scholarly journals Treatment of adjacent segment disease with percutaneous transforaminal endoscopic discectomy: Early experience and results

2020 ◽  
Vol 28 (3) ◽  
pp. 230949902096056
Author(s):  
Stylianos Kapetanakis ◽  
Nikolaos Gkantsinikoudis ◽  
Grigorios Gkasdaris ◽  
Georgios Charitoudis
Keyword(s):  
Spinal Fusion ◽  
Short Form ◽  
Bodily Pain ◽  
Adjacent Segment Disease ◽  
Adjacent Segment ◽  
Significant Differentiation ◽  
Sf 36 ◽  
Endoscopic Discectomy ◽  
Percutaneous Transforaminal Endoscopic Discectomy

Purpose: Adjacent segment disease (ASD) constitutes a long-term complication of instrumented spinal fusion. Aim of this study is to analyze the utilization of percutaneous transforaminal endoscopic discectomy (PTED) for the treatment of symptomatic ASD, emphasizing basically in the postoperative course. Methods: A prospective study with 35 patients was designed. Patients enrolled in our study were distributed in two different groups. Group A constituted of 15 patients featuring ASD as a complication of a previously conducted lumbar spinal fusion. Group B was composed of 20 patients, presenting simple lumbar disc herniation (LDH). All patients were subjected to successful PTED for LDH. Patients were evaluated at regular intervals in 6-week and 3-, 6-, and 12-month postoperatively. Visual analog scale was utilized for leg (VAS-LP) and low back pain (VAS-BP) evaluation. Health-related quality of life was assessed with short-form 36 health survey questionnaire (SF-36). Results: VAS-BP scores were statistically significantly differentiated between the two groups in all intervals of follow-up. In contrast, VAS-LP scores demonstrated statistically significant differentiation in none of follow-up intervals, indicating similar results between the two groups. Maximal improvement was in both cases for all patients observed in 6-week postoperatively, with subsequent stabilization. SF-36 preoperative evaluation denoted a statistically significant differentiation in bodily pain and role emotional parameters, which was continually until the end of follow-up observed. The other SF-36 parameters featured similar values between the two groups preoperatively as well as during the follow-up intervals. Conclusion: PTED is capable of successfully dealing with LDH and furthermore with complications of fusion as ASD.

Implementation of Percutaneous Transforaminal Endoscopic Discectomy in Competitive Elite Athletes With Lumbar Disc Herniation: Original Study and Review of the Literature

2021 ◽  
Vol 49 (12) ◽  
pp. 3234-3241
Author(s):  
Stylianos Kapetanakis ◽  
Nikolaos Gkantsinikoudis ◽  
Georgios Charitoudis
Keyword(s):  
Elite Athletes ◽  
Lumbar Disc ◽  
Low Back ◽  
Sf 36 ◽  
Endoscopic Discectomy ◽  
Related Quality ◽  
Percutaneous Transforaminal Endoscopic Discectomy ◽  
Health Related

Background: Lumbar disc herniation (LDH) represents a frequent clinical entity in athletes. Surgical treatment of LDH with endoscopic spine surgical techniques has been proposed as a feasible alternative in these patients. Purpose: To study the particular outcomes of percutaneous transforaminal endoscopic discectomy (PTED) in competitive elite athletes with surgically treatable LDH. Study Design: Case series; Level of evidence, 4. Methods: A total of 55 competitive elite athletes with diagnosed LDH based on clinical and radiologic criteria were enrolled in this prospectively designed study. All patients underwent successful PTED. Clinical evaluation was conducted with the well-established visual analog scale for lower limb and low back pain separately. The 36-Item Short Form Health Survey (SF-36) was implemented for health-related quality of life analysis. Patients were assessed preoperatively and at regular postoperative intervals: 6 weeks and 3, 6, and 12 months, as well as 2 years. Results: Operated levels were L3-L4 (5.5%), L4-L5 (69.1%), and L5-S1 (25.4%). No major perioperative complications were observed. All patients successfully reached the end of follow-up at 2 years. Both visual analog scale scores (lower limb and low back pain) showed clinically and statistically significant improvement at 6 weeks postoperatively, with subsequent minor improvement and stabilization. All recorded SF-36 parameters demonstrated major clinical amelioration at 6 weeks, with subsequent minor but constant statistically significant improvement until the end of follow-up. Comparative evaluation of the SF-36 revealed that the physical function, bodily pain, role-emotional, and mental health parameters showed quantitatively greater improvement in comparison with rest indices. Conclusion: PTED constitutes a feasible and effective technique for surgical management of LDH in athletes, providing favorable outcomes in terms of postoperative pain and health-related quality of life. Proper performance of technique for specific cases of L5-S1 LDH may be more challenging, and these cases should be evaluated selectively for suitability for this procedure.

scholarly journals Use of osteogenic protein–1 in spinal fusion: literature review and preliminary results in a prospective series of high-risk cases

2002 ◽  
Vol 13 (6) ◽  
pp. 1-6 ◽  
Author(s):  
Preneshlin V. Govender ◽  
Yoga R. Rampersaud ◽  
Lynda Rickards ◽  
Michael G. Fehlings
Keyword(s):  
Risk Factors ◽  
Spinal Fusion ◽  
Short Form ◽  
Outcome Measurement ◽  
Heavy Smoking ◽  
Medical Risk ◽  
Medical Risk Factors ◽  
Sf 36 ◽  
Osteogenic Protein

Object The safety and effectiveness of osteogenic protein (OP)–1 putty (recombinant human bone morphogenetic protein–7) in promoting fusion in complex spinal cases was studied in nine cases. Methods The authors prospectively evaluated nine patients requiring spinal fusion in whom there were medical risk factors that would inhibit osseous fusion. Intraoperatively the OP-1 putty mixed with autologous bone was placed at the fusion site. Outcome measurement instruments were used to provide information on patient demographics, comorbidities, and pain. The Short Form (SF)–36 questionnaire and Oswestry Disability Index (ODI) were administered pre- and postoperatively. All patients underwent routine radiography of the surgery site during follow-up examination. The age of the five women and four men ranged from 21 to 74 years (mean height 1.6 m, mean weight 76.7 kg). Risk factors included mucopolysaccharide syndrome, adrenal insufficiency, rheumatoid arthritis with chronic corticosteroid use, morbid obesity, and heavy smoking. Surgery, which consisted of five cervical and four lumbar procedures, including intradural surgery in three patients, was uneventful in all cases without perioperative complication. The follow-up period ranged from 1 to 15 months (mean 5.22 months). The ODI score changed from severe disability (mean 46.89) pre-operatively to minimal and moderate disability (mean 34.56) postoperatively. The SF-36 survey showed overall improved mental and physical health scores. Fusion was present in all patients with greater than 3 months follow up. Conclusions The OP-1 putty appears to be safe and effective in promoting spinal arthrodesis in patients in whom adverse medical risk factors exist.

The Impact of Tinnitus on Quality of Life in Older Adults

2007 ◽  
Vol 18 (03) ◽  
pp. 257-266 ◽  
Author(s):  
David M. Nondahl ◽  
Karen J. Cruickshanks ◽  
Dayna S. Dalton ◽  
Barbara E.K. Klein ◽  
Ronald Klein ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Short Form ◽  
Linear Trend ◽  
Bodily Pain ◽  
Calidad De Vida ◽  
Sf 36 ◽  
The Impact

Few population-based data exist to assess the impact of tinnitus on quality of life. As part of the Epidemiology of Hearing Loss Study, self-reported data on tinnitus and quality of life were obtained by interview at the first follow-up examination (1998–2000; N = 2800; ages 53–97 years). The Medical Outcomes Study Short Form Health Survey (SF-36) was used to assess quality of life. Adjusted mean SF-36 scores decreased (worsened) with increasing tinnitus severity (None, Mild, Moderate, Severe) for the Role-Physical, Bodily Pain, Vitality, and Mental Health domains, and the Physical Component Summary scale (F-tests for linear trend, p < .05). Scores tended to be lower for those who first reported tinnitus at the follow-up (five-year incidence of tinnitus) compared to those who reported tinnitus at the baseline and follow-up examinations (prevalent tinnitus). This study documents clear associations between tinnitus and reduced quality of life in this large cohort of older adults. Existen pocos datos con base poblacional para evaluar el impacto del acúfeno sobre la calidad de vida. Como parte de un Estudio de Epidemiología de los Trastornos Auditivos, se obtuvieron datos de auto-reporte sobre el acúfeno y la calidad de vida por medio de entrevistas en el primer examen de seguimiento (1998-2000; N = 2800; edades: 53'97 años). La Encuesta de Salud de Fórmula Corta (SF-36) del Estudio de Resultados Médicos (MOS) fue utilizado para evaluar la calidad de vida. Los puntajes medios ajustados de la SF-36 disminuyeron (se deterioraron) conforme aumentó la severidad del acúfeno (Ninguno, Leve, Moderado, Severo) en las áreas de Papel Físico, Dolor Corporal, Vitalidad, y Salud Mental, y de acuerdo a la Escala Resumen de Componente Físico (Prueba F para tendencias lineales, p < 0.05). Los puntajes tendieron a ser más bajos para aquellos que reportaron el acúfeno en la cita de seguimiento (una incidencia de cinco años del acúfeno) comparados con aquellos que reportaron el acúfeno al inicio y en el seguimiento (acúfeno prevalente). Este estudio documenta una clara asociación entre el acúfeno y una reducción en la calidad de vida, en esta grande cohorte de adultos mayores.

scholarly journals Long-Term Residual-Mobility and Adjacent Segment Disease After Total Lumbar Disc Replacement

2020 ◽  
pp. 219256822093581
Author(s):  
Joep Kitzen ◽  
Timon F. G. Vercoulen ◽  
Martijn G. M. Schotanus ◽  
Sander M. J. van Kuijk ◽  
Nanne P. Kort ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Spinal Fusion ◽  
Adjacent Segment Disease ◽  
Disc Replacement ◽  
Adjacent Segment ◽  
Segmental Motion ◽  
Flexion Extension ◽  
Patient Reported

Study Design: Retrospective cohort study. Objectives: Total disc replacement (TDR) has been introduced in order to preserve segmental motion and thus reduce adjacent segment disease (ASD) as seen after spinal fusion. However, it is uncertain whether these presumed beneficial effects remain. The aim of this study was to evaluate the long-term incidence of ASD and residual-mobility in relation to clinical outcome. Methods: A total of 210 patients treated with lumbar TDR for degenerative disc disease were invited for follow-up. ASD was reported in case of severe degeneration in an adjacent disc at latest follow-up, or if an increase in disc degeneration was observed in these adjacent segments as compared to direct postoperative radiographs. Residual-mobility of the TDR was defined as a minimal rotation of 4.6° on flexion-extension radiographs. Patient-reported outcome measures were obtained. Results: Fifty-seven patients (27.1%) were lost to follow-up. In 32 patients (15.3%) a revision by spinal fusion had been performed. In 20 patients this revision had occurred ≥5 years after TDR and were included. Consequently, 141 patients were available for analysis (mean follow-up of 16.7 years). Residual-mobility was noted in 38.0%. No significant associations were observed between residual-mobility and the occurrence of ASD, or with clinical outcome. In addition, ASD and clinical outcome were not related either. Conclusions: It appears that long-term preservation of motion after TDR is met for only a third of patients. However, residual-mobility is not associated with the occurrence of ASD, and both residual-mobility and ASD do not appear to be related to long-term clinical outcome.

Seven-Year Follow-up of Matrix-Induced Autologous Implantation in Talus Articular Defects

2017 ◽  
Vol 11 (2) ◽  
pp. 133-137 ◽  
Author(s):  
Christopher Kreulen ◽  
Eric Giza ◽  
Judie Walton ◽  
Martin Sullivan
Keyword(s):  
Short Form ◽  
Bodily Pain ◽  
Case Series ◽  
Osteochondral Lesions ◽  
Clinical Evaluations ◽  
Sf 36 ◽  
Chondrocyte Implantation ◽  
Prospective Case Series ◽  
American Orthopaedic

Background. Osteochondral lesions of the talus (OLT) are difficult to treat because of the poor intrinsic healing capability of articular cartilage. Matrix-induced autologous chondrocyte implantation (MACI) has been shown to be a reliable method for treating cartilage lesions that fail to respond to traditional microfracture and debridement. The purpose of this study was to assess 7-year clinical follow-up data of this technique and demonstrate midterm success of this implant. Methods. A prospective investigation of MACI was performed on 10 patients with OLTs who had failed previous arthroscopic treatment. In all, 5 male and 5 female patients were included in the study. Of the 10 patients, 9 were available for 7-year follow-up. Functional and clinical evaluations were done at 7 years postoperatively using the American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot evaluation and the Short Form Health Survey (SF-36) and compared with preoperative values. Results. SF-36 data at 7 years showed significant improvements in Physical Functioning (P < .01), Lack of Bodily Pain (P < .1), and Social Functioning (P < .001) compared with preoperative data. The mean AOFAS hindfoot scores of the 9 patients at 7 years was 78.3 ± 18.1 (P = .05) compared with their preoperative mean of 61.8 ± 14.3. Conclusions. MACI provides a stable midterm chondral replacement strategy for osteochondral lesions that fail initial microfracture. Levels of Evidence: Level IV: Prospective case series

Comparing durability of water- and land-based exercise benefits among older adults in South Korea: A randomized controlled trial with 1-year follow-up

2021 ◽  
pp. 1-11
Author(s):  
Se Jun Oh ◽  
Sang Heon Lee
Keyword(s):  
Exercise Intervention ◽  
External Rotation ◽  
Short Form ◽  
Controlled Trial ◽  
Weight Bearing ◽  
Aquatic Exercise ◽  
Step Test ◽  
Sf 36 ◽  
Partial Weight

BACKGROUND: Aquatic exercise can improve strength, flexibility, and aerobic function while safely providing partial weight-bearing support through viscosity and buoyancy. OBJECTIVE: The aim of the present study was to compare the effects of water-based exercise with land-based exercise before and after a 10-week exercise intervention and again at one-year follow-up. METHODS: Eighty participants aged 65 years and older were randomly assigned to either a water- or a land-based 10-week exercise program. Assessment included the Senior Fitness Test (SFT), the Modified Falls-Efficacy Scale, and the 36-Item Short-Form Health Survey (SF-36). Hip and knee strength was also measured. All assessments were completed at three time points: pre- (T1), post- (T2), and at 1-year follow-up (T3). RESULTS: Significant differences were observed between the two groups on three parameters: the SFT timed up-and-go test; lower hip muscle strength in extension, adduction, and external rotation; and quality of life (QoL) measured by the SF-36 (p< 0.05). No significant differences were observed in the SFT chair stand test, dominant arm curl test, two-minute step test, chair sit-and-reach test, back scratch test, and Modified Falls-Efficacy Scale. CONCLUSION: Aquatic exercise provided greater improvement of physical health and QoL among older people than land-based exercise.

EVALUATION OF QUALITY OF LIFE IN BRACHIAL PLEXUS INJURY PATIENTS AFTER RECONSTRUCTIVE SURGERY

Hand Surgery ◽  
2006 ◽  
Vol 11 (03) ◽  
pp. 103-107 ◽  
Author(s):  
Izuru Kitajima ◽  
Kazureru Doi ◽  
Yasunori Hattori ◽  
Semih Takka ◽  
Emmanuel Estrella
Keyword(s):  
Quality Of Life ◽  
Brachial Plexus ◽  
Upper Extremity ◽  
Brachial Plexus Injury ◽  
Short Form ◽  
Bodily Pain ◽  
Summary Score ◽  
Joint Function ◽  
Sf 36

To evaluate the subjective satisfaction of brachial plexus injury (BPI) patients after surgery based on the medical outcomes study 36-item short form health survey (SF-36) and to correlate their SF-36 scores with upper extremity functions. Four items were assessed statistically for 30 patients: SF-36 scores after BPI surgery were compared with Japanese standard scores; the correlation between SF-36 scores and objective joint functions; difference in SF-36 scores between each type of BPI; and influence of each joint function on the SF-36 scores. The SF-36 subscale: PF — physical functioning, RP — role-physical, BP — bodily pain, and the summary score PCS — physical component summary, were significantly inferior to the Japanese standard scores. SF-36 is more sensitive to shoulder joint function than to elbow and finger joint functions. Little correlation was found between SF-36 scores and objective evaluations of joint functions. Greater effort is needed to improve the quality of life (QOL) of BPI patients. This study showed that SF-36 is not sensitive enough to evaluate regional conditions. A region- or site-specific questionnaire is required to evaluate upper extremity surgery.

Sign in / Sign up

Export Citation Format

Share Document