Clinical Effectiveness of Percutaneous Full-endoscopy Spine Surgery Combined With Holmium Laser in the Treatment of Lumbar Disc Herniation

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.

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Application of continuous epidural anesthesia in transforaminal lumbar endoscopic surgery: a prospective randomized controlled trial

Journal of International Medical Research ◽

10.1177/0300060518817218 ◽

2019 ◽

Vol 47 (3) ◽

pp. 1146-1153 ◽

Cited By ~ 1

Author(s):

Tiantong Xu ◽

Rong Tian ◽

Pan Qiao ◽

Zhihua Han ◽

Qingfeng Shen ◽

...

Keyword(s):

Back Pain ◽

Lower Back Pain ◽

Epidural Anesthesia ◽

Leg Pain ◽

X Ray ◽

Lower Back ◽

Group A ◽

Vas Scores ◽

Group B ◽

Surgical Duration

Objective This study aimed to compare intraoperative lower back pain and leg pain, surgical time, and intraoperative X-ray dose in patients offered local infiltration anesthesia or continuous epidural anesthesia for transforaminal endoscopic spine system (TESSYS) surgery. Methods A total of 98 patients who received TESSYS treatment for single-segmental lumbar disc herniation were included, and were randomly divided into two groups: group A (49 cases; local infiltration anesthesia) and group B (49 cases; continuous epidural anesthesia). Surgical duration, intraoperative X-ray dose, and visual analog scale (VAS) scores of lower back pain and leg pain before surgery, during surgery, and 48 h after surgery were recorded and compared. Results After surgery, the VAS scores of both lower back pain and leg pain decreased in group A, and similar findings were found in group B. Group B had a shorter surgical duration, lower intraoperative X-ray dose, and lower intraoperative VAS scores of lower back pain and leg pain compared with group A. Conclusion Compared with local infiltration anesthesia, continuous epidural anesthesia was more effective for pain relief during TESSYS for single-segmental lumbar disc herniation, and also contributed to a shorter surgical duration and lower X-ray exposure.

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Influence of postoperative adhesions after caesarean section on chronic lower back pain – A pilot study of osteopathic manipulative treatment.

European Journal of Osteopathic Research ◽

10.35740/ejor.2019.1.1.5 ◽

2019 ◽

Vol 1 (1) ◽

pp. 38-46

Author(s):

Michaela Liedler ◽

Gebhard Woisetschläger

Keyword(s):

Back Pain ◽

Caesarean Section ◽

Pain Intensity ◽

Lower Back Pain ◽

Postoperative Treatment ◽

Chronic Lower Back Pain ◽

Postoperative Adhesions ◽

Lower Back ◽

Group A ◽

Group B

Background: Despite the prevalence of abdominal adhesions after a caesarean section, there exist few postoperative treatment approaches which specifically target adhesions or establish their connection with chronic lower back pain (cLBP). Aims: To investigate if the osteopathic approach of treating adhesions after a caesarean section reduces existing cLBP symptoms and alleviates associated pain. Methods: The subjects received two 30-minute treatments with a one week pause between treatments. The intervention group A (n=18), those who received osteopathic treatment, were compared to a control group B (n=16), who received scar treatment using traditional physiotherapy. The evaluation of subjective (pain intensity with a numeric rating scale, or NRS) and objective (symptom evaluation using the Oswestry Low Back Pain Questionnaire) parameters was accomplished using questionnaires before and after the treatments. Results: Pain intensity reduced clinically relevant in group A by MA21=-2.6; SDA21=1.33 on the NRS. The average Oswestry Disability Index (ODI) in group A decreased from M1=18.3%; SD1=7.8 to M2=6.2%; SD2=6.2. In group B, the decrease from M1=19.1%; SD1=11.1 to M2=14.0%; SD2=10.1 was significantly smaller (p=0,005). Conclusions: Postoperative adhesions could cause cLBP. Treatment of adhesions using oste-opathy results in a significant reduction of pain symptoms for cLBP. Due to the sample size calculation, further studies addressing adhesions and chronic lower back pain would be rec-ommended. Keywords: peritoneal adhesions; visceral adhesions; caesarean section; chronic lower back pain (cLBP)

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Efficacy of Integrated Neuromuscular Inhibition Technique Versus Mulligan Mobilization on Pain and Functional Disability in Subjects with Non-Specific Low Back Pain –A Research Protocol

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2021/v33i45a32719 ◽

2021 ◽

pp. 99-104

Author(s):

Neha Chitale ◽

Deepali Patil ◽

Pratik Phansopkar

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Lower Back Pain ◽

Functional Disability ◽

Rating Scale ◽

Low Back ◽

Lower Back ◽

Group A ◽

Group B ◽

Inhibition Technique

Introduction: Pain in lower back region is a problem everyone deals with at least once in their life. Chronic back pain in lower back region is the pain which is present for more than 3 months. We can divide lower back pain as specific back pain or non-specific back pain. Non-specific pain in lower back region is because of unknown origin. Treating low back pain is a main challenge physiotherapist faces. Mulligan mobilization is a techniques used to facilitate range of motion and reducing pain whereas integrated neuromuscular inhibition is a technique used to treat any abnormality in muscle. Methodology: 80 participants with non-specific low back pain will be included. Integrated neuromuscular inhibition technique will be given to Group A and group B will get mulligan mobilization. Group A will have 40 participants and Group B will have 40 participants. Treatment will be given for 6 weeks and pain and functional disability will be documented and statistical analysis will be done. Discussion: In this study integrated neuromuscular inhibition and mulligan mobilization’s efficacy will be seen in subjects with chronic non- specific lower back pain on pain and functional disability using modified oswestry scale for functional disability and numeric pain rating scale for pain. Conclusion: Conclusion will be drawn post study as which technique of mulligan mobilization and integrated neuromuscular inhibition is better to reduce disability and pain in patients with non-specific lower back pain. This study will give a better approach to the physiotherapist in managing the low back pain

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Effects of Tailored Motor Control Rehabilitation Vs Standard Exercise Program in Management Of Chronic Nonspecific LBP

10.53350/pjmhs2115113219 ◽

2021 ◽

Vol 15 (11) ◽

pp. 3219-3221

Author(s):

Maryam Liaquat ◽

Wajida Perveen ◽

Danish Hassan ◽

Misbah Amanat Ali ◽

Muhammad Akhtar ◽

...

Keyword(s):

Low Back Pain ◽

Motor Control ◽

Back Pain ◽

Clinical Study ◽

Exercise Program ◽

Low Back ◽

Randomized Clinical Study ◽

Lower Back ◽

Group A ◽

Group B

Lower back pain is one of the most common problems in adults all over the world, and chances of having back pain increases with the age. Objectives: To determine the effect of tailored motor control rehabilitation versus standard exercise program in chronic nonspecific lower back pain. Study Design: Non randomized clinical study. Methodology: A non randomized clinical study was conducted in six-month during 2018 after ethical approval. 40 patients were enrolled through non-probability purposive sampling technique and allocated into two groups (Group A & B). Informed consent was obtained. Individuals between twenty to forty years with chronic nonspecific low back pain with intensity at least 3 on a 10cm visual analog scale (VAS) were included and individuals with past history of trauma of the spine and hip and with any red flags were excluded. Outcomes were measures by Modified Oswestry Disability Index (MODI) and Visual Analogue Scale (VAS). Statistical analysis: Data was analyzed by SPSS software, version 19 as qualitative variables were expressed as mean ± SD. Independent sample T test was also applied. Results: The mean age Group A was 29.05±8.58 and Group B, was 32.05±6.53 years. The result shows that there was a significant difference in outcomes among tailored motorcontrol rehabilitation (Group A) and standard exercise program (Group B). Conclusion: We concluded that motor control rehabilitation was more effective than standard exercise program in decreasing low back pain and improving quality of life. Key Words: Low Back Pain, Tailored Motor Control Rehabilitation, Standard Exercise Program and Modified Oswastry Disability Index.

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Analyzing the Influence of Modic Changes on Patients with Lower Back Pain Undergoing Conservative Treatment

Pain Research and Management ◽

10.1155/2019/8185316 ◽

2019 ◽

Vol 2019 ◽

pp. 1-5

Author(s):

Yufeng Chen ◽

Huilin Yang ◽

Lianfang Zhang ◽

Yue Wang ◽

Jun Zou

Keyword(s):

Back Pain ◽

Lower Back Pain ◽

Modic Changes ◽

Nonsurgical Treatment ◽

Type I ◽

Type Ii ◽

Lower Back ◽

Significant Difference ◽

Modic Type ◽

Vas Scores

Objective. This study aimed to investigate if the presence of Modic changes (MCs) was correlated with lower back pain (LBP) and LBP-related disability in patients who underwent nonsurgical treatment. Methods. In this study, 129 patients who experienced consecutive LBP and underwent lumbar spine magnetic resonance imaging in our institute were divided into three groups according to the presence or type of MCs. The Oswestry Disability Index (ODI) and visual analog scale (VAS) were used to assess the outcomes of the treatment. Results. Based on the achieved results, there was no significant difference between three groups before treatment (P>0.05). Three months after undergoing nonsurgical treatment, the rates of improved ODI and VAS scores were statistically significantly different (P=0.014, 0.023). After an additional 3 months of treatment, in patients with Modic type I changes, the symptoms significantly improved in comparison with those 3 months prior (P=0.037, 0.026), while that improvement did not occur in patients with Modic type II changes (P>0.05). Conclusions. The existence of MCs affects the outcomes of nonsurgical treatment in patients with LBP. However, symptoms can be improved after an additional round of treatment for Modic type I changes, while this is not confirmed for Modic type II changes.

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

http://isrctn.com/ ◽

10.1186/isrctn15050704 ◽

2018 ◽

Author(s):

Sally Cinnamond

Keyword(s):

Back Pain ◽

Lower Back Pain ◽

Lumbar Disc ◽

Lower Back ◽

Herniated Lumbar Disc ◽

Mechanical Traction

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Factors for Predicting Favorable Outcome of Percutaneous Epidural Adhesiolysis for Lumbar Disc Herniation

Pain Research and Management ◽

10.1155/2017/1494538 ◽

2017 ◽

Vol 2017 ◽

pp. 1-10 ◽

Cited By ~ 2

Author(s):

Sang Ho Moon ◽

Jae Il Lee ◽

Hyun Seok Cho ◽

Jin Woo Shin ◽

Won Uk Koh

Keyword(s):

Back Pain ◽

Lumbar Disc Herniation ◽

Disc Herniation ◽

Lower Back Pain ◽

Rating Scale ◽

Lumbar Disc ◽

Multivariate Logistic Regression Analysis ◽

Long Term Outcome ◽

Lower Back ◽

High Intensity Zone

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.

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Open Fenestration Discectomy Versus Microscopic Fenestration Discectomy for Lumbar Disc Herniation: a randomized controlled trial

10.21203/rs.3.rs-16951/v2 ◽

2020 ◽

Author(s):

Sherwan Hamawandi ◽

Injam Ibrahim Sulaiman ◽

Ameer Kadhim Al-Humairi

Keyword(s):

Back Pain ◽

Lumbar Disc Herniation ◽

Disc Herniation ◽

Oswestry Disability Index ◽

Lumbar Disc ◽

Daily Activities ◽

Leg Pain ◽

Group A ◽

Group B ◽

Type Of Surgery

Abstract Background: Fenestration discectomy, for symptomatic lumbar disc herniation, is the most common surgical procedure in spine surgery. It can be done by open or microscopic procedures. This study compared the results of fenestration microdiscectomy with open fenestration discectomy in the treatment of symptomatic lumbar disc herniation as a relation to the functional outcome, leg pain, back pain, hospital stay, returns to daily activity, cost, recurrence, reoperation and type of surgery for recurrent disc herniation.Methods: 60 patients age (29 - 50 years), with L4-L5 disc herniation, are divided randomly into group A- 30 patients underwent an open fenestration discectomy- and group B- 30 patients underwent fenestration microdiscectomy. All patients are assessed at 1 week, 3months, 6 months, 12 months after surgery for Oswestry disability index and Visual analogue scale for back pain and leg pain and followed up for 4 years. Results: In both groups, all patients have minimal disability by Oswestry Disability Index after surgery.There were significant differences between means of post-operative VAS for back pain between these two groups after one weeks (3.7 in group A versus 2.2 in group B) (t= 13.28, P=<0.001٭) and after 3 months (1.73 in group A versus 0.43 in group B) (t=10.54, P=<0.001٭).There were no significant differences between two groups regarding post-operative VAS for leg pain, recurrence (5 patients in group A versus 4 patients in group B) and reoperation rate (2 patients in each group).There were significant differences between means of length of hospital stay (2.10 in group A versus 1.06 in group B) (P<0.001), time of returning to daily activities (7.33 in group A versus 4.03 in group B) (P<0.001) and cost of surgery (1996.66 in group A versus 3003.3 in group B) (P<0.001).Conclusion: Use of microscope in fenestration discectomy for treatment of symptomatic lumbar disc herniation can achieve the same goals of open fenestration regarding nerve root decompression and relief of leg pain with advantage of less back pain, less hospital staying and early return to daily activities with disadvantage of more cost with the use of microscope. With 4 years follow up, there was no significant deference in rate of recurrence and reoperation with the use of microscope but we found that type of surgery for recurrent cases may be less invasive if microscope was used in primary surgery.Trial registration: NCT, NCT04112485. Registered 30 September 2019 - Retrospectively registered, https://clinicaltrials.gov/NCT04112485

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A Study to Compare the Efficacy of Back Strengthening Therapy in Patients with Lower Back Pain on Analgesics to that of those on Placebo in a Tertiary Care Hospital in Chennai

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2021/v33i47b33221 ◽

2021 ◽

pp. 982-987

Author(s):

R. Nehaapriya ◽

Damodharan Vasudevan ◽

K. Gunalan

Keyword(s):

Back Pain ◽

Lower Back Pain ◽

Tertiary Care ◽

Cross Sectional Study ◽

Care Hospital ◽

Cross Sectional ◽

Lower Back ◽

Strengthening Exercises ◽

Reduction Of Pain ◽

Group B

Aim: Isometric and Core strengthening exercises for lower back pain provides relief to patients, whereas combing it with analgesics also provides relief of pain, thereby in this study the efficacy of isometric and core strengthening exercises alone is evaluated. Method: A cross-sectional study involving 200 subjects was conducted in the OPD of department of Orthopaedics, Saveetha Medical college and hospital. Assessment of lower back pain was done using ODI (Oswestry Disability Index) among patients receiving Isometric and Core strengthening exercises with and without analgesics for a period of 3 months. Results: There is no significance difference in the reduction of pain among group A who received analgesics along with isometric and core strengthening exercises and group B who received only isometric and core strengthening exercises. Conclusion: Isometric and core strengthening exercises alone is as effective as its combination with analgesics.

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Anti-Nociceptive Effects of Elcatonin Injection for Postmenopausal Women with Back Pain: A Randomized Controlled Trial

The Open Orthopaedics Journal ◽

10.2174/1874325001004010132 ◽

2010 ◽

Vol 4 (1) ◽

pp. 132-136 ◽

Cited By ~ 3

Author(s):

Shota Ikegami ◽

Mikio Kamimura ◽

Shigeharu Uchiyama ◽

Hiroyuki Nakagawa ◽

Hiroyuki Hashidate ◽

...

Keyword(s):

Placebo Group ◽

Back Pain ◽

Postmenopausal Women ◽

Lower Back Pain ◽

Trigger Point ◽

Controlled Study ◽

Analgesic Effects ◽

Lower Back ◽

Vas Scores ◽

The Mean

Background: Eel calcitonin (elcatonin) injection is widely used for elderly patients suffering from somatic pain in Japan. However, there have been few reports on the analgesic effects of elcatonin injection. The purpose of this study was to examine the analgesic effects of elcatonin injection in postmenopausal women with lower back pain. Methods: This study was designed as a double-blind, randomized, placebo-controlled study. Thirty-six women aged ≥50 years with acute lower back pain participated in this study. They were randomly divided into two treatment groups according to whether they received a placebo or a weekly trigger point injection of elcatonin (20 units). They were observed for 5 weeks and the extent of pain at motion and at rest according to the visual analog scale (VAS) was evaluated. The mean VAS scores for the elcatonin group were then compared with those of the placebo group. Results: There were no statistically significant differences in the mean VAS scores for pain at rest between the two groups during the 5-week treatment course. However, the mean VAS scores for motion pain in the elcatonin group were significantly lower than those in the placebo group at the third, fifth and sixth weeks. Conclusions: Elcatonin injection (20 units) significantly relieved motion pain in the lower back in postmenopausal women after three weeks of treatment. This analgesic effect continued for the subsequent 3 weeks.

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