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Gogos C, Filippiadis DK, Velonakis G, Kelekis N, Papagelopoulos P, Kelekis A. Intradiscal Gelified Ethanol Nucleolysis versus Endoscopic Surgery for Lumbar Disc Herniation Radiculopathy. Diagnostics (Basel) 2023; 13:2164. [PMID: 37443558 DOI: 10.3390/diagnostics13132164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 06/02/2023] [Accepted: 06/19/2023] [Indexed: 07/15/2023] Open
Abstract
The purpose of this study was to retrospectively compare efficacy and safety between intradiscal injection of a gelified ethanol product and tubular discectomy in the treatment of intervertebral disk herniation. A bi-central institutional database research identified forty (40) patients suffering from symptomatic contained disc herniation. Nucleolysis Group included 20 patients [mean 50.05 ± 9.27 years-of-age (male/female 14/6-70/30%)] and Surgery Group included 20 patients [mean 48.45 ± 14.53 years-of-age, (male/female 12/8-60/40%)]. Primary outcome was overall 12-month improvement over baseline in leg pain (NVS units). Procedural technical outcomes were recorded, and adverse events were evaluated at all follow-up intervals. CIRSE classification system was used for complications' reporting. Mean pre-operative pain score in Nucleolysis Group was 7.95 ± 0.94 reduced to 1.25 ± 1.11 at month 1 and 0.45 ± 0.75 NVS units at year 1. Mean pre-operative pain score in Surgery Group was 7.65 ± 1.13 reduced to 1.55 ± 1.79 at month 1 and 0.70 ± 1.38 NVS units at year 1. Pain decrease was statistically significant after both procedures (p < 0.001). There was no statistically significant difference between pain reduction in both groups (p = 0.347). The decrease differences of the pain effect upon general activities, sleeping, socializing, walking, and enjoying life in the follow-up period between the two groups were not statistically significant. No complications were noted in both groups. Results from the current study report that intradiscal injection of a gelified ethanol and tubular discectomy were equally effective on terms of efficacy and safety for the treatment of symptomatic lumbar intervertebral disc herniation regarding the 12-month mean leg pain improvement. Both achieved similar rapid significant clinical improvement persisting throughout follow-up period.
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Affiliation(s)
- Christos Gogos
- Neurosurgery Clinic, General Hospital "Asklepieio", 16673 Athens, Greece
| | - Dimitrios K Filippiadis
- 2nd Department of Radiology, University General Hospital "ATTIKON", Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece
| | - Georgios Velonakis
- 2nd Department of Radiology, University General Hospital "ATTIKON", Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece
| | - Nikolaos Kelekis
- 2nd Department of Radiology, University General Hospital "ATTIKON", Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece
| | - Panayiotis Papagelopoulos
- Orthopaedic Surgery & Traumatology, University General Hospital "ATTIKON", Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece
| | - Alexis Kelekis
- 2nd Department of Radiology, University General Hospital "ATTIKON", Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece
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Sayed D, Grider J, Strand N, Hagedorn JM, Falowski S, Lam CM, Tieppo Francio V, Beall DP, Tomycz ND, Davanzo JR, Aiyer R, Lee DW, Kalia H, Sheen S, Malinowski MN, Verdolin M, Vodapally S, Carayannopoulos A, Jain S, Azeem N, Tolba R, Chang Chien GC, Ghosh P, Mazzola AJ, Amirdelfan K, Chakravarthy K, Petersen E, Schatman ME, Deer T. The American Society of Pain and Neuroscience (ASPN) Evidence-Based Clinical Guideline of Interventional Treatments for Low Back Pain. J Pain Res 2022; 15:3729-3832. [PMID: 36510616 PMCID: PMC9739111 DOI: 10.2147/jpr.s386879] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 11/17/2022] [Indexed: 12/12/2022] Open
Abstract
Introduction Painful lumbar spinal disorders represent a leading cause of disability in the US and worldwide. Interventional treatments for lumbar disorders are an effective treatment for the pain and disability from low back pain. Although many established and emerging interventional procedures are currently available, there exists a need for a defined guideline for their appropriateness, effectiveness, and safety. Objective The ASPN Back Guideline was developed to provide clinicians the most comprehensive review of interventional treatments for lower back disorders. Clinicians should utilize the ASPN Back Guideline to evaluate the quality of the literature, safety, and efficacy of interventional treatments for lower back disorders. Methods The American Society of Pain and Neuroscience (ASPN) identified an educational need for a comprehensive clinical guideline to provide evidence-based recommendations. Experts from the fields of Anesthesiology, Physiatry, Neurology, Neurosurgery, Radiology, and Pain Psychology developed the ASPN Back Guideline. The world literature in English was searched using Medline, EMBASE, Cochrane CENTRAL, BioMed Central, Web of Science, Google Scholar, PubMed, Current Contents Connect, Scopus, and meeting abstracts to identify and compile the evidence (per section) for back-related pain. Search words were selected based upon the section represented. Identified peer-reviewed literature was critiqued using United States Preventive Services Task Force (USPSTF) criteria and consensus points are presented. Results After a comprehensive review and analysis of the available evidence, the ASPN Back Guideline group was able to rate the literature and provide therapy grades to each of the most commonly available interventional treatments for low back pain. Conclusion The ASPN Back Guideline represents the first comprehensive analysis and grading of the existing and emerging interventional treatments available for low back pain. This will be a living document which will be periodically updated to the current standard of care based on the available evidence within peer-reviewed literature.
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Affiliation(s)
- Dawood Sayed
- Department of Anesthesiology and Pain Medicine, The University of Kansas Medical Center, Kansas City, KS, USA,Correspondence: Dawood Sayed, The University of Kansas Health System, 3901 Rainbow Blvd, Kansas City, KS, 66160, USA, Tel +1 913-588-5521, Email
| | - Jay Grider
- University of Kentucky, Lexington, KY, USA
| | - Natalie Strand
- Interventional Pain Management, Mayo Clinic, Scottsdale, AZ, USA
| | | | - Steven Falowski
- Functional Neurosurgery, Neurosurgical Associates of Lancaster, Lancaster, PA, USA
| | - Christopher M Lam
- Department of Anesthesiology and Pain Medicine, The University of Kansas Medical Center, Kansas City, KS, USA
| | - Vinicius Tieppo Francio
- Department of Rehabilitation Medicine, University of Kansas Medical Center, Kansas City, KS, USA
| | | | - Nestor D Tomycz
- AHN Neurosurgery, Allegheny General Hospital, Pittsburgh, PA, USA
| | | | - Rohit Aiyer
- Interventional Pain Management and Pain Psychiatry, Henry Ford Health System, Detroit, MI, USA
| | - David W Lee
- Physical Medicine & Rehabilitation and Pain Medicine, Fullerton Orthopedic Surgery Medical Group, Fullerton, CA, USA
| | - Hemant Kalia
- Rochester Regional Health System, Rochester, NY, USA,Department of Physical Medicine & Rehabilitation, University of Rochester, Rochester, NY, USA
| | - Soun Sheen
- Department of Physical Medicine & Rehabilitation, University of Rochester, Rochester, NY, USA
| | - Mark N Malinowski
- Adena Spine Center, Adena Health System, Chillicothe, OH, USA,Ohio University Heritage College of Osteopathic Medicine, Athens, OH, USA
| | - Michael Verdolin
- Anesthesiology and Pain Medicine, Pain Consultants of San Diego, San Diego, CA, USA
| | - Shashank Vodapally
- Physical Medicine and Rehabilitation, Michigan State University, East Lansing, MI, USA
| | - Alexios Carayannopoulos
- Department of Physical Medicine and Rehabilitation, Rhode Island Hospital, Newport Hospital, Lifespan Physician Group, Providence, RI, USA,Comprehensive Spine Center at Rhode Island Hospital, Newport Hospital, Providence, RI, USA,Neurosurgery, Brown University, Providence, RI, USA
| | - Sameer Jain
- Interventional Pain Management, Pain Treatment Centers of America, Little Rock, AR, USA
| | - Nomen Azeem
- Department of Neurology, University of South Florida, Tampa, FL, USA,Florida Spine & Pain Specialists, Riverview, FL, USA
| | - Reda Tolba
- Pain Management, Cleveland Clinic, Abu Dhabi, United Arab Emirates,Anesthesiology, Cleveland Clinic Lerner College of Medicine, Cleveland, OH, USA
| | - George C Chang Chien
- Pain Management, Ventura County Medical Center, Ventura, CA, USA,Center for Regenerative Medicine, University Southern California, Los Angeles, CA, USA
| | | | | | | | - Krishnan Chakravarthy
- Division of Pain Medicine, Department of Anesthesiology, University of California San Diego, San Diego, CA, USA,Va San Diego Healthcare, San Diego, CA, USA
| | - Erika Petersen
- Department of Neurosurgery, University of Arkansas for Medical Science, Little Rock, AR, USA
| | - Michael E Schatman
- Department of Anesthesiology, Perioperative Care, and Pain Medicine, NYU Grossman School of Medicine, New York, New York, USA,Department of Population Health - Division of Medical Ethics, NYU Grossman School of Medicine, New York, New York, USA
| | - Timothy Deer
- The Spine and Nerve Center of the Virginias, Charleston, WV, USA
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Yılmaz M, Karabulut N. How Can we Improve the Comfort Level and Sleep Quality After Surgery? J Perianesth Nurs 2021; 37:100-104. [PMID: 34836766 DOI: 10.1016/j.jopan.2021.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 05/15/2021] [Accepted: 05/15/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE The aim of this study was to determine the effect of progressive relaxation exercises on the comfort level and sleep quality of patients undergoing lumbar disc herniation surgery. METHODS The study was conducted between July 2015 and October 2016 in the neurosurgery clinic. The sample consisted of 96 patients (n = 56, experimental patients; n = 40 control patients) randomized into groups. The data was collected by using the personal information form, The Perianesthesia Comfort Questionnaire, The General Comfort Questionnaire and Visual Analog Sleep Scale. FINDINGS In the postoperative General Comfort Scale that there was a statistically significant difference between the mean of the control group and experimental group on the final test (P < .05). When the Visual Analog Sleep Scale mean of the experimental and control group patients were compared between the groups, there was a statistically significant difference on the postoperative 2nd day and 3rd day (P < .05). CONCLUSION This study supports previous work that progressive relaxation exercises are feasible and effective to improve patient comfort levels after lumbar disc surgery.
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Affiliation(s)
- Mesut Yılmaz
- Health Services Vocational School, Operating Room Services Program, Muş Alparslan University, Muş, Turkey
| | - Neziha Karabulut
- The Nursing Faculty, Department of Surgical Nursing, Atatürk University, Erzurum, Turkey.
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Comparison of interventions for lumbar disc herniation: a systematic review with network meta-analysis. Spine J 2021; 21:1750-1762. [PMID: 33667683 DOI: 10.1016/j.spinee.2021.02.022] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 02/06/2021] [Accepted: 02/27/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND Implants for use in disc herniation surgery have been commercially available for some time. Several clinical trials have shown promising results. There are now a wide variety of surgical methods for treating lumbar disc herniation. PURPOSE The objective of this systematic review was to compare all current surgical methods for disc herniation, including newer methods with implants for annulus repair and dynamic stabilization. STUDY DESIGN Systematic review and network meta-analysis. METHODS PRISMA-P guidelines were followed in this review. Literature search in PubMed, Embase, and Cochrane library databases identified eligible randomized controlled trials (RCT) studies comparing interventions for lumbar disc surgery. The investigated outcomes were: changes in pain score, disability score and reoperation rate with a minimum follow-up of 1 year. Risk of bias was assessed in concordance with Cochrane Neck and Back Review Group recommendation. A network meta-analysis was performed using gemtc and BUGSnet software, and each outcome evaluated using Confidence in Network Meta-Analysis (CINeMA). RESULTS Thirty-two RCT studies, with 4,877 participants, and eight different interventions were identified. A significant difference was seen in change of pain score, as all treatments were superior to conservative treatment and percutaneous discectomy. This difference was only found to be of clinically importance when comparing conservative treatment and dynamic stabilization. There was no significant difference in reoperation rates or change in disability score, regardless of treatment. However, SUCRA plots showed a trend in ranking annulus repair and dynamic stabilization highest. Risk of bias assessment showed that 15 studies had a high overall risk of bias. Meta-regression with risk of bias as covariate did not indicate any influence in risk of bias on the model. Confidence in Network Meta-Analysis evaluation showed a high level of confidence for all treatment comparisons. CONCLUSIONS With this network meta-analysis, we have aimed to compare all treatments for herniated lumbar disc in one large comprehensive systematic review and network meta-analysis. We have compared across the three main outcomes: disability score, pain score and reoperation rate. We were not able to rank one single treatment as the best. Most of the treatment performed at the same level. However percutaneous discectomy and conservative treatment consistently performed worse than the other treatments. In general, the CINeMA evaluation according to the GRADE recommendations gave a high level of confidence for the study comparisons.
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Yin H, Zhang X, Huang Z, Song Y, Zhu Q. Efficacy of Single Level Versus Double Levels Surgery of Percutaneous Disc Nucleoplasty (PDN) Approach in Treating Lumbar Disc Herniation. Med Sci Monit 2021; 27:e930000. [PMID: 34321453 PMCID: PMC8330383 DOI: 10.12659/msm.930000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background Although percutaneous disc nucleoplasty (PDN) has been widely applied in treating lumbar disc herniation (LDH) in recent years, the efficacy of surgical levels for PDN on LDH has been reported in limited studies. This study aimed to explore and compare the efficacy of surgical levels (single level vs double level) of PDN in treating LDH. Material/Methods All patients diagnosed with LDH from January 2012 to December 2014 in our hospital who underwent PDN were included in this study. Patients were divided into a single-level group and double-level group based on the number of discs/surgical treatment levels. The improvement of visual analog scale (VAS) score, patient satisfaction, and reoperation occurrence were compared between the 2 groups. Results Of 105 total patients, 75 patients were treated with single-level treatment and 30 patients with double-level treatment. VAS for leg pain and patient satisfaction scores in the double-level group were worse than those in the single-level group at 6 months after surgery (P<0.05). Among all 105 patients, the incidence of reoperation was 11.4%. Also, there was a marked difference in reoperation occurrence at 6 months after surgery between the single-level (6.7%) and double-level (23.3%) groups; however, the difference was not statistically significant (P=0.05). Conclusions PDN is a safe and minimal-invasive approach, which could effectively treat LDH. The number of surgical levels might be an important factor influencing the efficacy of PND. Caution should be exercised to strictly follow the clinical indications for nucleoplasty.
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Affiliation(s)
- Haidong Yin
- Department of Orthopedics, Panyu Hospital of Chinese Medicine, Guangzhou, Guangdong, China (mainland)
| | - Xinmei Zhang
- Department of Cardiovascular Medicine, Shunde Hospital, Southern Medical University, Foshan, Guangdong, China (mainland)
| | - Zhiping Huang
- Department of Spinal Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China (mainland)
| | - Yang Song
- Department of Cardiovascular Medicine, Shunde Hospital, Southern Medical University, Foshan, Guangdong, China (mainland)
| | - Qingan Zhu
- Department of Spinal Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China (mainland)
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Wei FL, Li T, Gao QY, Yang Y, Gao HR, Qian JX, Zhou CP. Eight Surgical Interventions for Lumbar Disc Herniation: A Network Meta-Analysis on Complications. Front Surg 2021; 8:679142. [PMID: 34355013 PMCID: PMC8329383 DOI: 10.3389/fsurg.2021.679142] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Accepted: 06/16/2021] [Indexed: 01/05/2023] Open
Abstract
Objective: Therapeutic options for lumbar disc surgery (LDH) have been rapidly evolved worldwide. Conventional pair meta-analysis has shown inconsistent results of the safety of different surgical interventions for LDH. A network pooling evaluation of randomized controlled trials (RCT) was conducted to compare eight surgical interventions on complications for patients with LDH. Methods: PubMed, Embase, and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched for RCT from inception to June 2020, with registration in PROSPERO (CRD42020176821). This study is conducted in accordance with Cochrane guidelines. Primary outcomes include intraoperative, post-operative, and overall complications, reoperation, operation time, and blood loss. Results: A total of 27 RCT with 2,948 participants and eight interventions, including automated percutaneous lumbar discectomy (APLD), chemonucleolysis (CN), microdiscectomy (MD), micro-endoscopic discectomy (MED), open discectomy (OD), percutaneous endoscopic lumbar discectomy (PELD), percutaneous laser disc decompression (PLDD), and tubular discectomy (TD) were enrolled. The pooling results suggested that PELD and PLDD are with lower intraoperative and post-operative complication rates, respectively. TD, PELD, PLDD, and MED were the safest procedures for LDH according to complications, reoperation, operation time, and blood loss. Conclusion: The results of this study provided evidence that PELD and PLDD were with lower intraoperative and post-operative complication rates, respectively. TD, PELD, PLDD, and MED were the safest procedures for LDH according to complications, reoperation, operation time, and blood loss. Systematic Review Registration: PROSPERO, identifier CRD42020176821.
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Affiliation(s)
- Fei-Long Wei
- Department of Orthopedics, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Tian Li
- School of Basic Medicine, Fourth Military Medical University, Xi'an, China
| | - Quan-You Gao
- Department of Orthopedics, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Yi Yang
- Department of Pain Treatment, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Hao-Ran Gao
- Department of Orthopedics, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Ji-Xian Qian
- Department of Orthopedics, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Cheng-Pei Zhou
- Department of Orthopedics, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
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Zheng Q, Wang R, Shi Y, Sun Q. Effects of acupoint massage combined with relaxation therapy on patients with postoperative fatigue syndrome after lumbar surgery. Medicine (Baltimore) 2021; 100:e25849. [PMID: 34106628 PMCID: PMC8133127 DOI: 10.1097/md.0000000000025849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 04/19/2021] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND : Lumbar disc herniation (LDH) is a common disease in orthopedics. Surgery is shown to provide significant faster relief of pain compared to conservative therapy. However, due to the influence of surgical trauma, anesthesia and other perioperative stress factors, patients may have complications. Among them, postoperative fatigue syndrome (POFS) is a common complication. Traditional Chinese medicine or integrated traditional Chinese and Western medicine have been proved to be effective in improving postoperative fatigue. METHODS : This study is a randomized controlled trial. One hundred eighty Chinese patients with POFS of LDH will be randomly divided into control group, experimental group 1, experimental group 2 and experimental group 3 according to the ratio of 1:1:1:1. The patients in the control group will be treated with conventional treatment after operation, the patients in the experimental group 1 will be treated with acupoint massage, the patients in the experimental group 2 will be treated with relaxation therapy, and the patients in the experimental group 3 will be treated with acupoint massage combined with relaxation therapy. The whole treatment will last for 5 days. The main outcome measures will be fatigue visual analogue scale and identity-consequence fatigue scale, and the secondary outcome measures will be hospital anxiety and depression scale. DISCUSSION : This study is to observe the effects of acupoint massage comblined with relaxation therapy on reducing postoperative fatigue of lumbar disc herniation surgical patients. TRIAL REGISTRATION : Chinese Clinical Trial Registry (http://www.chictr.org.cn/edit.aspx?pid=123978&htm=4), No. ChiCTR2100044788. Registered on March 27, 2021.
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Affiliation(s)
- Qiuhui Zheng
- Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University
| | - Rongyun Wang
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, China
| | - Yanan Shi
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, China
| | - Qiuhua Sun
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, China
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Qie S, Li W, Li X, Chen X, Gong W, Xi J, Sun F, Yue S. Electromyography activities in patients with lower lumbar disc herniation. J Back Musculoskelet Rehabil 2020; 33:589-596. [PMID: 31658036 PMCID: PMC7458508 DOI: 10.3233/bmr-181308] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Lumbar disc herniation (LDH) can affect lower limb muscle function resulting in an abnormal gait. This study aims to use surface electromyography (SEMG) to evaluate patients with L4/L5 and L5/S1 LDH throughout muscle movement. METHODS Twenty L4/L5 LDH patients (L5 Group), twenty L5/S1 LDH patients (S1 Group), and twenty healthy controls (Healthy) were recruited for the study. SEMG of bilateral tibialis anterior (TA) and lateral gastrocnemius (LG) muscles of patients were recorded using the DELSYS Wireless EMG System (TrignoTM Wireless Systems, Delsys Inc., USA). Root-mean-square (RMS), mean power frequency (MPF), and median frequency (MF) were compared between bilateral limbs in each participant. RESULTS Reduced MPF and MF was found in TA measurements of the L5 Group and LG measurements of the S1 Group. The MPF and MF of the TA of symptomatic limbs of the L5 Group were reduced when compared to asymptomatic limbs (p= 0.006, p= 0.012, p< 0.05), and there were no significant differences in LG measurements (p> 0.05). The LG MPF and MF of the S1 Group in symptomatic limbs were reduced when compared to asymptomatic limbs (p= 0.006, p= 0.017, p< 0.05), and there were no significant differences in TA measurements (p> 0.05). Although there were no significant differences in RMS between bilateral limbs of the L5 and S1 Groups, we found some changes in RMS curves. First, compared to asymptomatic limbs of L4/L5LDH patients, β-peaks in the TA of symptomatic limbs appeared earlier. Second, two peaks in the LG of symptomatic limbs were found in L5/S1 LDH patients. CONCLUSION TA is affected in patients with LDH of L4/L5, and LG is affected in patients with LDH of L5/S1. As demonstrated, SEMG can identify LDH-related muscle dysfunction.
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Affiliation(s)
- Shuyan Qie
- Department of Physical Medicine and Rehabilitation, Qilu Hospital of Shandong University, Jinan, China
| | - Wei Li
- Department of Physical Medicine and Rehabilitation, Qilu Hospital of Shandong University, Jinan, China,Department of Rehabilitation, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Xiangrong Li
- Department of Respiratory Medicine, School Hospital of Peking University, Haidian District, Beijing, China
| | - Xuemei Chen
- Department of Health Management, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Weijun Gong
- Department of Neurological Rehabilitation, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Jianing Xi
- Department of Neurological Rehabilitation, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Fenglong Sun
- Department of Orthopedics, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Shouwei Yue
- Department of Physical Medicine and Rehabilitation, Qilu Hospital of Shandong University, Jinan, China,Corresponding author: Shouwei Yue, Department of Physical Medicine and Rehabilitation, Qilu Hospital of Shandong University, Jinan, Shandong, China. Tel.: +86 531 81309107; E-mail:
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Li Q, Zhou Y. Comparison of conventional fenestration discectomy with Transforaminal endoscopic lumbar discectomy for treating lumbar disc herniation:minimum 2-year long-term follow-up in 1100 patients. BMC Musculoskelet Disord 2020; 21:628. [PMID: 32967661 PMCID: PMC7513495 DOI: 10.1186/s12891-020-03652-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 09/16/2020] [Indexed: 01/05/2023] Open
Abstract
Purpose To compare the efficacy of conventional interlaminar fenestration discectomy (IFD) with transforaminal endoscopic lumbar discectomy (TELD) for treating lumbar disc herniation (LDH). Methods The clinical data of 1100 patients who had been diagnosed with LDH between January 2012 and December 2017 were retrospectively analysed. IFD was performed on 605 patients in Group A, whereas TELD was performed on 505 patients in Group B. The Oswestry Disability Index, Visual Analogue Scale for pain and modified MacNab criteria were used to evaluate the outcomes. The surgery duration, intraoperative blood loss, postoperative off-bed activity and postoperative length of hospital stay were recorded. Results The follow-up period ranged from 24 to 60 months, with an average of 43 months. The excellent and good outcome rates were 93.5% in Group A and 92.6% in Group B. There was no significant difference in efficacy between the groups (P > 0.05). However, Group B had significantly less intraoperative blood loss and shorter bed rest duration and postoperative length of hospital stay than Group A (P < 0.05). There were two cases of postoperative recurrence in Group A and three in Group B. Conclusions Although conventional IFD and TELD had similar levels of efficacy in treating LDH, TELD had several advantages. There was less intraoperative bleeding, shorter length of hospital stay and shorter bed rest duration. It can be considered a safe and effective surgical option for treating LDH.
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Affiliation(s)
- Quanyi Li
- Department of Orthopedic, Shaanxi Provincial People's Hospital, 256# You-yi West Road, Xi'an, 710068, Shaanxi, People's Republic of China
| | - Yongchun Zhou
- Department of Orthopedic, Shaanxi Provincial People's Hospital, 256# You-yi West Road, Xi'an, 710068, Shaanxi, People's Republic of China.
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Complication rates of different discectomy techniques for symptomatic lumbar disc herniation: a systematic review and meta-analysis. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2020; 29:1752-1770. [DOI: 10.1007/s00586-020-06389-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Revised: 02/27/2020] [Accepted: 03/21/2020] [Indexed: 12/14/2022]
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11
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Complication rates of different discectomy techniques for the treatment of lumbar disc herniation: a network meta-analysis. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2019; 28:2588-2601. [DOI: 10.1007/s00586-019-06142-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 05/24/2019] [Accepted: 09/07/2019] [Indexed: 02/07/2023]
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12
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The Effect of Low Back Pain on Daily Activities and Sleep Quality in Patients With Lumbar Disc Herniation: A Pilot Study. J Neurosci Nurs 2019; 51:184-189. [DOI: 10.1097/jnn.0000000000000446] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Affiliation(s)
- Yong Ahn
- Department of Neurosurgery, Gil Medical Center, Gachon University College of Medicine, Incheon, South Korea
| | - Uhn Lee
- Department of Neurosurgery, Gil Medical Center, Gachon University College of Medicine, Incheon, South Korea
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Kumar N, Zaw AS, Kumar N, Sonawane D, Hey HWD, Kumar A. Annulo-Nucleoplasty Using Disc-Fx in the Management of Degenerative Lumbar Disc Pathology: How Long Can the Effect Last? Global Spine J 2018; 8:365-373. [PMID: 29977721 PMCID: PMC6022958 DOI: 10.1177/2192568217726525] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
STUDY DESIGN Prospective analysis. OBJECTIVES To evaluate 2-year clinical outcomes in patients undergoing Disc-FX for the management of low back pain (LBP) due to degenerate disc (DD) or contained lumbar disc herniation (CLDH). To study salient factors that can potentially influence the clinical outcomes. METHODS We analyzed the prospectively collected data of 51 patients who underwent Disc-FX procedure for DD or CLDH, nonresponsive to 6 months of nonoperative treatment. Clinical outcome measures collected were visual analogue scale (VAS), Oswestry Disability Index (ODI), and MacNab scores. These preoperative values were compared with respective values at immediate, 6 months, 1 year, and 2 years postoperation. Minimum clinically important difference values for these outcomes in accordance with previously published data was used to evaluate the effectiveness of Disc-FX intervention. RESULTS Of 51 patients, 84% had DD and 16% had CLDH. Significant improvement (P < .01) in VAS and ODI scores was observed at all assessment periods compared to the respective preoperative values. Based on the MacNab scores, there was significant increase (P < .01) in the proportion of patients with excellent/good MacNab outcomes at each time point after the procedure; 78% achieving excellent/good outcomes at 2-year follow-up. Ease of access to the disc space was significantly influencing VAS, ODI, and MacNab scores at 1-year and 2-year follow-ups. VAS and MacNab scores were negatively influenced by high body mass index and smoking status at 6 and 12 months postoperation. CONCLUSIONS Our data suggests that Disc-FX may be helpful in selected patients with symptomatic degenerative disc disease providing favorable outcomes lasting up to 2 years or more. The results were more favorable in patients with easier access to disc space.
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Affiliation(s)
- Naresh Kumar
- National University Hospital, Singapore, Singapore,Naresh Kumar, Department of Orthopaedic Surgery, University Orthopaedics, Hand & Reconstructive Microsurgery Cluster, 1E Kent Ridge Road, NUHS Tower Block, Level 11, 119228 Singapore.
| | | | | | - Dhiraj Sonawane
- National University Hospital, Singapore, Singapore,Grant Medical College, Mumbai, India
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