In-Space Interspinous Distraction Device for Stabilization of Lumbar Spine in Motion Segment Instability in Lumbar Disc Herniation

2014 ◽  
pp. 243-243
Author(s):  
PS Ramani
Keyword(s):  
Lumbar Spine ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Motion Segment ◽  
Distraction Device ◽  
Interspinous Distraction

Computer Three-Dimensional Reconstruction and Pain Management for Lumbar Disc Herniation Treated by Intervertebral Foramen Endoscopy

2019 ◽  
Vol 9 (8) ◽  
pp. 1776-1781
Author(s):  
Zhaowen Peng ◽  
Wenwen Zhao ◽  
Shaohua Hu
Keyword(s):  
Lumbar Spine ◽  
Pain Management ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Three Dimensional ◽  
Operation Time ◽  
Control Group ◽  
Intervertebral Foramen ◽  
Experimental Group

Objective: Lumbar disc herniation leads the numbness and pain in the waist and lower limbs. Intervertebral foramen endoscopy is a minimally invasive procedure for the treatment of disc herniation. Adequate preoperative evaluation is conducive to this percutaneous skin surgery. The purpose of this study is to improve the efficacy of intervertebral foramen endoscopy in the treatment of lumbar disc herniation by preoperative computer three-dimensional reconstruction combined with pain management. Method: Fifty patients with lumbar disc herniation who met the indications of intervertebral foramen endoscopy were randomly divided into experimental group and control group. The control group was operated according to experience based on the common axial image. The experimental group was punctured according for three-dimensional visualization model of lumbar spine. Preoperative simulated puncture catheterization and perioperative pain management was applied. The catheterization time, operation time under endoscopy, fluoroscopy times during operation, the Visual Analogue Scale (VAS) and Japanese Orthopaedic Association (JOA) scores before and 1 d, 1 m and 3 m after operation were compared between two groups. Result: The three-dimensional visualization model of lumbar spine was reconstructed based on thin-layer data. According to the results of software measurement, the skin puncture point was located and the puncture angle was obtained. Compared with the control group, the catheterization time, operation time under endoscopy, fluoroscopy times during operation in experimental group were significantly reduced. There was no statistical difference in VAS and JOA scores between two groups before operation. Compared with control group, the VAS scores in experimental group at 1 d, and 1 m after operation were decreased statistically, while the JOA scores were increased statistically. Conclusion: Three-dimensional visualization model of lumbar spine and virtual operation planning can directly judge the feasibility of intervertebral foramen endoscopy in the treatment of lumbar disc herniation, improve the efficiency of operation, and further improve postoperative efficacy with pain management.

scholarly journals Clinical Significance of Protrusion Edge Enhancement Using Contrast-Enhanced Magnetic Resonance Imaging in The Conservative Treatment of Giant Lumbar Disc Herniation: A Prospective Observational Study

2020 ◽  
Author(s):  
Zhijia Ma ◽  
Pengfei Yu ◽  
Yuxiang Dai ◽  
Qiuxiang Feng ◽  
Hong Jiang ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Lumbar Spine ◽  
Conservative Treatment ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Resonance Imaging ◽  
Contrast Enhanced ◽  
Significant Difference ◽  
Bull's Eye

Abstract Background: Contrast-enhanced lumbar spine magnetic resonance imaging (MRI) was used to predict the efficacy of conservative treatment of giant lumbar disc herniation.Methods: From June 2017 to June 2019, 30 patients with giant lumbar disc herniation with positive and negative bull’s eye signs on contrast-enhanced lumbar spine MRI were assessed to measure differences in the rate of intervertebral disc herniation, rate of protrusion absorption, treatment effect, protrusion rate, and curative effect according to the lumbar Japanese Orthopedic Association (JOA) score before and after treatment.Results: Thirty patients with positive and negative bull’s eye signs (36 men and 24 women) aged 19 to 58 years (mean, 36.37 ± 9.56 years) were included. All patients were followed up for more than 1 year, and at least one MRI review was conducted within 1 year of treatment. The results of the first and final MRI examinations were compared. The protrusion rate was 82.16% ± 14.58% before treatment and 32.20% ± 30.80% after treatment, and the absorptivity of the protrusion was 59.48% ± 38.62%. There was no statistically significant difference in the general data before treatment between the positive and negative groups (P > 0.05). After treatment, the protrusion rate in the positive and negative bull’s eye sign groups was 14.41% ± 14.37% and 49.99% ± 32.70%, respectively (P < 0.05). The absorptivity in the positive and negative bull’s eye sign groups was 83.09% ± 15.54% and 35.87% ± 40.49%, respectively (P < 0.05). There was no statistically significant difference in the JOA score between the two groups before treatment (P > 0.05); however, there was a statistically significant difference in the JOA score between the two groups at 3 months (P < 0.05) and 1 year (P < 0.05) after treatment.Conclusions: Conservative treatment of giant lumbar disc herniation has a satisfactory clinical effect. Contrast-enhanced MRI can be used to predict the resorption of giant lumbar disc herniation. Protrusion resorption is more likely to occur in patients with than without a bull’s eye sign.Trial registration: Chinese Clinical Trial Registry (No. ChiCTR1900022377). Retrospectively registered 08 April 2019.

Lumbar disc herniation surgery in adolescents and young adults

2019 ◽  
Vol 101-B (12) ◽  
pp. 1534-1541 ◽  
Author(s):  
Tobias Lagerbäck ◽  
Hans Möller ◽  
Paul Gerdhem
Keyword(s):  
Young Adults ◽  
Lumbar Spine ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Adolescents And Young Adults ◽  
Lumbar Spine Surgery ◽  
Patient Reported

AimsThe purpose of this study was to investigate the risk of additional surgery in the lumbar spine and to describe long-term changes in patient-reported outcomes after surgery for lumbar disc herniation in adolescents and young adults.Patients and MethodsWe conducted a retrospective study design on prospectively collected data from a national quality register. The 4537 patients were divided into two groups: adolescents (≤ 18 years old, n = 151) and young adults (19 to 39 years old, n = 4386). The risk of additional lumbar spine surgery was surveyed for a mean of 11.4 years (6.0 to 19.3) in all 4537 patients. Long-term patient-reported outcomes were available at a mean of 7.2 years (5.0 to 10.0) in up to 2716 patients and included satisfaction, global assessment for leg and back pain, Oswestry Disability Index, visual analogue scale for leg and back pain, EuroQol five-dimension questionnaire (EQ-5D), and 36-Item Short-Form Health Survey (SF-36) Mental Component Summary and Physical Component Summary scores. Statistical analyses were performed with Cox proportional hazard regression, chi-squared test, McNemar’s test, Welch–Satterthwaite t-test, and Wilcoxon’s signed-rank test.ResultsAny type of additional lumbar spine surgery was seen in 796 patients (18%). Surgery for lumbar disc herniation accounted for more than half of the additional surgeries. The risk of any additional surgery was 0.9 (95% confidence interval (CI) 0.6 to 1.4) and the risk of additional lumbar disc herniation surgery was 1.0 (0.6 to 1.7) in adolescents compared with the young adult group. Both age groups improved their patient-reported outcome data after surgery (all p < 0.001). Changes between short- (mean 1.9 years (1.0 to 2.0)) and long-term follow-up (mean 7.2 years (5.0 to 10.0)) were small.ConclusionThe risk of any additional lumbar spine surgery and additional lumbar disc herniation surgery was similar in adolescents and young adults. All patient-reported outcomes improved from preoperative to the short-term follow-up, while no likely clinically important differences between the short- and long-term follow-up were seen within both groups. Cite this article: Bone Joint J 2019;101-B:1534–1541

Anteroposterior Lumbar Spine X-ray of L5 Lamina for Evaluation of Lower Lumbar Disc Herniation in Young Adults

2020 ◽  
Author(s):  
Lin Jin ◽  
Li Zhang ◽  
Jialiang Guo ◽  
Ruipeng Zhang ◽  
Yingchao Yin ◽  
...  
Keyword(s):  
Young Adults ◽  
Lumbar Spine ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Lumbar Vertebra ◽  
Control Group ◽  
X Ray ◽  
Significant Difference ◽  
Lower Lumbar

Abstract Background: Plain radiographs are rarely used in the diagnostic evaluation of lumbar disc herniation (LDH). The L5 lamina is the important skeletal structure at the back of the lower lumbar vertebra. This study investigated the association between the height of L5 lamina under anteroposterior lumbar spine X-ray and lower LDH, to determine its significance to the onset of LDH in young adults.Methods: We conducted a retrospective study of 160 patients aged 18 to 39 years with lower LDH and 160 healthy controls. The anteroposterior lumbar spine X-ray was used to image features of the L5 lamina. The height of L5 lamina (“h”) and of the space between L4 and S1 lamina (“H”) were measured. The difference in height of L5 lamina in each study group was assessed as the ratio of “h/H”. Results: There was no significant difference in sex, age, occupation type, body mass index (BMI), family history or smoking status (p>0.05) between LDH group and the control group. The mean ratio (95% CI) of “h/H” in LDH and control group was 0.28 (0.26, 0.31) and 0.35 (0.32, 0.38) respectively, with statistical difference (p<0.05). The diagnostic accuracy of “h/H” ratio was investigated using the receiver operating characteristic (ROC) curve. The area under the curve was 0.835 (95% CI 0.789, 0.881), using a cut-off of 0.315 (sensitivity 0.806, specificity 0.794). A decrease in the “h/H” ratio, showed an increasing linear trend in the protrusion proportion of L4/5 segments (Z=5.943, p<0.05).Conclusions: The onset of lower LDH in young adults is related to the developmental difference in L5 Lamina. Young adults with developmental defects of L5 lamina are more likely to develop lower LDH. Assessment of “h/H” ratio could be used for evaluation or prediction of asymptomatic or mildly symptomatic lower LDH in young adults.

Continuous lumbar spine rhythms during level walking, stair climbing and trunk flexion in people with and without lumbar disc herniation

2018 ◽  
Vol 63 ◽  
pp. 296-301 ◽  
Author(s):  
Shengzheng Kuai ◽  
Xinyu Guan ◽  
Wenyu Zhou ◽  
Rui Zhang ◽  
Run Ji ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Stair Climbing ◽  
Trunk Flexion ◽  
Level Walking

scholarly journals Anteroposterior lumbar spine X-ray of L5 lamina for screening of possibility of lower lumbar disc herniation in young adults

2020 ◽  
Author(s):  
Lin Jin ◽  
Li Zhang ◽  
Jialiang Guo ◽  
Ruipeng Zhang ◽  
Yingchao Yin ◽  
...  
Keyword(s):  
Young Adults ◽  
Lumbar Spine ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Lumbar Vertebra ◽  
Control Group ◽  
X Ray ◽  
Significant Difference ◽  
Lower Lumbar

Abstract Background: Plain radiographs are rarely used in the imaging evaluation of lumbar disc herniation (LDH). The L5 lamina is the important skeletal structure at the back of the lower lumbar vertebra. This study investigated the association between the height of L5 lamina under anteroposterior lumbar spine X-ray and lower LDH, to determine its significance to the onset of LDH in young adults.Methods: We conducted a retrospective study of 160 patients aged 18 to 39 years with lower LDH and 160 healthy controls. The anteroposterior lumbar spine X-ray was used to image features of the L5 lamina. The height of L5 lamina (“h”) and of the space between L4 and S1 lamina (“H”) were measured. The difference in height of L5 lamina in each study group was assessed as the ratio of “h/H”. Results: There was no significant difference in sex, age, occupation type, body mass index (BMI), family history or smoking status (p>0.05) between LDH group and the control group. The mean ratio (95% CI) of “h/H” in LDH and control group was 0.28 (0.26, 0.31) and 0.35 (0.32, 0.38) respectively, with statistical difference (p<0.05). The diagnostic accuracy of “h/H” ratio was investigated using the receiver operating characteristic (ROC) curve. The area under the curve was 0.835 (95% CI 0.789, 0.881), using a cut-off of 0.315 (sensitivity 0.806, specificity 0.794). A decrease in the “h/H” ratio, showed an increasing linear trend in the protrusion proportion of L4/5 segments (Z=5.943, p<0.05).Conclusions: Young adults with developmental defects of L5 lamina are more likely to develop lower LDH. Assessment of “h/H” ratio could be used for screening or prediction of asymptomatic or mildly symptomatic lower LDH in young adults.

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