Scheuermann’s Disease as a Risk Factor for Lumbar Disc Herniation Recurrence

OBJECT In this study, the authors aimed to identify specific risk factors for postdecompression lumbar disc herniation (PDLDH) in patients who have not undergone discectomy and/or fusion. METHODS Between 2007 and 2012, 493 patients with lumbar spinal stenosis underwent bilateral partial laminectomy without discectomy and/or fusion in a single hospital. Eighteen patients (herniation group [H group]: 15 men, 3 women; mean age 65.1 years) developed acute sciatica as a result of PDLDH within 2 years after surgery. Ninety patients who did not develop postoperative acute sciatica were selected as a control group (C group: 75 men, 15 women; mean age 65.4 years). Patients in the C group were age and sex matched with those in the H group. The patients in the groups were also matched for decompression level, number of decompression levels, and surgery date. The radiographic variables measured included percentage of slippage, intervertebral angle, range of motion, lumbar lordosis, disc height, facet angle, extent of facet removal, facet degeneration, disc degeneration, and vertebral endplate degeneration. The threshold for PDLDH risk factors was evaluated using a continuous numerical variable and receiver operating characteristic curve analysis. The area under the curve was used to determine the diagnostic performance, and values greater than 0.75 were considered to represent good performance. RESULTS Multivariate analysis revealed that preoperative retrolisthesis during extension was the sole significant independent risk factor for PDLDH. The area under the curve for preoperative retrolisthesis during extension was 0.849; the cutoff value was estimated to be a retrolisthesis of 7.2% during extension. CONCLUSIONS The authors observed that bilateral partial laminectomy, performed along with the removal of the posterior support ligament, may not be suitable for lumbar spinal stenosis patients with preoperative retrolisthesis greater than 7.2% during extension.

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CHRNA5/CHRNA3 gene cluster is a risk factor for lumbar disc herniation: a case-control study

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-019-1254-2 ◽

2019 ◽

Vol 14 (1) ◽

Author(s):

Xuejun Yang ◽

Xiaodong Guo ◽

Zhi Huang ◽

Yifeng Da ◽

Wenhua Xing ◽

...

Keyword(s):

Risk Factor ◽

Gene Cluster ◽

Lumbar Disc Herniation ◽

Disc Herniation ◽

Case Control Study ◽

Lumbar Disc ◽

Case Control ◽

Control Study

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Minimum of Two-Year Follow-up After Percutaneous Endoscopic Transforaminal Discectomy on Lumbar Disc Herniation: Clinical and Radiographic Outcomes

10.21203/rs.3.rs-1050709/v1 ◽

2021 ◽

Author(s):

Lei Yue ◽

Hao Chen ◽

Guanzhang Mu ◽

Bingxu Li ◽

Haoyong Fu ◽

...

Keyword(s):

Factor Analysis ◽

Risk Factor ◽

Intervertebral Disc ◽

Clinical Outcomes ◽

Disc Degeneration ◽

Lumbar Disc Herniation ◽

Disc Herniation ◽

Lumbar Disc

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.

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Numbness and Weakness Recovered at a Less Extent in Patients with Lumbar Disc Herniation after Percutaneous Endoscopic Lumbar Discectomy

Pain Research and Management ◽

10.1155/2019/4642701 ◽

2019 ◽

Vol 2019 ◽

pp. 1-7

Author(s):

Yuming Wang ◽

Fuqiang Gao ◽

Haibo Zou

Keyword(s):

Risk Factor ◽

Lumbar Disc Herniation ◽

Disc Herniation ◽

Independent Risk Factor ◽

Lumbar Disc ◽

Lumbar Discectomy ◽

Preoperative Pain ◽

Curative Effect ◽

Percutaneous Endoscopic Lumbar Discectomy ◽

Endoscopic Lumbar Discectomy

Background. Patients with lumbar disc herniation (LDH) may present with motor disorders and various sensory disorders, among which pain and numbness are the most common ones. Percutaneous endoscopic lumbar discectomy (PELD) is reported to be both safe and effective. However, most of the previous studies focused on the recovery of pain, and the relief extent of numbness and weakness has rarely been reported. The Sciatica Bothersomeness Index (SBI) is a self-assessment tool for LDH patients. It has demonstrated acceptable reliability, construct validity, and responsiveness. Objectives. Our aim was to explore the curative effect of percutaneous endoscopic lumbar discectomy and to compare the various extent of relief among pain, numbness, and weakness. Methods. The medical records of patients admitted for LDH from September 2016 to December 2018 were collected, and the patients were followed up for 3 months to evaluate the relief of their clinical symptoms. Preoperative and postoperative total scores and subitem scores of SBI were compared to evaluate the relief of pain, numbness, and weakness. Surgical outcomes of PELD were evaluated by the Nakai score, and patients were divided into two groups accordingly, which were the relief group (excellent and good in the Nakai score) and the less relief group (fair and poor in the Nakai score). Risk factors for PELD outcomes and preoperative presence of numbness and/or weakness were analyzed by the logistic model, and p value less than 0.05 was considered significant. Results. A total of 86 patients met the inclusion criteria and acquired 3 months follow-up. Relief extent of pain, numbness, and weakness, was 82%, 41%, and 21%, respectively. There were 71 cases in the relief group and 15 cases in the less relief group. Results of the logistic regression analysis showed that the preoperative pain score of SBI (p=0.002; OR: 1.647 (1.199–2.261)) was a relatively independent risk factor for PELD outcomes, and multiplicativity of duration of preoperative symptoms and imaging grade [p=0.004; OR: 1.015 (1.005–1.026)] was a relatively independent risk factor for preoperative presence of numbness and/or weakness. Conclusions. PELD had a good curative effect in the treatment of LDH. Patients of LDH recovered best from pain, followed by numbness and weakness after PELD. Higher level of patients self-reported preoperative pain indicated a better surgical outcome for LDH patients, and preoperative long duration of symptoms together with a severe compression of nerve root significantly increased the risk of presenting numbness and/or weakness.

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