scholarly journals Long-Term Course to Lumbar Disc Resorption Patients and Predictive Factors Associated with Disc Resorption

2017 ◽  
Vol 2017 ◽  
pp. 1-10 ◽  
Author(s):  
Jinho Lee ◽  
Joowon Kim ◽  
Joon-Shik Shin ◽  
Yoon Jae Lee ◽  
Me-riong Kim ◽  
...  
Keyword(s):  
Predictive Factors ◽  
Lumbar Disc ◽  
Intervertebral Disc Herniation ◽  
Lumbar Intervertebral Disc ◽  
Korean Medicine ◽  
Factors Associated ◽  
Lumbar Intervertebral Disc Herniation ◽  
Symptom Recurrence

The long-term course to lumbar intervertebral disc herniation (LDH) patients receiving integrative Korean medicine treatment and predictive factors associated with disc resorption were investigated. LDH patients who received integrative Korean medicine treatment from February 2012 to December 2015 and were registered in the “longitudinal project for LDH on MRI” were included. Disc resorption amount was measured 3-dimensionally with disc degeneration and modic change levels on baseline and follow-up MRIs. Patient characteristics, Korean medicine use, pain, symptom recurrence, and satisfaction were assessed through medical records and phone surveys. Of 505 participants, 19 did not show disc resorption, while 486 did. A total of 220 displayed resorption rates of ≥50%. LDH volume at baseline was 1399.82±594.96 mm3, and that on follow-up MRI was 734.37±303.33 mm3, indicating a 47.5% decrease (p<0.0001). Predictive factors for disc resorption were disc extrusion, Komori migration classification, and LDH amount. Approximately 68.4% did not experience symptom recurrence over the 51.86±19.07-month follow-up, and 90.3% were satisfied with Korean medicine treatment. The majority of LDH patients who improved after integrative Korean medicine treatment showed disc resorption within 1 year with favorable long-term outcomes. Predictive factors for disc resorption should be duly considered for informed decision-making. This trial is registered with ClinicalTrials.gov NCT02841163.

scholarly journals Functional outcome of patients undergoing lumbar discectomy

2018 ◽  
Vol 4 (3) ◽  
pp. 514
Author(s):  
Harpreet Singh ◽  
Parth B. Bhavsar ◽  
Ankit Singh ◽  
Saurin Patel
Keyword(s):  
Functional Outcome ◽  
Lumbar Disc ◽  
Subjective Evaluation ◽  
Lumbar Discectomy ◽  
Intervertebral Disc Herniation ◽  
Disc Prolapse ◽  
Duration Of Symptoms ◽  
Lumbar Disc Prolapse ◽  
Lumbar Intervertebral Disc Herniation

<p class="abstract"><strong>Background:</strong> Sciatica resulting from a lumbar intervertebral disc herniation is the most common cause of radicular leg pain in adult working population. It can be treated with both conservative and operative methods. In our study, surgical treatment of lumbar disc prolapse has been done by open discectomy. We wish to assess the outcome of surgery in patients with lumbar disc prolapse undergoing lumbar discectomy.</p><p class="abstract"><strong>Methods:</strong> 40 patients were included in this study and were followed up for up to 1 year postoperatively. We assessed the outcome of each patient with ODI and VAS post-operatively and on follow-up at 3 weeks, 6 months and 1 year. Subjective evaluation of the patient’s satisfaction at the final follow-up was also done.<strong></strong></p><p class="abstract"><strong>Results:</strong> We found that males had higher incidence of PIVD with an average duration of symptoms before surgery about 8.62 months. Left side was most involved and level l4-l5 was most involved level. The mean ODI and VAS score pre-operatively were 26.85±4.20 and 7.73±0.88 respectively, which changed to 4.48±5.15 and 1.70±1.57, respectively at 1 year post-operative follow-up. These were statistically highly significant. Most of the patients (34) gave a subjective evaluation as excellent at 1 year follow-up.</p><p class="abstract"><strong>Conclusions:</strong> Our study established that open discectomy has a satisfactory functional outcome and leads to a significant improvement in the patients’ quality of life.</p>

scholarly journals The Long-Term Course of Outcomes for Lumbar Intervertebral Disc Herniation following Integrated Complementary and Alternative Medicine Inpatient Treatment: A Prospective Observational Study

2017 ◽  
Vol 2017 ◽  
pp. 1-9 ◽  
Author(s):  
Moon-Hwi Kim ◽  
Yoon Jae Lee ◽  
Joon-Shik Shin ◽  
Jinho Lee ◽  
Haechan Jeong ◽  
...  
Keyword(s):  
Observational Study ◽  
Intervertebral Disc ◽  
Alternative Medicine ◽  
Complementary And Alternative Medicine ◽  
Prospective Observational Study ◽  
Leg Pain ◽  
Intervertebral Disc Herniation ◽  
Lumbar Intervertebral Disc ◽  
Lumbar Intervertebral Disc Herniation

A prospective observational study was conducted in 524 lumbar intervertebral disc herniation (LDH) inpatients to report the long-term effects of complementary and alternative medicine (CAM) treatment. Participants received integrative CAM treatment during hospitalization, from June 2012 to May 2013, and long-term outcomes were assessed from July to August 2016. Numerical rating scales (NRSs) of back and leg pain, the Oswestry disability index (ODI), satisfaction, surgery, recurrence, and current care status were investigated. Baseline characteristics were analyzed to determine factors that predicted long-term satisfaction. A total of 367 patients were available for follow-up. The long-term change in NRS of back and leg pain and ODI was 3.53 (95% CI, 3.22, 3.83), 2.72 (2.34, 3.11), and 32.89 (30.21, 35.57), respectively, showing that improvements were well sustained. Regarding satisfaction, 86.11% responded that they were “slightly improved” or better. Range of lumbar flexion ≤ 60° and both legs’ pain at admission were significant predictors of “much improved” or better satisfaction in the long term. Overall, LDH patients who received CAM treatment maintained favorable states in the long term. However, as an uncontrolled observational study, further studies with placebo and/or active controls are warranted. Trial Registration. This trial is registered with ClinicalTrials.gov  NCT02257723 (date of registration: October 2, 2014).

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 A CLINICO-OPERATIVE STUDY OF LUMBAR INTERVERTEBRAL DISC HERNIATION

2021 ◽  
Vol 5 (10) ◽  
Author(s):  
Yogesh Kumar ◽  
Rohit Amar
Keyword(s):  
Back Pain ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Clinical Signs ◽  
Leg Pain ◽  
Herniated Disc ◽  
Intervertebral Disc Herniation ◽  
Older Individuals ◽  
Lumbar Intervertebral Disc ◽  
Lumbar Intervertebral Disc Herniation

Background: Herniation is a greater threat in younger individuals between the ages of 30 and 50 years, in whom the nucleusmaterial has good turgor, in contrast to older individuals in whom the nucleus is desiccated and fibrotic. Open discectomy is the gold standard for operative intervention in patients with herniated disc where conservative treatment has failed. Aim of objective: To study the reliability of clinical signs in diagnosing lumbar disc herniation. Material and Methods: This study was done collecting data of patients presenting to, JLNMCH, Bhagalpur. During this period there were 46 patients with a history of low back pain and at least one symptom suggesting root compression (Radiating pain, numbness,weakness or loss of sensation) who underwent surgery. Conclusion: Commonest presentation is that of, long histories of back pain with superimposed syndrome of sciatica. Patients with predominant leg pain or only leg pain have high incidences of ruptured herniations. Keywords: Herniation, Sciatica, Numbness, loss of sensation.

scholarly journals Expression and Distribution of M1 and M2 Macrophages in the Degeneration Process of Human Lumbar Intervertebral Disc Herniation: A Histological and Clinical Efficacy Analysis

2020 ◽  
Author(s):  
Xiao-Chuan Li ◽  
Chun-Ming Huang ◽  
Shao-Jian Luo ◽  
Wu Fan ◽  
Tian-Li Zhou ◽  
...  
Keyword(s):  
Clinical Efficacy ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Intervertebral Disc Herniation ◽  
M2 Macrophages ◽  
Lumbar Intervertebral Disc ◽  
Efficacy Analysis ◽  
High Intensity Zone ◽  
Lumbar Intervertebral Disc Herniation ◽  
M1 And M2 Macrophages

Abstract Background: Macrophages were previously proved to participate in the progression of lumbar disc herniation (LDH), but the phenotypic subtypes of macrophages and the association between M1/M2 positivity and clinical efficacy in LDH are not understood. This study aimed to determine the expression and distribution of M1 and M2 macrophages in LDH and investigate the association between M1/M2 positivity and outcome of LDH therapy. Methods: Immunohistochemical analyses of M1 and M2 markers were used to identify M1/M2 macrophages and their prevalence and distribution in LDH patients. The association among prevalence, clinical characteristics, and clinical efficacy was evaluated. Differences in the presence of M1 and M2 macrophages with or without modic changes (MCs) and those in the high-intensity zone (HIZ) were also analyzed. Results: The induced nitric oxide synthase (iNOS) and CD206 were expressed in all 79 LDH patients tested. The morphology and distribution of iNOS+ and CD206+ cells varied at different degenerative LDH stages. iNOS+ cells significantly decreased with increasing Pfirrmann grade and age, whereas CD206 cells increased. iNOS+ cells showed a positive correction with visual analog scale scores, while CD206+ exhibited positive correction with the Oswestry disability index on pre-operative day 3. A significant increase in iNOS+ cells was observed in the HIZ, whereas more CD206+ cells were found in MC tissues. Conclusions: Differences in morphology and distribution of M1/M2 cells in LDH suggested that these cells originated from both recruited and resident macrophages. Significantly different expression in MCs and the HIZ and significant correlation with clinical efficacy indicated the important role of the M1/M2 transition in the immune and inflammatory response in LDH. Management of the M1/M2 transition may be a feasible approach for preventing LDH.

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