Computer Three-Dimensional Reconstruction and Pain Management for Lumbar Disc Herniation Treated by Intervertebral Foramen Endoscopy

2019 ◽  
Vol 9 (8) ◽  
pp. 1776-1781
Author(s):  
Zhaowen Peng ◽  
Wenwen Zhao ◽  
Shaohua Hu
Keyword(s):  
Lumbar Spine ◽  
Pain Management ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Three Dimensional ◽  
Operation Time ◽  
Control Group ◽  
Intervertebral Foramen ◽  
Experimental Group

Objective: Lumbar disc herniation leads the numbness and pain in the waist and lower limbs. Intervertebral foramen endoscopy is a minimally invasive procedure for the treatment of disc herniation. Adequate preoperative evaluation is conducive to this percutaneous skin surgery. The purpose of this study is to improve the efficacy of intervertebral foramen endoscopy in the treatment of lumbar disc herniation by preoperative computer three-dimensional reconstruction combined with pain management. Method: Fifty patients with lumbar disc herniation who met the indications of intervertebral foramen endoscopy were randomly divided into experimental group and control group. The control group was operated according to experience based on the common axial image. The experimental group was punctured according for three-dimensional visualization model of lumbar spine. Preoperative simulated puncture catheterization and perioperative pain management was applied. The catheterization time, operation time under endoscopy, fluoroscopy times during operation, the Visual Analogue Scale (VAS) and Japanese Orthopaedic Association (JOA) scores before and 1 d, 1 m and 3 m after operation were compared between two groups. Result: The three-dimensional visualization model of lumbar spine was reconstructed based on thin-layer data. According to the results of software measurement, the skin puncture point was located and the puncture angle was obtained. Compared with the control group, the catheterization time, operation time under endoscopy, fluoroscopy times during operation in experimental group were significantly reduced. There was no statistical difference in VAS and JOA scores between two groups before operation. Compared with control group, the VAS scores in experimental group at 1 d, and 1 m after operation were decreased statistically, while the JOA scores were increased statistically. Conclusion: Three-dimensional visualization model of lumbar spine and virtual operation planning can directly judge the feasibility of intervertebral foramen endoscopy in the treatment of lumbar disc herniation, improve the efficiency of operation, and further improve postoperative efficacy with pain management.

scholarly journals Integrative TCM Conservative Therapy for Low Back Pain due to Lumbar Disc Herniation: A Randomized Controlled Clinical Trial

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Wei An Yuan ◽  
Shi Rong Huang ◽  
Kai Guo ◽  
Wu Quan Sun ◽  
Xiao Bing Xi ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Conservative Therapy ◽  
Lumbar Disc ◽  
Control Group ◽  
Low Back ◽  
Randomized Controlled ◽  
Experimental Group

Low back pain due to lumbar disc herniation (LDH) is very common in clinic. This randomized controlled trial was designed to investigate the effects of integrative TCM conservative therapy for low back pain due to LDH. A total of 408 patients with low back pain due to LDH were randomly assigned to an experimental group with integrative TCM therapy and a control group with normal conservative treatment by the ratio of 3 : 1. The primary outcome was the pain by the visual analogue scale (VAS). The secondary outcome was the low back functional activities by Chinese Short Form Oswestry Disability Index (C-SFODI). Immediately after treatment, patients in the experimental group experienced significant improvements in VAS and C-SFODI compared with the control group (between-group difference in mean change from baseline, −16.62 points,P<0.001in VAS; −15.55 points,P<0.001in C-SFODI). The difference remained at one-month followup, but it is only significant in C-SFODI at six-month followup (−7.68 points,P<0.001). No serious adverse events were observed. These findings suggest that integrative TCM therapy may be a beneficial complementary and alternative therapy for patients with low back pain due to LDH.

scholarly journals Lumbopelvic Biomechanics in Patients with Lumbar Disc Herniation—Prospective Cohort Study

Symmetry ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 602
Author(s):  
Tomasz Kuligowski ◽  
Tomasz Sipko
Keyword(s):  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Three Dimensional ◽  
Herniated Disc ◽  
Body Region ◽  
Control Group ◽  
Healthy Controls ◽  
Compensation Mechanisms ◽  
Pelvis Rotation

Low back pain (LBP) is the most frequent cause of adult disability. One of the main reasons can be a herniated disc (lumbar disc herniation—LDH), potentially disturbing spinal movement patterns. Its influence on gait and lumbopelvic biomechanics still remains unclear. Little to no evidence was found on lumbopelvic kinematics and gait in young LDH adults. The purpose of this study was to analyze the lumbopelvic biomechanics in young adult individuals with lumbar disc herniation diagnosed by MRI. Forty-three participants (18–35 years) were divided into two groups: an LDH group (n = 19) and a control group (n = 24). All participants underwent dynamic lumbopelvic and gait measures by a G-Walk wearable device in a 6-m walking test (6MWT). The Oswestry Disability Index (ODI) questionnaire was used for subjective disability assessment. The LDH group showed higher speed (p = 0.02), lower symmetry of pelvis tilt (p = 0.01), and lower pelvis rotation (p = 0.04) compared to the healthy controls. Correlation calculations showed significance between pelvis obliquity and pelvis rotation (r = 0.53) but only in healthy controls. The lumbopelvic biomechanics shows differences in pelvis tilt and symmetry index of rotation parameters between LDH and healthy controls. In conclusion, LDH affects the gait kinematics, causing three-dimensional disorders and lack of synergy. This is probably due to pain avoidance behaviors and the compensation mechanisms of the adjacent body region.

scholarly journals Impact Of Combined Lumbar Traction with Cervical Traction in Chronic Lumbar Disc Herniation

2021 ◽  
Vol 12 (6) ◽  
pp. 1124-1131
Author(s):  
Al-Qudah, Et. al.
Keyword(s):  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Control Group ◽  
Stabilization Exercise ◽  
Core Stabilization ◽  
Significant Difference ◽  
Cervical Traction ◽  
Lumbar Traction ◽  
Experimental Group

Traction Is Part Of The Evidence Based Manual Physical Therapy Management Due To Its Mechanical Nature. The Efficacy Of Lumbar Traction (Lt) Has Been Established, Lt As The Most Used Method Of Spinal Decompression Therapy (Sdt) Reduces The Intradiscal Pressure And Vertically Increases The Intervertebral Space And Restore Disc Height Allowing Nutrients And Oxygen Supply To The Disc. While Lt Had Recently Been Used As A Conservative Treatment For Chronic Lumbar Disc Herniation (Cldh), Combined Lumbar Traction With Cervical Traction (Cltct) As One Intervention Which Has Been Suggested By (Al-Qudah, M.K) Was Used As A Part Of Rehabilitative Program In Patients With Cldh. Therefore, The Effectiveness Of Cltct Separately At Any Other Interventions Remains Absolutely Unclear And Uncertain. Objective: The Aim Of The Presented Work Is To Identify The Effectiveness Of Cltct [(Positional Sustained Lumbar Traction (Pslt) Combined With Mechanical Sustained Cervical Traction (Msct) As One Intervention] On Patients With Moderate (L4-L5) (L5-S1) Cldh, And To Compare Cltct With Traditional Mechanical Lumbar Traction (Mlt). Methods: In This Study, Twelve Outdoor Male Patients Diagnosed With Magnetic Resonance Imaging (Mri), Had Accepted To Participate The Study. They Were Chosen From Al-Karak Governmental Hospital, From 20th Of December To 1st February 2021. Subjects Were Divided Randomly In To Two Groups, Experimental Group (N=6) Performed Cupping Massage (Cm), Cltct And Core Stabilization Exercise (Cse), While The Control Group (N=6) Performed Cm, Mlt And Cse. All Subjects Were Advised To   Perform The Cse Three Times Daily As A Home Program In Addition To One Set During Each Session Under The Therapist Supervision. All Subjects Had Exposed (18) Sessions For (6) Weeks. The Results Were Analyzed Using The Spss System. Results: Indicates That There Was Statistically Significant Difference Between The Pre And Post Measurements In Both Groups In Favor Of The Post Measurements In Term Of Pain And Disability. Also Results Indicate That There Was Statistically Significant Difference Between The Groups In Favor Of Experimental Group. Conclusions: The Present Study Demonstrates That The Use Of Cltct Has A Positive Effect On Patients With Cldh More Than Mlt.  

scholarly journals Deep Learning-Based Correlation Analysis between Spine Surgery Lumbar Facet Joint and Lumbar Disc Herniation Using Magnetic Resonance Images

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Chao Wang ◽  
Jiabin Yuan ◽  
Zebin Huang ◽  
Zhicai Shi
Keyword(s):  
Lumbar Spine ◽  
Magnetic Resonance ◽  
Lumbar Disc Herniation ◽  
Facet Joint ◽  
Lumbar Disc ◽  
Magnetic Resonance Images ◽  
Control Group ◽  
Lumbar Facet Joint ◽  
Lumbar Facet ◽  
Experimental Group

The research aimed at discussing the analytic function of convolutional neural network (CNN) algorithm-based magnetic resonance images (MRI) in the correlation between lumbar disc herniation (LDH) and angle and irregular variation of joint (IVJ) of lumbar facet-joint (LFJ). First, CNN-based MRI (CNNM) algorithm was constructed, and Markov random field (MRF) and fuzzy C-means (FCM) algorithms were introduced for comparison. Meanwhile, all patients received MRI examination of lumbar, and CNNM algorithm was adopted in MRI images. The results showed that the sensitivity, specificity, accuracy, and precision (98.53%, 93.65%, 99.56%, and 98.74%, respectively) of the CNNM algorithm were all superior to those of MRF algorithm (90.41%, 81.11%, 91.18%, and 91.13%, respectively) and of FCM algorithm (93.14%, 82.86%, 93.23%, and 93.08%, respectively) ( P < 0.05 ). Besides, the lumbar spine angles of L3-L4, L4-L5, and L5-S1 (6.03 ± 1.34°, 7.14 ± 1.18°, and 8.96 ± 3.26°, respectively) in the experimental group was obviously less than those in the control group (6.84 ± 1.15°, 9.85 ± 1.25°, and 17.34 ± 4.79°, respectively) ( P < 0.05 ). In the experimental group, there was irregular mutation of LFJ in 78 cases, while 8 cases suffered from irregular mutation of LFJ in the control group. The proportions of protrusion in L3/4, L4/5, and L5/S1 segments (11 cases, 53 cases, and 14 cases, respectively) was higher than that in the control group (1 case, 5 cases, and 2 cases, respectively) ( P < 0.05 ). In short, the constructed CNNM algorithm had excellent performance in diagnosing lumbar MRI images and had clinical research and promotion value. Moreover, the IVJ of patients with LDH was notably increased, most of the physiological angle of the lumbar spine changed, and facet joint was correlated with the occurrence of LDH.

Anteroposterior Lumbar Spine X-ray of L5 Lamina for Evaluation of Lower Lumbar Disc Herniation in Young Adults

2020 ◽  
Author(s):  
Lin Jin ◽  
Li Zhang ◽  
Jialiang Guo ◽  
Ruipeng Zhang ◽  
Yingchao Yin ◽  
...  
Keyword(s):  
Young Adults ◽  
Lumbar Spine ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Lumbar Vertebra ◽  
Control Group ◽  
X Ray ◽  
Significant Difference ◽  
Lower Lumbar

Abstract Background: Plain radiographs are rarely used in the diagnostic evaluation of lumbar disc herniation (LDH). The L5 lamina is the important skeletal structure at the back of the lower lumbar vertebra. This study investigated the association between the height of L5 lamina under anteroposterior lumbar spine X-ray and lower LDH, to determine its significance to the onset of LDH in young adults.Methods: We conducted a retrospective study of 160 patients aged 18 to 39 years with lower LDH and 160 healthy controls. The anteroposterior lumbar spine X-ray was used to image features of the L5 lamina. The height of L5 lamina (“h”) and of the space between L4 and S1 lamina (“H”) were measured. The difference in height of L5 lamina in each study group was assessed as the ratio of “h/H”. Results: There was no significant difference in sex, age, occupation type, body mass index (BMI), family history or smoking status (p>0.05) between LDH group and the control group. The mean ratio (95% CI) of “h/H” in LDH and control group was 0.28 (0.26, 0.31) and 0.35 (0.32, 0.38) respectively, with statistical difference (p<0.05). The diagnostic accuracy of “h/H” ratio was investigated using the receiver operating characteristic (ROC) curve. The area under the curve was 0.835 (95% CI 0.789, 0.881), using a cut-off of 0.315 (sensitivity 0.806, specificity 0.794). A decrease in the “h/H” ratio, showed an increasing linear trend in the protrusion proportion of L4/5 segments (Z=5.943, p<0.05).Conclusions: The onset of lower LDH in young adults is related to the developmental difference in L5 Lamina. Young adults with developmental defects of L5 lamina are more likely to develop lower LDH. Assessment of “h/H” ratio could be used for evaluation or prediction of asymptomatic or mildly symptomatic lower LDH in young adults.

scholarly journals Anteroposterior lumbar spine X-ray of L5 lamina for screening of possibility of lower lumbar disc herniation in young adults

2020 ◽  
Author(s):  
Lin Jin ◽  
Li Zhang ◽  
Jialiang Guo ◽  
Ruipeng Zhang ◽  
Yingchao Yin ◽  
...  
Keyword(s):  
Young Adults ◽  
Lumbar Spine ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Lumbar Vertebra ◽  
Control Group ◽  
X Ray ◽  
Significant Difference ◽  
Lower Lumbar

Abstract Background: Plain radiographs are rarely used in the imaging evaluation of lumbar disc herniation (LDH). The L5 lamina is the important skeletal structure at the back of the lower lumbar vertebra. This study investigated the association between the height of L5 lamina under anteroposterior lumbar spine X-ray and lower LDH, to determine its significance to the onset of LDH in young adults.Methods: We conducted a retrospective study of 160 patients aged 18 to 39 years with lower LDH and 160 healthy controls. The anteroposterior lumbar spine X-ray was used to image features of the L5 lamina. The height of L5 lamina (“h”) and of the space between L4 and S1 lamina (“H”) were measured. The difference in height of L5 lamina in each study group was assessed as the ratio of “h/H”. Results: There was no significant difference in sex, age, occupation type, body mass index (BMI), family history or smoking status (p>0.05) between LDH group and the control group. The mean ratio (95% CI) of “h/H” in LDH and control group was 0.28 (0.26, 0.31) and 0.35 (0.32, 0.38) respectively, with statistical difference (p<0.05). The diagnostic accuracy of “h/H” ratio was investigated using the receiver operating characteristic (ROC) curve. The area under the curve was 0.835 (95% CI 0.789, 0.881), using a cut-off of 0.315 (sensitivity 0.806, specificity 0.794). A decrease in the “h/H” ratio, showed an increasing linear trend in the protrusion proportion of L4/5 segments (Z=5.943, p<0.05).Conclusions: Young adults with developmental defects of L5 lamina are more likely to develop lower LDH. Assessment of “h/H” ratio could be used for screening or prediction of asymptomatic or mildly symptomatic lower LDH in young adults.

scholarly journals Spinal Biomechanical Modelling in the Process of Lumbar Intervertebral Disc Herniation in Middle-Aged and Elderly

2021 ◽  
Vol 2021 ◽  
pp. 1-12
Author(s):  
Xinyu Zhang ◽  
Zhe Zhao ◽  
Chunlei Niu ◽  
Zengbiao Ma ◽  
Jianlei Hou ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Three Dimensional ◽  
Biomechanical Properties ◽  
Lumbar Spine Surgery ◽  
Articular Process ◽  
Lower Lumbar Spine

Lumbar disc herniation is one of the common clinical diseases of the lower lumbar spine in orthopedics. The purpose is to remove the herniated disc nucleus pulposus tissue, remove the compressed part of the disease, and relieve symptoms, such as nerve pain. In the past, biomechanics research mostly relied on in vitro measurements, but the complicated internal environment of the human body prevented us from further measurement and research. However, with the development of computer technology, the use of computer CT scanning, software three-dimensional reconstruction, and displacement study three-dimensional spine biomechanics method makes the research of biomechanics into in vitro simulation stage and has gradually become the focus of current research. The postoperative biomechanics was simulated and the comparison model was established at the same time. At the same time, we combined the clinical follow-up data and studied the clinical data for the treatment of postoperative recurrence of lumbar disc herniation. We compared and analyzed the initial operation method and the experimental results and obtained the prevention of recurrence. The results showed that when one inferior articular process was removed, the lumbar spine appeared unstable to rotate to the opposite side; when one inferior articular process was completely removed, the movement of the lumbar spine in all directions was unstable. Better research on the biomechanical properties of the spine will help the diagnosis and treatment of clinical lumbar disc herniation. Therefore, when performing posterior lumbar spine surgery, not only should the exposure of the surgical field and thorough decompression be considered, but also the biomechanical properties of the lumbar spine should be comprehensively evaluated.

scholarly journals Microscopic extra-laminar sequestrectomy (MELS) for the treatment of hidden zone lumbar disc herniation: report of the surgical technique, patient selection, and clinical outcomes

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Chunxiao Wang ◽  
Yao Zhang ◽  
Xiaojie Tang ◽  
Haifei Cao ◽  
Qinyong Song ◽  
...  
Keyword(s):  
Blood Loss ◽  
Learning Curve ◽  
Clinical Outcomes ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Operation Time ◽  
Operation Duration ◽  
The Mean

Abstract Background The area which located at the medial pedicle, posterior vertebral body and ventral hemilamina is defined as the hidden zone. Surgical management of hidden zone lumbar disc herniation (HZLDH) is technically challenging due to its difficult surgical exposure. The conventional interlaminar approach harbors the potential risk of post-surgical instability, while other approaches consist of complicated procedures with a steep learning curve and prolonged operation time. Objective To introduce microscopic extra-laminar sequestrectomy (MELS) technique for treatment of hidden zone lumbar disc herniation and present clinical outcomes. Methods Between Jan 2016 to Jan 2018, twenty one patients (13 males) with HZLDH were enrolled in this study. All patients underwent MELS (19 patients underwent sequestrectomy only, 2 patients underwent an additional inferior discectomy). The nerve root and fragment were visually exposed using MELS. The operation duration, blood loss, intra- and postoperative complications, and recurrences were recorded. The Visual Analog Scale (VAS), Oswestry Disability Index (ODI), and the modified MacNab criteria were used to evaluate clinical outcomes. Postoperative stability was evaluated both radiologically and clinically. Results The mean follow-up period was 20.95 ± 2.09 (18–24) months. The mean operation time was 32.43 ± 7.19 min and the mean blood loss was 25.52 ± 5.37 ml. All patients showed complete neurological symptom relief after surgery. The VAS and ODI score were significantly improved at the final follow-up compared to those before operation (7.88 ± 0.70 vs 0.10 ± 0.30, 59.24 ± 10.83 vs 11.29 ± 3.59, respectively, p < 0.05). Seventeen patients (81%) obtained an “excellent” outcome and the remaining four (19%) patients obtained a “good” outcome based the MacNab criteria. One patient suffered reherniation at the same level one year after the initial surgery and underwent a transforaminal endoscopic discectomy. No major complications and postoperative instability were observed. Conclusions Our observation suggest that MELS is safe and effective in the management of HZLDH. Due to its relative simplicity, it comprises a flat surgical learning curve and shorter operation duration, and overall results in reduced disturbance to lumbar stability.

Application of Three-dimensional Visualization assisted Ultrasound for Percutaneous Renal Puncture

2020 ◽  
Author(s):  
Zhibin Xu ◽  
Zhenchi Li ◽  
Maomao Guo ◽  
Hao Bian ◽  
Tianli Niu ◽  
...  
Keyword(s):  
Clearance Rate ◽  
3D Visualization ◽  
Three Dimensional ◽  
Operation Time ◽  
Control Group ◽  
Transfusion Rate ◽  
Stone Clearance ◽  
Time Operation ◽  
Postoperative Blood Transfusion ◽  
Experimental Group

Abstract We present here the three-dimensional (3D) visualization fused with ultrasound and to evaluate its clinical application effect preliminarily. One hundred and eighteen patients with renal calculi in our hospital from September 2017 to December 2019 were prospectively randomized into two groups. The experimental group was treated with percutaneous renal puncture guided by the 3D visualization fused with ultrasound. The control group was treated with percutaneous renal puncture guided by B-ultrasonography (B-US). The puncture time, operation time, and the loss of hemoglobin in the experimental group were lower than those in the control group, and the success rate of establishing the channel at one time, and the coincidence rate between the channel and the longitudinal axis of the target renal calyx were higher. The stone clearance rate in the experimental group was higher, while the postoperative blood transfusion rate and interventional embolization rate in the experimental group were significantly lower. The difference was statistically significant (P < 0.05). 3D visualization assisted ultrasound could preliminarily guide precise navigation to puncture tissues, reduced operation time and bleeding, improved stone clearance rate and operation safety.

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