Correlation of matrix metalloproteinases–1 and –3 with patient age and grade of lumbar disc herniation

Object The authors studied the histological alterations and the expression of matrix metalloproteinase (MMP)–1 and MMP-3 in disc specimens of patients who had undergone operations for lumbar disc herniation. Methods Forty-three lumbar disc specimens were evaluated histopathologically for degenerative changes and immunohistochemical expression of MMP-1 and MMP-3. The observed degenerative changes provided a degenerative score that was applied in each patient. Sections of disc immunostained for MMP-1 and MMP-3 were evaluated semiquantitatively. Patients were categorized in 3 age groups: < 30 years, between 30 and 60 years, and > 60 years of age. The expression of MMP-1 and MMP-3 were correlated to patient's age, degenerative score, and grade of lumbar disc herniation. Results There was no statistically significant difference in the degenerative score between the age groups. Degenerative changes were more pronounced in greater grades of herniation (p < 0.0001). In the group of patients < 30 years of age there was a significant correlation between MMP-1 and MMP-3 expression and both degenerative score and herniation grade. For the group of patients 30–60 years of age, there was no significant difference between MMP-1 expression and degenerative score, but the correlation between MMP-1 expression and grade of herniation was significant. There was a significant correlation between MMP-3 expression and both degenerative score and herniation grade. Regarding the patients > 60 years of age, there was a significant correlation between MMP-1 and MMP-3 expression and both degenerative score and herniation grade. There was a significantly lower expression of both MMP-1 and MMP-3 in the group < 30 years of age compared with the other ages. No significant correlation was found in MMP-1 and MMP-3 expression between the groups of patients who were 30–60 and > 60 years of age. Interestingly, in age groups > 30 years, there were no statistically significant differences between the expression of MMP-1 and MMP-3, whereas in patients < 30 years of age the expression of MMP-3 was significantly lower than the expression of MMP-1. Conclusions The expression of MMP-1 and MMP-3 were strongly correlated to the age of the patients and the grade of herniation. An important finding in this study is the differential expression of MMP-1 and MMP-3 between the age groups. In the young age group it appears that deregulation of MMP-1 expression is higher than that of MMP-3 in the pathogenesis of lumbar disc herniation.

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A Study of Lumbar Disc Herniation and Facet Joint Asymmetry

International Surgery ◽

10.9738/intsurg-d-16-00119.1 ◽

2019 ◽

Vol 103 (1-2) ◽

pp. 87-94

Author(s):

Qi Lai ◽

Yuan Liu ◽

Runsheng Guo ◽

Xin Lv ◽

Qiang Wang ◽

...

Keyword(s):

Lumbar Disc Herniation ◽

Disc Herniation ◽

Facet Joint ◽

Lumbar Disc ◽

Patients Âgés ◽

Lower Lumbar Spine ◽

Significant Difference ◽

Facet Joint Degeneration ◽

Disc Herniations ◽

Lumbar Facet

Purpose: To investigate the association of facet joint asymmetry with lumbar disc herniation at the lower lumbar spine. Methods: A total of 90 patients (ages 18–40 years) with single-level disc herniation (L3–L4, L4–L5, or L5–S1) were included in the study. Facet asymmetry was defined as a difference of 10° in facet joint angles between right and left sides. Normal discs in the same segment of other individuals were used as a control. Patients had facet asymmetry measured for L3 to S1 through 3.0T magnetic resonance imaging, and information was collected, including age, sex, degenerative degree of lumbar facet joints, and the presence or absence of lumbar disc herniation and type. Results: At the L3 to L4 level, 2 cases had facet asymmetry in 8 patients with lumbar disc herniation, compared with 17 cases of facet asymmetry in 82 patients without disc herniation (P = 0.7776, r = 0.030). At the L4 to L5 level, there were 21 cases of facet asymmetry in 45 patients with lumbar disc herniation, compared with 5 cases of asymmetry in 45 patients without disc herniation (P = 0.00019, r = 0.392). At the L5 to S1 level, there were 25 cases of facet asymmetry in 37 patients with lumbar disc herniation, compared with 11 cases of facet asymmetry in 53 patients without disc herniation (P = 0.0000, r = 0.492). There were 23 cases of facet asymmetry in 28 disc herniations of side type compared with 2 cases of facet asymmetry in 9 herniations of center type (P = 0.0008, r = 0.364). There was no significant difference in the relationship between age, facet joint degeneration, and lumbar facet joint asymmetry (P > 0.05). Conclusion: Facet asymmetry is significantly associated with lumbar disc herniation at the L4 to L5 and the L5 to S1 levels, whereas there is an obvious association with the side type of lumbar disc herniation at the L5 to S1 level.

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71. Long-term Outcomes of Standard Discectomy for Lumbar Disc Herniation in Different Age Groups

The Spine Journal ◽

10.1016/j.spinee.2007.07.086 ◽

2007 ◽

Vol 7 (5) ◽

pp. 35S

Author(s):

Etsuro Yorimitsu ◽

Kazuhiro Chiba ◽

Yoshiaki Toyama ◽

Yosio Shinozaki

Keyword(s):

Lumbar Disc Herniation ◽

Disc Herniation ◽

Lumbar Disc ◽

Age Groups ◽

Long Term Outcomes

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Comparison of Outcomes Postoperation between Straight Leg Raising Test Negative and Positive Patients Who Underwent Percutaneous Transforaminal Endoscopic Discectomy for Lumbar Disc Herniation

10.21203/rs.2.15446/v1 ◽

2019 ◽

Author(s):

Feilong Wei ◽

Haoran Gao ◽

Yifang Yuan ◽

Shu Qian ◽

Quanyou Guo ◽

...

Keyword(s):

Lumbar Disc Herniation ◽

Disc Herniation ◽

Lumbar Disc ◽

Related Factors ◽

Significant Difference ◽

Endoscopic Discectomy ◽

Straight Leg Raising ◽

Percutaneous Transforaminal Endoscopic Discectomy ◽

Relevant Factors

Abstract Background: Percutaneous Transforaminal Endoscopic Discectomy is used increasingly in patients with Lumbar Disc Herniation. There is little knowledge on the related factors including SLR test influencing the operation. Therefore, we designed this prospective study to explore the relevant factors influencing postoperative effect of PTED surgery.Methods: Consecutive patients with LDH who came to our hospital from August 2015 to September 2016 and received PTED surgery. 4 kinds of scales including VAS (lumbar/leg), ODI and JOA were measured and reassessed at 1 day, 3 months, 6 months, 12months and 36 months after the PTED to assess their surgical outcomes. Results: All the patients had successful surgery. ODI and VAS (lumbar/leg) decreased in all patients and groups. And there was a statistically significant difference in each postoperative follow-up compared with that before surgery in every visit. In addition, the increase of JOA in postoperation was statistically significant compared with that before surgery. And, there is statistically significant difference between the three subpopulations (patients with SLR Positive (0°-30°), SLR Positive (31°-60°) and SLR Negative (61°-) in the changes of the scores of VAS(leg), ODI and JOA. However, there is no statistically significant difference between the three subpopulations (patients with SLR Positive (0°-30°), SLR Positive (31°-60°) and SLR Negative (61°--RRB- in the changes of the score of VAS(lumbar). Conclusions: PTED showed great effect on treating patients with lumbar disc herniation. And the main scale score such as VAS(leg). ODI and JOA showed that there is a statistically significant difference between the three subpopulations treated by PTED. Patients with SLR negative may get greater benefit from PTED.

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Does the sagittal spinal profile differ between the elderly Chinese populations with and without lumbar disc herniation?

10.21203/rs.3.rs-827940/v1 ◽

2021 ◽

Author(s):

Jipeng Song ◽

Fumin Pan ◽

Chao Kong ◽

Xiangyao Sun ◽

Yu Wang ◽

...

Keyword(s):

Disc Degeneration ◽

Lumbar Disc Herniation ◽

Disc Herniation ◽

Lumbar Disc ◽

Age Groups ◽

Lumbar Disc Degeneration ◽

Roussouly Classification ◽

Asymptomatic Volunteers ◽

Two Populations

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.

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To study the effect of Triamcinolone injection for low back pain due to lumbar disc herniation

Bhutan Health Journal ◽

10.47811/bhj.58 ◽

2018 ◽

Vol 4 (1) ◽

pp. 55-59

Author(s):

Tashi Wangchuk ◽

Kunzang P. Wangmo ◽

Thinley Norbu

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Lumbar Disc Herniation ◽

Disc Herniation ◽

Lumbar Disc ◽

Low Back ◽

Trauma History ◽

Pain Scores ◽

Significant Difference ◽

Epidural Steroid

Introduction: Low back pain is one of the most common complaints in the general population which represents a significant public health problem. Epidural Steroid Injection is being considered as a simple, effective and minimally invasive treatment modality for lumbar disc herniation. However, most studies only find a short-term benefit. In Bhutan, till date, no study has been done in Bhutan on this subject. The objective of our study was to find the effect of epidural steroid injection for low back pain due to lumbar disc herniation. Methods: An observational one-year-period study completed in Jigme Dorji Wangchuck National Referral Hospital. Symptomatic and positive Magnetic Resonance Imaging patients with lumbar disc herniation were included in our study. Pain scores were collected using Numeric Rating Scale at three different points of study. We also included patients’ age, weight and trauma history as some of the independent variables to study their associations with pain scores. The data obtained were analyzed using the Stata software program. One way repeated measures ANOVA was used to assess the significant difference in pain score. Results: Out of 100 participants recruited for the study, 91 of them completed demographic data and only 81 patients completed follow-up till 4 weeks post-treatment for demographic analysis and analytical analysis, respectively. There was a significant difference in pain scores in all three different points of study (p <0.01). No significant difference was observed in the pain scores amongst different age groups, gender, occupation and trauma history (p >0.05) at all three points of study. Conclusion: Our study observed a significant short-term benefit from epidural Triamcinolone injection for symptomatic lumbar disc herniation.

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Open discectomy versus microscopic discectomy for lumbar disc herniation

10.21203/rs.3.rs-16951/v1 ◽

2020 ◽

Author(s):

Sherwan Hamawandi ◽

Injam Ibrahim Sulaiman ◽

Ameer Kadhim Al-Humairi

Keyword(s):

Back Pain ◽

Hospital Stay ◽

Lumbar Disc Herniation ◽

Disc Herniation ◽

Lumbar Disc ◽

Postoperative Hospital Stay ◽

Daily Activities ◽

Leg Pain ◽

Significant Difference ◽

Pain Duration

Abstract Background Discectomy for symptomatic lumbar disc herniation is the most common surgical procedure in spine surgery. Lumbar discectomy can be done by traditional open method or by varieties of minimal invasive techniques mainly microscopic or endoscopic procedures. This study evaluates the effectiveness of microdiscectomy compared with open discectomy in the treatment of lumbar disc herniation as a relation to the relief of leg pain, post-operative back pain, postoperative hospital stay and returns to daily activity. Methods Sixty patients were included in this study, 30 patients underwent an open discectomy and 30 patients underwent microdiscectomy. Those patients were followed up for 12 months after surgery. Each patient was evaluated for the postoperative back pain, leg pain, duration of hospital stay postoperatively and return to sedentary daily activity. The methods used to evaluate each patient are Visual analogue scale for back pain and leg pain and Oswestry disability index. Results Results showed that there is a significant difference in the postoperative back pain, duration of postoperative hospital stay and the time of return to sedentary daily activities between open discectomy and microdiscectomy with superiority for microdiscectomy while there is no significant difference in the relieving leg pain between the open discectomy and microdiscectomy. Conclusion Microdisctomy is effective as open discectomy in the aspect of relieving the leg pain with the advantage of less postoperative back pain, less postoperative hospital stay and early return to sedentary daily activities.

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Learning curve of trans-sacral epiduroscopic laser decompression in herniated lumbar disc disease

10.21203/rs.3.rs-35673/v1 ◽

2020 ◽

Author(s):

Seong Son ◽

Chan Jong Yoo ◽

Byung Rhae Yoo ◽

Woo Seok Kim ◽

Tae Seok Jeong

Keyword(s):

Clinical Outcome ◽

Minimally Invasive ◽

Learning Curve ◽

Lumbar Disc Herniation ◽

Disc Herniation ◽

Lumbar Disc ◽

Operation Time ◽

Early Group ◽

Significant Difference ◽

Late Group

Abstract Background: Trans-sacral epiduroscopic laser decompression (SELD) using slender epiduroscope and a holmium YAG laser is one of the minimally invasive surgical options for lumbar disc herniation. However, the learning curve of SELD and the effect of surgical proficiency on clinical outcome have not yet been established. We investigated patients with lumbar disc herniation undergoing SELD to report the clinical outcome and learning curve. Methods: Retrospective analysis of clinical outcome and learning curve were performed at a single center from clinical data collected from November 2015 to November 2018. A total of 82 patients who underwent single-level SELD for lumbar disc herniation with a minimum follow-up of 6.0 months were enrolled. Based on the findings that the cut-off of familiarity was 20 cases according to the cumulative study of operation time, patients were allocated to two groups: early group (n = 20) and late group (n = 62). The surgical, clinical, and radiological outcomes were retrospectively evaluated between the two groups to analyze the learning curve of SELD.Results: According to linear and log regression analyses, the operation time was obtained by the formula: operation time = 58.825 - (0.181 × [case number]) (p < 0.001). The mean operation time was significantly different between the two groups (mean 56.95 minutes; 95% confidence interval [CI], 49.12–64.78 in the early group versus mean 45.34 minutes; 95% CI, 42.45–48.22 in the late group; p = 0.008, non-parametric Mann-Whitney U test).Baseline characteristics, including demographic data, clinical factors, and findings of preoperative magnetic resonance imaging, did not differ between the two groups. Also, there was no significant difference in terms of surgical outcomes, including complication and failure rates, as well as clinical and radiological outcomes between the two groups.Conclusion: The learning curve of SELD was not as steep as that of other minimally invasive spinal surgery techniques, and the experience of surgery was not an influencing factor for outcome variation.

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Learning curve of trans-sacral epiduroscopic laser decompression in herniated lumbar disc disease

10.21203/rs.3.rs-35673/v3 ◽

2020 ◽

Author(s):

Seong Son ◽

Chan Jong Yoo ◽

Byung Rhae Yoo ◽

Woo Seok Kim ◽

Tae Seok Jeong

Keyword(s):

Clinical Outcome ◽

Minimally Invasive ◽

Learning Curve ◽

Lumbar Disc Herniation ◽

Disc Herniation ◽

Lumbar Disc ◽

Operation Time ◽

Early Group ◽

Significant Difference ◽

Late Group

Abstract Background: Trans-sacral epiduroscopic laser decompression (SELD) using slender epiduroscope and a holmium YAG laser is one of the minimally invasive surgical options for lumbar disc herniation.However, the learning curve of SELD and the effect of surgical proficiency on clinical outcome have not yet been established. We investigated patients with lumbar disc herniation undergoing SELD to report the clinical outcome and learning curve.Methods: Retrospective analysis of clinical outcome and learning curve were performed at a single center from clinical data collected from November 2015 to November 2018. A total of 82 patients who underwent single-level SELD for lumbar disc herniation with a minimum follow-up of 6.0 months were enrolled. Based on the findings that the cut-off of familiarity was 20 cases according to the cumulative study of operation time, patients were allocated to two groups: early group (n = 20) and late group (n = 62). The surgical, clinical, and radiological outcomes were retrospectively evaluated between the two groups to analyze the learning curve of SELD.Results: According to linear and log regression analyses, the operation time was obtained by the formula: operation time = 58.825 - (0.181 × [case number]) (p < 0.001). The mean operation time was significantly different between the two groups (mean 56.95 minutes; 95% confidence interval [CI], 49.12–64.78 in the early group versus mean 45.34 minutes; 95% CI, 42.45–48.22 in the late group; p = 0.008, non-parametric Mann-Whitney U test).Baseline characteristics, including demographic data, clinical factors, and findings of preoperative magnetic resonance imaging, did not differ between the two groups. Also, there was no significant difference in terms of surgical outcomes, including complication and failure rates, as well as clinical and radiological outcomes between the two groups.Conclusion: The learning curve of SELD was not as steep as that of other minimally invasive spinal surgery techniques, and the experience of surgery was not an influencing factor for outcome variation.

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The effect of multimedia-based nursing visit on preoperative anxiety and vital signs in patients undergoing lumbar disc herniation surgery: A randomised clinical trial

Journal of Perioperative Practice ◽

10.1177/1750458917742045 ◽

2018 ◽

Vol 28 (1-2) ◽

pp. 7-15 ◽

Cited By ~ 5

Author(s):

Behrooz Zarei ◽

Sina Valiee ◽

Bijan Nouri ◽

Fatemeh Khosravi ◽

Mohammad Fathi

Keyword(s):

Clinical Trial ◽

Lumbar Disc Herniation ◽

Disc Herniation ◽

Lumbar Disc ◽

Vital Signs ◽

Randomised Clinical Trial ◽

Preoperative Anxiety ◽

Nursing Visit ◽

Significant Difference ◽

Before And After

This study was a randomised clinical trial on 60 candidates undergoing lumbar disc herniation surgery. Anxiety rate and vital signs were measured before and after the intervention. There was a statistically significant difference between the two groups in terms of the preoperative anxiety, systolic and diastolic blood pressure, pulse and respiratory rate (P = 0.0001). Neurosurgery perioperative nurses can make use of multimedia in preoperative nursing visit based on the needs of patients.

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Does the microendoscopic technique reduce mortality and major complications in patients undergoing lumbar discectomy? A propensity score–matched analysis using a nationwide administrative database

Neurosurgical FOCUS ◽

10.3171/2015.10.focus15479 ◽

2016 ◽

Vol 40 (2) ◽

pp. E5 ◽

Cited By ~ 13

Author(s):

Junichi Ohya ◽

Yasushi Oshima ◽

Hirotaka Chikuda ◽

Takeshi Oichi ◽

Hiroki Matsui ◽

...

Keyword(s):

Propensity Score ◽

Lumbar Disc Herniation ◽

Disc Herniation ◽

Spinal Surgery ◽

Lumbar Disc ◽

Lumbar Discectomy ◽

Volume Number ◽

Minimally Invasive Spinal Surgery ◽

Major Complications ◽

Significant Difference

OBJECTIVE Although minimally invasive spinal surgery has recently gained popularity, few nationwide studies have compared the adverse events that occur during endoscopic versus open spinal surgery. The purpose of this study was to compare perioperative complications associated with microendoscopic discectomy (MED) and open discectomy for patients with lumbar disc herniation. METHODS The authors retrospectively extracted from the Diagnosis Procedure Combination database, a national inpatient database in Japan, data for patients admitted between July 2010 and March 2013. Patients who underwent lumbar discectomy without fusion surgery were included in the analysis, and those with an urgent admission were excluded. The authors examined patient age, sex, Charlson Comorbidity Index, body mass index, smoking status, blood transfusion, duration of anesthesia, type of hospital, and hospital volume (number of patients undergoing discectomy at each hospital). One-to-one propensity score matching between the MED and open discectomy groups was performed to compare the proportions of in-hospital deaths, surgical site infections (SSIs), and major complications, including stroke, acute coronary events, pulmonary embolism, respiratory complications, urinary tract infection, and sepsis. The authors also compared the hospital length of stay between the 2 groups. RESULTS A total of 26,612 patients were identified in the database. The mean age was 49.6 years (SD 17.7 years). Among all patients, 17,406 (65.4%) were male and 6422 (24.1%) underwent MED. A propensity score–matched analysis with 6040 pairs of patients showed significant decreases in the occurrence of major complications (0.8% vs 1.3%, p = 0.01) and SSI (0.1% vs 0.2%, p = 0.02) in patients treated with MED compared with those who underwent open discectomy. Overall, MED was associated with significantly lower risks of major complications (OR 0.62, 95% CI 0.43–0.89, p = 0.01) and SSI (OR 0.29, 95% CI 0.09–0.87, p = 0.03) than open discectomy. There was a significant difference in length of hospital stay (11 vs 15 days, p < 0.001) between the groups. There was no significant difference in in-hospital mortality between MED and open discectomy. CONCLUSIONS The microendoscopic technique was associated with lower risks for SSI and major complications following discectomy in patients with lumbar disc herniation.

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