Implications of Age, Gender and Lumbar Disc Level on Symptomatic Herniated Nucleus Pulposus

2021 ◽  
Vol 15 (10) ◽  
pp. 2893-2895
Author(s):  
Muhammad Tayyab Naeem ◽  
Muhammad Aslam Shaikh ◽  
Muhammad Ahmad ◽  
Adeel Ijaz ◽  
Mohammad Huzefa Abid ◽  
...  
Keyword(s):  
Nucleus Pulposus ◽  
Elderly Population ◽  
Lumbar Disc ◽  
Spinal Column ◽  
Herniated Disc ◽  
Intervertebral Space ◽  
Spinal Segments ◽  
Lumbar Spinal ◽  
Disc Level ◽  
Herniated Nucleus Pulposus

Background: A herniated-disc inside the spinal column is a condition applying displacement of nucleus pulposus from intervertebral space causing back pain. Objective: To analyse the association of age, gender and lumbar disc level with herniated nucleus pulposus. Study Design: Retrospective study Place and Duration of Study: Department of Neurosurgery, Shaikh Zayed Hospital, Lahore from 1st January 2011 to 31st January 2020. Methodology: One hundred and twenty patients to investigate association of herniated nucleus pulposus with age, gender and lumbar disc level were enrolled. Patient’s demographic, clinical and radiological assessments were completed for categorizing their condition and level of lumbar disc involvement. Results: There were 72.5% males and 27.5% females with a mean age of 48.6±1.26 years. The study revealed that 72.5% nucleus pulposus herniation cases were within the age group of 51-70 years. L5-S1 is more susceptible to nucleus pulposus herniation (62.5%) followed by L4-L5 (34.2%), L3-L4 (2.5%) and L1-L2 (0.8%). Conclusion: Elderly population with >51 years in males is highly prone for nucleus pulposus herniation with L5-S1 to be most affected lumbar spinal segments. Key words: Nucleus pulposus herniation, Vertebral column level, Lumbar disc level

Foot drop due to lumbar degenerative conditions: mechanism and prognostic factors in herniated nucleus pulposus and lumbar spinal stenosis

2009 ◽  
Vol 10 (3) ◽  
pp. 260-264 ◽  
Author(s):  
Yoichi Iizuka ◽  
Haku Iizuka ◽  
Satoshi Tsutsumi ◽  
Yumi Nakagawa ◽  
Takashi Nakajima ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Nucleus Pulposus ◽  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Tibialis Anterior ◽  
Foot Drop ◽  
Muscle Testing ◽  
Extensor Hallucis Longus ◽  
Lumbar Spinal ◽  
Herniated Nucleus Pulposus

Object The aim of this study was to analyze the mechanism and prognostic factors of foot drop caused by lumbar degenerative conditions. Methods The authors retrospectively reviewed the charts of 28 patients with foot drop due to a herniated nucleus pulposus (HNP) or lumbar spinal stenosis (LSS), scoring between 0 and 3 on manual muscle testing for the tibialis anterior muscles. They analyzed the mechanism of foot drop and whether the duration before the operation, preoperative tibialis anterior and extensor hallucis longus strength, age, gender, and diabetes mellitus were all found to be prognostic factors for postoperative tibialis anterior recovery. They also investigated whether the diagnosis had any influence on the prognosis. Results The compression of double roots and a sequestrated fragment were observed, respectively, in 9 and 13 of 16 patients with HNP. Multiple levels including the L4–5 segment were decompressed in 8 of 12 patients with LSS. Analysis did not demonstrate any prognostic factor in surgically treated HNP, but significant associations with prognosis were observed with respect to preoperative tibialis anterior (p = 0.033) and extensor hallucis longus (p = 0.020) strength in patients with LSS. In addition, the postoperative muscle recovery in patients with HNP was significantly superior to that in patients with LSS (p = 0.011). Conclusions Double root compression was the most common condition associated with foot drop due to HNP. The diagnosis and preoperative tibialis anterior and extensor hallucis longus strength in LSS were factors that influenced recovery following an operation.

Viscoelastic Behaviour of the Human Spinal Disc

2010 ◽  
Author(s):  
Harcharan Singh Ranu ◽  
Aman Sweet Bhullar ◽  
Abdulrahim Zakaria
Keyword(s):  
Stress Relaxation ◽  
Nucleus Pulposus ◽  
Pressure Transducer ◽  
Compressive Load ◽  
Intradiscal Pressure ◽  
Similar Response ◽  
Functional Aspect ◽  
Spinal Disc ◽  
Spinal Segments ◽  
Lumbar Spinal

An intradiscal pressure transducer (IDPT) and a set of intervertebral pressure transducer (IVPT) were developed to measure the pressures in the nucleus pulposus and around the annulus. Human lumbar spinal segments were loaded up to 2.0 kN and following parameters were recorded: applied compressive load as a function of time, intradiscal pressure as a function of time, intervertebral pressure as a function of time for anterior and lateral edges of the vertebra, strain as a function of time for anterior and lateral right and left sites of the vertebra, stress-relaxation of the complete segment as a function of time. All show very similar response to loading and stress-relaxation. However, annulus pressure did not respond to stress-relaxation. This was due to functional aspect of annulus.

scholarly journals Increased hemoglobin and heme in MALDI-TOF MS analysis induce ferroptosis and promote degeneration of herniated human nucleus pulposus

2021 ◽  
Vol 27 (1) ◽  
Author(s):  
Liang Shan ◽  
Ximing Xu ◽  
Jing Zhang ◽  
Peng Cai ◽  
Han Gao ◽  
...  
Keyword(s):  
Nucleus Pulposus ◽  
Clinical Relevance ◽  
Lumbar Disc ◽  
Notch Pathway ◽  
Heme Iron ◽  
Maldi Tof Ms ◽  
Maldi Tof ◽  
Herniated Nucleus Pulposus ◽  
Tof Ms

Abstract Background Neovasculogenesis is characteristic of herniated lumbar discs, in which extruded nucleus pulposus is prone to heme iron-induced cytotoxicity (increased oxidative stress causing ferroptosis). However, recent analyses of neovascularization are very complicated, and the mechanism of action is rarely reported. Methods Matrix-assisted laser desorption/ionization–time-of-flight mass spectrometry (MALDI-TOF MS) was performed to analyze human herniated and nonherniated nucleus pulposus. Then, the clinical relevance of the MALDI-TOF MS results and Pfirrmann classification of the degenerative nucleus pulposus were analyzed. To explore the mechanism, the heme-induced ferroptosis effect was evaluated at both the tissue and cell levels using high-resolution MALDI-TOF MS and molecular biology methods. Results The spectra revealed that hemoglobin (Hb) and heme signals were greatly increased, thus serving as predictors of vasculogenesis in herniated nucleus pulposus. The clinical relevance analysis demonstrated that the intensity of Hb and heme peaks was closely related to the Pfirrmann classification of degenerative nucleus pulposus. Mechanistically, increased heme catabolism and downregulation of glutathione peroxidase 4 (GPX4) levels were detected in herniated nucleus pulposus, reflecting iron-dependent cell death or ferroptosis. Iron levels was also increased in herniated nucleus pulposus compared with that in nonherniated nucleus pulposus. Furthermore, accuracy mass measurements confirmed that the levels of ferroptosis-related metabolites, such as glutathione, arachidonic acid (AA), sphinganine, polyunsaturated fatty acid (PUFA), and tricarboxylic acid (TCA) cycle metabolites, were significantly different between herniated and nonherniated tissues, indicating that the interior of the herniated tissues is a pro-oxidant environment. Moreover, heme-induced ferroptosis was verified in human nucleus pulposus cells (HNPCs), and the underlying mechanism might be associated with the Notch pathway. Conclusions Neovascularization in herniated nucleus pulposus may expose tissues to high levels of heme, which can induce cytotoxicity and ferroptosis within tissues and accelerate the progressive degeneration of herniated nucleus pulposus. This study is beneficial for understanding the pathological mechanism of herniated nucleus pulposus and facilitating the development of nonoperative interventions for treating lumbar disc herniation (LDH).

scholarly journals Pathogenetic aspects and risk factors for recurrent lumbar disc herniation: literature review

2021 ◽  
Vol 18 (1) ◽  
pp. 47-52
Author(s):  
O. N. Dreval ◽  
A. V. Kuznetsov ◽  
V. A. Chekhonatsky ◽  
A. V. Baskov ◽  
A. A. Chekhonatsky ◽  
...  
Keyword(s):  
Risk Factors ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Spinal Column ◽  
Pain Syndrome ◽  
Herniated Disc ◽  
Scientific Publications ◽  
Recurrent Disc Herniation ◽  
Herniated Discs ◽  
Recurrent Lumbar Disc Herniation

One of the main causes of the development of debilitating pain syndrome after surgical treatment of a herniated disc is herniation recurrence. This pathology dictates the need to perform reoperation on an already operated segment of the spinal column, which complicates the technique of surgical intervention and negatively affects the relief of pain syndrome. In the presented review of scientific publications selected from the medical literature databases PubMed, E-library and Cochrane, the current problems of the pathogenesis of recurrent herniated discs in the lumbar spine are considered. The concept of risk factors for the development of recurrent disc herniation is highlighted, their characteristics are given, and the significance of each of them in the development of recurrent disc herniation is analyzed.

Prompt Return to Work after Bilateral Transforaminal Full-endoscopic Lateral Recess Decompression under Local Anesthesia: A Case Report

2020 ◽  
Author(s):  
Kosuke Sugiura ◽  
Kazuta Yamashita ◽  
Hiroaki Manabe ◽  
Yoshihiro Ishihama ◽  
Fumitake Tezuka ◽  
...  
Keyword(s):  
Return To Work ◽  
Local Anesthesia ◽  
Skin Incision ◽  
Leg Pain ◽  
Lateral Recess ◽  
Canal Stenosis ◽  
Transforaminal Approach ◽  
Lateral Recess Stenosis ◽  
Lumbar Spinal ◽  
Herniated Nucleus Pulposus

AbstractTransforaminal full-endoscopic lumbar diskectomy became established early in the 21st century. It can be performed under local anesthesia and requires only an 8-mm skin incision, making it the least invasive disk surgery method available. The full-endoscopic technique has recently been used to treat lumbar spinal canal stenosis. Here, we describe the outcome of simultaneous bilateral decompression of lumbar lateral recess stenosis via a transforaminal approach under local anesthesia in a 60-year-old man. The patient presented with a complaint of bilateral leg pain that was preventing him from standing and walking, and he had been able to continue his work as a dentist by treating patients while seated. Imaging studies revealed bilateral lumbar lateral recess stenosis with central herniated nucleus pulposus at L4/5. We performed simultaneous bilateral transforaminal full-endoscopic lumbar lateral recess decompression (TE-LRD) under local anesthesia. Both decompression and diskectomy were successfully completed without complications. Five days after TE-LRD, he was able to return to work, and 3 months after the surgery, he resumed playing golf. Full-endoscopic surgery under local anesthesia can be very effective in patients who need to return to work as soon as possible after surgery.

Presence and Distribution of Antigen-Antibody Complexes in the Herniated Nucleus Pulposus

Spine ◽  
1999 ◽  
Vol 24 (19) ◽  
pp. 1980 ◽  
Author(s):  
Koichiro Satoh ◽  
Shinichi Konno ◽  
Keiji Nishiyama ◽  
Kjell Olmarker ◽  
Shinichi Kikuchi
Keyword(s):  
Nucleus Pulposus ◽  
Antigen Antibody ◽  
Herniated Nucleus Pulposus
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