scholarly journals Characteristics and Short-Term Surgical Outcomes of Patients with Recurrent Lumbar Disc Herniation after Percutaneous Laser Disc Decompression

Medicina ◽  
2021 ◽  
Vol 57 (11) ◽  
pp. 1225
Author(s):  
Hidetomi Terai ◽  
Koji Tamai ◽  
Masayoshi Iwamae ◽  
Kunikazu Kaneda ◽  
Hiroshi Katsuda ◽  
...  
Keyword(s):  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Matched Control ◽  
Lumbar Disc ◽  
Control Group ◽  
Mixed Effect ◽  
Matched Control Group ◽  
Clinical Scores ◽  
Laser Disc ◽  
Surgical Data

Background and Objectives: Although percutaneous laser disc decompression (PLDD) is one of the common treatment methods for patients with lumbar disc herniation (LDH), the recurrence of LDH after PLDD is estimated at 4–5%. This study compares the preoperative clinical data and clinical outcomes of patients who underwent primary microendoscopic discectomy (MED) or MED following PLDD. Materials and Methods: We retrospectively analyzed 2678 patients who underwent MED for LDH. The PLDD group included patients with previous PLDD history at the same level of LDH, and a matched control group was created using propensity score matching for age, sex, and body mass index. Preoperative data, preoperative radiographic findings, and surgical data of the groups were compared. To compare postoperative changes in clinical scores between the groups, a mixed-effect model was used. Results: As a result, 42 patients (1.6%) had previously undergone PLDD, and a control group with 42 patients were created. The disc degeneration severity was not significantly different between the groups. However, Modic changes were more frequent in the PLDD group than in the matched control group (p = 0.028). There were no significant differences in dural adhesion rate or surgery-related complications including dural injury, length of stay, and recurrence rate of LDH after surgery. In addition, the improvement of clinical scores did not significantly differ between the two groups (p = 0.112, 0.913, respectively). Conclusions: We concluded that patients with recurrent LDH after PLDD have advanced endplate degeneration, which may reflect endplate injury from a previous PLDD. However, a previous history of PLDD does not have a negative impact on the clinical result of MED.

scholarly journals The relationship of the shear wave elastography findings of patients with unilateral lumbar disc herniation and clinical characteristics

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Qingyuan Wang ◽  
Hao Zhang ◽  
Jinxin Zhang ◽  
Hanqi Zhang ◽  
Hui Zheng
Keyword(s):  
Sciatic Nerve ◽  
Shear Wave ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Clinical Characteristics ◽  
Lumbar Disc ◽  
Shear Wave Elastography ◽  
Control Group ◽  
Symptom Duration ◽  
Foraminal Stenosis

Abstract Background The aim of this study was to find out whether the shear wave elastography (SWE) findings of patients with unilateral lumbar disc herniation (LDH) were related to clinical characteristics. Methods For this purpose, the study group included patients (N = 20; 13 male, 7 female) with complaints of unilateral sciatica, with foraminal stenosis caused by one level of LDH (L4-L5 or L5-S1). An gender-and age-matched control group (N = 27; 16 male, 11 female) was included. All the patients were examined on both the axial and longitudinal planes bilaterally at the same level using a convex array probe (1- 6 MHz, Supersonic Imagine, Aix en Provence, France). Results The sciatic nerve stiffness measured on longitudinal planes of the affected side was significantly higher than unaffected side (p < 0.001) and the control group (P < 0.05). Furthermore, the symptom duration of unilateral LDH is positively correlated with the stiffness the sciatic nerve (r = 0.52, p = 0.019). Conclusion According to these findings, ultrasound imaging can be considered as a useful tool to detect changes in the sciatic nerve due to disc herniation. This technique will have a promising prospect for many patients with unilateral LDH in monitoring stiffness during rehabilitation and before or after surgery.

scholarly journals Dysfunctional muscle activities and co-contraction in the lower-limb of lumbar disc herniation patients during walking

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Wei Wang ◽  
Hui Wei ◽  
Runxiu Shi ◽  
Leitong Lin ◽  
Lechi Zhang ◽  
...  
Keyword(s):  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lower Limb ◽  
Gait Cycle ◽  
Lumbar Disc ◽  
Lower Limbs ◽  
Heel Strike ◽  
Control Group ◽  
Double Support ◽  
Support Phase

AbstractThis study aimed to investigate lower-limb muscle activities in gait phases and co-contraction of one gait cycle in patients with lumbar disc herniation (LDH). This study enrolled 17 LDH patients and 17 sex- and age-matched healthy individuals. Bilateral muscle activities of the rectus femoris (RF), biceps femoris long head (BL), tibialis anterior (TA), and lateral gastrocnemius (LG) during walking were recorded. The gait cycle was divided into four phases by the heel strike and top off according to the kinematics tracks. Root mean square (RMS), mean frequency (MF), and co-contraction of surface electromyography signals were calculated. The LDH patients showed enhanced BL RMS during the single support phase (SS), second double support phase, and swing phase (SW) as well as decreased MF of RF during SS and of TA and LG during SW (p < 0.05). The co-contraction of the TA-LG was increased in LDH patients than in the control group (p < 0.05). Positive correlations were observed between TA-LG co-contraction (affected side, r = 0.557, p = 0.020; contralateral side, r = 0.627, p = 0.007) and the Oswestry disability index scores in LDH patients. LDH patients have increased BL firing rate and insufficient motor unit recruitment in specific phases in the lower limbs during walking. Dysfunction in LDH patients was associated with immoderate intermuscular co-contraction of the TA-LG during walking.

scholarly journals Integrative TCM Conservative Therapy for Low Back Pain due to Lumbar Disc Herniation: A Randomized Controlled Clinical Trial

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Wei An Yuan ◽  
Shi Rong Huang ◽  
Kai Guo ◽  
Wu Quan Sun ◽  
Xiao Bing Xi ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Conservative Therapy ◽  
Lumbar Disc ◽  
Control Group ◽  
Low Back ◽  
Randomized Controlled ◽  
Experimental Group

Low back pain due to lumbar disc herniation (LDH) is very common in clinic. This randomized controlled trial was designed to investigate the effects of integrative TCM conservative therapy for low back pain due to LDH. A total of 408 patients with low back pain due to LDH were randomly assigned to an experimental group with integrative TCM therapy and a control group with normal conservative treatment by the ratio of 3 : 1. The primary outcome was the pain by the visual analogue scale (VAS). The secondary outcome was the low back functional activities by Chinese Short Form Oswestry Disability Index (C-SFODI). Immediately after treatment, patients in the experimental group experienced significant improvements in VAS and C-SFODI compared with the control group (between-group difference in mean change from baseline, −16.62 points,P<0.001in VAS; −15.55 points,P<0.001in C-SFODI). The difference remained at one-month followup, but it is only significant in C-SFODI at six-month followup (−7.68 points,P<0.001). No serious adverse events were observed. These findings suggest that integrative TCM therapy may be a beneficial complementary and alternative therapy for patients with low back pain due to LDH.

scholarly journals The relationship of the shear wave elastography findings of patients with unilateral lumbar disc herniation and clinical characteristics

2019 ◽  
Author(s):  
qingyuan wang ◽  
jinxin zhang ◽  
hanqi zhang ◽  
hui zheng ◽  
Hao Zhang
Keyword(s):  
Sciatic Nerve ◽  
Shear Wave ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Clinical Characteristics ◽  
Lumbar Disc ◽  
Shear Wave Elastography ◽  
Control Group ◽  
Symptom Duration ◽  
Foraminal Stenosis

Abstract Abstract Background The aim of this study was to find out whether the shear wave elastography (SWE) findings of patients with unilateral lumbar disc herniation (LDH)were related to clinical characteristics . Methods For this purpose,the study group included patients(N=20; 13 male, 7 female) with complaints of unilateral sciatica , with foraminal stenosis caused by one level of LDH (L4-L5 or L5-S1).An gender-and age-matched control group(N=27; 16 male, 11 female) was included.All the patients were examined on both the axial and longitudinal planes bilaterally at the same level using a convex array probe(1- 6MHz,Supersonic Imagine,Aix en Provence,France). Results The sciatic nerve stiffness measured on longitudinal planes of the affected side was significantly higher than unaffected side (p < 0.001)and the control group (P<0.05).Furthermore,the symptom duration of unilateral LDH is positively correlated with the stiffness the sciatic nerve(r=0.52,p=0.019). Conclusion According to these findings, ultrasound imaging can be considered as a useful tool to detect changes in the sciatic nerve due to disc herniation. This technique will have a promising prospect for many patients with unilateral LDH in monitoring stiffness during rehabilitation and before or after surgery. Keywords Ultrasound 、Sciatic nerve、Shear wave elastography、lumbar disc herniation

scholarly journals The relationship of the shear wave elastography findings of patients with unilateral lumbar disc herniation and clinical characteristics

2019 ◽  
Author(s):  
qingyuan wang ◽  
jinxin zhang ◽  
hanqi zhang ◽  
hui zheng ◽  
Hao Zhang
Keyword(s):  
Sciatic Nerve ◽  
Shear Wave ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Clinical Characteristics ◽  
Lumbar Disc ◽  
Shear Wave Elastography ◽  
Control Group ◽  
Symptom Duration ◽  
Foraminal Stenosis

Abstract Abstract Background The aim of this study was to find out whether the shear wave elastography (SWE) findings of patients with unilateral lumbar disc herniation (LDH)were related to clinical characteristics . Methods For this purpose,the study group included patients(N=20; 13 male, 7 female) with complaints of unilateral sciatica , with foraminal stenosis caused by one level of LDH (L4-L5 or L5-S1).An gender-and age-matched control group(N=27; 16 male, 11 female) was included.All the patients were examined on both the axial and longitudinal planes bilaterally at the same level using a convex array probe(1- 6MHz,Supersonic Imagine,Aix en Provence,France). Results The sciatic nerve stiffness measured on longitudinal planes of the affected side was significantly higher than unaffected side (p < 0.001)and the control group (P<0.05).Furthermore,the symptom duration of unilateral LDH is positively correlated with the stiffness the sciatic nerve(r=0.52,p=0.019). Conclusion According to these findings, ultrasound imaging can be considered as a useful tool to detect changes in the sciatic nerve due to disc herniation. This technique will have a promising prospect for many patients with unilateral LDH in monitoring stiffness during rehabilitation and before or after surgery. Keywords Ultrasound 、Sciatic nerve、Shear wave elastography、lumbar disc herniation

scholarly journals Value of ultrasound-guided transforaminal nerve block in the treatment of lumbar disc herniation

2020 ◽  
Vol 48 (4) ◽  
pp. 030006052091091
Author(s):  
Liu Guang-hui ◽  
Zhu Guang-yu ◽  
Liu Yu-zhang ◽  
Zhu Yong-Tao ◽  
Zhang Shi-min ◽  
...  
Keyword(s):  
Nerve Block ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Japanese Orthopaedic Association ◽  
Lumbar Vertebra ◽  
Control Group ◽  
Study Group ◽  
Ultrasound Guided ◽  
Lumbar Intervertebral Disc

Objective This study was performed to investigate the effectiveness and safety of ultrasound-guided transforaminal nerve block in the treatment of lumbar disc herniation. Methods Sixty patients who underwent treatment for protrusion of a lumbar intervertebral disc in Wangjing Hospital from January 2016 to December 2017 were divided into the study group and the control group. The visual analog scale (VAS) pain scores, the Japanese Orthopaedic Association (JOA) scores of the lumbar vertebra, PRI (pain rating index), and PPI (present pain intensity) were recorded at 30 minutes, 1 week, and 3 months after the operation. Results There were significant differences in the VAS, JOA, PRI, and PPI scores between the study group and control group. Conclusion Ultrasound guidance can improve the efficacy and safety of transforaminal nerve block in the treatment of lumbar disc herniation and shorten the operative duration.

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