Percutaneous endoscopic lumbar discectomy for lumbar disc herniation

Li, Xinhua; Han, Yingchao; Di, Zhi; Cui, Jian; Pan, Jie; Yang, Mingjie; Sun, Guixin; Tan, Jun; Li, Lijun

doi:10.1016/j.jocn.2016.01.043

Cited by 74 publications

(53 citation statements)

References 28 publications

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“…The annual cost of IVDD‐related disease treatment is over $100 billion in the US alone, which is even more than the total cost of treating stroke, respiratory infection, diabetes, coronary artery disease, and rheumatoid disease 2,3 . Currently available treatments only provide symptomatic relief from pain through physical therapy, and activity modification or surgical intervention, 4‐6 such as disc decompression and spinal fusion. These interventions cannot decelerate or prevent the progression of degeneration or restore physiological function of the intervertebral disc (IVD).…”

Section: Introductionmentioning

confidence: 99%

Ciliary IFT80 is essential for intervertebral disc development and maintenance

Yang

Han

et al. 2020

FASEB j.

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The intervertebral disc degeneration (IVDD)-related diseases occur in more than 90% of the population older than 50 years. Owing to the lack of understanding of the cellular mechanisms involved in IVDD formation effective treatment options are still unavailable. Primary cilia are microtubule-based organelles that play important roles in the organ development. Intraflagellar transport (IFT) proteins are essential for the assembly and bidirectional transport within the cilium. Role of cilia and IFT80 protein in intervertebral disc (IVD) development, maintenance, and degeneration are largely unknown. Using cilia-GFP mice, we found presence of cilia on growth plate (GP), cartilage endplate (EP) annulus fibrosus (AF), and nucleus pulposus (NP) with varying ciliary length. Cilia length in NP and AF during IVDD were significantly decreased. However, cilia numbers increased by 63% in AF during repair. Deletion of IFT80 in type II collagen-positive cells resulted in cilia loss in GP and EP, and disrupted IVD structure with disorganized and decreased GP, EP, and internal AF (IAF), and less compact and markedly decreased gel-like matrix in the NP. Deletion of IFT80 in type I collagen-positive cells led to a disorganized outer AF (OAF) with thinner, loosened, and disconnected fiber alignment. Mechanistic analyses showed that loss of IFT80 caused a significant increase in cell apoptosis in the IVD, and a marked decrease in expression of chondrogenic markers -type II collagen, sox9, aggrecan, and hedgehog (Hh) signaling components, including Gli1 and Patch1 in the IVD of IFT80 fl/fl ; Col2-creERT mice, and Gli1 and Patch1 expression in the OAF of IFT80 fl/fl ; Col1-creERT mice. Interestingly, Smoothened agonist-SAG rescued OAF cell proliferation and osteogenic differentiation. Our findings demonstrate that ciliary IFT80 is important for the maintenance of IVD cell organization and function through regulating the cell survival and Hh signaling. K E Y W O R D S annulus fibrosus, IFT80, intervertebral disc degeneration, nucleus pulposus, primary cilia 6742 | LI et aL.

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Section: Introductionmentioning

confidence: 99%

Ciliary IFT80 is essential for intervertebral disc development and maintenance

Yang

Han

et al. 2020

FASEB j.

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“…Using facetectomy, TLIF allows entrance into previously unharmed virgin tissue avoiding the difficult dissection of fibrotic scar tissues and excessive retraction of scarred nerve roots and dura, minimizing the potential for dural and nerve injuries [1,15]. Nevertheless, a higher incidence of dural and nerve injuries was reported with MISS; therefore, this has been challenged by some authors [16]. The restoration of the disc height by the cage indirectly decompresses the neuroforamen thereby improving the leg symptoms [15].…”

Section: Discussionmentioning

confidence: 99%

Minimally Invasive Transforaminal Lumbar Interbody Fusion for the Surgical Management of Post-Discectomy Syndrome

et al. 2020

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Study Design: This was a prospective case series of 30 patients with post-discectomy syndrome with an average of 18 months of follow-up (level IV).Purpose: The efficacy of post-discectomy syndrome managed by minimally invasive surgery transforaminal lumbar interbody fusion (MIS-TLIF) was evaluated.Overview of Literature: In post-discectomy syndrome wherein conservative treatment had failed, the best surgical treatment modality still remains controversial.Methods: Patients were functionally assessed using the Visual Analog Scale (VAS) for low back pain (LBP) and leg pain (LP) and Oswestry Disability Index (ODI). Radiological fusion was confirmed with plain X-rays and when indicated with computed tomography scan at 12 months postoperatively. A total of 30 patients with 37 operated at lumbar levels with failed discectomy surgery who met our inclusion criteria were treated with MIS-TLIF.Results: The ODI of all patients showed significant improvement from a mean of 73.78% preoperatively to 16.67% at 1 month and 14.13% at 12 months postoperatively. The preoperative LBP VAS score (mean, 4.37) showed a significant decrease (<i>p</i> <0.001) to 1.90 at 1 month and 1.10 at 12 months. Preoperative LP VAS score of limb pain averaged 7.53 and showed a significant (<i>p</i> <0.001) decrease to 3.47 at 1 month and 1.10 at 12 months. All patients attained radiological fusion at 12 months.Conclusions: MIS-TILF constitutes a valid and effective treatment option for patients with post-discectomy syndrome.

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“…When comparing medium-and long-term (6 months and more than 2 years), primary outcomes (pain improvement, complication incidence, and functional outcomes) some studies show similar results, 5,6 whereas others demonstrate DEPL superiority over MDL in both primary [7][8][9] and secondary outcomes (surgical time, length of stay and bleeding volume). 10,11 Supported by studies with earlier initial assessment, 12,13 we have designed a patient evaluation protocol that starts much earlier than most studies on DEPL, beginning 48 hours after surgery, while the first assessment usually takes place within 4 to 6 weeks. Since the technique's medium-and long-term safety and effectiveness are proven, [14][15][16][17][18] we want to verify when clinical improvement actually begins, which may be a determining factor in choosing between surgical techniques with similar results.…”

Section: Introductionmentioning

confidence: 99%

Evolução funcional após discectomia endoscópica lombar, uma avaliação mais precoce de 32 casos

Aprile¹,

Amato²,

Oliveira³

2020

Rev Bras Ortop (Sao Paulo)

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Palavras-chave► coluna vertebral ► deslocamento do disco invertebral ► avaliação de resultados (cuidados de saúde) ► endoscopia ResumoObjetivo Determinar o tempo de alta hospitalar e o período de melhora funcional e da dor dos pacientes submetidos a discectomia endoscópica percutânea lombar (DEPL). Métodos Avaliação retrospectiva do tempo de internação e dos questionários escala visual análoga (EVA), índice de incapacidade Oswestry (IIO), e Roland-Morris de 32 pacientes submetidos a DEPL nos períodos pré-operatório e com 2 dias, e 1, 2, 4, 6, e 12 semanas pós-operatórias. Resultados Todos os pacientes receberam alta em menos de 6 horas houve melhora estatística entre o período pré-operatório e 2 dias pós-operatório , sendo o valor médio do questionário EVA axial de 6,63 para 3,31, do EVA irradiado de 6,66 para 2,75, do IIO de 44,59% para 33,17% e do Roland-Morris de 14,03 para 10,34. Tal diferença apresentou melhora progressiva até 12 semanas em todos os questionários. O IIO atingiu valores de incapacidade mínima (19,39%) com 6 semanas de avaliação. Conclusão Todos os 32 pacientes receberam alta hospitalar em até 6 horas. Houve melhora significativa dos sintomas funcionais e de dor já com 48 horas, apresentando ainda melhora adicional significativa e progressiva até o 3°mês. AbstractObjective To determine time period for hospital discharge and pain and function improvement in patients submitted to percutaneous endoscopic lumbar discectomy (PELD). Methods Retrospective evaluation of length of stay and visual analog scale (VAS), Oswestry disability index (ODI), and Roland-Morris questionnaire results in 32 patients undergoing PELD at the preoperative period and at 2 days and 1, 2, 4, 6 and 12 postoperative weeks. Results All patients were discharged in less than 6 hours. There was a statistically significant improvement between the results obtained before the procedure and 2 days

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Percutaneous endoscopic lumbar discectomy for lumbar disc herniation

Cited by 74 publications

References 28 publications

Ciliary IFT80 is essential for intervertebral disc development and maintenance

Ciliary IFT80 is essential for intervertebral disc development and maintenance

Minimally Invasive Transforaminal Lumbar Interbody Fusion for the Surgical Management of Post-Discectomy Syndrome

Evolução funcional após discectomia endoscópica lombar, uma avaliação mais precoce de 32 casos

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