1.Correlation between spinous process deviation and lumbar disc herniation in young patients.
Zhi-Jie CHEN ; Chun-Mei CHEN ; Zhong-Sheng BI ; Da LIU ; Tao LIN ; Ming LU ; Rui WANG
China Journal of Orthopaedics and Traumatology 2023;36(6):554-558
OBJECTIVE:
To explore the relationship between spinous process deviation and lumbar disc herniation in young patients.
METHODS:
From March 2015 to January 2022, 30 treated young (under the age of 30) patients with lumbar disc herniation were included as the young group. In addition 30 middle-aged patients (quinquagenarian group) with lumbar disc herniation and 30 patients with non-degenerative spinal diseases (young non-degenerative group) were selected as control groups. The angle of the spinous process deviation was measured on CT and statistically analyzed by various groups. All the data were measured twice and the average value was taken and recorded.
RESULTS:
The average angle of spinous process deviation in the degenerative lumbar vertebra of young patients were (3.89±3.77) degrees, similar to the (3.72±2.98) degrees of quinquagenarian patients(P=0.851). The average angle of s spinous process deviation young non-degenerative group were (2.20±2.28) degrees, significantly less than young group(P=0.040). The spinous process deviation angle of the superior vertebral of the degenerative lumbar in the young group was (4.10±3.44) degrees, which similar to the (3.47±2.87) degrees in the quinquagenarian group (P=0.447). A total of 19 young patients had the opposite deviation direction of the spinous process of the degenerative lumbar vertebra and upper vertebra, while only 7 quinquagenarian patients had this condition(P=0.02). The type of lumbar disc herniation in young patients had no significant relationship with the direction of spinous process deflection of the degenerative or upper lumbar vertebra (P>0.05).
CONCLUSION
Spinous process deviation is a risk factor of young lumbar disc herniation patients. If the deviation directions of adjacent lumbar spinous processes are opposite, it will increase the incidence of lumbar disc herniation in young patients. There was no significant correlation between the type of disc herniation and the deviation direction of the spinous process of the degenerative or upper lumbar vertebra. People with such anatomical variation can strengthen the stability of spine and prevent lumbar disc herniation through reasonable exercise.
Middle Aged
;
Humans
;
Intervertebral Disc Displacement/complications*
;
Vertebral Body
;
Spinal Diseases
;
Spinal Fusion/adverse effects*
;
Lumbar Vertebrae/diagnostic imaging*
;
Intervertebral Disc Degeneration/etiology*
2.Influential factors related to functional status after full-endoscopic lumbar discectomy.
Wei ZHU ; Bin ZHU ; Xiao Guang LIU
Journal of Peking University(Health Sciences) 2023;55(3):537-542
OBJECTIVE:
To explore the influential factors associated with functional status of those patients who undertook a full-endoscopic lumbar discectomy operation.
METHODS:
A prospective study was conducted. A total of 96 patients who undertook a full-endoscopic lumbar discectomy operation and met inclusive criteria were enrolled in the study. The postoperative follow-up was held 1 month, 3 months and 6 months after operation. The self-developed record file was used to collect the patient's information and medical history. Visual analogue scale (VAS) score, Oswestry disability index (ODI) score, Gene-ralised anxiety disorder-7 (GAD-7) scale score and patient health questionnaire-9 (PHQ-9) scale score were applied to measure pain intensity, functional status, anxiety status and depression status. Repeated measurement analysis of variance was used to explore the ODI score 1 month, 3 months and 6 months after operation. Multiple linear regression was recruited to illuminate the influential factors associated with functional status after the operation. Logistic regression was employed to explore the independent risk factors related to return to work 6 months after operation.
RESULTS:
The postoperative functional status of the patients improved gradually. The functional status of the patients 1 month, 3 months and 6 months after operation were highly positively correlated with the current average pain intensity. The factors influencing the postoperative functional status of the patients were different according to the recovery stage. One month and 3 months after operation, the factors influencing the postoperative functional status were the current average pain intensity; 6 months after operation, the factors influencing the postoperative functional status included the current average pain intensity, preoperative average pain intensity, gender and educational level. The risk factors influencing return to work 6 months after operation included women, young age, preoperative depression status and high average pain intensity 3 months after operation.
CONCLUSION
It is feasible to treat chronic low back pain with full-endoscopic lumbar discectomy operation. In the process of postoperative functional status recovery, medical staffs should not only take analgesic mea-sures to reduce the pain intensity experienced by the patients, but also pay attention to the impact of psychosocial factors on the recovery. Women, young age, preoperative depression status, and high average pain intensity 3 months after operation may delay return to work after the operation.
Humans
;
Female
;
Infant
;
Intervertebral Disc Displacement/etiology*
;
Prospective Studies
;
Functional Status
;
Treatment Outcome
;
Diskectomy/adverse effects*
;
Endoscopy
;
Pain
;
Lumbar Vertebrae/surgery*
;
Retrospective Studies
4.Lumbar disc herniation and andrological diseases.
National Journal of Andrology 2015;21(10):867-870
Lumbar disc herniation is a common male disease. In the past, More academic attention was directed to its relationship with lumbago and leg pain than to its association with andrological diseases. Studies show that central lumber intervertebral disc herniation may cause cauda equina injury and result in premature ejaculation, erectile dysfunction, chronic pelvic pain syndrome, priapism, and emission. This article presents an overview on the correlation between central lumbar intervertebral disc herniation and andrological diseases, focusing on the aspects of etiology, pathology, and clinical progress, hoping to invite more attention from andrological and osteological clinicians.
Chronic Pain
;
etiology
;
Erectile Dysfunction
;
etiology
;
Humans
;
Intervertebral Disc Displacement
;
complications
;
Lumbar Vertebrae
;
Male
;
Pelvic Pain
;
etiology
;
Polyradiculopathy
;
etiology
;
Premature Ejaculation
;
etiology
;
Priapism
;
etiology
5.Progress on the cause and mechanism of a separation of clinical symptoms and signs and imaging features in lumbar disk herniation.
China Journal of Orthopaedics and Traumatology 2015;28(10):970-975
A few of patients with lumbar disk herniation having a separation of clinical symptoms and signs and imaging features, can be found in clinic, but the traditional theory of direct mechanical compression of nerve roots by herniated nucleus pulposus can't be used to explain this abnormal protrusion of lumbar intervertebral disc. The clinical symptoms and signs of the atypical lumbar disk herniation are affected by multiple factors. The indirect mechanical compression and distraction effect of spinal nerve roots may play an important role in the occurrence of the separation, and the appearance of abnormal clinical symptoms and signs is closely related to the migration of herniated nucleus pulposus tissue, transmission of injury information in the nervous system, and the complex interactions among the nucleus pulposus, dural sac and nerve roots. Moreover,the changes of microcirculation and inflammation secondary to the herniated nucleus pulposus tissue, the hyperosteogeny in the corresponding segment of the lumbar vertebrae and the posture changes all results in a diversity of symptoms and signs in patients with lumbar intervertebral disc herniation. Besides, there exist congenital variation of lumbosacral nerve roots and vertebral bodies in some patients, and the misdiagnosis or missed diagnosis of imaging finding may occur in some cases. However, the appearance of a separation of clinical symptoms and signs and imaging examination in patients may be caused by a variety of reasons in clinic. The exact mechanism involved in the interaction among nucleus pulposus tissue, dural sac and nerve root, secondary changes of pathophysiology and biomechanics around the nucleus pulposus, the determination of lesioned responsible segments, and how to overcome the limitations of imaging all need the further researches.
Humans
;
Intervertebral Disc Displacement
;
complications
;
diagnosis
;
Lumbar Vertebrae
;
Nerve Compression Syndromes
;
etiology
6.Efficacy of Percutaneous Epidural Neuroplasty Does Not Correlate with Dural Sac Cross-Sectional Area in Single Level Disc Disease.
Gyu Yeul JI ; Chang Hyun OH ; Bongju MOON ; Seung Hyun CHOI ; Dong Ah SHIN ; Young Sul YOON ; Keung Nyun KIM
Yonsei Medical Journal 2015;56(3):691-697
PURPOSE: Percutaneous epidural neuroplasty (PEN) is a minimally invasive treatment. The efficacy of PEN has been relatively well investigated; however, the relationship between the clinical effectiveness of PEN and the severity of spinal canal stenosis by disc material has not yet been established. The purpose of this study was to compare clinical outcomes of PEN according to the dural sac cross-sectional area in single level disc disease. MATERIALS AND METHODS: This study included 363 patients with back pain from single level disc disease with and without radiculopathy. Patients were categorized into groups according to spinal canal compromise by disc material: Category 1, less or more than 50%; and Category 2, three subgroups with lesser than a third, between a third and two thirds, and more than two thirds. Clinical outcomes were assessed according to the Visual Analog Scale (VAS) score for back pain and leg pain and Odom's criteria at 1, 3, 6, 12, and 24 months after treatment. RESULTS: The demographic data showed no difference between groups according to spinal canal compromise by disc material except age (older age correlated with more spinal canal compromise). The dural sac cross-sectional area did not correlate with the VAS scores for back and leg pain after PEN in single level disc disease in Groups 1 and 2. Odom's criteria after PEN were also not different according to dural sac cross-sectional area by disc material. CONCLUSION: PEN is an effective procedure in treating single level lumbar disc herniation without affecting dural sac cross-sectional area.
Adult
;
Aged
;
Back Pain/etiology/*surgery
;
Dura Mater/*pathology
;
Female
;
Humans
;
Intervertebral Disc
;
Intervertebral Disc Displacement
;
Magnetic Resonance Imaging
;
Male
;
Middle Aged
;
Reconstructive Surgical Procedures
;
Spinal Stenosis/complications/*pathology
;
Tissue Adhesions/*surgery
;
Treatment Outcome
;
Visual Analog Scale
8.Case of anal pain caused by lumbar disc herniation.
Tian YE ; Chu MENG ; Shan-shan WANG
Chinese Acupuncture & Moxibustion 2014;34(4):346-346
9.Clinical significance of specific lumbocrural pain for the diagnosis of lumbar intervertebral disc herniation.
Shi-rong HUANG ; Yin-yu SHI ; Hong-sheng ZHAN
China Journal of Orthopaedics and Traumatology 2013;26(12):1041-1047
Lumbar intervertebral disc herniation clinical symptoms and signs are very complicated, lumbocrural pain is the most characteristic clinical symptoms,and show the site (range or area), intensity, nature, evolution, influence factors and adjoint symptoms and so on has certain characteristics and rules. Among them, the dermatomal pain, kinesthetic dysesthesia, dynamic changing pain and lesions segment vertebral side deep tenderness are the most impotent characteristics and rules of pain, therefore, can be regarded as the main basis of clinical diagnosis of the disease, and also the core content of this article.
Back Pain
;
diagnosis
;
etiology
;
pathology
;
Humans
;
Intervertebral Disc Displacement
;
diagnosis
;
pathology
;
Lumbar Vertebrae
;
injuries
;
pathology

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