scholarly journals Extruded disc herniations are experienced earlier by inactive young people in the high-tech gaming era

2021 ◽  
Vol 14 (3) ◽  
pp. 402-407
Author(s):  
Demet Ucar ◽  
◽  
Sedat Duman ◽  
Yusuf Bayram ◽  
Bekir Yavuz Ucar ◽  
...  
Keyword(s):  
Young People ◽  
Lumbar Disc ◽  
Young Patients ◽  
Lifestyle Changes ◽  
Herniated Disc ◽  
Surgical Approaches ◽  
High Tech ◽  
Familial Predisposition ◽  
Disc Herniations ◽  
Disc Extrusion

In this study, we would like to draw attention to the advanced disc diseases seen in young people. The objective is to investigate the reasons for the increasing trend of disc herniations in young people. A total of 33 young patients with extruded lumbar disc herniations managed by conservative or surgical approaches between 2017 and 2018 were included. The average patient age was 25 years. Smoking, familial predisposition, sporting activity, and the occupation of the patients were questioned and noted. A visual analog scale (VAS) was used to assess the efficacy of pain. Body mass index (BMI) was calculated. All patients were subjected to lumbar magnetic resonance imaging. Eighteen patients (8 females, 10 males) had disc extrusion at the L5-S1 level, whereas 12 patients (8 females, 4 males) had disc extrusion at the L4-L5 level. Three other patients had disc extrusion at the level of both L4-L5 and L5-S1 levels. Motor deficits were detected in four patients, and surgical treatment was required and performed. The other 29 patients were treated conservatively. Young non-sport-oriented patients may face severe disc herniations. Understanding how spine degeneration can affect the likelihood of developing a herniated disc can help people make small lifestyle changes to postpone any serious pain and deficits. While aging is unavoidable, simple lifestyle changes can help improve overall spine health and deter the risk of developing a degenerative spine condition.

scholarly journals Genotypic and Antimicrobial Characterisation ofPropionibacterium acnesIsolates from Surgically Excised Lumbar Disc Herniations

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Jess Rollason ◽  
Andrew McDowell ◽  
Hanne B. Albert ◽  
Emma Barnard ◽  
Tony Worthington ◽  
...  
Keyword(s):  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Herniated Disc ◽  
Type Ii ◽  
Type Ia ◽  
Disc Herniations ◽  
Typing Methods ◽  
Human Infections ◽  
Clinical Conditions

The anaerobic skin commensalPropionibacterium acnesis an underestimated cause of human infections and clinical conditions. Previous studies have suggested a role for the bacterium in lumbar disc herniation and infection. To further investigate this, five biopsy samples were surgically excised from each of 64 patients with lumbar disc herniation.P. acnesand other bacteria were detected by anaerobic culture, followed by biochemical and PCR-based identification. In total, 24/64 (38%) patients had evidence ofP. acnesin their excised herniated disc tissue. UsingrecAand mAb typing methods, 52% of the isolates were type II (50% of culture-positive patients), while type IA strains accounted for 28% of isolates (42% patients). Type III (11% isolates; 21% patients) and type IB strains (9% isolates; 17% patients) were detected less frequently. The MIC values for all isolates were lowest for amoxicillin, ciprofloxacin, erythromycin, rifampicin, tetracycline, and vancomycin (≤1mg/L). The MIC for fusidic acid was 1-2 mg/L. The MIC for trimethoprim and gentamicin was 2 to ≥4 mg/L. The demonstration that type II and III strains, which are not frequently recovered from skin, predominated within our isolate collection (63%) suggests that the role ofP. acnesin lumbar disc herniation should not be readily dismissed.

scholarly journals Early Postoperative Results after Removal of Cranially Migrated Lumbar Disc Prolapse: Retrospective Comparison of Three Different Surgical Strategies

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
C. Schulz ◽  
U. Kunz ◽  
U. M. Mauer ◽  
R. Mathieu
Keyword(s):  
Lumbar Disc ◽  
Leg Pain ◽  
Surgical Approaches ◽  
Postoperative Results ◽  
Retrospective Comparison ◽  
Interlaminar Approach ◽  
Disc Material ◽  
Disc Herniations ◽  
Group A ◽  
Group B

Background. To compare the early postoperative results of three surgical approaches to lumbar disc herniations that migrated cranially. Minimally invasive techniques such as the translaminar and endoscopic transforaminal approaches are utilized in patients with lumbar disc herniations to gain access to cranially located disc material and to avoid the potentially destabilizing resection of ligament and bone tissue, which is associated with an extended interlaminar approach.Methods. This retrospective study compares the postoperative pain and functional capacity levels of 69 patients who underwent an interlaminar (Group A,n=27), a translaminar (Group B,n=22), or an endoscopic transforaminal procedure (Group C,n=20).Results. Median VAS scores for leg pain decreased significantly from before to after surgery in all groups. Surgical revisions were required in thirteen cases (five in Group A, one in Group B, and seven in Group C;P=0.031). After six weeks, there were significant differences in back pain and functional outcome scores and in the results for the MacNab criteria but not in leg pain scores.Conclusions. The interlaminar and translaminar techniques were the safest and fastest ways of gaining access to cranially migrated disc material and the most effective approaches over a period of six weeks.

Anterior Lumbar Microdiscectomy and Interbody Fusion for the Treatment of Recurrent Disc Herniation

Neurosurgery ◽  
2001 ◽  
Vol 48 (2) ◽  
pp. 334-338 ◽  
Author(s):  
A. Giancarlo Vishteh ◽  
Curtis A. Dickman
Keyword(s):  
Interbody Fusion ◽  
Lumbar Disc ◽  
Posterior Longitudinal Ligament ◽  
Radicular Pain ◽  
Neurological Deficits ◽  
Herniated Disc ◽  
X Rays ◽  
Lumbar Microdiscectomy ◽  
Disc Herniations

Abstract OBJECTIVE To demonstrate the feasibility of anterior lumbar microdiscectomy in patients with recurrent, sequestered lumbar disc herniations. METHODS Between 1997 and 1999, six patients underwent a muscle-sparing “minilaparotomy” approach and subsequent microscopic anterior lumbar microdiscectomy and fragmentectomy for recurrent lumbar disc extrusions at L5–S1 (n = 4) or L4–L5 (n = 2). A contralateral distraction plug permitted ipsilateral discectomy under microscopic magnification. Effective resection of the extruded disc fragments was accomplished by opening the posterior longitudinal ligament. Interbody fusion was performed by placing cylindrical threaded titanium cages (n = 4) or threaded allograft bone dowels (n = 2). RESULTS There were no complications, and blood loss was minimal. Follow-up magnetic resonance imaging revealed complete resection of all herniated disc material. Plain x-rays revealed excellent interbody cage position. Radicular pain and neurological deficits resolved in all six patients (mean follow-up, 14 mo). CONCLUSION Anterior lumbar microdiscectomy with interbody fusion provides a viable alternative for the treatment of recurrent lumbar disc herniations. Recurrent herniated disc fragments can be removed completely under direct microscopic visualization, and interbody fusion can be performed in the same setting.

scholarly journals Classical open lumbar laminectomy and discectomy for disc herniations among manual labourers in India

2017 ◽  
Vol 5 (12) ◽  
pp. 5156
Author(s):  
Surendra Kumar Chellarapu ◽  
Satya Vara Prasad Kadali ◽  
Raja Sekhar B. ◽  
Raman B. V. S.
Keyword(s):  
Success Rate ◽  
Lumbar Disc ◽  
Gait Training ◽  
Herniated Disc ◽  
Canal Diameter ◽  
Adjacent Disc ◽  
Strenuous Work ◽  
Fibrotic Scar ◽  
Disc Herniations ◽  
History Of

Background: Lumbar disc herniations are most common at L4/5 and L5/S1 levels and this is most prevalent condition among manual laborers. The aim of the study to analyze the clinical presentation, age and sex distribution, immediate postoperative complications and long-term complications/recurrence of symptoms and to formulate recommendations to avoid complications and recurrence of symptoms.Methods: This is a retrospective study which includes 250 patients operated for lumbar disc herniations at L4/5 and L5/S1 levels. A detailed history of presenting complaints, clinical examination and corresponding findings on imaging are correlated. In all these patients, there was severe symptomatology with failed conservative management which necessitated classical open lumbar laminectomy and discectomy. These patients were followed for a period of 5 to 10 years.Results: Assessment of outcome was done using the modified Macnab criteria. The overall success rate was 96% in our series. Post operatively, 9.2% of them experienced localized low back pain which is mild to moderate and being treated with NSAIDS and exercises. 2.4% developed residual disc herniation or hypertrophic fibrotic scar at the operated site which needed surgical intervention. 2% developed spondylolysis and spondylolesthesis at the level of previous surgery, and 4.4% developed adjacent disc herniations.Conclusions: The overall success rate was 96% in our series. In addition to removal of herniated disc other compressing elements like hypertrophied Ligamentumflavum, facet arthropathy and narrowed spinal canal diameter are also addressed with open procedure. To prevent later complications, these patients are supposed to avoid strenuous work, lifting weights, torsion and jerky movements, faulty posture at work and rest, gait training, crouching, sitting on the floor and haunches.

Evaluation of varied surgical approaches used in the management of 170 far-lateral lumbar disc herniations: indications and results

1995 ◽  
Vol 83 (4) ◽  
pp. 648-656 ◽  
Author(s):  
Nancy E. Epstein
Keyword(s):  
Lumbar Disc ◽  
Degenerative Spondylolisthesis ◽  
Lateral Compartment ◽  
Surgical Approaches ◽  
Content Type ◽  
Direct Exposure ◽  
Disc Herniations ◽  
Complicating Factors ◽  
Far Lateral ◽  
Fine Print

✓ This study was undertaken to determine and compare indications and relative benefits of various surgical approaches in 170 patients (average age 55 years) with far-lateral herniated lumbar discs, identified by magnetic resonance (MR) imaging and computerized tomography (CT) and operated on between 1984 and 1994. Essentially three surgical procedures were performed: complete facetectomy in 73 patients, laminotomy with medial facetectomy in 39 patients, and intertransverse discectomy (also known as ITT) in 58 patients. Follow-up periods averaged 5 years (range 0.5–10 years). Outcomes were scored as excellent (no deficit), good (mild radiculopathy), fair (moderate radiculopathy), and poor (unchanged or worse). Overall, excellent and good results were achieved in 73 and 51 patients, respectively, and fair and poor results in 26 and 20, respectively. There was little difference among the results encountered for the three major surgical groups: 79% of the intertransverse (ITT) group had good-to-excellent outcomes, as compared with 70% of the facetectomy group, and 68% of the group who underwent at minimum laminotomy, and additional hemilaminectomy or laminectomy with medial facetectomy. Results were the same for the 121 patients followed for more than 2 years and for the 49 patients studied for under 2 years. In the management of far-lateral discs, total facetectomy provides the best exposure, but increases the risk of instability. Laminotomy and medial facetectomy uncover the lateral and subarticular recess and preserve stability, but visualization of the far-lateral compartment is often inadequate. The intertransverse approach offers extensive far-lateral but not medial intraforaminal exposure, while also preserving stability. Full facetectomy, laminotomy with medial facetectomy, and the intertransverse approaches yielded nearly comparable outcomes in far-lateral disc surgery. Only the full facetectomy exposes the entire course of the nerve root both medially and laterally, whereas the intertransverse procedure provides direct exposure of the far-lateral compartment alone. It is important to select the correct approach or combination of approaches to address attendant complicating factors such as spinal stenosis, spondyloarthrosis, and degenerative spondylolisthesis identified on CT and MR studies.

scholarly journals Does Size Matter? An Analysis of the Effect of Lumbar Disc Herniation Size on the Success of Nonoperative Treatment

2019 ◽  
Vol 10 (7) ◽  
pp. 881-887 ◽  
Author(s):  
Anmol Gupta ◽  
Shivam Upadhyaya ◽  
Caleb M. Yeung ◽  
Peter J. Ostergaard ◽  
Harold A. Fogel ◽  
...  
Keyword(s):  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Conservative Management ◽  
Spinal Canal ◽  
Lumbar Disc ◽  
Nonoperative Treatment ◽  
Herniated Disc ◽  
Mri Scan ◽  
Cronbach's Alpha ◽  
Disc Herniations

Study Design: Retrospective study. Objective: In this study, we examined whether the size of a lumbar disc herniation (LDH) is predictive of the need for surgical intervention within 2 years after obtaining an initial magnetic resonance imaging (MRI) scan. We hypothesized that a fragment that occupied a larger percentage of the spinal canal would not predict which patients failed conservative management. Methods: Using the ICD-10 code M51.26, we identified patients at a single academic institution, across the 2-year period from 2015 to 2016, who received a diagnosis of primary lumbar radicular pain, had MRI showing a disc herniation, and underwent at least 6 weeks of nonoperative management. Patients experiencing symptoms suggesting cauda equina syndrome and those with progressive motor neurological deficits were excluded from analysis, as were patients exhibiting “hard” disc herniations. Within the axial view of an MRI, the following measurements were made on AGFA-IMPACS for a given disc herniation: the length of both the canal and the herniated disc along the anterior-posterior axis, the average width of the disc within the canal; the total canal area, and the area of the disc herniation. Data analysis was conducted in SPSS and a 2-tailed reliability analysis using Cronbach’s alpha as a measure of reliability was obtained. Results: A total of 368 patients met the inclusion and exclusion criteria for this study. Of these, 14 (3.8%) had L3-L4 herniations, 185 had L4-L5 herniations (50.3%), and 169 had L5-S1 herniations (45.9%). Overall, 336 (91.3%) patients did not undergo surgery within 1 year of the LDH diagnosis. Patients who did not receive surgery had an average herniation size that occupied 31.2% of the canal, whereas patients who received surgery had disc herniations that occupied 31.5% of the canal on average. A Cronbach’s alpha of .992 was observed overall across interobserver measurements. After controlling for age, race, gender, and location of herniation through a logistic regression, it was found that the size of the herniation and the percentage of the canal that was occupied had no predictive value with regard to failure of conservative management, generating an odds ratio for surgery of 1.00. Conclusions: The percentage of the spinal canal occupied by a herniated disc does not predict which patients will fail nonoperative treatment and require surgery within 2 years after undergoing a lumbar spine MRI scan.

Effectiveness of Traction in Young Patients Representing Different Stages of Degenerative Disc Disease

2019 ◽  
Vol 21 (3) ◽  
pp. 187-196 ◽  
Author(s):  
Tomasz Kuligowski ◽  
Agnieszka Dębiec-Bąk ◽  
Anna Skrzek
Keyword(s):  
Young People ◽  
Functional Status ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Degenerative Disc Disease ◽  
Lumbar Disc ◽  
Clinical Status ◽  
Young Patients ◽  
Disc Disease ◽  
Degenerative Disc

Background. Low back pain (LBP) currently ranks among the most frequent musculoskeletal pathologies, and the average age of those affected is constantly decreasing. One of the causes of LBP is lumbar disc herniation (LDH). If untreated, it causes disability and leads to socio-economic problems. Traction techniques are a popular method of treating this condition. The stage of LDH (protrusion, extrusion) in young people appears to determine patients’ clinical status, necessitating diversification of treatment methods with regard to the type of damage. Material and methods. The study enrolled 37 people aged 22-35. The subjects underwent radiological evalu­ation (MRI), which constituted the basis for assigning them to one of two groups: a protrusion group (PRO) or an extrusion group (EXT). During the experiment, the patient was in the supine position while the therapist administered three-dimensional traction using a manual therapy belt. The Oswestry questionnaire, MRC scale, NRS, SLR test, PLE test and measurements of lumbar segment mobility were used for clinical evaluation. Statistica 12.5 was used to perform statistical calculations. Results. An analgesic effect was noted with regard to the following two parameters in both groups: ODI (PRO 28 → 14 and EXT 30 → 28, p <0.01) and NRS (PRO 6 → 2 and EXT 6 → 3, p <0.01). The subjects improved clinically, with regard to PLE (EXT 22% → 0%, p <0.04) and SLR (PRO 100% → 29%, p <0.01, and EXT 100% → 57%, p <0.01). Conclusions. 1. The type of intervertebral disc damage determines the functional status of young people with degenerative disc disease. 2. The study demonstrated and confirmed a positive effect of traction on the functional status of subjects with lumbar disc herniation. 3. Traction techniques are safe and can be successfully used in the treatment of LDH.

scholarly journals Clinical outcomes after minimal-access surgery for recurrent lumbar disc herniation

2003 ◽  
Vol 15 (3) ◽  
pp. 1-4 ◽  
Author(s):  
Hoang Le ◽  
Faheem A. Sandhu ◽  
Richard G. Fessler
Keyword(s):  
Clinical Outcomes ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Length Of Hospital Stay ◽  
Surgical Approaches ◽  
Published Data ◽  
Minimal Access ◽  
Disc Herniations ◽  
Recurrent Lumbar Disc Herniation

Object Experience with minimal-access surgical approaches for revision lumbar surgery has not been previously reported. Methods During a 7-month period, 10 consecutive patients with recurrent disc herniations underwent revision operations in which microendoscopic discectomy (MED) was performed. Perioperative data and clinical outcomes (according to Macnab criteria) were compared with those obtained in 25 consecutive patients who underwent routine single-level MED as well as with previously published data. Overall, outcome of the MED-treated revision group was excellent or good in 90% during a mean follow-up period of 18.5 months (minimum 12 months). Operative blood loss, duration, complications, and length of hospital stay were not significantly different between the revision and primary MED-treated groups. Conclusions Analysis of these early data suggests equivalent or superior results are obtained when performing MED compared with historical controls in which conventional surgery was conducted for recurrent disc surgery. The procedure appears to be a safe and effective alternative in cases in which recurrent lumbar disc herniation causes radiculopathy.

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