Biomechanical Factors could Affect Lumbar Disc Reherniation after Microdiscectomy

Abstract

Low back pain affects an estimated half a billion people at any time worldwide. Although several noninvasive treatment strategies have been developed, in many cases, they cannot relief patients' symptoms, thus low back discectomy is the appropriate treatment of choice. It is widely accepted that surgery alters the biomechanics of the functional motion segment and results in additional disc herniation at the adjacent level or the opposite side, more commonly than expected. After the discectomy, changes in vertebral load properties and kinetics could occur. As a result, biomechanical stress on the affected level as well as cyclic loads can cause lumbar disc reherniation (rLDH).Since the rate of recurrent disc herniation is about 5%-15%, further research should be done so as to quantify the postoperative lumbar spine kinematic pattern, with the use of wearable sensors technology, that could be a potential biomechanical factor causing rLDH.

Application of Wearable Sensors Technology for Lumbar Spine Kinematic Measurements during Daily Activities following Microdiscectomy Due to Severe Sciatica

“…Continuous monitoring of spine motion provides the opportunity for objective and quantitative analysis of kinematics, which offers insight into how spinal movements affect mechanical changes and, hence, disc herniation development. [16]. Our study provided such valuable data for patients subjected to lumbar spine microdiscectomy for the first time.…”

“…Moreover, existing wearable sensors solutions integrate biofeedback functions apart from measuring kinematics. An example is a vibrating ring in MetaMotionR+/Mbientlab sensors that could alert patients by applying vibration when they exceed ROMs, which can potentially be harmful to rLDH; as a result, this can protect them from risky movements [16].…”

Lumbar Kinematics Assessment of Patients with Chronic Low Back Pain in Three Bridge Tests Using Miniaturized Sensors

“…The development of miniature sensors has created new opportunities for simultaneous and long-term recording and the quantification of human body kinematics, including objective evaluation of motor abnormalities that spontaneously emerge and are recreated by individuals in real-world settings [ 62 , 63 ]. Their lightness, compact size, relatively inexpensive cost, energy efficiency, and mobility characteristics make them appropriate for several applications, providing an objective assessment component for various clinical tests.…”

Recurrence of lumbar disk herniation after microdiscectomy: a two-center retrospective analysis of 1214 cases and identification of risk factors

“…Lumbar disc herniation (LDH) is the most common cause of low back pain, leg pain and work loss related with them [ 1 , 2 ]. While 90% of patients with LDH can be treated conservatively, 10% require surgical treatment [ 3 , 4 ]. Compared to conservative treatment, surgery allows faster and more effective pain relief, and prevents progression of motor deficits due to LDH [ 5 ].…”