Impaired Fibrinolytic Activity in Defined Chronic Back Pain Syndromes

Pountain, G; Keegan, A.; Jayson, M. I. V.

doi:10.1097/00007632-198703000-00002

Cited by 43 publications

(11 citation statements)

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“…We are very pleased to note that Hurri and colleagues (1991) have confirmed our observation of defective fibrinolytic activity in patients with chronic back pain (Jayson et al 1984, Pountain et al 1987. They demonstrated this by a significant reduction in tissue plasminogen activator activity (TPA.Ac).…”

Section: To the Editorsupporting

confidence: 68%

Fibrinolytic defect in chronic back pain

Jayson

Hurri²

1992

Acta Orthopaedica Scandinavica

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Section: To the Editorsupporting

confidence: 68%

Fibrinolytic defect in chronic back pain

Jayson

Hurri²

1992

Acta Orthopaedica Scandinavica

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“…Therefore, nerve roots start to become OR become continuously and easily excited by even a very weak stimulus 17,18. Through these mechanisms, the fibrin generated by FBSS is around nerve roots causes damage and compression of the nerve roots and suppresses the mobility of the nerve roots thereby causing chronic pain 7,8. Therefore, a steroid is effective in relieving initial pain in radiculopathy but not so as effective in cases where fibroblast proliferation, collagen deposition, and scar formation around the nerve root during the latter period of the inflammatory process 19…”

Section: Discussionmentioning

confidence: 99%

“…Fibroplasia suppresses the mobility of nerve roots. So certain motions trigger pain by stretching nerve root 7,8. Extremely fibroplasias limits the diffusion of drugs, thereby reducing the efficacy of drugs injected for treatment 9…”

Section: Introductionmentioning

confidence: 99%

The Effect of Hyaluronidase in Interlaminar Lumbar Epidural Injection for Failed Back Surgery Syndrome

Kim

Lee

et al. 2012

Ann Rehabil Med

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ObjectiveTo evaluate the effect of hyaluronidase in patients with failed back surgery syndrome (FBSS) treated with interlaminar lumbar epidural injection (ILEI).MethodSixty patients suffering from severe low back pain and sciatica were randomly allocated into three groups. Group T received ILEI with 2 ml triamcinolone 40 mg/ml and 5 ml bupivacaine 0.25%. Group H received ILEI with 1500 IU hyaluronidase and 5 ml bupivacaine 0.25%. Group TH received interlaminar lumbar epidural injection (ILEI) with 1500 IU hyaluronidase, 2 ml triamcinolone 40 mg/ml and 5 ml bupivacaine 0.25%. The effect was evaluated using Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI) at pre-injection, 2 weeks, 6 weeks and 12 weeks after ILEI.ResultsAfter 2 weeks and after 6 weeks, patients in both Group T and Group TH had significant effectiveness more than Group H in decrease of VAS and ODI. After 12 weeks, only patients in Group TH had significant effectiveness in decrease of VAS and ODI (p<0.05). In every period, Group TH had the most effectivess in decrease of VAS and ODI after ILEI.ConclusionILEI for FBSS with triamcinolone and hyaluronidase is considered to have more long term effectiveness to reduce pain and improve function after ILEI than injection with triamcinolone alone or hyaluronidase alone.

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“…In the previous study [13] within the same group of patients, we found that patients with pre-operative impaired fibrinolytic activity had a poorer outcome from surgery than those with normal fibrinolytic activity. An explanation for this relationship is related to the theory that defects in the fibrinolytic system may increase the development of epidural fibrosis [7,16,20]. Magnetic resonance imaging (MRI) has proven its usefullness in detecting postoperative scar tissue in low-back diseases [4,10,14,17,19,23].…”

Section: Discussionmentioning

confidence: 99%

Is the outcome of traditional lumbar disc surgery related to the size of the exposure?

Graver

Ljunggren²,

Magnæs

et al. 1996

Acta neurochir

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The purpose of this study was to evaluate whether wide surgical exposures result in poorer outcome of lumbar disc surgery compared to smaller traditional exposures. The aim was also to assess if a dural tear has any impact on the postoperative clinical outcome. One hundred and twenty-two patients (56 women and 66 men, mean age 40.8 years) with herniated intervertebral lumbar disc and no previous back surgery, were included. Postoperatively they were grouped according to surgery as follows: surgery on one vs. two herniated discs (106 vs. 16 patients), partial vs. full laminectomy (93 vs. 29 patients), and the occurrence or not of a dural rent (8 vs. 114 patients). The outcome of surgery was evaluated one years postoperatively mainly by a composite clinical overall score (COS) and by its separate elements, which were: pain intensity in the lower-back or leg (VAS), neurological and clinical examination, functional capacity (Oswestry), and the need for analgesics. The results of the statistical regression analyses did not reveal significant differences in the postoperative outcome scores in the various groups of patients. The groups were comparable; no significant differences were seen in the pre-operative clinical overall scores.

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Impaired Fibrinolytic Activity in Defined Chronic Back Pain Syndromes

Cited by 43 publications

References 0 publications

Fibrinolytic defect in chronic back pain

Fibrinolytic defect in chronic back pain

The Effect of Hyaluronidase in Interlaminar Lumbar Epidural Injection for Failed Back Surgery Syndrome

Is the outcome of traditional lumbar disc surgery related to the size of the exposure?

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