A study to investigate the effectiveness of mechanical traction in treating people with lower back pain and sciatica caused by a herniated lumbar disc

2018 ◽  
Author(s):  
Sally Cinnamond
Electronics ◽  
2021 ◽  
Vol 10 (8) ◽  
pp. 982
Author(s):  
Wafa Mbarki ◽  
Moez Bouchouicha ◽  
Frederick Tshibasu Tshienda ◽  
Eric Moreau ◽  
Mounir Sayadi

A frequent cause of lower back pain presenting with leg pain is a herniated lumbar intervertebral disc. A herniation or a herniated lumbar disc is a change of position of disc material (nucleus pulpous or annulus fibrosis). Usually, the lower back pain goes away within days or weeks. Regular treatment techniques for lower back pain include medication, exercises, relaxation methods and surgery. Back pain and back problems regularly occur in the lumbar region. The spinal canal is made up of vertebrae; each one protects the spinal nerves. Intervertebral discs and facet joints connect the vertebrae above and below. Groups of muscles and ligaments hold the vertebrae and the discs together. Muscles support the spine and the body weight, and they allow us to move. Pressure can result in excessive wear and tear of the other structures. For example, a common problem in the lower back is disc herniation. In this case, pressure on an intervertebral disc makes its center, the nucleus pulposus, protrude backwards and push against the spinal nerves, leading to lower back pain. Detection and classification are the two most important tasks in computer aided diagnosing systems. Detection of a herniated lumbar disc from magnetic resonance imaging (MRI) is a very difficult task for radiologist. The extraction of herniated discs has been achieved by different approaches such as active contours, region growing, watershed techniques, thresholding and deep learning. In this study, to detect intervertebral disc from axial MRIs we develop a method using generative adversarial networks (GANs), especially the CycleGAN model, to automatically generate and detect intervertebral disc and to classify the type of the herniated lumbar disc such as foraminal or median. We propose to explore the importance of axial view MRI to determine the herniation type. Accurately, GANs and other generative networks have created several ways to tackle different problems well known and challenging of medical image analysis, such as segmentation, reconstruction, data simulation, medical image de-noising, and classification. Moreover, their efficiency to synthesize images and data at unprecedented levels of realism also gives hope that the chronic scarcity of labeled data in the medical field can be resolved with the help of these generative models. In our case, having a database that contains several images is a very difficult task. In this paper, we put forward a new approach based on GANs, in order to solve the problem of lumbar intervertebral disc images reduction. This method is based especially on CycleGAN. Consequently, the essential objective of our work is to generate and automatically classify the herniation type as foraminal or median using GANs. Our computer aided diagnosis (CAD) system achieved a 97.2% accuracy on our dataset. This result represents a very high-performance results by providing the state of the art and our work utilizing the GANs technique. Our CAD is very effective and efficient for classifying herniations of lumbar intervertebral discs. Therefore, the contribution of this study appears in: firstly, the use of the CycleGAN model based on convolutional layers to detect and classify the herniation type (median or foraminal) in lumbar intervertebral discs, secondly, the use of axial view MRI in order to classify the type of the herniated intervertebral disc. The main objective of this paper is to help radiologists automatically recognize and classify herniated lumbar discs.


2017 ◽  
Vol 2017 ◽  
pp. 1-10 ◽  
Author(s):  
Sang Ho Moon ◽  
Jae Il Lee ◽  
Hyun Seok Cho ◽  
Jin Woo Shin ◽  
Won Uk Koh

Background. Lower back pain is a common reason for disability and the most common cause is lumbar disc herniation. Percutaneous epidural adhesiolysis has been applied to relieve pain and increase the functional capacity of patients who present this condition.Objectives. In this study, we retrospectively evaluated the factors which predict the outcome of percutaneous epidural adhesiolysis in patients who were diagnosed with lumbar disc herniation.Methods. Electronic medical records of patients diagnosed with lumbar disc herniation who have received percutaneous epidural adhesiolysis treatment were reviewed. The primary outcome was the factors that were associated with substantial response of ≥4 points or ≥50% of pain relief in the numerical rating scale pain score 12 months after the treatment.Results. Multivariate logistic regression analysis demonstrated that the presence of high-intensity zone (HIZ) at magnetic resonance imaging was a predictor of substantial response to percutaneous epidural adhesiolysis for 12 months (P=0.007). The presence of a condition involving the vertebral foramen was a predictor for unsuccessful response after 12 months (P=0.02).Discussion and Conclusion. The presence of HIZ was a predictor of favorable long-term outcome after percutaneous epidural adhesiolysis for the treatment of lower back pain with radicular pain caused by lumbar disc herniation.


2020 ◽  
Vol 27 (03) ◽  
pp. 506-510
Author(s):  
Ramesh Kumar ◽  
Asim Rehmani ◽  
Qazi Muhammad Zeeshan ◽  
Atiq Ahmed Khan ◽  
Shiraz Ahmed Gauri ◽  
...  

Objectives: In our study we evaluate the hyperuricemia levels in patients presenting to us with the chief complaint of chronic lower back pain and determine the associations with age, gender and radiographic findings. Study Design: Cross sectional study. Setting: Dow University of Health Science Civil Hospital Karachi. Period: From April 2017 to September 2017. Material & Methods: Patients with lower back pain of a duration longer than three months and between the ages of 18 and 70 years were included. A complete history and physical examination was done for all the patients including relevant laboratory, radiographic and anthropometric measurements. The neurosurgeon also assessed the patient’s lower back pain and associated findings in the lower limbs. The patients also underwent radiographic evaluations via X-rays and Magnetic resonance imaging. Data were analyzed using IBM SPSS statistical software version 20. We considered a p value of < 0.05 to be statistically significant. Results: The final study population consisted of n= 110 patients of which n= 54 were males and n= 56 were females. Of the total patient population of the study n= 31 (28.18%) had increased serum uric acid and had nearly equal incidence in males and females (27.77% and 28.57% respectively). The highest incidence of hyperuricemia was found patients between 26 and 60 years of age. In our study n= 22 patients did not have any comorbid condition while joint pain was found in n= 24 patients (p-value of <0.05) of these patients they suffered from pain in their knees and tarsal joints. Lumbar disc prolapse was found in n= 21 patients (p-value of <0.05), lumbar disc degeneration was found in n= 16 patients (p-value of <0.0579). Furthermore, disc space narrowing was found in n= 27 patients having a p-value of <0.05. Conclusion: According to the results of our study hyperuricemia is found in one of every four with low back pain. There is a variable association between comorbid conditions and hyperuricemia. While an equal association is found between gender and hyperuricemia. There is also a strong association of hyperuricemia with joint space narrowing and lumbar disc narrowing of the lumbar vertebrae and it augments degenerative spondylolisthesis.


Author(s):  
Yeh-Chan Kao ◽  
Ji-Ying Chen ◽  
Hsi-Han Chen ◽  
Kuang-Wen Liao ◽  
Shiau-Shian Huang

Objective Chronic lower back pain induced by lumbar disc degeneration or herniation exerts a great impact on patients’ daily lives. Depression and anxiety often exist among patients with lower back pain. Some studies mentioned about mechanisms, such as inflammatory biomarkers, which are commonly seen in herniated intervertebral disc (HIVD) and major depressive disorder (MDD). Method: Our study used a large database from the National Health Insurance to explore the incidence rate of MDD in patients with HIVD and correlated risk factors. A total of 41,874 patients with HIVD were included in this work. The control group was matched by using propensity scores. Results: The results showed a temporal association between prior HIVD and subsequent MDD after adjusting for potential confounding factors. Patients with HIVD were at high risk of developing MDD (hazard ratio, HR: 9.00, 95% confidence interval, CI: 7.196–11.257) even after adjusting for demographic characteristics and comorbidities (HR: 8.47, 95% CI: 6.84–10.49, p < 0.0001). Conclusions: The combination of HIVD and MDD represents an important health problem that is associated with higher disability rates, socioeconomic disadvantage, and greater utilization of health care resources. Early detection and combined treatment of depressive symptoms may benefit patients with HIVD.


2021 ◽  
Author(s):  
Song Guo ◽  
Kai Zhu ◽  
Fu Qiang ◽  
Meiju Yan ◽  
Donghua Hang

Abstract Background Oxidative stress has been considered a critical mediator in the pathogenesis of lumbar disc degeneration, which can lead to the severe lower back pain. Inhibition of the excessive oxidative stress has become a therapeutic target for controlling discogenic lower back pain. Recently, more studies have shown that holmium laser can effectively suppress oxidative stress. This work aims to study the clinical outcomes of percutaneous full-endoscopy spine surgery combined with holmium laser for treating symptomatic lumbar disc degeneration (IDD). Methods We designed and conducted a retrospective study on the patients with lumbar disc herniation who had been treated by percutaneous full-endoscopy spine surgery at Shanghai General Hospital from June 2018 to March 2020. The patients were divided into group A (holmium laser treatment group) and group B (Elliquence radiofrequency group) according to the medical record. Operation time and hospitalization time of both groups were recorded and compared. Additionally, VAS scores and ODI scores were used to evaluate the lower back pain, lower extremity radiation pain and quality of life before and 3 days, 6 months, and 12 months after surgery. Results Forty-five patients were included in group A while the other 55 patients were included in group B. Operation time of group A was significantly shorter than that of group B (40.60±5.59 minutes vs. 50.80±3.19 minutes). VAS scores of lower back pain and lower extremity radiation pain at postoperative 3 days, 6 months, and 12 months were significantly lower than those before surgery in both groups. The postoperative lower back pain VAS scores of group A were significantly lower than those of group B, while the postoperative lower extremity radiation pain VAS scores had no significant difference between both groups. The ODI scores of both groups at postoperative 3 days, 6 months, and 12 months were significantly lower than those before surgery. Conclusions These findings confirmed that application of holmium laser can significantly improve the clinical outcomes in percutaneous full-endoscopy spine surgery.


2010 ◽  
Vol 38 (9) ◽  
pp. 24
Author(s):  
ELIZABETH MECHCATIE
Keyword(s):  

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