Comparing the surgical efficacy of a newly designed endoscopic visualized trephine and a conventional trephine for percutaneous endoscopic lumbar discectomy with foraminoplasty for patients with single-segment lumbar disc herniation: A retrospective case -control study

Author(s):  
Shangbo Niu ◽  
Dehong Yang ◽  
Jie Li ◽  
Wenbo Diao ◽  
Jian Gao ◽  
...  

Abstract Background Owing to the remarkable evolution of percutaneous endoscopic lumbar discectomy (PELD), the application of spinal endoscopy is shifting from the treatment of soft disk herniation to complex lumbar spinal stenosis. This study aim to compare the surgical efficacy of a newly designed endoscopic visualized trephine and a conventional trephine for PELD with foraminoplasty for patients with single-segment lumbar disc herniation (LDH). Methods A total of 54 patients who were diagnosed with single-segment LDH and received PELD with foraminoplasty at Xuzhou Central Hospital (Xuzhou, China) from January 2016 to June 2020 were included in this case-control study. Data related to the length of incision, amount of intraoperative bleeding, the time required to create the working channel, and intraoperative and postoperative complications were recorded. The Visual Analog Scale (VAS) score was used to assess low back pain and leg pain. Besides, the Oswestry Disability Index (ODI) and Japanese Orthopedic Association (JOA) scores were utilized to evaluate patients’ pain intensity and their sitting and standing abilities. The X-ray fluoroscopy was performed to measure the horizontal and angular displacements of lumbar extension-flexion, and to evaluate the stability of lumbar spine. Results All the patients successfully underwent surgical procedures, except for two patients with injuries in the spinal nerve root of the responsible segment in the conventional trephine group, who were given nutritional supplements for nerve treatment. Besides, there was no significant difference in incision length and operative blood loss between the modern trephine and the conventional trephine groups. However, the time required to create the channel and the duration of fluoroscopy in the modern trephine group were significantly less than those in the conventional trephine group (34.24 ± 5.38 vs. 44.76 ± 6.37 min, P < 0.05). In addition, the VAS, ODI, and JOA scores significantly decreased postoperatively in the two groups. We also found no significant difference in horizontal and angular displacements of lumbar extension-flexion between the two groups pre-operation and at 3- and 12-month post-operation. Conclusion In spite of similar surgical efficacy of the two techniques, the newly designed endoscopic visualized trephine outperformed in terms of operation time and duration of fluoroscopy.

2016 ◽  
Vol 19 (2;2) ◽  
pp. 69-75
Author(s):  
Fu Qiang

Background: Percutaneous endoscopic interlaminar discectomy (PEID), which poses advantages for certain types of herniated disc, is gaining wider acceptance in clinical practice. We retrospectively analyzed the efficacy of the PEID technique in treatment of calcified lumbar disc herniation. Study Design: A retrospective case-control study. Setting: University hospital in China. Objective: To evaluate the efficacy of the PEID technique in treatment of calcified lumbar disc herniation, and a comparison between calcified and noncalcified disc herniation was drawn to analyze the causes of herniated disc calcification. Methods: Data from patients who underwent full-endoscopic lumbar discectomy in our department between March 2011 and May 2013 were collected. Thirty cases with calcified lumbar disc herniation were included in the study group, and 30 age-, gender-, and body mass index (BMI)-matched cases with noncalcified lumbar disc herniation served as controls. Perioperative data, preoperative and postoperative Visual Analog Scale (VAS) scores, Oswestry Disability Index (ODI) values, MacNab scores, and postoperative low-extremity dysesthesia among patients in the 2 groups were collected. Results: The values of computed tomography (CT) in the calcified group were significantly higher than those in the noncalcified group (P < 0.01). The preoperative disease courses in the 2 groups were similar. However, there was a statistically significant difference in the duration of traditional Chinese medicines (TCM) administration (P < 0.01). VAS and ODI scores improved significantly after surgery, but there were no significant differences between the 2 groups (P > 0.05). Three months after surgery, the rate of low-extremity dysesthesia in the calcified group was significantly higher than that in the control group (P = 0.03) but became similar at 6 months. By applying MacNab criteria the proportions of good and excellent were greater than 90% in both groups, and there was no difference between groups (P > 0.05). Limitations: The sample size was small in this retrospective study. Conclusion: The PEID technique is an effective method in the treatment of calcified lumber disc herniation, although the rate of postoperative dysesthesia is higher in this group during the early postoperative period. Long-term TCM administration may be related to the calcification of herniated lumbar discs. Key words: Lumbar disc herniation, percutaneous endoscopic lumbar discectomy, interlaminar approach, calcification


Author(s):  
Zoran Z. Sarcevic ◽  
Andreja P. Tepavcevic

BACKGROUND: Subacromial pain (SAP) is a common complaint of young athletes, independently of the sport engaged. The prevalence of SAP in some sports is up to 50%. OBJECTIVE: The study was aimed to investigate some new factors possibly associated to subacromial pain in young athletes. The factors considered were the grade of tightness of the clavicular portion of the pectoralis major, dysfunction of the sternoclavicular joint, and serratus anterior and lower trapezius strength. METHODS: This case-control study included 82 young athletes 9–15 years, 41 with the symptoms of SAP and 41 controls. All participants self-reported whether they had subacromial pain. In addition, Hawkins–Kennedy Test was performed to all the participants to evaluate the subacromial pressure. Main outcome measures were the grade of tightness of the clavicular portion of the pectoralis major, dysfunction of the sternoclavicular joint, and serratus anterior and lower trapezius strength. The grade of tightness of the clavicular portion of the pectoralis major and the dysfunction of the sternoclavicular joint were measured with an inclinometer. Serratus anterior and lower trapezius strength were measured by a handheld dynamometer with external belt-fixation. The data were analyzed using t-test for independent samples, Mann-Whitney U test, contingency coefficients and a stepwise binary logistic regression. RESULTS: Significant statistical difference was observed in the grade of tightness of the clavicular portion of the pectoralis major and in the variable representing the physiological functioning of the sternoclavicular joint, between the cases and the controls. There was no significant difference in serratus anterior and lower trapezius strength between the cases and the controls. Logistic regression analysis showed that the variable representing the physiological functioning of the sternoclavicular joint and the grade of shortening of the clavicular portion of the pectoralis major were good predictors for presence of SAP. CONCLUSIONS: A strong association was determined between subacromial pain in young athletes, clavicular portion of pectoralis major tightness and the dysfunction of the sternoclavicular joint.


Author(s):  
Yachao Zhao ◽  
Haidong Wang ◽  
Zhaohui Li ◽  
Zhiwei Wang ◽  
Yachong Huo ◽  
...  

2015 ◽  
Vol 43 (6) ◽  
Author(s):  
Tanya Maric ◽  
Natasha Singh ◽  
Keith Duncan ◽  
Guy J. Thorpe-Beeston ◽  
Makrina D. Savvidou

AbstractTo investigate the relation between first-trimester fetal growth discrepancy, as assessed by crown-rump length (CRL) at 11+0 to 13+6 weeks of gestation, and subsequent development of preeclampsia (PE) in dichorionic diamniotic (DCDA) twin pregnancies. The association between inter-twin CRL and birth weight (BW) discrepancy was also investigated.This was a retrospective, case-control study of DCDA twin pregnancies. Inter-twin CRL discrepancy was calculated as 100×(larger CRL–smaller CRL)/larger CRL. BW discordance was calculated as 100×(larger BW–smaller BW)/larger BW.The study included 299 DCDA pregnancies that remained normotensive and 35 that subsequently developed PE. There was no significant difference in the inter-twin CRL discrepancy between pregnancies complicated by PE and those that were not [3.2%, interquartile range (IQR): 0.5–4.5% vs. 3.3%, IQR: 1.4–5.5%; P=0.17]. There was a positive correlation between inter-twin CRL and BW discrepancy but only in pregnancies that remained normotensive (P<0.001). In women that subsequently developed PE, there was no association between inter-twin CRL and BW discordance (P=0.54).In unselected DCDA twins, first-trimester CRL discrepancy is not different between pregnancies that subsequently develop PE and those that remain normotensive. Furthermore, in pregnancies that are complicated by PE, the association between inter-twin CRL and BW discrepancy appears to be lost.


2021 ◽  
Vol 8 (4) ◽  
pp. 325-332
Author(s):  
Kate Deepali Rajesh ◽  
Puranam Vatsalaswamy ◽  
Manvikar Purshotam Rao

To study the relevance of sperm telomere length and infertility in men. : Our case-control study included twenty-five males in couple with sub-fertility/infertility (test group) and twenty five healthy males (control group) with proven paternity in the age group 25 to 35 years. The Absolute Sperm Telomere length (aSTL) was measured by real-time PCR. We investigated whether any significant difference in the aSTL value existed between the groups and analysed the relationship between aSTL and other sperm parameters.The mean (SE) aSTL recorded in the infertile cases was significantly shorter than for the control group being 140.60 (6.66) Kb/genome and 239.63 (12.32) Kb/genome respectively (p &#60;0.001) A weak correlation was eminent between aSTL kb/genome and the total sperm count mil/ml (rho= 0.04, p - 0.86), progressive sperm motility (rho= - 0.02, p=0.934) and sperm viability (rho= - 0.07 p=0.741) in the infertile group. The measurement of aSTL by real-time PCR is a simple and rapid method that offers further paramount information with respective to the quality of sperm. It is befitted for epidemiological studies, hence opening new perspectives in the evaluation of male infertility. Limitations - Our study was confined to men aged between 25 and 35 years. Further comparative studies are needed to explore the significance of STL and infertility in older males. Additional studies will help illumine the significance of aSTL as a prognostic biomarker in assisted reproduction.


2019 ◽  
Author(s):  
Aida Torkzaban ◽  
Seyed Amir Mansour Alavi Naeini ◽  
Akbar Hassanzadeh ◽  
Mehrdad Namdari

Abstract Background Coronary hearth diseases are among the main causes of death in adults. Increase of oxidative stress and defects in antioxidant defense play a major role in endothelium performance and are an effective factor in progress of atherosclerosis. Some studies have also reported different malondialdehyde and total antioxidant capacity among the atherosclerosis patients.Methods In this case-control study, 44 atherosclerosis patients referring to Shahid Madani treatment-education center were considered as the case group; while 44 healthy peoples were placed in the control group. Demographic data and anthropometric indices were measured. Food frequency questionnaire and international physical activity questionnaires were also completed. After 12 hours of fasting, 10 ml blood was sampled from the participants. Uric acid, vitamin C, TAC and MDA were also measured. The data were finally analyzed by SPSS Ver 22 software.Results A significant difference was observed between the two groups in terms of uric acid (P<0.001) and vitamin C (P<0.03). However, mean MDA and TAC showed no significant difference between the two groups. The two groups’ difference in terms of vitamin A, E and beta carotene, zinc and selenium intake was not significant. A significant difference was however detected between the two groups in terms of vitamin C (P<0.047). A significant relationship was also observed between the systolic pressure and CHD (P<0.028).Conclusion Results of this study indicated that the uric acid and vitamin C levels of atherosclerosis patients had significant increase and decrease in comparison with the healthy subjects, respectively. Mean TAC and antioxidant levels of their diets (except for vitamin C) showed no significant difference. Systolic blood pressure of the patients was significantly higher than the controls.


2019 ◽  
Author(s):  
Forough Saki ◽  
Seyed Reza Kassaee ◽  
Azita Salehifar Salehifar ◽  
gholamhossein Ranjbar omrani

Abstract Background:phosphate homeostasis is mediated through complex counter regulatory feed-back balance between parathyroid hormone, FGF-23 and 1,25(OH)2D. Both parathyroid hormone and FGF-23 regulate proximal tubular phosphate excretion through signaling on sodium- phosphate cotransporters II a and II c . However, the interaction between these hormones on phosphate excretion is not clearly understood. We performed the present study to evaluate whether the existence of sufficient parathyroid hormone is necessary for full phosphaturic function of FGF-23 or not. Methods:In this case-control study, 19 patients with hypoparathyroidism and their age- and gender-matched normal population were enrolled. Serum calcium, phosphate, alkaline phosphatase,parathyroid hormone, FGF-23, 25(OH)D, 1,25(OH)2D and Fractional excretion of phosphorous were assessed and compared between the two groups, using SPSS software. Results:The mean serum calcium and parathyroid hormone level was significantly lower in hypoparathyroid patients in comparison with the control group(P<0.001 and P<0.001, respectively). We found high serum level of phosphate and FGF-23 in hypoparathyroid patients compared to the control group (P<0.001 and P<0.001,respectively). However, there was no significant difference in Fractional excretion of phosphorous or 1,25OH2D level between the two groups. There was a positive correlation between serum FGF-23 and Fractional excretion of phosphorous just in the normal individuals (P <0.001, r = 0.79). Conclusions:Although the FGF-23 is a main regulator of urinary phosphate excretion but the existence of sufficient parathyroid hormone is necessary for the full phosphaturic effect of FGF-23.


2018 ◽  
Vol 23 (01) ◽  
pp. 41-46 ◽  
Author(s):  
Guillaume Bacle ◽  
Emilie Marteau ◽  
Philippe Corcia ◽  
Pascal Garaud ◽  
Jacky Laulan

Background: Causality has not been formally demonstrated between carpal tunnel syndrome and osteoarthritis of the wrist or at the base of the thumb. The purpose of this study was to assess the relationship between carpal tunnel syndrome and concomitant degenerative osteoarthritis of the wrist or basal thumb joint. We hypothesised that wrist osteoarthritis by reducing the free volume of the carpal tunnel would be associated with carpal tunnel syndrome, while basal thumb osteoarthritis would show no direct correlation with carpal tunnel syndrome. Methods: A case-control study including 95 cases and 99 control subjects, has been carried out. Sixty-eight per group were matched for age and sex. Posterior-anterior and lateral plain wrist radiographs for the two matched groups were analysed. Results: Except for scaphotrapeziotrapezoid location, degenerative osteoarthritis of the wrist was significantly linked with carpal tunnel syndrome, whereas there was no significant difference between case and control groups for prevalence of basal osteoarthritis of the thumb. Conclusions: These results suggest that basal osteoarthritis of the thumb is not a causal factor in carpal tunnel syndrome. In contrast, degenerative osteoarthritis of the wrist was strongly associated with carpal tunnel syndrome, suggesting a causal relation.


2020 ◽  
Author(s):  
Md Ziaul Islam ◽  
Tasnim Disu ◽  
Shatmin Farjana ◽  
Mohammad Rahman

Abstract Background: Malnutrition and depression are highly prevalent in the elderly and can lead to disparaging outcomes. Analytical studies on malnutrition concerning geriatric depression (GD) are very scarce in Bangladesh, although the size of the elderly population is increasing fast in the country. The current study aimed to assess the association between malnutrition and depression and associated risk factors in the rural elderly.Methods: A case-control study was conducted in 600 elderly residents (aged ≥60 years) of three rural communities of Bangladesh from January to October 2019. Three hundred depressed elderly people were enrolled as cases and 300 non-depressed elderly individuals were included as community controls by matching the age and living area of the cases. We used a semi-structured questionnaire based on the Geriatric Depression Scale-15 and the Bangla version of Mini-Nutritional Assessment-Short Form to collect data through face-to-face interviews. Measures included baseline and personal characteristics, malnutrition, GD, and associated risk factors. A binary logistic regression model was fitted to identify variables associated with the risk of GD.Results: The study found no significant difference in gender (male Vs. female) between cases (44.0% Vs. 56.0%) and controls (46.0% Vs. 54.0%). The study revealed that malnutrition was significantly (p<0.01) higher in cases (56.0%) than in controls (18.0%). The malnourished elderly had around three times AOR=3.155; 95% CI: 1.53-6.49, p=0.002) more (risk of having depression than the controls. The unemployed elderly (AOR=4.964; 95% CI: 2.361-10.440; p=0.0001) and the elderly of the lower and middle class (AOR=3.654; 95% CI: 2.266-7.767; p=0.001) were more likely to experience depression. The elderly having a poor diet were more likely to experience depression (AOR=3.384; 95% CI: 1.764-6.703; p=0.0001). The single elderly (AOR=2.368; 95% CI: 1.762-6.524; p=0.001) and the elderly tobacco users (AOR=2.332; 95% CI: 1.663-5.623; p=0.003) were more likely to experience depression.Conclusions: A significant association between malnutrition and depression is evident in the rural elderly individuals of Bangladesh. It will be a prolific initiative if policymakers merge malnutrition and the risk factors associated with geriatric depression in the provision of universal health care for better health and well-being of the rural elderly populations.


2018 ◽  
Vol 33 (01) ◽  
pp. 067-072 ◽  
Author(s):  
Fırat Seyfettinoğlu ◽  
Özkan Köse ◽  
Hasan Ulaş Oğur ◽  
Ümit Tuhanioğlu ◽  
Hakan Çiçek ◽  
...  

AbstractThis study was aimed to investigate the role of anatomic variations in patellofemoral alignment in patients with or without Osgood-Schlatter disease (OSD) and to determine the potential anatomic risk factors that may play role in the etiology. This prospective observational case-control study was conducted on two groups of adolescent patients. Group 1 comprised patients who were diagnosed as having OSD and group 2 consisted of an equal number of age-matched patients who presented to the outpatient clinic with traumatic knee injury and underwent knee radiographic examination but without a diagnosis of OSD. Age, height, weight, body mass index (BMI), dominant side, and level of sporting activity were recorded. Quadriceps (Q) angles were measured using a long-arm goniometer with patients lying in the supine position with their knees in full extension and contracting the Q muscles. On anteroposterior, lateral knee, and tangential patella (Merchant and Laurin views) radiographs, the following measurements were performed: Insall–Salvati (IS), Caton–Deschamps (CD), and Blackburne–Peel (BP) indexes, congruence angles, lateral patellofemoral angles, sulcus angles, and patella type according to Grelsamer's morphology classification. Both groups were similar in respect of age (p = 0.160), sex (p = 0.311), height (p = 0.326), weight (p = 0.596), BMI (p = 0.153), and dominancy (p = 0.500). The rate of patients engaged in sports activities was significantly greater in the OSD group (p = 0.003). No significant difference was determined between the groups in respect to IS index, CD index, BP index, sulcus angle, lateral patellofemoral angle, and congruence angle (p–values: 0.358, 0.995, 0.912, 0.802, 1.000, and 0.907, respectively). The mean Q angle was measured as 15.6 ± 2.2 degrees in the OSD group and 14.3 ± 2.5 degrees in the control group (p = 0.014). Despite the difference being statistically significant, it was clinically insignificant because the difference was only 1.3 degrees. The principle etiologic factor seems to be increased physical activity rather than subtle variations is patellofemoral anatomy and alignment of extensor mechanism.


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