P12. Comparisons of patterns of upregulation of inflammatory cytokines in herniated nucleus pulposus, disc and nerve root lavagates and in the serum of patients with acute sciatica secondary to lumbar disc herniation undergoing surgery

The use of chymopapain in the treatment of lumbar disc herniation has been widely studied since Smith first described its use in humans in 1963. The authors describe the use of chymopapain intraoperatively in open lumbar microdiscectomy in 63 patients. When combined with the results of a previous study performed at the same institution, the authors found that this technique significantly reduces the rate of recurrent disc herniation when compared with traditional laminotomy with discectomy. This procedure maximizes the benefits of each approach taken separately, allowing for decompression of the nerve root from a free fragment or sequestered disc and preventing recurrence through dissolution of the nucleus pulposus. Overall, outcome was good or excellent immediately postoperatively in 73% of the 63 patients and in 64% at last follow-up evaluation. Additionally, this procedure is safe with no complications noted in the immediate perioperative period or at follow-up evaluation.

Download Full-text

The effects of a 5-HT2A receptor antagonist on blood flow in lumbar disc herniation : application of nucleus pulposus in a canine model

European Spine Journal ◽

10.1007/s00586-007-0534-4 ◽

2007 ◽

Vol 17 (2) ◽

pp. 307-313 ◽

Cited By ~ 9

Author(s):

Miho Sekiguchi ◽

Shin-ichi Konno ◽

Shin-ichi Kikuchi

Keyword(s):

Blood Flow ◽

Receptor Antagonist ◽

Nucleus Pulposus ◽

Lumbar Disc Herniation ◽

Disc Herniation ◽

Lumbar Disc ◽

Canine Model

Download Full-text

Analysis of the efficacy of ozone therapy on different types of lumbar disc herniation: a new guidance is coming? [abstract]

Journal of Ozone Therapy ◽

10.7203/jo3t.3.4.2019.15506 ◽

2019 ◽

Vol 3 (4) ◽

Author(s):

Kenan Hao ◽

Huan Liu ◽

Yang Yang ◽

Qingle Zeng ◽

Xiaofeng He

Keyword(s):

Nucleus Pulposus ◽

Lumbar Disc Herniation ◽

Disc Herniation ◽

Lumbar Disc ◽

Ozone Treatment ◽

Type I ◽

Type Ii ◽

Ring Type ◽

Type Iv ◽

Fibre Ring

PURPOSE: To investigate the sub-types of lumbar disc herniation, compare efficacies of ozone treatment in various types of lumbar disc herniation and analyze the mechanisms. MATERIAL AND METHODS: A total of 250 patients (159 males, 91 females; age range: 14 - 85 years) diagnosed of lumbar disc herniation from January 2009 to Jun 2014 in Nanfang Hospital were enrolled. Disc Lesions, classified by Magnetic Resonance examinations and images when injecting ozone under Digital Subtraction Angiography, were divided into four types: type I: Non-prominent nucleus pulposus with ruptured fibre ring; type II: Prominent nucleus pulposus with ruptured fibre ring; type III: Non-prominent nucleus pulposus with Non-ruptured fibre ring; type IV: Prominent nucleus pulposus with Non-ruptured fibre ring. All patients underwent intradiscal and paravertebral injection of oxygen-ozone. Visual Analogue Scale (VAS) weighted score was administered for the measurement of low back pain before treatment, and the evaluation of efficacy respectively at 1 week, 1 month, 6 month and 12 month follow-up period. RESULTS: Most of the patients (about 4/5) showed better response to ozone treatment. Herniated disc shrinkage was obtained among type II and IV. The type II had the most reduction of average score while the type III had the least. The proportion of patients who had once experienced pain relief at the follow up interval, namely the curative efficacy, showed significant difference: type I occupied the most, type IV occupied the least. CONCLUSION: Ozone treatment is effective and safe for all types of lumbar disc herniation, but efficacy varies according the types, of which type I has the best results and type IV has the worst ones.

Download Full-text

The Diagnostic Value of the Coronal MRI for Lumbosacral Nerve Root Lesions in Lumbar Disc Herniation.

Orthopedics & Traumatology ◽

10.5035/nishiseisai.40.1463 ◽

1992 ◽

Vol 40 (4) ◽

pp. 1463-1465

Author(s):

Hironobu Taniguchi ◽

Naoya Tajima ◽

Shigeru Kuwahara ◽

Kouichi Matsumoto ◽

Sadahito Uemura ◽

...

Keyword(s):

Lumbar Disc Herniation ◽

Disc Herniation ◽

Nerve Root ◽

Lumbar Disc ◽

Diagnostic Value

Download Full-text

Study of Lumbar Disc Herniation Compressing the Adjacent Nerve Root.

Orthopedics & Traumatology ◽

10.5035/nishiseisai.45.954 ◽

1996 ◽

Vol 45 (3) ◽

pp. 954-957

Author(s):

Takeshi Hashikawa ◽

Keisuke Sera ◽

Masakazu Nakamura ◽

Kenji Miyahara

Keyword(s):

Lumbar Disc Herniation ◽

Disc Herniation ◽

Nerve Root ◽

Lumbar Disc

Download Full-text

Preoperative retrolisthesis as a risk factor of postdecompression lumbar disc herniation

Journal of Neurosurgery Spine ◽

10.3171/2015.6.spine15288 ◽

2016 ◽

Vol 24 (4) ◽

pp. 592-601 ◽

Cited By ~ 4

Author(s):

Shota Takenaka ◽

Kosuke Tateishi ◽

Noboru Hosono ◽

Yoshihiro Mukai ◽

Takeshi Fuji

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Spinal Stenosis ◽

Lumbar Spinal Stenosis ◽

Lumbar Disc Herniation ◽

Disc Herniation ◽

Lumbar Disc ◽

Area Under The Curve ◽

Lumbar Spinal ◽

Acute Sciatica

OBJECT In this study, the authors aimed to identify specific risk factors for postdecompression lumbar disc herniation (PDLDH) in patients who have not undergone discectomy and/or fusion. METHODS Between 2007 and 2012, 493 patients with lumbar spinal stenosis underwent bilateral partial laminectomy without discectomy and/or fusion in a single hospital. Eighteen patients (herniation group [H group]: 15 men, 3 women; mean age 65.1 years) developed acute sciatica as a result of PDLDH within 2 years after surgery. Ninety patients who did not develop postoperative acute sciatica were selected as a control group (C group: 75 men, 15 women; mean age 65.4 years). Patients in the C group were age and sex matched with those in the H group. The patients in the groups were also matched for decompression level, number of decompression levels, and surgery date. The radiographic variables measured included percentage of slippage, intervertebral angle, range of motion, lumbar lordosis, disc height, facet angle, extent of facet removal, facet degeneration, disc degeneration, and vertebral endplate degeneration. The threshold for PDLDH risk factors was evaluated using a continuous numerical variable and receiver operating characteristic curve analysis. The area under the curve was used to determine the diagnostic performance, and values greater than 0.75 were considered to represent good performance. RESULTS Multivariate analysis revealed that preoperative retrolisthesis during extension was the sole significant independent risk factor for PDLDH. The area under the curve for preoperative retrolisthesis during extension was 0.849; the cutoff value was estimated to be a retrolisthesis of 7.2% during extension. CONCLUSIONS The authors observed that bilateral partial laminectomy, performed along with the removal of the posterior support ligament, may not be suitable for lumbar spinal stenosis patients with preoperative retrolisthesis greater than 7.2% during extension.

Download Full-text