Disc herniation and disc disease: the present and the future of management

Benzakour, Thami; Benzakour, Ahmed

doi:10.1007/s00264-019-04324-y

Cited by 8 publications

(7 citation statements)

References 33 publications

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“…This improvement in clinical e cacy is closely related to spinal sagittal balance and ASD after spinal surgery. 18 Intractable low-back pain is a common complication after lumbar spinal surgery, and in severe cases, reoperation is required. 19 Previous studies have shown that the incidence of low-back pain after lumbar discectomy is 5-36%.…”

Section: Discussionmentioning

confidence: 99%

A comparison of long-term efficacy of K-rod-assisted non-fusion operation and posterior lumbar interbody fusion for single-segmental lumbar disc herniation

Cheng

Dong

et al. 2022

Journal of Clinical Neuroscience

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BACKGROUNDSince the development of internal xation, posterior lumbar interbody fusion (PLIF) surgery has become the gold standard for the treatment of lumbar disc herniation. Although it has good short-term clinical e cacy, it can result in problems such as postoperative intractable lower back pain and degeneration of adjacent segments. K-rod-assisted non-fusion surgery for the treatment of lumbar disc herniation has also been proven to have clinical e cacy; however, its long-term effects have not been examined. AIMTo compare the long-term clinical e cacy of K-rod-assisted non-fusion operation to the clinical e cacy of PLIF in the management of single-segment lumbar disc herniation. METHODSThis study retrospectively analyzed 22 patients with lumbar disc (L4/5) herniation who underwent K-rodassisted non-fusion operation (n=13) or PLIF (n=9) between December 2010 and December 2013 and were followed-up for more than 5 years. Clinical outcomes were evaluated by the Oswestry Disability Index (ODI), pain Visual Analogue Score (VAS), and Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ). Imaging evaluations included adjacent segmental intervertebral height, range of motion (ROM) of the vertebrae, incidence of lumbar instability, spino-pelvic parameters, P rrmann grading, Modic changes, and University of California Los Angeles (UCLA) grading. RESULTSClinical outcomes, namely operation times (110.5±11.15 min vs. 134.44±12.36 min, P <0.05) and blood loss (59.2±7.03 ml vs. 80.0±8.66 ml, P <0.05), were signi cantly reduced in the K-rod group compared to the PLIF group. At the last follow-up, the clinical outcomes of the K-rod group were improved compared to those of the PLIF group as observed by the VAS score (2.1±0.9 vs. 3.0±0.7, P <0.05), JOABPEQ (26.7±1.1 vs. 25.2±1.5, P <0.05), and ODI (21.0±3.7 vs. 28.4±6.9, P <0.05). Imaging outcomes at the last follow-up indicated that the loss of height in the L3/4 intervertebral space (0.4±0.9 mm vs. 1.5±0.7 mm, P <0.05) and L5/S1 intervertebral space (0.2±0.5 mm vs. 1.8±1.7 mm, P <0.05), the ROM of L3/4 (4.9±2.0 vs. 8.8±2.4, P <0.05), the ROM of L5/S1 (5.7±1.7 vs. 8.6±1.2, P <0.05), and the incidence of adjacent segment degeneration (7.7% vs. 38.9%, P <0.05) in the PLIF group were signi cantly higher than those in the K-rod group. According to P rrmann grading, Modic changes, and UCLA grading, the incidence of adjacent segment degeneration was 55.6% in the PLIF group and 15.4% in the K-rod group. Changes in spino-pelvic parameters between the two groups were as follows: pelvic index remained unchanged, pelvic tilt angle increased, and lumbar lordosis and sacral slope decreased. CONCLUSION

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Section: Discussionmentioning

confidence: 99%

A comparison of long-term efficacy of K-rod-assisted non-fusion operation and posterior lumbar interbody fusion for single-segmental lumbar disc herniation

Cheng

Dong

et al. 2022

Journal of Clinical Neuroscience

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“…If the symptoms worsen after a period of conservative treatment or if there is an exacerbation of the neurological deficiency, surgical treatments may be recommended. After all, one of the most common spine surgery operations carried out by specialists or even some general surgeons with the necessary training are a discectomy [ 31 ].…”

Section: Reviewmentioning

confidence: 99%

Management of Lumbar Disc Herniation: A Systematic Review

Awadalla,

Aljulayfi,

Alrowaili

et al. 2023

Cureus

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A herniated disc in the spine is a condition during which a nucleus pulposus is displaced from intervertebral space. It is a common cause of back pain. The patients who experience pain related to a herniated disc often remember an inciting event that caused their pain. This activity reviews the evaluation and management of lumbar disc herniation and discusses the role of the healthcare team in evaluating and improving care for patients with this condition. Data sources were PubMed/Medline and Embase. Our review investigated English-language articles (from 2010 to 2023) according to the PRISMA guidelines. Overall, there were seven articles. Surveys and analyses of national databases were the most widely used methods (n=7). The search identified 777 studies; 7 were eligible for inclusion in the analysis. Further understanding of spinal disc herniation and treatment protocols may help improve evaluation and management in the future. Our research covered a range of management options. Disc herniation is a frequent problem for internists, emergency department doctors, nurse practitioners, and primary care physicians. To manage efficiently, an interprofessional team is needed. The first course of treatment is conservative, with paracetamol and anti-inflammatories being frequently used to relieve pain. A chemist must supervise the use of opioid analgesics in certain situations. Although surgery is sometimes the final option, patients frequently have neurological damage and lingering discomfort. In circumstances where physical treatment is not working, MRI interpretation becomes necessary. Primary care physicians or mental health professionals should handle back pain as it is frequently linked to mental health issues. Results can be enhanced by regular exercise and preserving a healthy body weight.

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“…Lumbar disc herniation (LDH) is a common cause of pain in the lower back and legs clinically, which makes it difficult for patients to work and live normally, or to take care of themselves in severe cases. 1 , 2 In clinical practice, conservative treatment and surgery are commonly used to treat this disease. Surgery includes percutaneous endoscopic lumbar discectomy (PDLE) and posterior lumbar interbody fusion (PLIF).…”

Section: Introductionmentioning

confidence: 99%

A comparative study on the clinical efficacy of percutaneous endoscopic lumbar discectomy and conventional open surgery in the treatment of lumbar disc herniation

Li,

Jiang,

2023

Pak J Med Sci

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Objective: To analyze the efficacy of single-channel percutaneous endoscopic lumbar discectomy (PELD) and conventional open surgery in the treatment of lumbar disc herniation (LDH). Methods: This is a retrospective study. A total of 66 patients with LDH admitted to Tianjin Medical University from June 2017 to June 2018 were divided into two groups: the observation group (single-channel PELD) and the control group (posterior lumbar interbody fusion), with 33 cases in each group. The two groups were compared in terms of visual analogue scale(VAS), oswestry disability index (ODI), Japanese Orthopaedic Association Score(JOA), perioperative indicators, clinical efficacy, postoperative complications, changes in inflammatory factors and serum T lymphocyte subsets. Results: The operation time, incision length, intraoperative blood loss, time in bed, hospital stay in the observation group were all lower than those in the control group. At 7d after treatment, the improvement of ODI, VAS and JOA in the observation group were better than that in the control group. At the last follow-up, there was no significant difference in Cobb angle and lumbar lordosis angle between the two groups. The levels of serum IL-1, IL-6 and TNF-α in the observation group were lower than those in the control group. The degree of reduction of serum CD3+ and CD4+ in the observation group were higher than those in the control group. And the level of elevation of CD8+ in the observation group was lower than that in the control group. Moreover, there was no significant difference in CD4+/CD8+ level between the two groups. The excellent rate of surgical results in the observation group was higher than that in the control group. Complications occurred in both groups, with no significant difference between the two groups. Conclusions: Single-channel PELD can achieve superior clinical efficacy over conventional open surgery in the treatment of LDH. doi: https://doi.org/10.12669/pjms.40.3.6678 How to cite this: Li Z, Jiang C, Xu B. A comparative study on the clinical efficacy of percutaneous endoscopic lumbar discectomy and conventional open surgery in the treatment of lumbar disc herniation. Pak J Med Sci. 2024;40(3):---------. doi: https://doi.org/10.12669/pjms.40.3.6678 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Disc herniation and disc disease: the present and the future of management

Cited by 8 publications

References 33 publications

A comparison of long-term efficacy of K-rod-assisted non-fusion operation and posterior lumbar interbody fusion for single-segmental lumbar disc herniation

A comparison of long-term efficacy of K-rod-assisted non-fusion operation and posterior lumbar interbody fusion for single-segmental lumbar disc herniation

Management of Lumbar Disc Herniation: A Systematic Review

A comparative study on the clinical efficacy of percutaneous endoscopic lumbar discectomy and conventional open surgery in the treatment of lumbar disc herniation

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