scholarly journals Low-Concentration Oxygen/Ozone Treatment Attenuated Radiculitis and Mechanical Allodynia via PDE2A-cAMP/cGMP-NF-κB/p65 Signaling in Chronic Radiculitis Rats

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Junnan Wang ◽  
Mingyi Wu ◽  
Xiaowen Lin ◽  
Yun Li ◽  
Zhijian Fu
Keyword(s):  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Mechanical Allodynia ◽  
Lumbar Disc ◽  
Intrathecal Administration ◽  
Guanosine Monophosphate ◽  
Ozone Treatment ◽  
Invasive Technique ◽  
Enzyme Linked Immunosorbent Assay ◽  
Low Concentration

Background. Oxygen/ozone therapy is a minimally invasive technique for the treatment of radiculitis from lumbar disc herniation. This study aimed at investigating whether intrathecal administration of low-concentration oxygen/ozone could attenuate chronic radiculitis and mechanical allodynia after noncompressive lumbar disc herniation and at elucidating the underlying mechanisms. Methods. First, we transplanted autologous nucleus pulposus into dorsal root ganglions to establish chronic radiculitis in rats. Then, filtered oxygen or oxygen/ozone (10, 20, or 30 μg/mL) was intrathecally injected on day 1 after surgery. The ipsilateral paw withdrawal thresholds (PWTs) to mechanical stimuli were tested daily with von Frey filaments. The expression of the tumor necrosis factor- (TNF-) α, interleukin- (IL-) 1β, IL-6, cyclic adenosine monophosphate (cAMP), cyclic guanosine monophosphate (cGMP), phosphodiesterase 2A (PDE2A), and nuclear factor- (NF-) κB/p65 in spinal dorsal horns was measured by enzyme-linked immunosorbent assay, polymerase chain reaction, and western blot on day 7 after surgery. Results. Chronic radiculitis was established in rats. Intrathecal administration of 10 μg/mL, 20 μg/mL, or 30 μg/mL oxygen/ozone significantly attenuated the decreased mechanical PWTs, downregulated the overexpression of spinal TNF-α, IL-1β, and IL-6, and increased the expression of cGMP and cAMP in chronic radiculitis rats. In addition, the effects of treatment with 20 μg/mL oxygen/ozone were greater than the effects of the 10 μg/mL or 30 μg/mL doses. Moreover, intrathecal administration of 20 μg/mL oxygen/ozone reversed the increased levels of spinal PDE2A and NF-κB/p65 mRNA and protein expressions in rats with chronic radiculitis. Conclusion. Intrathecal administration of low-concentration oxygen/ozone alleviated mechanical allodynia and attenuated radiculitis, likely by a PDE2A-cGMP/cAMP-NF-κB/p65 signaling pathway in chronic radiculitis rats.

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

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.

scholarly journals Based on HPA axis to explore the mechanism of waist-rubbing therapy in the treatment of lumbar disc herniation model rats

2020 ◽  
Author(s):  
Yuhang Qin ◽  
Facai Lin ◽  
Yunchuan Wu ◽  
Ying Xiong ◽  
Guanghan Sun
Keyword(s):  
Spinal Cord ◽  
Hpa Axis ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Frictional Heat ◽  
Lumbar Spinal Cord ◽  
Enzyme Linked Immunosorbent Assay ◽  
Model Group ◽  
Lumbar Spinal

Abstract Background lumbar disc herniation (LDH) is a high-risk species in the world with serious harm. Traditional Chinese Tuina is the first choice in the treatment of LDH. In the past clinical studies, we have achieved good results in the treatment of LDH with the waist-rubbing method recorded in an ancient Chinese medical book of Qing Dynasty. Now we further explore its internal mechanism of action from the perspective of animal experiments. Waist-rubbing is a frictional heat-generating stimulus that acts on the surface of the skin. It does not relieve the compression in spinal canal, but can effectively eliminate the symptoms of LDH patients. This suggests that waist-rubbing may play a therapeutic role by interfering the autoimmunity of LDH. For a long time, the treatment of LDH mainly focused on how to relieve the mechanical compression caused by lumbar disc herniation, but little attention was paid to the autoimmune inflammation of LDH. In this study, from the point of view of regulating LDH's autoimmunity, the waist-rubbing method was taken as the treatment measure, and the lumbar strain rats in upright position were taken as the model. The neuroendocrine immunology mechanism of waist-rubbing method in treating LDH was revealed, which provided new ideas and scientific basis for Tuina clinical treatment of LDH, and also provided strong evidence for the theory of LDH's autoimmunity. Methods 30 SD rats were randomly divided into three groups of the blank, the model and the waist wiping. The LDH model of the forelimb-free standing rats was established. Each group was treated according to the corresponding method. The waist-rubbing group was treated once a day for 15 days. After the experiment, the blood and lumbar spinal cord samples were collected after rats been killed. The contents of the CRH(Corticotropin releasing hormone), ACTH(Adrenocorticotropic hormone), CORT(Cortisol), IL-17(Interleukin-17), IL-6(Interleukin-6), TGF-β1(Transforming growth factor-β1) and IL-10(Interleukin-10) in peripheral blood and the GRα(Glucocorticoid receptor α) and 5-HT1A(Five hydroxytryptamine 1A) receptor in L4-L6 segment of rat lumbar spinal cord were detected by ELISA(Enzyme-linked immunoSorbent assay). Results Compared with the blank group, the contents of CRH, ACTH, CORT, GRα, 5-HT1A receptor, TGF-β1 and IL-10 in the model group were significantly decreased (P < 0.05), while the contents of IL-17 and IL-6 were significantly increased (P < 0.05). Compared with the model group, the contents of CRH, ACTH, CORT, GRα, 5-HT1A receptor, TGF-β1 and IL-10 in the waist-rubbing group were significantly increased (P < 0.05), while the contents of IL-17 and IL-6 were significantly decreased (P < 0.05). Conclusion The waist-rubbing method may eliminate the autoimmune inflammatory reaction of LDH by correcting the hypofunction of HPA axis, so as to achieve the therapeutic effect of LDH.

scholarly journals SURGERY FOR LUMBAR DISC HERNIATION: OPEN X MINIMALLY INVASIVE TECHNIQUE

2021 ◽  
Vol 20 (1) ◽  
pp. 47-49
Author(s):  
Rangel Roberto de Assis ◽  
Helton Luis Aparecido Defino ◽  
Herton Rodrigo Tavares Costa ◽  
Álvaro Dowling ◽  
João Paulo Machado Bergamaschi
Keyword(s):  
Minimally Invasive ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Endoscopic Technique ◽  
Invasive Technique ◽  
Open Technique ◽  
Level Of Evidence ◽  
Unified Health System ◽  
Statistical Relevance

ABSTRACT Objective: In Brazil, there are no studies comparing endoscopic treatment of lumbar disc herniation with the conventional open technique in SUS (Unified Health System) with regard to hospitalization time and complications occurring within one year, which is the objective of this study. Methods: A survey of 32 surgeries performed in 2019 (11 open and 21 endoscopic) to evaluate pain parameters before and after surgery (VAS), days of hospitalization, and complications. The data were submitted to statistical analysis (ANOVA) using the Kruskal-Wallis test. Results: Fourteen patients were female and eighteen were male, with a mean age of 41.35 years (p> 0.05 between sexes). The pre- and postoperative VAS for pain radiating to the lower limb were similar between the groups: 8.5 ± 0.82 with the open technique and 8.19 ± 1.15 with endoscopic technique. In both groups there was an improvement in the pain pattern with a significant reduction in the VAS (p < 0.05) and there was no statistical relevance between the groups in terms of pain improvement. There was statistical relevance between the groups in the comparison of days of hospitalization required, with the group submitted to endoscopic surgery having a lower number of days. The complications reported were compatible with those found in the literature (postoperative dysesthesia, new herniation). Conclusions: The endoscopic technique resulted in an important reduction in the number of days of hospitalization, a factor with a high impact on the costs of any surgical procedure, which can be a determining factor in the feasibility of minimally invasive techniques. Level of evidence IV; Therapeutic Study.

Selective phosphodiesterase-2A inhibitor alleviates radicular inflammation and mechanical allodynia in non-compressive lumbar disc herniation rats

2017 ◽  
Vol 26 (7) ◽  
pp. 1961-1968 ◽  
Author(s):  
Jun-Nan Wang ◽  
Xue-jun Zhao ◽  
Zhi-hua Liu ◽  
Xu-li Zhao ◽  
Tao Sun ◽  
...  
Keyword(s):  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Mechanical Allodynia ◽  
Lumbar Disc

scholarly journals Intraoperative chymopapain in lumbar laminotomy for disc disease: a less invasive technique

1998 ◽  
Vol 4 (2) ◽  
pp. E12 ◽  
Author(s):  
Tord D. Alden ◽  
George J. Kaptain ◽  
John A. Jane ◽  
John A. Jane
Keyword(s):  
Nucleus Pulposus ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Nerve Root ◽  
Lumbar Disc ◽  
Perioperative Period ◽  
Invasive Technique ◽  
Disc Disease ◽  
Lumbar Microdiscectomy

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.

scholarly journals Feasibility and surgical technique of percutaneous transforaminal discectomy for the treatment of lumbar disc herniation

2021 ◽  
Vol 29 (1) ◽  
pp. 85-95
Author(s):  
D. Ferdinandov
Keyword(s):  
Surgical Technique ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Early Discharge ◽  
Infectious Complications ◽  
Invasive Technique ◽  
Worst Case ◽  
Endoscopic Discectomy ◽  
Disc Herniations

Percutaneous transforaminal endoscopic discectomy (PTED) is an alternative minimally invasive technique for the treatment of lumbosacral radicular syndrome resulting from lumbar disc herniation. The latter is performed with the help of local anesthesia and sedation in an awake patient with the advantage of direct feedback. Access to the target is lateral and follows a safe trajectory through the Kambin triangle. The main advantages of this surgical technique are the possibility of early discharge within 2 hours after its completion, negligible blood loss, lower risk of infectious complications, convenience in patients with obesity, reduced risk of epidural fibrosis. There are currently no large randomized trials of good quality demonstrating the advantage of PTED over open interlaminar access established in practice. In the worst case, endoscopic discectomy is not known to pose additional risks to patients. The operative technique with a clinical case and a discussion about the applicability of the new approach for the treatment of lumbar disc herniations are presented.

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