Intraregional differences of perioperative management strategy for lumbar disc herniation: is the Devil really in the details?

Zoia, Cesare; Bongetta, Daniele; Poli, Jacopo C.; Verlotta, Mariarosaria; Pugliese, Raffaelino; Gaetani, Paolo

doi:10.14444/4001

Cited by 6 publications

(5 citation statements)

References 20 publications

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“…This is the first survey of Australasian neurosurgeons detailing the peri-operative management of patients undergoing lumbar discectomy. Australasian practice is generally consistent with international practice and demonstrates a similar degree of heterogeneity (4)(5)(6)(7).…”

Section: Discussionmentioning

confidence: 74%

Perioperative care for lumbar microdiscectomy: a survey of Australasian neurosurgeons

et al. 2018

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Australasian neurosurgical lumbar microdiscectomy perioperative care practices are generally consistent with international practices and demonstrate a similar degree of heterogeneity. Recommendation of post-operative activity restrictions by Australasian neurosurgeons is still common. This suggests a role for the investigation of the necessity of such restrictions in the era of minimally invasive spine surgery.

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Section: Discussionmentioning

confidence: 74%

Perioperative care for lumbar microdiscectomy: a survey of Australasian neurosurgeons

et al. 2018

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“…Выявлены существенные различия между нейрохирургами Великобритании, Австралии, Италии и России, рекомендующими возвращение к повседневной двигательной активности пациентов в диапазоне от двух дней до 3 мес. [3][4][5][6].…”

Section: Discussionunclassified

“…Несмотря на большое количество исследований по эффективности реабилитационных мероприятий после микродискэктомии, в клинической практике наблюдаются значительные различия в содержании, продолжительности и интенсивности восстановительных программ, а сроки возвращения к привычной активности варьируют в зависимости от страны лечения, больницы и даже лечащего врача [1,2]. В литературе обсуждаются различия в сроках реабилитации, рекомендуемых нейрохирургами [3][4][5][6], однако их сопоставление с рекомендациями других специалистов мультидисциплинарной бригады (неврологов, реабилитологов) отсутствует.…”

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Is it possible to obtain consensus on the tactics of early rehabilitation period after lumbar microdisCectomy?

et al. 2020

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Objective. To analyze distinctions in multidisciplinary approaches with respect to the timing of patients returning to daily physical activity after uncomplicated lumbar microdisectomy and to the readiness of doctors of various specialties to work according consensus guidelines.Material and Methods. A written questionnaire survey of 60 specialists (20 neurosurgeons, 28 neurologists and 12 rehabilitologists) involved in the management of patients during the first six months after uncomplicated lumbar microdisectomy was conducted. The questionnaire included 12 questions with several answer options on the timing of returning to daily physical activity, and on the need to provide patients with written recommendations on limitations in motion regimen, physical work, sexual activity, and bracing.Results. Significant dissonance both between doctors of the same specialty and of different specialties was demonstrated in the tactics of postoperative management of patients regarding the recommended terms for returning to daily activity. All respondents found it useful to create unified written recommendations on the motion regime, 90 % of specialists are ready to use the proposed recommendations after some modification. There was a slight increase in the recommended timing for return to daily physical activity compared with the recommendations of doctors in other countries.Conclusion. The demonstrated interdisciplinary differences in the treatment, rehabilitation and timing of physical activity restriction for patients after lumbar microdisectomy require unification of the tactics of postoperative management.

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“…[6][7][8][9] While analgesic drugs, glucocorticoids, and neurotrophic medications can partially prevent or alleviate residual symptoms, their overall efficacy is limited. [10,11] Feng et al • Medicine (2024) 103: 28 Medicine…”

Section: Introductionmentioning

confidence: 99%

Enhancing treatment of lumbar disc herniation with Erxian decoction and auricular acupoint pressure: A randomized controlled trial

Feng,

Du,

Zhao

2024

Medicine

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Objective: The incidence of lumbar disc herniation (LDH) is on the rise annually, with an emerging trend of affecting younger age groups. This study aims to investigate the clinical effectiveness of combining Erxian decoction with auricular acupoint pressure therapy in treating LDH. Our objective is to furnish evidence supporting the incorporation of traditional Chinese medicine (TCM) rehabilitation techniques in clinical settings. Methods: This randomized controlled trial enrolled 102 patients diagnosed with LDH and allocated them into Control and Intervention groups. The Control group underwent a 2-week rehabilitation regimen, whereas the Intervention group received an augmented treatment comprising Erxian decoction along with auricular acupoint pressure therapy based on the Control group. Main outcome measures included 3 scales – visual analog scale (VAS), Japanese Orthopedic Association (JOA), and Oswestry Disability Index – as well as 3 inflammatory markers: C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α). Additionally, pressure pain threshold and pain tolerance threshold values were evaluated. Participants were assessed at baseline, on 14-day, and on 28-day posttreatment. Results: After 2 weeks of treatment, both the Control and Intervention groups exhibited significant improvements in the VAS, JOA, ODI, CRP, IL-6, TNF-α, pressure pain threshold, and pain tolerance threshold (P < .05). These improvements persisted at the 28-day in the VAS, JOA, and ODI scores (P < .05). On 14-day, the Intervention group showed significantly better outcomes compared to the Control group in terms of the VAS, JOA, ODI, CRP, TNF-α, and pressure pain threshold (P < .05). Conclusion: Compared to conventional rehabilitation therapy, the combination of Erxian decoction and auricular acupoint pressure therapy demonstrates clear benefits in alleviating symptoms in patients with LDH. This approach offers fresh perspectives and substantiates evidence for future treatment strategies in managing LDH.

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Intraregional differences of perioperative management strategy for lumbar disc herniation: is the Devil really in the details?

Abstract: Background

Cited by 6 publications

References 20 publications

Perioperative care for lumbar microdiscectomy: a survey of Australasian neurosurgeons

Perioperative care for lumbar microdiscectomy: a survey of Australasian neurosurgeons

Is it possible to obtain consensus on the tactics of early rehabilitation period after lumbar microdisCectomy?

Enhancing treatment of lumbar disc herniation with Erxian decoction and auricular acupoint pressure: A randomized controlled trial

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