scholarly journals OUTCOMES OF SURGICAL TREATMENT OF LUMBAR DISK HERNIATION USING AN ANNULAR CLOSURE DEVICE

2018 ◽  
Vol 17 (3) ◽  
pp. 188-194 ◽  
Author(s):  
Abdugafur Jabborovich Sanginov ◽  
Aleksandr Vladimirovich Krutko ◽  
Evgenii Sergeevich Baykov ◽  
Anatoliy Andreevich Lutsik

ABSTRACT Objective: The aim of the study was to investigate the clinical and radiological results of using the annular closure device in patients with lumbar disc herniation (LDH). Methods: The study involved 120 patients with LDH operated on by limited discectomy and annular closure using the Barricaid device. A literature review was conducted to evaluate the effectiveness of the annuloplasty. Results: All patients showed postoperative regression of the radicular pain syndrome and were mobilized on the day of surgery. The correlation between the removed nucleus pulposus and changes in DHI was studied by linear regression. The results revealed that disc height loss is directly correlated with the volume of removed nucleus pulposus (p <0.05). Modic changes were present in 22 (22%) patients. Endplate changes (resorption and erosion) were present in 25 patients (20.7%). We found that these changes in MR and CT images have no effect on the clinical presentation of the disease. No intraoperative complications, such as severe hemorrhage requiring blood transfusion, or injury to the dura mater or nerve roots, were observed in our case series. Postoperative complications occurred in 3 (2.5%) patients. The reoperation rate was 4.2%. Conclusions: The use of the Barricaid annular closure device in 120 patients with lumbar disc herniation and high risk of recurrent herniation showed good clinical and radiographic outcomes. The reoperation rate in our study was 2.5%; disc reherniation at the operated level was observed in 1.7% of patients. This is a good outcome compared to the data reported for patients having a high risk of disc reherniation. Level of Evidence IV; Case series.

2021 ◽  
Vol 4 (12) ◽  
pp. e2136809
Author(s):  
Claudius Thomé ◽  
Adisa Kuršumović ◽  
Peter Douglas Klassen ◽  
Gerrit J. Bouma ◽  
Richard Bostelmann ◽  
...  

2019 ◽  
Vol 12 (2) ◽  
pp. 139-146
Author(s):  
Mladen E. Ovcharov ◽  
Iliya V. Valkov ◽  
Milan N. Mladenovski ◽  
Nikolay V. Vasilev

Summary Lumbar disc herniation (LDH) is the most common pathology in young people, as well as people of active age. Despite sophisticated and new minimally invasive surgical techniques and approaches, reoperations for recurrent lumbar disc herniation (rLDH) could not be avoided. LDH recurrence rates, reported in different studies, range from 5 to 25%. The purpose of this study was to estimate the recurrence rates of LDH after standard discectomy (SD) and microdiscectomy (MD), and compare them to those reported in the literature. Retrospectively, operative reports for the period 2012-2017 were reviewed on LDH surgeries performed at the Neurosurgery Clinic of Dr Georgi Stranski University Hospital in Pleven. Five hundred eighty-nine single-level lumbar discectomies were performed by one neurosurgeon. The diagnoses of recurrent disc herniation were based on the development of new symptoms and magnetic resonance/computed tomography (MRI/CT) images showing compatible lesions in the same lumbar level as the primary lumbar discectomies. The recurrence rate was determined by using chi-square tests and directional measures. SD was the most common procedure (498 patients) followed by MD (91 patients). The cumulative reoperation rate for rLDH was 7.5%. From a total number of reoperations, 26 were males (59.1%) and 18 were females (40.9%). Reoperation rates were 7.6% and 6.6% after SD and MD respectively. The recurrence rate was not significantly higher for SD. Our recurrence rate was 7.5%, which makes it comparable with the rates of 5-25% reported in the literature.


2019 ◽  
Vol 3 (4) ◽  
Author(s):  
Kenan Hao ◽  
Huan Liu ◽  
Yang Yang ◽  
Qingle Zeng ◽  
Xiaofeng He

PURPOSE: To investigate the sub-types of lumbar disc herniation, compare efficacies of ozone treatment in various types of lumbar disc herniation and analyze the mechanisms. MATERIAL AND METHODS: A total of 250 patients (159 males, 91 females; age range: 14 - 85 years) diagnosed of lumbar disc herniation from January 2009 to Jun 2014 in Nanfang Hospital were enrolled. Disc Lesions, classified by Magnetic Resonance examinations and images when injecting ozone under Digital Subtraction Angiography, were divided into four types: type I: Non-prominent nucleus pulposus with ruptured fibre ring; type II: Prominent nucleus pulposus with ruptured fibre ring; type III: Non-prominent nucleus pulposus with Non-ruptured fibre ring; type IV: Prominent nucleus pulposus with Non-ruptured fibre ring. All patients underwent intradiscal and paravertebral injection of oxygen-ozone. Visual Analogue Scale (VAS) weighted score was administered for the measurement of low back pain before treatment, and the evaluation of efficacy respectively at 1 week, 1 month, 6 month and 12 month follow-up period. RESULTS: Most of the patients (about 4/5) showed better response to ozone treatment. Herniated disc shrinkage was obtained among type II and IV. The type II had the most reduction of average score while the type III had the least. The proportion of patients who had once experienced pain relief at the follow up interval, namely the curative efficacy, showed significant difference: type I occupied the most, type IV occupied the least. CONCLUSION: Ozone treatment is effective and safe for all types of lumbar disc herniation, but efficacy varies according the types, of which type I has the best results and type IV has the worst ones.


2013 ◽  
Vol 41 (05) ◽  
pp. 983-994 ◽  
Author(s):  
Wei Zhang ◽  
Wei Guo ◽  
Ping Zhao ◽  
Wei Zhou ◽  
Jie Wei ◽  
...  

A clinical study was conducted in 72 lumbar disc herniation (LDH) patients and 40 asymptomatic subjects to evaluate the efficacy of Feng's spinal manipulation (FSM). FSM was performed twice a week for less than 20 days. Changes in the symmetrical index of spinal column (SISC) and quantified symptom index (QSI) before and after FSM in both groups were collected. The QSI consisted of the visual analogue scale (VAS), score of the Japanese Orthopedic Association, and straight leg raising test, for measurement of pain perception, dysfunction of lower limb extension or flexion, and symptomatic relief. A correlation analysis was conducted to compare the difference in protruded nucleus pulposus size using computerized projection grating profilometry, SISC, and QSI before and after the therapy. The results showed that the SISC and QSI significantly decreased after treatment in the LDH group (p < 0.01). The SISC before and after treatment was closely correlated with the improvement of QSI, although there was no change in protruded nucleus pulposus following the therapy. Among the five components in SISC, the LR was found to be an ideal indicator for evaluation of the real circumstances in LDH patients. Our data suggested that FSM achieved satisfactory therapeutic effects in relieving the symptom of LDH while no effects were observed in asymptomatic subjects.


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