The effect of lumbar spinal surgery history on intradiscal O2-O3 treatment results in patients with lumbar disc herniation

OBJECT In this study, the authors aimed to identify specific risk factors for postdecompression lumbar disc herniation (PDLDH) in patients who have not undergone discectomy and/or fusion. METHODS Between 2007 and 2012, 493 patients with lumbar spinal stenosis underwent bilateral partial laminectomy without discectomy and/or fusion in a single hospital. Eighteen patients (herniation group [H group]: 15 men, 3 women; mean age 65.1 years) developed acute sciatica as a result of PDLDH within 2 years after surgery. Ninety patients who did not develop postoperative acute sciatica were selected as a control group (C group: 75 men, 15 women; mean age 65.4 years). Patients in the C group were age and sex matched with those in the H group. The patients in the groups were also matched for decompression level, number of decompression levels, and surgery date. The radiographic variables measured included percentage of slippage, intervertebral angle, range of motion, lumbar lordosis, disc height, facet angle, extent of facet removal, facet degeneration, disc degeneration, and vertebral endplate degeneration. The threshold for PDLDH risk factors was evaluated using a continuous numerical variable and receiver operating characteristic curve analysis. The area under the curve was used to determine the diagnostic performance, and values greater than 0.75 were considered to represent good performance. RESULTS Multivariate analysis revealed that preoperative retrolisthesis during extension was the sole significant independent risk factor for PDLDH. The area under the curve for preoperative retrolisthesis during extension was 0.849; the cutoff value was estimated to be a retrolisthesis of 7.2% during extension. CONCLUSIONS The authors observed that bilateral partial laminectomy, performed along with the removal of the posterior support ligament, may not be suitable for lumbar spinal stenosis patients with preoperative retrolisthesis greater than 7.2% during extension.

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Microendoscopic Spinal Surgery for Extremely Migrated Lumbar Disc Herniation with Bi-radicular lesion: A Report of Two Cases

Orthopedics & Traumatology ◽

10.5035/nishiseisai.57.221 ◽

2008 ◽

Vol 57 (2) ◽

pp. 221-224

Author(s):

Kanehiro Matsuyama ◽

Fumito Tanabe ◽

Eiji Taketomi ◽

Yasuhiro Ishidou ◽

Takuya Yamamoto ◽

...

Keyword(s):

Lumbar Disc Herniation ◽

Disc Herniation ◽

Spinal Surgery ◽

Lumbar Disc

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

10.21203/rs.3.rs-20031/v1 ◽

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.

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Comparison of the application value of two commonly used minimally invasive spinal surgery in the treatment of lumbar disc herniation

Experimental and Therapeutic Medicine ◽

10.3892/etm.2021.9730 ◽

2021 ◽

Vol 21 (4) ◽

Author(s):

Yingbo Zhang ◽

Jinping Chen ◽

Haiyang Xie ◽

Kui Li ◽

Ye Wang ◽

...

Keyword(s):

Minimally Invasive ◽

Lumbar Disc Herniation ◽

Disc Herniation ◽

Spinal Surgery ◽

Lumbar Disc ◽

Minimally Invasive Spinal Surgery

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DEGREE OF SATISFACTION WITH THE ENDOSCOPIC TREATMENT OF LUMBAR DISC HERNIATION

Coluna/Columna ◽

10.1590/s1808-185120191801185352 ◽

2019 ◽

Vol 18 (1) ◽

pp. 43-46

Author(s):

Cristiano Gatelli ◽

Xavier Soler Graells ◽

Álynson Larocca Kulcheski ◽

Marcel Luiz Benato ◽

Pedro Grein Santoro

Keyword(s):

Lumbar Disc Herniation ◽

Disc Herniation ◽

Endoscopic Surgery ◽

Lumbar Disc ◽

Common Complication ◽

Treatment Results ◽

Level Of Evidence ◽

Degree Of Satisfaction ◽

Endoscopic Lumbar Discectomy ◽

Conventional Open Surgery

ABSTRACT Objective: To evaluate the degree of patient satisfaction and complications after endoscopic surgery for the treatment of lumbar disc herniation. Methods: We retrospectively evaluated 94 patients with lumbar disc herniation undergoing endoscopic lumbar discectomy through the MacNab questionnaire and four subjective questions related to the procedure. Results: Approximately 82% of the patients had good and excellent results, and 91.4% reported being satisfied with the surgical result obtained with endoscopy. The rate of complications with the method was 9.5%, with recurrent disc herniation being the most common complication (5.4% of cases). Conclusions: Endoscopic surgery proved to be an effective and safe method, and an alternative to conventional open surgery. Level of evidence; III. Therapeutic studies - Investigation of treatment results.

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Does the microendoscopic technique reduce mortality and major complications in patients undergoing lumbar discectomy? A propensity score–matched analysis using a nationwide administrative database

Neurosurgical FOCUS ◽

10.3171/2015.10.focus15479 ◽

2016 ◽

Vol 40 (2) ◽

pp. E5 ◽

Cited By ~ 13

Author(s):

Junichi Ohya ◽

Yasushi Oshima ◽

Hirotaka Chikuda ◽

Takeshi Oichi ◽

Hiroki Matsui ◽

...

Keyword(s):

Propensity Score ◽

Lumbar Disc Herniation ◽

Disc Herniation ◽

Spinal Surgery ◽

Lumbar Disc ◽

Lumbar Discectomy ◽

Volume Number ◽

Minimally Invasive Spinal Surgery ◽

Major Complications ◽

Significant Difference

OBJECTIVE Although minimally invasive spinal surgery has recently gained popularity, few nationwide studies have compared the adverse events that occur during endoscopic versus open spinal surgery. The purpose of this study was to compare perioperative complications associated with microendoscopic discectomy (MED) and open discectomy for patients with lumbar disc herniation. METHODS The authors retrospectively extracted from the Diagnosis Procedure Combination database, a national inpatient database in Japan, data for patients admitted between July 2010 and March 2013. Patients who underwent lumbar discectomy without fusion surgery were included in the analysis, and those with an urgent admission were excluded. The authors examined patient age, sex, Charlson Comorbidity Index, body mass index, smoking status, blood transfusion, duration of anesthesia, type of hospital, and hospital volume (number of patients undergoing discectomy at each hospital). One-to-one propensity score matching between the MED and open discectomy groups was performed to compare the proportions of in-hospital deaths, surgical site infections (SSIs), and major complications, including stroke, acute coronary events, pulmonary embolism, respiratory complications, urinary tract infection, and sepsis. The authors also compared the hospital length of stay between the 2 groups. RESULTS A total of 26,612 patients were identified in the database. The mean age was 49.6 years (SD 17.7 years). Among all patients, 17,406 (65.4%) were male and 6422 (24.1%) underwent MED. A propensity score–matched analysis with 6040 pairs of patients showed significant decreases in the occurrence of major complications (0.8% vs 1.3%, p = 0.01) and SSI (0.1% vs 0.2%, p = 0.02) in patients treated with MED compared with those who underwent open discectomy. Overall, MED was associated with significantly lower risks of major complications (OR 0.62, 95% CI 0.43–0.89, p = 0.01) and SSI (OR 0.29, 95% CI 0.09–0.87, p = 0.03) than open discectomy. There was a significant difference in length of hospital stay (11 vs 15 days, p < 0.001) between the groups. There was no significant difference in in-hospital mortality between MED and open discectomy. CONCLUSIONS The microendoscopic technique was associated with lower risks for SSI and major complications following discectomy in patients with lumbar disc herniation.

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