scholarly journals KẾT QUẢ ĐIỀU TRỊ TRƯỢT ĐỐT SỐNG THẮT LƯNG BẰNG PHẪU THUẬT ÍT XÂM LẤN GIẢI ÉP, GHÉP XƯƠNG LIÊN THÂN ĐỐT QUA LỖ LIÊN HỢP

2021 ◽  
Vol 507 (1) ◽  
Author(s):  
Phạm Hồng Phong ◽  
Nguyễn Lê Bảo Tiến ◽  
Vũ Văn Cường ◽  
Võ Văn Thanh

Mục tiêu: Mô tả kết quả điều trị trượt đốt sống thắt lưng bằng phẫu thuật ít xâm lấn giải ép, ghép xương liên thân đốt qua lỗ liên hợp. Đối tượng và phương pháp: Nghiên cứu mô tả chùm ca bệnh 51 trường hợp bệnh nhân trượt đốt sống thắt lưng đơn tầng được phẫu thuật ít xâm lấn giải ép, ghép xương liên thân đốt qua lỗ liên hợp tại khoa Phẫu thuật cột sống, Bệnh viện Hữu nghị Việt Đức từ 01/2019 - 12/2020. Kết quả: 51 bệnh nhân (11 nam, 40 nữ), tuổi trung bình là 47,9 ± 12,9 (từ 15 đến 72) đã được phẫu thuật ít xâm lấn giải ép, ghép xương liên thân đốt qua lỗ liên hợp. Kết quả xa sau mổ được đánh giá theo tiêu chuẩn MacNab tại thời điểm 12 tháng sau mổ 44/51 bệnh nhân khám lại (86,3%): rất tốt: 28 (63,6%), tốt: 14 (31,8%), khá: 2 (4,6%), xấu: 0 (0,0%). Đánh giá cải thiện triệu chứng lâm sàng sau mổ tại thời điểm khám lại cuối cùng: điểm đau lưng VAS (Visual Analogue Scale) trước mổ 6,22 ± 1,06, sau mổ 12 tháng 1,89 ± 1,50, điểm đau chân VAS trước mổ 5,90 ± 1,40, sau mổ 12 tháng 1,25 ± 1,50, ODI (Oswestry Disability Index) trước mổ 49,41 ± 8,0, ODI sau mổ 12 tháng 15,18 ± 11,58. Đánh giá mức độ liền xương theo Bridwell tại thời điểm sau mổ 12 tháng, tỷ lệ liền xương đạt 97,8%. Biến chứng trong mổ: tổn thương rễ 2 trường hợp, chiếm 3,9%. Kết luận: Phẫu thuật ít xâm lấn giải ép, ghép xương liên thân đốt qua lỗ liên hợp là một phương pháp an toàn và hiệu quả trong điều trị TĐS thắt lưng đơn tầng.

2010 ◽  
Vol 67 (3) ◽  
pp. ons171-ons188 ◽  
Author(s):  
Krishna Kumar ◽  
Rita Nguyen ◽  
Sharon Bishop

Abstract BACKGROUND: The most common complication of osteoporosis is vertebral fractures, which occur more frequently than all other fractures (hip, wrist, and ankle). OBJECTIVE: To prospectively analyze vertebroplasty compared with kyphoplasty for the treatment of osteoporotic vertebral compression fractures using improvement in pain, functional capacity, and quality of life as outcome measures. METHODS: The study population included 28 patients in the vertebroplasty group and 24 patients in the kyphoplasty group. The mean follow-up period was 42.2 weeks and 42.3 weeks in the vertebroplasty and kyphoplasty groups, respectively. Outcomes were measured pre- and postoperatively using the visual analogue scale, the Oswestry Disability Index, the EuroQol-5D questionnaire, and the Short-Form 36 Health Survey. RESULTS: In the vertebroplasty group, visual analogue scale scores improved from a mean of 8.0 cm to 5.5 cm at last follow-up (P = .001). Preoperatively, the Oswestry Disability Index was 57.6, which improved to 38.4 (P = .006). The EuroQol-5D score preoperatively was 0.157 and improved to 0.504 (P = .001). The Short-Form 36 Health Survey showed greatest improvement in the areas of physical health, role physical, body pain, and vitality. In the kyphoplasty group, visual analogue scale scores improved from a mean of 7.5 cm preoperatively to 2.5 cm postoperatively (P = .000001). The mean Oswestry Disability Index preoperatively was 50.7 and improved to 28.8 (P = .002). The EuroQol-5D score improved from a mean of 0.234 preoperatively to 0.749 (P = .00004). The Short-Form 36 Health Survey showed greatest improvement in the areas of physical health, physical functioning, role physical, body pain, and social functioning. CONCLUSION: Both vertebroplasty and kyphoplasty are effective at improving pain, functional disability, and quality of life; however, kyphoplasty provides better results, which are maintained over long-term follow-up.


2015 ◽  
Vol 20 (1) ◽  
pp. e8-e11 ◽  
Author(s):  
Hong-Yu Tan ◽  
Li-Min Wang ◽  
Liang Zhao ◽  
Yi-Lin Liu ◽  
Rui-Peng Song

BACKGROUND: Percutaneous vertebroplasty (PVP) for patients with chronic painful osteoporotic compression fractures has not been extensively studied.OBJECTIVE: To prospectively evaluate the efficacy of PVP for patients with chronic painful osteoporotic vertebral compression fractures (VCFs).METHODS: Sixty-two consecutive patients with chronic painful osteoporotic VCFs for ≥3 months underwent PVP. All procedures were performed under local anesthesia. The outcomes were pain relief at one week, one month, three months, six months and one year, as measured by visual analogue scale, Oswestry Disability Index, Quality of Life Questionnaire of the European Foundation for Osteoporosis (QUALEFFO) and Roland Morris Disability Questionnaire scores.RESULTS: The PVP procedures were technically successful and well tolerated in all patients. Sixty-two patients underwent PVP on 92 vertebrae in 73 procedures three to five days after referral, and no 30-day mortality was observed. Compared with baseline scores, improvement in visual analogue scale, Oswestry Disability Index, QUALEFFO and Roland Morris Disability Questionnaire scores was significantly greater after PVP at one week (P<0.001), one month (P<0.001), three months (P<0.001), six months (P<0.001) and one year (P<0.001), and the number of patients using drugs for pain treatment was significantly reduced. Five new fractures were reported in five of 62 patients treated with PVP during follow-up.CONCLUSION: PVP is effective in patients with chronic painful osteoporotic VCFs. Pain relief after PVP was immediate, was sustained for one year and may be an important factor for reducing persistent pain.


Neurosurgery ◽  
2009 ◽  
Vol 65 (1) ◽  
pp. 95-99 ◽  
Author(s):  
Jin-Sung Kim ◽  
Sang-Ho Lee ◽  
Ki-Hyoung Moon ◽  
Ho-Yeon Lee

ABSTRACT OBJECTIVE This study was conducted to investigate the efficacy of treating central or paramedian disc herniations of the upper lumbar levels, including the thoracolumbar junction, through the oblique paraspinal approach. We published a technical case report on this subject in 2004. METHODS Nineteen consecutive patients with intracanalicular disc herniations of the upper lumbar levels underwent the oblique paraspinal approach, which utilizes an operating microscope, from March 2005 through January 2008. Their clinical and radiological data were collected and analyzed. The patients were assessed with standard examinations preoperatively and evaluated with dynamic lumbar x-rays, 3-dimensional computed tomographic scans, magnetic resonance imaging, standard pain and disability measurements, a visual analogue scale, the Oswestry disability index, and a patient satisfaction rate that checked their pain scores postoperatively. RESULTS The average follow-up period was 28.1 months, with a maximum of 48 months. The visual analogue scale for back and leg pain and the Oswestry disability index, which recorded a preoperative mean of 6.7%, 7.2%, and 64.7% and a postoperative mean of 3.2%, 3.0%, and 21.47%, respectively, showed statistically significant improvement at the time of the last follow-up evaluation, compared with preoperative scores. There have been neither recurrent disc herniations nor spinal instability during the follow-up period. CONCLUSION In this study, 19 cases of intracanalicular disc herniations at the upper lumbar levels, including the thoracolumbar junction, were successfully excised with the oblique paraspinal approach without recurrence or instability. We found that the oblique paraspinal approach, which resulted in satisfactory clinical outcomes with few complications, could be one of the main surgical procedures used to treat intracanalicular disc herniations at the upper lumbar levels.


2021 ◽  
Vol 6 (3) ◽  
pp. 300-309
Author(s):  
Iu. O. Pavlova ◽  
◽  
O. B. Fedorovych ◽  
A. V. Perederiy ◽  
K. A. Tymruk-Skoropad

Tools based on patient assessment (Patient-Reported Outcome Measures, PROMs) have significant interest in rehabilitation practice. Nowadays, this approach is considered reliable, trustworthy, and reasonable. Tools that have undergone all stages of adaptation and validation are highly proven and meet international standards, which, in particular, is a guarantee of high-quality survey results. The purpose of the study was to conduct an intercultural adaptation of the Oswestry Disability Index to the Ukrainian language and further verify the validity of this version of the instrument. Materials and methods. The study included individuals who had complaints of back pain (n = 104, 60.6 % females; age (M±SE) – 36.9±1.6 years old). Three different tools were used to assess pain (Oswestry Disability Index, Visual Analogue Scale) and various parameters of life quality (“The MOS 36-Item Short-Form Health Survey”). The internal consistency of the Oswestry Disability Index questionnaire was evaluated (the α-Cronbach’s index was determined), its reliability was studied (according to the test-retest procedure), and correlation and regression analyzes were used to check the constructive validity. The structure of the questionnaire was studied using exploratory factor analysis. Results and discussion. The proposed Ukrainian version of the questionnaire passed all stages of translation and intercultural adaptation, which meets the international standards and requirements of the MAPI Research Trust. In addition to the scientific coordinators, a sufficient number of translators, editor of the scientific literature, and a group of patients were involved in these processes. The questionnaire has high internal consistency (α-Cronbach = 0.931) and reliability (Spearman’s rho = 0.94, p < 0.01). In the structure of the tool, two factors explain 69.165% of the total variance. Issues related to walking and social life were related to the first factor, sitting, standing, traveling – to the second factor, the intensity of pain, self-care, lifting objects, and sex life – were related to both the first and second factors. The questionnaire has a sufficient level of constructive validity. An average correlation with the value of the Visual Analogue Scale (r = 0.547, p < 0.001), a strong correlation with the life quality scale “Physical Functioning” (r = -0.871, p < 0.001) were identified. Conclusion. The Ukrainian version of the Oswestry Disability Index questionnaire can be used to assess the level of pain, physical well-being, and physical component of the life quality of patients who have complaints of back pain


2019 ◽  
Vol 26 (7) ◽  
pp. 1-10
Author(s):  
Ana Claudia Aparecida Pelegrini ◽  
Eduardo Gasoto ◽  
Jean Marcos Bussolaro ◽  
Gabriel Segatti ◽  
Carlos Eduardo de Albuquerque ◽  
...  

Background/aimsDespite electrostimulation being a common adjuvant therapy for non-specific low back pain, the use of Aussie current for muscle contraction is still underreported in the literature. The present study aimed to assess the use of Aussie current in the treatment of chronic, non-specific lumbar pain.MethodsTwenty-four young women with chronic non-specific low back pain were randomly assigned to the Aussie current group or control group. Pain (visual analogue scale and McGill Pain Questionnaire), function (Oswestry Disability Index), trunk muscle resistance (the time the participant remained in a predefined static position) and multifidus muscle thickness (ultrasound images) were analysed bilaterally before, at the end of and 30 days after completing the treatment protocol. The treatment group received 12 sessions of Aussie current over a period of 4 weeks. The electrodes were arranged laterally and bilaterally to the spinous processes of the first and fifth lumbar vertebrae.ResultsThere was a reduction in the pain profile for the Aussie group, as measured by a visual analogue scale and the McGill Pain Questionnaire. There was an increase in trunk muscle resistance and in muscle thickness in the Aussie group when compared to the control group. There were no changes in the Oswestry Disability Index in either group.ConclusionsAussie current resulted in significant improvements in pain, endurance and muscle thickness in women with chronic, non-specific low back pain.


2021 ◽  
Vol 122 (4) ◽  
pp. 278-284
Author(s):  
Zafer Gündoğdu ◽  
Mesut Öterkuş ◽  
Ümit Karatepe

In this study, we aimed to investigate the effect of radiofrequency denervation procedure on pain and quality of life of patients with facet joint syndrome. Forty-seven patients who were admitted to our hospital with low back pain and diagnosed with facet joint syndrome between January 2018 and December 2018 were included in our study. The patients underwent denervation with radiofrequency under fluoroscopy in a sterile operating room condition. The pre-procedure and 6th month follow-up VAS (visual analogue scale) and ODI (Oswestry disability index) scores of the patients were recorded. When the demographic data of the patients were analysed, the mean age of the patients was found to be 52. Of the patients, 61.7% were female. In the evaluation of VAS and ODI scores, which we used to measure the efficiency of the procedure, the 6th month values were found to be statistically lower than the pre-procedure values (p<0.05). The first treatment for facet joint syndrome is bed rest and medical treatment. Resistant cases also benefit from physical therapy and intra-articular steroid injection. In patients unresponsive to these treatments, denervation with radiofrequency appears to be an effective method. At least two levels must be performed for the procedure to be successful. Studies have shown that pain decreases in the long term (6–12 months) and quality of life increases. We also obtained similar results in our studies. In conclusion, we think that RF (radiofrequency) can be used as an effective method in cases where other treatments fail.


Author(s):  
Krishna Kumar ◽  
A.K. Verma ◽  
Jefferson Wilson ◽  
Alika LaFontaine

ABSTRACT:Objective:Our goal was to perform a quantitative evaluation of the improvement in functional capacity, quality of life, mental function, reduction in drug intake and impact on hospital admissions after vertebroplasty in the treatment of osteoporotic compression fractures. The efficacy of vertebroplasty in relief of pain has been addressed in previous publications but the quantitative evaluation of improvement in quality of life has not been addressed before.Methods:This is a prospective study of 42 patients with 83 symptomatic vertebral fractures treated by vertebroplasty with a mean follow-up of 9.1 months. The outcome was measured by pre and postoperatively utilizing the Visual Analogue Scale, the Oswestry Disability Index, the Rolland Morris Scale for Back Pain and EuroQol-5D questionnaire (EQ-5D). The postoperative evaluations were performed at one week, one month, three month, and six month intervals thereafter.Results:In 34 out of 39 active patients, marked pain relief was noted (87%). The Visual Analogue Scale score improved from a mean preoperative score of 8.2 to a mean postoperative score of 2.9 (p=0.0000003) at one week follow up and 3.9 at the last follow-up. The Rolland Morris Scale for Back Pain showed a drop from a mean preoperative rating of 13 to a mean postoperative rating of 10, showing a 25% improvement (p= 0.0207). The Oswestry Disability Index preoperatively was 64.4 which improved to 43.8 postoperatively, showing a 32% improvement (p= 0.0207). The EQ-5D showed a mean preoperative index value of 0.097 and mean postoperative index value of 0.592 (p = 0.0000003). All p-values were determined by the Willcoxin sign-ranked test.Conclusion:Vertebroplasty is a safe and efficacious procedure with a resulting improvement in pain and quality of life.


2009 ◽  
Vol 8 (3) ◽  
pp. 303-309
Author(s):  
José Alberto de Castro Guimarães Consciência

INTRODUÇÃO: na última década, a instrumentação interespinhosa vem sendo mais frequentemente utilizada. Apesar dos inúmeros artigos publicados em revistas internacionais de reconhecido mérito científico, são escassas as referências à modificação da altura do disco no segmento tratado, secundária àquela instrumentação. OBJECTIVO: quantificar uma eventual modificação da altura discal decorrente da aplicação de instrumentação interespinhosa (DIAM - Cousin-Biotech - Medtronic Sofamor Danek Inc©). MÉTODOS: o autor avalia um grupo de 20 pacientes com patologia degenerativa da coluna lombar e os seguintes critérios de inclusão: idade >40 e <80; índice de massa corporal <40; dor visual analogue scale (VAS) >6; Oswestry Disability Index (ODI) >30; Zung Depression Rating Scale <39; Modified Somatic Perception Questionnaire (MSPQ) <15; degenerescência vertebral tipo 2 e 3 da classificação de Benzel e discal tipo 3 e 4 da classificação de Pfirrmann. Utilizando uma fórmula matemática, e um programa computorizado de imagem (Adobe Photoshop 9.0 CS2), foram efectuadas medições em radiografias da coluna lombar obtidas na incidência de perfil em posição ortostática. A amplificação utilizada para esses exames foi de 70%, tendo sido comparados os valores obtidos no pré-operatório com os referentes a dois anos após a cirurgia. RESULTADOS: foi constatado um aumento global em média de 1,53 mm com desvio padrão de 1,09 mm e p=0,0002, quando avaliadas as diferenças decorrentes da aplicação da referida fórmula. Contudo, quando foi analisada a variação anterior e posterior separadamente, observou-se diferença média superior (0,45 mm) na variação da distância intervertebral posterior (p=0,0002) quando comparada com a anterior (p=0,001), o que indicia um ligeiro efeito cifosante da instrumentação. CONCLUSÕES: nos casos de doença degenerativa lombar de tipo 2/3 de Benzel e 3/4 de Pfirmann, a aplicação de sistemas interespinhosos poderá proporcionar uma modificação da altura do disco intervertebral, aumentando-o ligeiramente, o que inevitavelmente influenciará as dimensões do canal vertebral.


2020 ◽  
Vol 4 (2) ◽  
pp. 44-57
Author(s):  
Lucky Anggiat ◽  
Indra Juni Fransisko ◽  
Soeparman SSt.Ft

Pada lansia dapat terjadi gangguan gerak dan nyeri pada beberapa bagian tubuh seperti leher, bahu, leher, punggung bawah, lutut dan kaki dengan prevalensi terbesar adalah nyeri punggung bawah. Beberapa faktor yang dapat mempengaruhi timbulnya nyeri punggung bawah atau Low Back Pain (LBP) pada lansia dapat disebabkan kebiasaan duduk lama, mudah lelah, atau akibat penyakit tertentu seperti jatuh terduduk yang menyebabkan hernia nukleus pulposus (HNP) di daerah tulang lumbal. Fisioterapi berperan penting dalam kondisi tersebut. Penelitian ini adalah penelitian studi kasus pada seorang lansia dengan LBP karena HNP. Pemeriksaan dilakukan adalah pemeriksaan nyeri dengan Visual Analogue Scale (VAS) dan kemampuan fungsional dengan Oswestry Disability Index (ODI). Tindakan fisioterapi yang diberikan pada lansia menggunakan intervensi konvensional seperti Ultrasound (US), Transcutaneous Electrical Nerve Stimulation (TENS) dan latihan metode McKenzie. Dengan tindakan fisioterapi konvensional dan metode McKenize memberikan hasil yang baik pada penurunan nyeri dan peningkatan kemampuan fungsional. Dari penelitian ini dapat disimpulkan pelaksanaan terapi konvensional dan metode McKenzie dapat memberikan pengaruh yang baik pada lansia dengan LBP karena HNP


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