scholarly journals Value of ultrasound-guided transforaminal nerve block in the treatment of lumbar disc herniation

2020 ◽  
Vol 48 (4) ◽  
pp. 030006052091091
Author(s):  
Liu Guang-hui ◽  
Zhu Guang-yu ◽  
Liu Yu-zhang ◽  
Zhu Yong-Tao ◽  
Zhang Shi-min ◽  
...  
Keyword(s):  
Nerve Block ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Japanese Orthopaedic Association ◽  
Lumbar Vertebra ◽  
Control Group ◽  
Study Group ◽  
Ultrasound Guided ◽  
Lumbar Intervertebral Disc

Objective This study was performed to investigate the effectiveness and safety of ultrasound-guided transforaminal nerve block in the treatment of lumbar disc herniation. Methods Sixty patients who underwent treatment for protrusion of a lumbar intervertebral disc in Wangjing Hospital from January 2016 to December 2017 were divided into the study group and the control group. The visual analog scale (VAS) pain scores, the Japanese Orthopaedic Association (JOA) scores of the lumbar vertebra, PRI (pain rating index), and PPI (present pain intensity) were recorded at 30 minutes, 1 week, and 3 months after the operation. Results There were significant differences in the VAS, JOA, PRI, and PPI scores between the study group and control group. Conclusion Ultrasound guidance can improve the efficacy and safety of transforaminal nerve block in the treatment of lumbar disc herniation and shorten the operative duration.

scholarly journals Clinical Study of Radiofrequency Ozone and Injection of Anti-inflammatory Analgesic Solution into the Internal Orifice of Nerve Root Combined with Traditional Chinese Medicine Hook Operation in the Treatment of Lumbar Disc Herniation

2021 ◽  
Author(s):  
WanHai Zhang ◽  
ZhiGang Wang ◽  
JianWei Yin ◽  
YuanYuan Bai ◽  
FengChao Qiu ◽  
...  
Keyword(s):  
Chinese Medicine ◽  
Treatment Group ◽  
Traditional Chinese Medicine ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Nerve Root ◽  
Lumbar Disc ◽  
Control Group ◽  
Lumbar Intervertebral Disc ◽  
Anti Inflammatory

Abstract Background: This study aims to explore the clinical efficacy of radiofrequency ozone and injection of anti-inflammatory analgesic solution into the internal orifice of nerve root combined with traditional Chinese medicine hook operation in the treatment of lumbar disc herniation. Methods: The patients with lumbar disc herniation in our hospital from December 20, 2017 to June 19, 2019 were selected as the main research subjects, and the patients were numbered according to the order of their first visits, and the included patients were divided into treatment group and control group using random number table method. Patients in the treatment group were treated with radiofrequency ozone and injection of anti-inflammatory analgesic solution into the internal orifice of nerve root combined with traditional Chinese medicine hook operation. Patients in the control group were treated with traditional lumbar intervertebral disc radiofrequency treatment. The clinical treatment effects of the two groups were observed. Results: A total of 113 patients were included in this study, of which 73 were in the treatment group and 40 were in the control group. The results of the study showed that the NRS scores of patients in the treatment group before treatment were 5±1.68 points, and the NRS scores were 2±0.78 points, 1±0.54 points, and 1±0.77 points 1 month, 3 months, and 1 year after treatment, respectively. The NRS scores of patients in the control group were 3±0.48 points, 2±0.63 points, and 2±0.85 points 1 month, 3 months, and 1 year after treatment. Compared with before treatment and the control group, there were significant differences (P<0.01). Conclusion: Compared with single lumbar intervertebral disc radiofrequency treatment, radiofrequency ozone and injection of anti-inflammatory analgesic solution into the internal orifice of nerve root combined with hook operation can obtain good short-term and medium-term effects in the treatment of lumbar disc herniation. It is a safe and effective minimally invasive treatment method.

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 Effect of combination of lateral recess decompression by Tessys technique and PTED in patients suffering from contralateral symptoms of lumbar disc herniation

2019 ◽  
Vol 17 ◽  
pp. 205873921882286
Author(s):  
Jingjing Liu ◽  
Han Wu ◽  
Ye Li ◽  
Yifu Sun
Keyword(s):  
Oxidative Stress ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Control Group ◽  
Study Group ◽  
Nerve Function ◽  
Lateral Recess ◽  
Significant Difference ◽  
Contralateral Symptoms

The aim was to explore the effect of lateral recess decompression by percutaneous transforaminal endoscopic spine system (Tessys) technique combined with percutaneous transforaminal endoscopic discectomy (PTED) on pain medium, nerve function and stress response in patients suffering from contralateral symptoms of lumbar disc herniation. A total of 96 patients with contralateral symptoms of lumbar disc herniation treated in our hospital from February 2015 to April 2017 were randomly divided into control group and study group, with 48 cases in each group. The control group underwent PTED, and the study group underwent lateral recess decompression by Tessys technique combined with PTED. The visual analogue scale (VSA) score and Japanese Orthopaedic Association (JOA) score before surgery and 3 months after surgery were compared between the two groups. The levels of serum pain medium (prostaglandin E2 (PGE2), histamine (HA), 5-hydroxytryptamine (5-HT)) and oxidative stress indexes (malondialdehyde (MDA), myeloperoxidase (MPO), superoxide dismutase (SOD), total antioxidant capacity (TAC)) before surgery and 7 days after surgery were compared. The clinical efficacy of the two groups was compared at 1 month after treatment. One month after treatment, the excellent and good rate in the study group was significantly higher than that in the control group (85.4% vs 56.3%; P < 0.05). There was no significant difference between VAS and JOA score in the two groups preoperatively ( P > 0.05). At 3 months after surgery, the VAS score in the study group was significantly lower than that in the control group ( P < 0.05), and the JOA score in the study group was significantly higher than that in the control group ( P < 0.05). There was no significant difference in serum PGE2, HA and 5-HT levels between the two groups preoperatively ( P > 0.05). At 7 days after surgery, the serum PGE2, HA and 5-HT levels in the study group were significantly lower than those in the control group ( P < 0.05). Preoperatively, the levels of serum MDA, MPO, SOD and TAC were not significantly different between the two groups ( P > 0.05). On the seventh day after surgery, the levels of serum MDA and MPO in the study group were significantly lower than those in the control group ( P < 0.05), and the levels of SOD and TAC were significantly higher than those in the control group ( P < 0.05). In conclusion, the combined therapy of lateral recess decompression by Tessys technique and PTED in patients suffering from contralateral symptoms of lumbar disc herniation has a definite clinical effect, which can significantly alleviate the symptoms of low back pain and motor nerve function and reduce the contents of serum pain medium and the levels of oxidative stress. It is worthy of clinical promotion.

scholarly journals The relationship of the shear wave elastography findings of patients with unilateral lumbar disc herniation and clinical characteristics

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Qingyuan Wang ◽  
Hao Zhang ◽  
Jinxin Zhang ◽  
Hanqi Zhang ◽  
Hui Zheng
Keyword(s):  
Sciatic Nerve ◽  
Shear Wave ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Clinical Characteristics ◽  
Lumbar Disc ◽  
Shear Wave Elastography ◽  
Control Group ◽  
Symptom Duration ◽  
Foraminal Stenosis

Abstract Background The aim of this study was to find out whether the shear wave elastography (SWE) findings of patients with unilateral lumbar disc herniation (LDH) were related to clinical characteristics. Methods For this purpose, the study group included patients (N = 20; 13 male, 7 female) with complaints of unilateral sciatica, with foraminal stenosis caused by one level of LDH (L4-L5 or L5-S1). An gender-and age-matched control group (N = 27; 16 male, 11 female) was included. All the patients were examined on both the axial and longitudinal planes bilaterally at the same level using a convex array probe (1- 6 MHz, Supersonic Imagine, Aix en Provence, France). Results The sciatic nerve stiffness measured on longitudinal planes of the affected side was significantly higher than unaffected side (p < 0.001) and the control group (P < 0.05). Furthermore, the symptom duration of unilateral LDH is positively correlated with the stiffness the sciatic nerve (r = 0.52, p = 0.019). Conclusion According to these findings, ultrasound imaging can be considered as a useful tool to detect changes in the sciatic nerve due to disc herniation. This technique will have a promising prospect for many patients with unilateral LDH in monitoring stiffness during rehabilitation and before or after surgery.

scholarly journals Dysfunctional muscle activities and co-contraction in the lower-limb of lumbar disc herniation patients during walking

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Wei Wang ◽  
Hui Wei ◽  
Runxiu Shi ◽  
Leitong Lin ◽  
Lechi Zhang ◽  
...  
Keyword(s):  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lower Limb ◽  
Gait Cycle ◽  
Lumbar Disc ◽  
Lower Limbs ◽  
Heel Strike ◽  
Control Group ◽  
Double Support ◽  
Support Phase

AbstractThis study aimed to investigate lower-limb muscle activities in gait phases and co-contraction of one gait cycle in patients with lumbar disc herniation (LDH). This study enrolled 17 LDH patients and 17 sex- and age-matched healthy individuals. Bilateral muscle activities of the rectus femoris (RF), biceps femoris long head (BL), tibialis anterior (TA), and lateral gastrocnemius (LG) during walking were recorded. The gait cycle was divided into four phases by the heel strike and top off according to the kinematics tracks. Root mean square (RMS), mean frequency (MF), and co-contraction of surface electromyography signals were calculated. The LDH patients showed enhanced BL RMS during the single support phase (SS), second double support phase, and swing phase (SW) as well as decreased MF of RF during SS and of TA and LG during SW (p < 0.05). The co-contraction of the TA-LG was increased in LDH patients than in the control group (p < 0.05). Positive correlations were observed between TA-LG co-contraction (affected side, r = 0.557, p = 0.020; contralateral side, r = 0.627, p = 0.007) and the Oswestry disability index scores in LDH patients. LDH patients have increased BL firing rate and insufficient motor unit recruitment in specific phases in the lower limbs during walking. Dysfunction in LDH patients was associated with immoderate intermuscular co-contraction of the TA-LG during walking.

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 Feasibility and Efficacy of Percutaneous Lateral Lumbar Discectomy in the Treatment of Patients with Lumbar Disc Herniation: A Preliminary Experience

2015 ◽  
Vol 2015 ◽  
pp. 1-6
Author(s):  
Wenjin Jiang ◽  
Bolin Sun ◽  
Qirui Sheng ◽  
Xuepeng Song ◽  
Yanbo Zheng ◽  
...  
Keyword(s):  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Japanese Orthopaedic Association ◽  
Japanese Orthopaedic Association Score ◽  
Lumbar Discectomy ◽  
Analog Scale ◽  
Association Score ◽  
Lumber Disc Herniation

Objective. This study was aimed at evaluating the effectiveness and safety of percutaneous lateral lumbar discectomy (PLLD) in treating patients with lumber disc herniation.Methods. A total of 183 patients with lumbar disc herniation were recruited to receive PLLD surgery from April 2006 to October 2011. All the adverse effects were recorded during the follow-up at 1, 3, 6, and 12 months after PLLD. The clinical outcomes were determined by visual analog scale and Japanese Orthopaedic Association score.Results. The surgery was performed successfully in all patients (102 males and 81 females aged from 21 to 66 years) with a mean 16.6-month follow-up (range from 26 to 65 months). No postoperative complications, including intestinal and vascular complications, nerve injuries, and postoperative infections, were associated with PLLD. At one month after surgery, visual analog scale (3.12±1.44versus6.76±2.31,P<0.05) was significantly lower than the baseline and was sustained until 24 months after surgery (3.25±1.78versus6.76±2.31,P<0.05). Besides that, Japanese Orthopaedic Association score (25.25±3.21versus11.78±2.38,P<0.05) was increased when compared to the baseline.Conclusions. PLLD was a promising, mini-invasive, and effective treatment for lumber disc herniation.

scholarly journals The relationship of the shear wave elastography findings of patients with unilateral lumbar disc herniation and clinical characteristics

2019 ◽  
Author(s):  
qingyuan wang ◽  
jinxin zhang ◽  
hanqi zhang ◽  
hui zheng ◽  
Hao Zhang
Keyword(s):  
Sciatic Nerve ◽  
Shear Wave ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Clinical Characteristics ◽  
Lumbar Disc ◽  
Shear Wave Elastography ◽  
Control Group ◽  
Symptom Duration ◽  
Foraminal Stenosis

Abstract Abstract Background The aim of this study was to find out whether the shear wave elastography (SWE) findings of patients with unilateral lumbar disc herniation (LDH)were related to clinical characteristics . Methods For this purpose,the study group included patients(N=20; 13 male, 7 female) with complaints of unilateral sciatica , with foraminal stenosis caused by one level of LDH (L4-L5 or L5-S1).An gender-and age-matched control group(N=27; 16 male, 11 female) was included.All the patients were examined on both the axial and longitudinal planes bilaterally at the same level using a convex array probe(1- 6MHz,Supersonic Imagine,Aix en Provence,France). Results The sciatic nerve stiffness measured on longitudinal planes of the affected side was significantly higher than unaffected side (p < 0.001)and the control group (P<0.05).Furthermore,the symptom duration of unilateral LDH is positively correlated with the stiffness the sciatic nerve(r=0.52,p=0.019). Conclusion According to these findings, ultrasound imaging can be considered as a useful tool to detect changes in the sciatic nerve due to disc herniation. This technique will have a promising prospect for many patients with unilateral LDH in monitoring stiffness during rehabilitation and before or after surgery. Keywords Ultrasound 、Sciatic nerve、Shear wave elastography、lumbar disc herniation

scholarly journals Analysis of Ultrasound-guided Ilioinguinal and Iliohypogastric Nerve Block in Tension-Free Inguinal Hernia Repair in Elderly Patients

2020 ◽  
Vol 4 (2) ◽  
Author(s):  
Qikai Liao ◽  
Dongmei Xie
Keyword(s):  
Inguinal Hernia ◽  
Elderly Patients ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Nerve Block ◽  
Control Group ◽  
Study Group ◽  
Ultrasound Guided ◽  
Hernia Sac ◽  
Tension Free

Objective: To explore the value of ultrasound-guided ilioinguinal and iliohypogastric nerve block (IINB) in tension-free inguinal hernia repair in elderly patients. Methods: A total of 70 elderly patients with tension-free inguinal hernia repair who treated in the hospital from April 2018 to November 2019 were selected and divided into two groups according to the random number table method, with 35 cases each. The control group underwent infiltration of local anesthesia(LA), and the study group added with IINB. The visual analogue scale (VAS) scores of the two groups of patients were compared. Results: The VAS score of the study group when pulling the hernia sac was lower than that of the control group, and the difference was statistically significant (P<0.05). Conclusion: IINB has good analgesic effect in tension-free inguinal hernia repair in elderly patients, and it is worth promoting.

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