5.3.5, and the evidence level will be assessed by using the method for Grading of Recommendations Assessment, Development, and Evaluation (GRADE).Discussion: The results of this review will provide reliable evidence for effectiveness and safety of moxibustion for treating LDH.Systematic review registration: CRD42020187626


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