The impact of spino-pelvic parameters on pathogenesis of lumbar disc herniation

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.

Download Full-text

The Impact of Epidural Steroid Injections on the Outcomes of Patients Treated for Lumbar Disc Herniation

The Journal of Bone and Joint Surgery (American) ◽

10.2106/jbjs.k.00341 ◽

2012 ◽

Vol 94 (15) ◽

pp. 1353-1358 ◽

Cited By ~ 41

Author(s):

Kristen Radcliff ◽

Alan Hilibrand ◽

Jon D Lurie ◽

Tor D Tosteson ◽

Lawrence Delasotta ◽

...

Keyword(s):

Lumbar Disc Herniation ◽

Disc Herniation ◽

Lumbar Disc ◽

Steroid Injections ◽

Epidural Steroid Injections ◽

Epidural Steroid ◽

The Impact

Download Full-text

The impact of obesity and smoking on young individuals suffering from lumbar disc herniation: a retrospective analysis of 97 cases

Neurosurgical Review ◽

10.1007/s10143-019-01151-y ◽

2019 ◽

Vol 43 (5) ◽

pp. 1297-1303

Author(s):

Sara Lener ◽

Christoph Wipplinger ◽

Sebastian Hartmann ◽

Claudius Thomé ◽

Anja Tschugg

Keyword(s):

Retrospective Analysis ◽

Lumbar Disc Herniation ◽

Disc Herniation ◽

Negative Impact ◽

Digital Health ◽

Lumbar Disc ◽

Motor Deficits ◽

Spinal Diseases ◽

Lower Pain ◽

The Impact

Abstract The negative impact on spinal diseases may apply not only to obesity but also to smoking. To investigate the influence of obesity and smoking on the development and recovery of lumbar disc herniation in young adults. Retrospective analysis of 97 patients who presented with lumbar disc herniation at the authors’ department between 2010 and 2017. Data were collected using the patients’ digital health records including demographics, clinical and neurological characteristics, treatment details, and outcomes. Ninety-seven patients between 17 and 25 years were included in this retrospective analysis. Patients were categorized into two groups according to their body mass index: obese (O, ≥ 30 kg/m2) and non-obese (NO, < 30 kg/m2). The proportion of obese patients in our cohort vs. in the overall population differed significantly (19.4% vs. 3.8–7.1%, RR 3.17; p < 0.01). Group NO showed a trend toward faster recovery of motor deficits (p = 0.067) and pain (p = 0.074). Also, the proportion of regular smokers differed significantly from the numbers of known smokers of the same age (62.4% vs. 30.2%, RR 2.0; p = 0.01). Obesity plus smoking showed a significantly negative impact on motor deficits postoperatively (p = 0.015) and at discharge (p = 0.025), as well as on pain values (p = 0.037) and on analgesic consumption (p = 0.034) at 6 weeks follow-up. The negative impact of obesity and smoking on the occurrence of lumbar disc herniation could be demonstrated for individuals aged 25 or younger. Furthermore, a trend to earlier recovery of motor deficits and significantly lower pain scales for non-obese and non-smoking patients could be shown.

Download Full-text

The Impact of Workersʼ Compensation on Outcomes of Surgical and Nonoperative Therapy for Patients With a Lumbar Disc Herniation

Spine ◽

10.1097/brs.0b013e3181c68047 ◽

2010 ◽

Vol 35 (1) ◽

pp. 89-97 ◽

Cited By ~ 73

Author(s):

Steven J. Atlas ◽

Tor D. Tosteson ◽

Emily A. Blood ◽

Jonathan S. Skinner ◽

Glenn S. Pransky ◽

...

Keyword(s):

Lumbar Disc Herniation ◽

Disc Herniation ◽

Lumbar Disc ◽

Nonoperative Therapy ◽

The Impact

Download Full-text

PTPN9 Genes Polymorphism as a Protect Factor in Lumbar Disc Herniation Development

10.21203/rs.3.rs-148793/v1 ◽

2021 ◽

Author(s):

Dandan Li ◽

Huqiang Mai ◽

Yuhe Wang ◽

Li Wang ◽

Xiaoli Liu ◽

...

Keyword(s):

Lumbar Disc Herniation ◽

Disc Herniation ◽

Lumbar Disc ◽

Additive Model ◽

Chinese Han Population ◽

Protective Effects ◽

Chinese Han ◽

Gender Stratification ◽

Han Population ◽

The Impact

Abstract Background: Lumbar disc herniation (LDH) is a high incidence spinal disease caused by disc degeneration, nuclear pulse displacement or fiber ring degeneration. This study aimed to explore the correlation between PTPN9 susceptibility and lumbar disc herniation in Chinese Han population.Methods: The subjects were 504 patients with lumbar disc hernia and 503 controls. PTPN9 polymorphism (rs76107647, rs10851882, rs753992, rs11072552) are genotype using Agena MassArray. In addition, Logistic regression was used for odds ratios (ORs) and 95% confidence intervals (CIs) to assess the impact of genetic polymorphisms on LDH occurrence.Results: In the allele model, rs76107647 A (p = 0.023) is associated with a reduced risk of LDH . In the analysis of genetic models, we found that rs76107647 (adjusted, A/A vs. G/G: p = 0.035; A/A vs. AG/GG: p = 0.044; log - additive model: p = 0.022, respectively) and rs11072552 (adjusted, C/C vs. A/A: p = 0.048; C/C vs. CA/AA: p = 0.010, respectively)were significantly related to LDH risk reduction. After age stratification, rs76107647（adjusted, A/A vs. G/G: p = 0.036; A/G vs. G/G: p = 0.008, ; AA/AG vs. G/G: p = 0.002; log–additive model: p = 0.001, respectively) can reduce the risk of LDH for young people ≤ 49 years old, while rs11072552 (adjusted, CC vs. CA/AA: p = 0.009) can significantly reduce the risk of LDH in patients over 49 years old. With gender stratification, rs76107647 (adjusted, A/A vs. G/G: p = 0.017, ; A/A vs. AG/GG: p = 0.019; log - additive model: p = 0.018, respectively) was significantly associated with reduced LDH risk in female. Conclusion: Our research suggests that PTPN9 polymorphisms may have protective effects on the risk of LDH in Chinese Han population.

Download Full-text

Faculty Opinions recommendation of The impact of workers' compensation on outcomes of surgical and nonoperative therapy for patients with a lumbar disc herniation: SPORT.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.1655956.1158054 ◽

2010 ◽

Author(s):

Kenneth Candido ◽

Maunak Rana

Keyword(s):

Lumbar Disc Herniation ◽

Disc Herniation ◽

Lumbar Disc ◽

Workers Compensation ◽

Nonoperative Therapy ◽

The Impact

Download Full-text

Caudal Lumbar Disc Herniations Are More Likely to Require Surgery for Symptom Resolution

Global Spine Journal ◽

10.1177/2192568220905849 ◽

2020 ◽

pp. 219256822090584

Author(s):

Anmol Gupta ◽

Shivam Upadhyaya ◽

Caleb M. Yeung ◽

Peter J. Ostergaard ◽

Harold A. Fogel ◽

...

Keyword(s):

Lumbar Disc Herniation ◽

Disc Herniation ◽

Nonoperative Management ◽

Lumbar Disc ◽

Strong Association ◽

Cauda Equina ◽

Radicular Pain ◽

Motor Deficits ◽

Disc Herniations ◽

The Impact

Study Design: Retrospective study. Objectives: We examined the impact that location of a lumbar disc herniation has on the likelihood that a patient will require surgery after at least 6 weeks of nonoperative management. Methods: Using ICD-10 codes M51.26 and M51.27, we identified patients at a single academic institution from 2015 to 2016 who received a diagnosis of primary lumbar radicular pain, had magnetic resonance imaging confirming a lumbar disc herniation, and underwent at least 6 weeks of nonoperative management. Patients experiencing symptoms suggesting cauda equina syndrome or progressive motor deficits were excluded. Results: Five hundred patients met inclusion/exclusion criteria. Twenty-nine (5.8%) had L3-L4 herniations, 245 (49.0%) had L4-L5 herniations, and 226 (45.2%) had L5-S1 herniations. Overall, 451 (90.2%) patients did not undergo surgery within 1 year of diagnosis. Nonsurgical patients had an average herniation size occupying 31.2% of the canal, compared with 31.5% in patients who underwent surgery. While herniation size, age, sex, and race failed to demonstrate a statistical association with the likelihood for surgery, location of disc herniation demonstrated a strong association. L3-L4 and L4-L5 herniations had odds ratios of 0.19 and 0.45, respectively, relative to L5-S1 herniations ( P = .0047). Patients were more than twice as likely to require a surgery on an L5-S1 herniation in comparison with an L4-L5 herniation ( P < .05). L3-L4 herniations rarely required surgery. Conclusions: Patients with caudal lumbar disc herniations were more likely to require surgery after at least 6 weeks of conservative management than those with disc herniations in the mid-lumbar spine.

Download Full-text

P33. The impact of residual low back pain on quality of life after surgical treatments for lumbar disc herniation

The Spine Journal ◽

10.1016/j.spinee.2004.05.190 ◽

2004 ◽

Vol 4 (5) ◽

pp. S93-S94

Author(s):

Etsuro Yorimitsu ◽

Kazuhiro Chiba ◽

Morio Matsumoto ◽

Yoshiaki Toyama

Keyword(s):

Quality Of Life ◽

Low Back Pain ◽

Back Pain ◽

Lumbar Disc Herniation ◽

Disc Herniation ◽

Lumbar Disc ◽

Low Back ◽

Surgical Treatments ◽

The Impact

Download Full-text

The impact of early recovery on long-term outcomes in a cohort of patients undergoing prolonged nonoperative treatment for lumbar disc herniation

Journal of Neurosurgery Spine ◽

10.3171/2013.5.spine12992 ◽

2013 ◽

Vol 19 (3) ◽

pp. 301-306 ◽

Cited By ~ 2

Author(s):

Matthew C. Cowperthwaite ◽

Wilbert B. van den Hout ◽

K. Michael Webb

Keyword(s):

Treatment Period ◽

Lumbar Disc Herniation ◽

Disc Herniation ◽

Lumbar Disc ◽

Gaussian Kernel ◽

Exact Tests ◽

The Impact ◽

Over Time ◽

Utility Scores

Object The authors comprehensively studied the recovery of individual patients undergoing treatment for lumbar disc herniation. The primary goal was to gain insight into the variability of individual patient utility scores within a treatment cohort. The secondary goal was to determine how the rates and variability of patient recovery over time, represented by improvement in utility scores, affected long-term patient outcomes. Methods EuroQol Group–5 Dimension (EQ-5D) scores were obtained at baseline and at 2, 4, 8, 12, 26, 38, and 52 weeks for 93 patients treated under a prolonged conservative care protocol for lumbar disc herniation. Gaussian kernel densities were used to estimate the distribution of utility scores at each time point. Logistic regression and multistate Markov models were used to characterize individual patient improvement over time. Fisher exact tests were used to compare the distribution of EQ-5D domain scores. Results The distribution of utility scores was bimodal at 1 year and effectively sorted patients into a “higher” utility group (EQ-5D = 1; 43% of cohort) and a “lower” utility group (EQ-5D ≤ 0.86; 57% of cohort). Fisher exact tests revealed that pain/discomfort, mobility, and usual activities significantly differed between the 2 utility groups (p ≪ 0.001). The utility groups emerged at 8 weeks and were stable for the remainder of the treatment period. Using utility scores from 8 weeks, regression models predicted 1-year outcomes with 62% accuracy. Conclusions This study is the first to comprehensively consider the utility recovery of individual patients within a treatment cohort for lumbar disc herniation. The results suggest that most utility is recovered during the early treatment period. Moreover, the findings suggest that initial improvement is critical to a patient's long-term outcome: patients who do not experience significant initial recovery appear unlikely to do so at a later time under the same treatment protocol.

Download Full-text