scholarly journals Relation between grades of intervertebral disc degeneration and occupational activities of patients with lumbar disc herniation

2017 ◽  
Vol 74 (12) ◽  
pp. 1121-1127
Author(s):  
Monika Papic ◽  
Vladimir Papic ◽  
Milena Kresoja ◽  
Valerija Munteanu ◽  
Ivan Mikov ◽  
...  
2021 ◽  
Author(s):  
Lei Yue ◽  
Hao Chen ◽  
Guanzhang Mu ◽  
Bingxu Li ◽  
Haoyong Fu ◽  
...  

Abstract Background Percutaneous endoscopic transforaminal discectomy (PETD) is a widely-used minimally invasive technique in treating lumbar disc herniation (LDH), our aim was to investigate the long-term effect of PETD on clinical outcomes and magnetic resonance imaging (MRI) characteristics of LDH patients.Methods This is a retrospective case series to assess patients who underwent single level PETD from January 2015 to June 2019 with a minimum follow-up of 2 years. Clinical outcomes included numeric rating scale (NRS), Oswestry Disability Index (ODI) and adverse events. Radiographic parameters included sagittal spine geometry, characteristics of protrusion, and degeneration grading of intervertebral disc and facet joint. Sensitivity analysis and risk factor analysis were also performed.Results Thirty-eight patients (43.16 ± 13.32 years; M: F = 20: 18) were assessed. During the follow-up period (33.47±12.53 months), the mean disc height decreased from 10.27 ± 1.92 mm to 8.95 ± 1.74 mm (P=0.000), and lumbar lordosis increased from 31.31 ± 8.63° to 35.07 ± 8.07° (P=0.002). The size of protrusion significantly decreased after PETD (P=0.000). Disc degeneration grading was generally higher at last follow-up compared with baseline (p=0.002). Compared with baseline, significant improvements were observed on NRS and ODI at 3-months follow-up and the last follow-up. On risk factor analysis, facet tropism was correlated with radiographic recurrence of disc herniation (OR=6.00 [95% confidential interval (CI)1.176-30.624], p=0.031).Conclusions This study demonstrates that at long-term follow-up, despite the good clinical results, the PETD resulted in significant aggravation of intervertebral disc degeneration.


2021 ◽  
Author(s):  
Zepeng Li ◽  
Lulu Liu ◽  
Hao Liu ◽  
Jinghua Tan ◽  
Xuelin Li ◽  
...  

Abstract Objective: To retrospectively analyze causes of, and factors influencing, early recurrence after percutaneous endoscopic transforaminal discectomy (PETD) used to treat lumbar-disc herniation. Methods: We included 285 patients with single-segment lumbar-disc herniation, treated using PETD from January 2017 to December 2019 in the First Affiliated Hospital of the University of South China. Patients were classified into early recurrence and non-early recurrence groups based on clinical symptoms and MRI reexamination. Differences in disc-height index (DHI), sagittal range of motion (sROM), base-width of intervertebral disc degeneration, and postoperative intervertebral annulus-fibrosus tear size were compared using independent-sample t test. Differences in degree of intervertebral disc degeneration and herniation sites were analyzed using rank-sum and chi-square tests. Logistic regression was used for multivariate analysis of factors associated with early recurrence after PETD. Results: Two hundred and eighty five patients completed surgery and underwent clinical follow-up. Mean follow-up duration was 15.5 months (12–24 months). During follow-up, 19 patients relapsed within 6 months post-surgery. Early recurrence rate was 6.7%, and mean recurrence duration was 73.4 days (3–168 days). Differences in DHI, base-width, postoperative annulus-fibrosus tear size, degree of intervertebral disc degeneration, and herniation sites between early recurrence and non-early recurrence groups were statistically significant (P<0.05). Herniation site and base-width of herniation were significantly correlated with early recurrence after PETD. Conclusions: DHI, postoperative annulus-fibrosus tear size, and degree of intervertebral disc degeneration were associated with early recurrence after PETD. Increased base-width of herniation was a risk factor for early recurrence after PETD. Central-herniation patients with were more prone to postoperative early recurrence than paracentral-herniation patients.


Author(s):  
Saeeda Baig

During the recent past focus has shifted from identifying intervertebral disc degeneration as being caused by physical exposure and strain to being linked with a variety of genetic variations. The objective of this review is to provide an up to date review of the existing research data regarding the relation of intervertebral disc degeneration to structural protein genes and their polymorphisms and thus help clearly establish further avenues where research into causation and treatment is needed. A comprehensive search using the keywords “Collagen”, “COL”, “Aggrecan”, “AGC”, “IVDD”, “intervertebral disc degeneration”, and “lumbar disc degeneration” from PubMed and Google Scholar, where literature in the English language was selected spanning from 1991 to 2019. There are many genes involved in the production of structural components of an intervertebral disc. The issues in production of these components involve the over-expression or under-expression of their genes, and single nucleotide polymorphisms and variable number of tandem repeats affecting their structures. These structural genes include primarily the collagen and the aggrecan genes. While genetic and environmental factors all come into play with a disease process like disc degeneration, the bulk of research now shows the significantly larger impact of hereditary over exposure. While further research is needed into some of the lesser studied genes linked to IVDD and also the racial variations in genetic makeup, the focus in the near future should be on establishment of genetic testing to identify individuals at greater risk of disease and deliberation regarding the use of gene therapy to prevent disc degeneration.


2017 ◽  
Vol 68 (2) ◽  
pp. 210-216 ◽  
Author(s):  
Semra Duran ◽  
Mehtap Cavusoglu ◽  
Hatice Gul Hatipoglu ◽  
Deniz Sozmen Cılız ◽  
Bulent Sakman

Purpose The aim of this study was to evaluate the association between vertebral endplate morphology and the degree of lumbar intervertebral disc degeneration via magnetic resonance imaging (MRI). Methods In total, 150 patients who met the inclusion criteria and were 20–60 years of age were retrospectively evaluated. Patients were evaluated for the presence of intervertebral disc degeneration or herniation, and the degree of degeneration was assessed at all lumbar levels. Vertebral endplate morphology was evaluated based on the endplate sagittal diameter, endplate sagittal concave angle (ECA), and endplate sagittal concave depth (ECD) on sagittal MRI. The association between intervertebral disc degeneration or herniation and endplate morphological measurements was analysed. Results In MRI, superior endplates ( ie, inferior endplates of the superior vertebra) were concave and inferior endplates ( ie, superior endplates of the inferior vertebra) were flat at all disc levels. A decrease in ECD and an increase in ECA were detected at all lumbar levels as disc degeneration increased ( P < .05). At the L4-L5 and L5-S1 levels, a decrease in ECD and an increase in ECA were detected in the group with herniated lumbar discs ( P < .05). There was no association between lumbar disc degeneration or herniation and endplate sagittal diameter at lumbar intervertebral levels ( P > .05). At all levels, ECD of women was significantly lesser than that of men and ECA of women was significantly greater than that of men ( P < .05). Conclusions There is an association between vertebral endplate morphology and lumbar intervertebral disc degeneration. Vertebral endplates at the degenerated disc level become flat; the severity of this flattening is correlated with the degree of disc degeneration.


2021 ◽  
Author(s):  
Jipeng Song ◽  
Fumin Pan ◽  
Chao Kong ◽  
Xiangyao Sun ◽  
Yu Wang ◽  
...  

Abstract Background The influence of spinopelvic morphology on the Chinese elderly LDH population was not clear. The purpose of this study is to explore its influence on the characteristics of lumbar disc herniation or degeneration. Methods 212 elderly patients with LDH and 213 asymptomatic volunteers were involved. Spinal parameters were measured on full-length X-ray and compared between two populations. In herniated group, sagittal profiles were determined according to the Roussouly classification, the degenerative grades, the herniated location and the number of intervertebral lumbar disc degeneration were evaluated from the L1 to S1 on MRI scans. The differences on them among Roussouly types were analyzed. Results There were no significant differences in BMI, the mean value of age and sex distribution between two populations. Patients were found to have significantly smaller TK, LL, and SS than those volunteers (p < 0.05), while contradicting observations on PT and TPA were obtained (p < 0.05). Roussouly type 1 and type 2 ( 50.4% and 28.7% respectively) are predominant in the LDH population and the proportion of type 1 in elderly LDH is further increased. Subjects with LDH in type 1 and 2 had lower mean herniated locations and fewer mean herniated numbers than those with type 3 and 4. Conclusions Sagittal spinopelvic parameters were found to be significantly different in elderly LDH patients and asymptomatic volunteers. There were significant differences in the Roussouly distribution among different age groups of LDH. Different Roussouly subtypes have different effects on lumbar disc degeneration and herniation.


2022 ◽  
Vol 2022 ◽  
pp. 1-11
Author(s):  
Shiyuan Wan ◽  
Bin Xue ◽  
Yanhao Xiong

Lumbar intervertebral disc protrusion disease refers to the degeneration of intervertebral disc, rupture of fibrous ring, nucleus pulpous protrusion and stimulation or compression of nerve root. The import command in Mimics medical 3D reconstruction software was used to erase the irrelevant image data and obtain vertebral body images. The original 3D model of each vertebral body was built by 3D computing function. A three-dimensional finite element model was established to analyze the effect of different surgical methods on the mechanical distribution of the spine after disentomb. The stress distribution of the spine, intervertebral disc, and left and right articular cartilage at L4/L5 stage and the position shift of the fourth lumbar vertebra were analyzed under 7 working conditions of vertical, forward flexion, extension, left and right flexion, and left and right rotation. The results showed that the established model was effective, and the smaller the area of posterior laminar decompression was, the lesser the impact on spinal stability was. The PELD treatment of lumbar disc herniation had little impact on spinal biomechanics and could achieve good long-term biomechanical stability. Combining the clinical experiment method and finite element simulation, using the advantages of finite element software to optimize the design function can provide guidance for the design and improvement of medical devices and has important significance for the study of clinical mechanical properties and biomechanics.


Sign in / Sign up

Export Citation Format

Share Document