Contemporary Management of Symptomatic Lumbar Disc Herniations

Jegede, Kolawole A.; Ndu, Anthony; Grauer, Jonathan N.

doi:10.1016/j.ocl.2010.01.003

Cited by 21 publications

(8 citation statements)

References 24 publications

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“…Operative intervention should be used only in cases of rupture of the annulus fibrosus (herniated disc) 4–6; in all other cases, conservative therapy alone is recommended 7, 8. Several minimally invasive methods have been proposed for the management of pain 9, 10.…”

Section: Introductionmentioning

confidence: 99%

Marital Status and Outcome of Patients Presenting with Acute Coronary Syndrome: An Observational Report

Khafaji

Habib

Asaad

et al. 2012

Clinical Cardiology

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Background & hypothesis:Data on the clinical characteristics and outcome of patients presenting with acute coronary syndrome (ACS) according to their marital status is not clear.Methods:A total of 5334 patients presenting with ACS in 65 hospitals in 6 Middle East countries in the 2nd Gulf Registry of Acute Coronary Events (Gulf RACE‐2) were studied according to their marital status (5024 married, 100 single, and 210 widowed patients).Result:When compared to married patients, widowed patients were older and more likely to be female. Widowed patients were more likely to have diabetes mellitus, hypertension, history of heart failure, and peripheral vascular disease and were less likely to be tobacco users when compared to the other groups. Widowed patients were also more likely to present with atypical symptoms and have advanced Killip class. Widowed patients were more likely to present with non‐ST‐elevation myocardial infarction (NSTEMI) when compared to the other 2 groups. Widowed patients were more likely to have heart failure (P = 0.001), cardiogenic shock (P = 0.001), and major bleeding (P = 0.002) when compared to the other groups. No statistically significant difference was observed in regard to duration of hospital stay, door to needle time in STEMI patients, or cardiac arrhythmias between the various groups. Widowed patients had higher in‐hospital, 30‐day, and 1‐year mortality rates (P = 0.001). Marital status was an independent predictor for in‐hospital mortality.Conclusion:Widowed marital status was associated with worse cardiovascular risk profile, and worse in‐hospital and 1‐year outcome. Future work should be focused on whether the provision of psychosocial support will result in improved outcomes among this high‐risk group. Clin. Cardiol. 2011 DOI: 10.1002/clc.22034Gulf RACE is a Gulf Heart Association (GHA) project and was financially supported by the GHA, Sanofi Aventis, and the College of Medicine Research Center at King Khalid University Hospital, King Saud University, and Riyadh, Saudi Arabia.The authors have no other funding, financial relationships, or conflicts of interest to disclose.

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Section: Introductionmentioning

confidence: 99%

Marital Status and Outcome of Patients Presenting with Acute Coronary Syndrome: An Observational Report

Khafaji

Habib

Asaad

et al. 2012

Clinical Cardiology

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“…Sık regresyon olmasa da disk hernisinin rezorbe olabilme olasılığı hastanın cerrahiye alınma kararını etkilemektedir. Acil cerrahi gerektiren kauda equina dışında konservatif tedaviye yanıt vermeyen hastalarda da cerrahi önerilmesi konusunda yaygın bir görüş birliği vardır 3 . Yapılan çalışmalarda, cerrahi girişim uygulanan veya uygulanmayan hastalarda bir ve iki yıl sonra ağrı, fiziksel fonksiyon ve özürlülük gibi sonuçlarda istatistiksel olarak anlamlı bir farklılık olmadığı görülmüş 8 .…”

Section: Discussionunclassified

“…LDH nedeniyle başvuran hastaların akut veya progresif nörolojik defisiti olmadıkça konservatif tedaviye cevapları iyidir. Bu hastaların yalnızca %5-10'u cerrahiye gereksinim duyar 2,3 . Konservatif tedavi yöntemleri; dinlenme, medikal tedavi, fiziksel tıp ve rehabilitasyon uygulamaları (analjezik akımlar, sıcak-soğuk uygulamaları, traksiyon, egzersizler), manipulasyon, spinal ortezler, kaplıca, epidural ve paravertebral kök bloklarını içermektedir 2,3 .…”

Section: Introductionunclassified

“…Bu hastaların yalnızca %5-10'u cerrahiye gereksinim duyar 2,3 . Konservatif tedavi yöntemleri; dinlenme, medikal tedavi, fiziksel tıp ve rehabilitasyon uygulamaları (analjezik akımlar, sıcak-soğuk uygulamaları, traksiyon, egzersizler), manipulasyon, spinal ortezler, kaplıca, epidural ve paravertebral kök bloklarını içermektedir 2,3 . LDH tedavi yöntemlerinden biri de tamamlayacı tıp yöntemlerinden olan akupunktur tedavisidir.…”

Section: Introductionunclassified

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Acupunture Treatment ın a Case Wıth Lumbar Dısk Hernıa Indıcated Surgıcal Treatment

Murat¹,

Algın²,

İçağasıoğlu³

2016

MMJ

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GİrİşBel ağrısı toplumların en sık görülen sağlık sorunların-dan biridir. Hastalığın yinelemesi nedeniyle sık tedavi gereksinimi olması, iş gücü kaybına yol açması ve sosyal destek gerektirmesi nedeniyle pahalı bir sosyomedikal sorundur 1. Mekanik bel ağrılarının %5-10'nunu lomber disk hernisi (LDH) oluşturur. LDH nedeniyle başvuran hastaların akut veya progresif nörolojik defisiti olmadıkça konservatif tedaviye cevapları iyidir. Bu hastaların yalnızca %5-10'u cerrahiye gereksinim duyar 2,3 . Konservatif tedavi yöntemleri; dinlenme, medikal tedavi, fiziksel tıp ve rehabilitasyon uygulamaları (analjezik akımlar, sıcak-soğuk uygulamaları, traksiyon, egzersizler), manipulasyon, spinal ortezler, kaplıca, epidural ve paravertebral kök bloklarını içermektedir 2,3 . LDH tedavi yöntemlerinden biri de tamamlayacı tıp yöntemlerinden olan akupunktur tedavisidir. Bu yazıda güncel literatür eşliğinde cerrahi endikasyon konulan bir vakada LDH ve akupunktur tedavisinin sonuçları tartışılacaktır. VAKAOtuz iki yaşında kadın hasta 4 haftadır medikal tedavi ve dinlenmeye rağmen, geçmeyen bel ağrısı nedeniyle polikliniğimize başvurdu. Muayenede lomber hareketleri ağrılı ve kısıtlı, düz bacak kaldırma testi sağda 50 derecede pozitifti. Nörolojik muayenesinde sağ başparmak dorsiflexsiyonu 3/5, sağ ayak plantar

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“…Generally surgical intervention is suggested to patients with acute and progressive neurological deficit and those who are nonresponsive to conservative treatments (7). In light of the costs of surgical treatments and the scale of possible complications, noninvasive treatment becomes the best option.…”

Section: Introductionmentioning

confidence: 99%

Effects of Artcure Diffusional Patch application on pain and functional status in lumbar disc herniation patients: a prospective randomized controlled study

Uğurlu¹,

Aksekili²,

Alkan³

et al. 2017

Turk J Med Sci

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IntroductionAmong Western societies 84% of adults suffer from low back pain at some time in their lives (1). Low back pain is the most frequent reason for disability in the population below the age of 45 (2). The treatment costs for low back pain are a significant part of medical costs and at about 34 billion dollars; by adding the economic loss due to workforce loss, this number increases to 100 billion dollars in the United States (3,4). Lumbar disc herniation with associated radiculopathy (LDHR) ranks first among the diseases that cause low back pain. For this reason, an inexpensive, noninvasive, and efficient treatment method is required in order to reduce and delay surgical interventions of LDHR patients and minimize the workforce loss during the period until surgical intervention.Lumbar disc herniation is the displacement of the nucleus pulposus by the breaching of the annulus fibrosus (5). With increasing age disc degeneration and disc height loss occur by the loss of proteoglycan and the effects of proinflammatory cytokines (6). As a result of these, clinical signs such as pressure on nerve roots and the spine occur. The purpose of treatment is reducing the pain and increasing the functional activity by removing the pressure on the nerve roots by either surgical or conservative methods.The decision between surgical and nonsurgical management of LDHR can be challenging for both the patient and the treating physician. Generally surgical intervention is suggested to patients with acute and progressive neurological deficit and those who are nonresponsive to conservative treatments (7). In light of the costs of surgical treatments and the scale of possible complications, noninvasive treatment becomes the best option. Since the intervertebral discs are the largest avascular structures of the body, nourishment is supplied by diffusion. Because of this avascularity, there is no possibility for spontaneous recovery (8).Background/aim: The aim of this study was to assess the efficacy of the Artcure Diffusional Patch, which contains a mixture of 6 herbal oils (oleum thymi, oleum limonis, oleum nigra, oleum rosmarini, oleum chamomilla, oleum lauriexpressum) and has a hypoosmolar lipid structure, in the conservative treatment of lumbar disc herniation patients and to show the advantages and/or possibility of using this as an alternative method to surgery. Materials and methods:Of the 120 patients enrolled, 79 clinically diagnosed patients were included in the study. Clinical evaluations were performed on patients who had findings of protrusion or extrusion in their magnetic resonance results. The treatment group was treated with the Artcure Diffusional Patch while the control group received a placebo transdermal diffusional patch. The functional state of patients was measured using the Oswestry Disability Index and pain intensity was measured with a visual analog scale as primary outcomes. Secondary outcomes of the study were Lasegue's sign, the femoral stretching test, and paravertebral muscle spasm. Results:The trea...

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Contemporary Management of Symptomatic Lumbar Disc Herniations

Cited by 21 publications

References 24 publications

Marital Status and Outcome of Patients Presenting with Acute Coronary Syndrome: An Observational Report

Marital Status and Outcome of Patients Presenting with Acute Coronary Syndrome: An Observational Report

Acupunture Treatment ın a Case Wıth Lumbar Dısk Hernıa Indıcated Surgıcal Treatment

Effects of Artcure Diffusional Patch application on pain and functional status in lumbar disc herniation patients: a prospective randomized controlled study

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