scholarly journals The association between continuity of care and surgery in lumbar disc herniation patients

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Eun-San Kim ◽  
Chang-yup Kim
Keyword(s):  
Continuity Of Care ◽  
Disc Herniation ◽  
Structural Model ◽  
Lumbar Disc ◽  
Quality Care ◽  
Target Population ◽  
National Sample ◽  
Marginal Structural Model ◽  
Lumbar Surgery ◽  
High Level

AbstractContinuity of care is a core dimension of high-quality care in the management of disease. The purpose of this study was to investigate the association between continuity of care and lumbar surgery in patients with moderate disc herniation. The Korean National Sample Cohort was used. The target population consisted of patients who have had disc herniation more than 6 months and didn’t get surgery and red flag signs within 6 months from onset. The population was enrolled from 2004 to 2013. The Bice-Boxerman Continuity of Care was used in measuring continuity of care. The marginal structural model with time dependent survival analysis was used. In total, 29,061 patients were enrolled in the cohort. High level of continuity of care was associated with a lower risk of lumbar surgery (HR, 0.27; 95% CI, 0.20–0.27). When the index was calculated only with outpatient visits to primary care with related specialty, the HR was 0.49 (95% CI: 0.43–0.57). In exploratory analysis, patients with lumbar stenosis and spondylolisthesis had higher risk of having a low level of continuity of care. These results indicate that continuity of care is associated with lower rates of lumbar surgery in patients with moderate disc herniation.

scholarly journals Athletic pubalgia misdiagnosed as lumbar radiculopathy – A case report

2019 ◽  
Vol 10 ◽  
pp. 224
Author(s):  
Ramsis F. Ghaly ◽  
Zinaida Perciuleac ◽  
Kenneth D. Candido ◽  
Nebojsa Nick Knezevic
Keyword(s):  
Case Report ◽  
Pain Relief ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Adductor Muscle ◽  
Case Description ◽  
Lumbar Radiculopathy ◽  
Lumbar Surgery ◽  
Current Case ◽  
Athletic Pubalgia

Background: Athletic pubalgia is a painful complex syndrome encountered by many athletes involved in sports. Multiple pathologies often coexist, and many systems can refer pain to the groin. The current case reflects the failure to distinguish pubalgia from lumbar radiculopathy. Case Description: Originally, a 47-year-old male with left-sided inner thigh pain was diagnosed as having a L3-4-disc herniation and spinal stenosis; he underwent a L3-4 and L4-5 laminectomy/discectomy. For 2 years postoperatively, the pain persisted. Ultimately, he underwent surgical reinsertion of the adductor muscle and experienced immediate and sustained pain relief. Conclusion: This case report highlights how pubalgia may be misdiagnosed as a lumbar disc herniation and may inadvertently lead to unnecessary lumbar surgery.

scholarly journals Spontaneous and rapid resolution of a massive lumbar disc herniation

2021 ◽  
Vol 12 ◽  
pp. 352
Author(s):  
Dinesh Naidoo
Keyword(s):  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Spontaneous Recovery ◽  
Surgical Intervention ◽  
Nonoperative Management ◽  
Lumbar Disc ◽  
Cauda Equina ◽  
Neurological Deficits ◽  
Lumbar Surgery ◽  
Disc Herniations

Background: Most lumbar disc herniations can be successfully treated conservatively. However, massive lumbar disc herniations are often treated surgically to avoid permanent cauda equina syndromes/neurological deficits and potential litigation. Nevertheless, here, we present a 51-year-old female who refused lumbar surgery due to coronavirus disease 2019 (COVID-19) and sustained a full spontaneous recovery without surgical intervention. Case Description: A 51-year-old female presented with a massive lumbar disc herniation at the L5S1 level. Despite refusing surgery for fear of getting COVID-19, she spontaneously neurologically improved without any residual neurological or radiographic sequelae. Conclusion: Although the vast majority of patients with massive lumbar disc herniations are managed surgically, there are rare instances in which nonoperative management may be successful.

scholarly journals Clinical Outcome of Percutaneous Endoscopic Lumbar Surgery (PELS) in Treatment of Lumbar Disc Herniation

2017 ◽  
Vol 07 (04) ◽  
pp. 99-109 ◽  
Author(s):  
Mangal P. Hirachan ◽  
Zengxin Gao ◽  
Yucheng Lin ◽  
Ratish Singh
Keyword(s):  
Clinical Outcome ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Lumbar Surgery

scholarly journals Lumbosacral Transitional Vertebrae in Adolescents: Effects on the Short-Term Outcomes of Percutaneous Endoscopic Lumbar Discectomy

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Yong Huang ◽  
Lu Mao ◽  
Hang Shi ◽  
Guanrui Ren ◽  
Lei Zhu ◽  
...  
Keyword(s):  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Leg Pain ◽  
Lumbar Surgery ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Endoscopic Lumbar Discectomy ◽  
Lumbosacral Transitional Vertebrae

Objective. To investigate whether lumbosacral transitional vertebrae (LSTV) affects the clinical outcomes of percutaneous endoscopic lumbar discectomy (PELD) in adolescent patients with lumbar disc herniation (LDH). Methods. This was a retrospective study with two groups. Group A was made up of 22 adolescent LDH patients with LSTV (18 males and 4 females). Group B was made up of 44 adolescent LDH patients without LSTV (36 males and 4 females), who were matched to group A for age, sex, and body mass index. All patients underwent PELD at the L4/5 or L5/S1 single level and were followed up at 18 months after surgery. We identified LSTV on radiographs and computed tomography and assessed the imaging characteristics of all patients. Outcomes were evaluated through a numerical rating scale (NRS), the Oswestry Disability Index (ODI), the modified MacNab grading system, and the incidence of additional lumbar surgery. Results. At 18 months after PELD, both groups had significant improvements in the mean NRS scores of low back pain (LBP) or leg pain and the ODI scores. In terms of the MacNab criteria, 90.9% in group A and 93.2% in group B showed excellent or good outcomes. The mean NRS scores of LBP or leg pain, ODI score, and MacNab grade after surgery were not significantly different between the 2 groups. Two patients (one patient had a recurrence; one patient had a new lumbar disc herniation) in group A and 3 patients (one patient had a recurrence; two patients had new lumbar disc herniations) in group B underwent additional lumbar surgery. Conclusions. Our study suggests that in terms of pain relief, life function improvement, and the incidence of additional lumbar surgery, LSTV has no effect on the short-term clinical outcomes of PELD in adolescents. A new lumbar disc herniation is an important reason for additional surgery in adolescents, regardless of the LSTV status.

scholarly journals A Protocol for Developing a Clinical Practice Guideline of Moxibustion in the Treatment of Lumbar Disc Herniation

2020 ◽  
Author(s):  
Fanghui Hua ◽  
Jun Xiong ◽  
Haifeng Zhang ◽  
Jie Xiang ◽  
Shouqiang Huang
Keyword(s):  
Clinical Practice ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Institute Of Medicine ◽  
Registration Number ◽  
Nerve Root Pain ◽  
Patient Values ◽  
Set Up ◽  
High Level

Abstract Background: Lumbar disc herniation(LDH), as a disease with great disturbance to life and work, is known as the origin of the severe and disabling forms of nerve root pain. Recognized as an increasingly widely accepted treatment, the efficacy of moxibustion on LDH has been affirmed. However, clinical practice guidelines (CPG) for the treatment of LDH with moxibustion have not been developed. Therefore, we will carry out this work following the accepted methodological quality standards.Methods: The new CPG will be developed according to the Institute of Medicine (IOM), the Appraisal of Guidelines for Research & EvaluationⅡ (AGREEⅡ) and WHO guideline handbook. And then determine recommendations based on high-level evidence. We will set up a Guideline Working Group and define clinical issues according to the PICO principles (Population, Intervention, Comparison, Outcomes). After evidence syntheses and several rounds of Delphi process, we will reach the consensus. In making the guideline, Patient values or preferences, results of peer review, and interest statements are all within the bounds of what we must consider. Results: As the study is not yet complete, no results can be reported.Conclusion: So far, we will develop the first CPG for moxibustion of LDH strictly based on systematic methodologies in China. This CPG will establish the standard of LDH in moxibustion therapy.Registration number: IPGRP-2020CN034.

Recurrence Rate of Lumbar Disc Herniation After Standard Discectomy and Microdiscectomy: A 5-Year Study

2019 ◽  
Vol 12 (2) ◽  
pp. 139-146
Author(s):  
Mladen E. Ovcharov ◽  
Iliya V. Valkov ◽  
Milan N. Mladenovski ◽  
Nikolay V. Vasilev
Keyword(s):  
Recurrence Rate ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Surgical Techniques ◽  
Reoperation Rate ◽  
University Hospital ◽  
Recurrence Rates ◽  
Chi Square ◽  
Common Procedure

Summary Lumbar disc herniation (LDH) is the most common pathology in young people, as well as people of active age. Despite sophisticated and new minimally invasive surgical techniques and approaches, reoperations for recurrent lumbar disc herniation (rLDH) could not be avoided. LDH recurrence rates, reported in different studies, range from 5 to 25%. The purpose of this study was to estimate the recurrence rates of LDH after standard discectomy (SD) and microdiscectomy (MD), and compare them to those reported in the literature. Retrospectively, operative reports for the period 2012-2017 were reviewed on LDH surgeries performed at the Neurosurgery Clinic of Dr Georgi Stranski University Hospital in Pleven. Five hundred eighty-nine single-level lumbar discectomies were performed by one neurosurgeon. The diagnoses of recurrent disc herniation were based on the development of new symptoms and magnetic resonance/computed tomography (MRI/CT) images showing compatible lesions in the same lumbar level as the primary lumbar discectomies. The recurrence rate was determined by using chi-square tests and directional measures. SD was the most common procedure (498 patients) followed by MD (91 patients). The cumulative reoperation rate for rLDH was 7.5%. From a total number of reoperations, 26 were males (59.1%) and 18 were females (40.9%). Reoperation rates were 7.6% and 6.6% after SD and MD respectively. The recurrence rate was not significantly higher for SD. Our recurrence rate was 7.5%, which makes it comparable with the rates of 5-25% reported in the literature.

EFFICACY OF ANTIBIOTICS PROPHYLAXIS IN PATIENTS WITH LUMBAR DISC HERNIATION UNDERGOING LUMBAR DISCETOMY

2018 ◽  
Vol 8 (5) ◽  
pp. 14-19
Author(s):  
Tri Truong Van ◽  
Tri Tran Duc Duy ◽  
Khai Vo Le Quang
Keyword(s):  
Surgical Site Infection ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Lumbar Discectomy ◽  
University Hospital ◽  
Site Infection ◽  
Surgical Wound ◽  
A Prospective Study ◽  
Length Of Hospitalization

Introduction: Surgical wound infection in developing coutries is about 3%. Antibiotics prophylaxis may help to reduce the surgical site infection. The objective of this study was to evaluate the efficacy of antibiotics prophylaxis in patients with lumbar disc herniation who were treated with lumbar discectomy at Hue University hospital. Materials and Methods: A prospective study was conducted at Hue University hospital from March 2015 to May 2018 on 54 patients with lumbar disc herniation who were used antibiotics prophylaxis when undergoing discectomy. Results: The infection rate in our study was 0%. Antibiotics prophylaxis reduced the length of hospitalization as well as the medical cost. Conclusion: Antibiotics prophylaxis was effective in preventing surgical site infection despite the fact that the condition of operating rooms did not meet the standard rules. Key words: prophylaxis antibiotics, lumbar disc herniation

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