Risk Factors and Post-Operative Predictors for Recurrent Lumbar Disc Herniation

The purpose of this study is to identify some risk factors and post-operative predictors for recurrent lumbar disc hernia (rLDH) during a long-term follow-up in patients treated with microdiscectomy. Aim of the paper: This study analyzes some risk factors and postoperative predictors for recurrent lumbar disc hernia (rLDH) during a long-term follow-up in patients treated with microdiscectomy. Material and methods. We analyzed retrospectively a consecutive series of patients who underwent lumbar spinal microdiscectomy for lumbar disc herniation (LDH) from January 2013 to June 2018 at our Institute. The rate of rLDH during long-term follow-up was analyzed and correlated with baseline and post-operative data. Results. A total of 263 patients were included with a median follow-up time of 24 months (from 13 to 43 months). Most of the patients had rLDH within the first 36 months after surgery. At multivariate analysis, recurrence of LDH was associated with higher pre-operative body mass index (BMI) and higher post-operative Oswentry disability index (ODI) with statistical significance. Conclusions. Baseline BMI and post-surgery ODI could predict rLDH after surgery during a long-term follow-up.

Paravertebral intramuscular ozone therapy in lumbar disc hernia: A comprehensive retrospective study

BACKGROUND: Clinical studies assessing the impacts of ozone on the musculoskeletal framework are slowly expanding. OBJECTIVE: In this study, we analyzed the impact of paravertebral ozone treatment (OT) injection treatment on distress and disability in patients with lumbar disc hernia (LDH). METHODS: The records of 432 patients with L4-5 and L5-S1 LDH were examined retrospectively. 298 patients who met the inclusion criteria and who provided written informed consent were divided into two groups. Each group received 15 sets of physiotherapy at a rate of five sets every week (study group (n= 139), control group (n= 159)). Six OT injections were applied solely to the study group, two days per week. A visual pain score (VAS) was set up for distress and the Oswestry Disability Questionnaire (ODI) for disablement was administered when the groups were called to control before treatment, towards the end of the treatment, and three months after the treatment ended. RESULTS: The groups had significantly reduced (p< 0.05) VAS and ODI scores following and three months after the treatment contrasted with their scores before the treatment. The Physiotherapy + OT group had significantly lower (p< 0.05) VAS and ODI scores than the physiotherapy group following and three months after the treatment. CONCLUSIONS: Paravertebral OT injection is quite a safe and helpful treatment technique in LDH patients. Further studies should be conducted to investigate the long-term outcomes of the paravertebral OT application.

FPGA implementation of fuzzy medical decision support system for disc hernia diagnosis

The aim of this study was to create a decision support system for disc hernia diagnostics based on real measurements of foot force values from sensors and fuzzy logic, as well as to implement the system on Field Programmable Gate Array (FPGA). The results show that the created fuzzy logic system had the 92.8% accuracy for pre-operational diagnosis and very high match between the Matlab and FPGA output (94.2% match for pre-operational condition, and 100% match for the post-operational and after physical therapy conditions). Interestingly enough, our system is also able to detect improvements in patient condition after the surgery and physical therapy. The main benefit of using FPGAs in this study is to create an inexpensive, portable expert system for real time acquisition, processing and providing the objective recommendation for disc hernia diagnosis and tracking the condition improvement.