scholarly journals Surgical outcomes of decompression alone versus transpedicular screw fixation for upper lumbar disc herniation

2021 ◽  
Vol 36 (1) ◽  
Author(s):  
Ahmed Y. Soliman ◽  
Amr Abu Elfadle
Keyword(s):  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Surgical Outcomes ◽  
Screw Fixation ◽  
Lumbar Disc ◽  
Transpedicular Screw ◽  
Group 2 ◽  
Upper Lumbar Disc Herniation ◽  
Transpedicular Screw Fixation ◽  
Group 1

Abstract Background Surgical outcomes of upper lumbar disc herniations (ULDHs) including T12-L1, L1-L2, and L2-L3 levels are characteristically less favorable and more unpredictable. Objectives This study was conducted to compare the surgical outcomes of decompression alone versus decompression combined with transpedicular screw fixation in treating upper lumbar disc herniation. Methods This retrospective cohort study was carried out at Neurosurgery Departments, Tanta University. The study included 46 patients with a symptomatic high lumbar herniated disc at T12-L1, L1-L2, and L2-L3 levels. The enrolled patients were divided into two groups depending on whether they were operated on via decompression and partial medial facetectomy (group 1, 22 patients) or via the previous maneuver plus transpedicular screw fixation (group 2, 24 patients). All patients were medically evaluated immediately after the operation; then, they were followed up at the 3rd and the 6th months following surgery. Patients’ outcomes were assessed by visual analogue score (VAS) and Oswestry Disability Index (ODI) scores. Results Median VAS scores in each group revealed significant reduction immediately following surgery and at each of 7 days, 3 months, and 6 months in comparison with the preoperative VAS score (p<0.001). Furthermore, each group showed significant stepwise reduction in the median ODI score at the 3rd and the 6th months postoperative compared to the preoperative ODI score (group 1 = 68.0, 19.0, 15.0; p< 0.001 and group 2 = 66.5, 20.0, 15.0; p< 0.001), with no significant differences between both groups (p> 0.05). Conclusions Both standalone decompression and decompression combined with transpedicular screw fixation revealed comparable favorable outcomes in patients with ULDH.

scholarly journals Efficacy of Intradiscal Ozone Therapy with or without Periforaminal Steroid Injection on Lumbar Disc Herniation: A Double-Blinded Controlled Study

2020 ◽  
Vol 5;23 (9;5) ◽  
pp. 477-484
Author(s):  
Tulay Ercalik
Keyword(s):  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Steroid Injection ◽  
Lumbar Disc ◽  
Leg Pain ◽  
Low Back ◽  
Ozone Therapy ◽  
Group 2 ◽  
Double Blinded ◽  
Group 1

Background: Intradiscal ozone therapy, a minimally invasive technique, is used in patients that do not respond to standard conservative therapies for low back pain due to degenerative disc-induced lumbar disc herniation (LDH). Many studies on clinical efficacy lack a standardized injection method and are limited by inadequate study design. Objective: This study aimed to determine the efficacy of periforaminal steroid injection together with intradiscal ozone therapy. Study Design: A prospective, double-blinded, randomized controlled trial. Setting: A tertiary care center. Methods: This study was conducted in 65 patients with low back and leg pain caused by LDH. Group 1 received intradiscal ozone therapy (n = 35) and Group 2 received intradiscal ozone therapy with periforaminal steroid injection (n = 30). Patients were evaluated for pain using the visual analogue scale (VAS), for disability using Oswestry Disability Index (ODI), and for quality of life using the short form 36 health survey administered pre-injection and at one and 6 months postinjection. All procedures were performed under sterile conditions using C-arm fluoroscopy. Results: Significant improvements were observed in pain, disability, and quality of life in both groups post-treatment compared to pre-injection. Mean pre-injection VAS was not significantly different between the groups (VAS: 7.8 ± 1.1 for Group 1, 7.8 ± 1.2 for Group 2). VAS values at 6 months for Group 1 and Group 2 were as follows: 3.6 ± 2.4, 4.1 ± 1.6, respectively) (P < 0.001). Mean pre-injection ODI was not significantly different between the groups (ODI: 20.9 ± 9.6 for Group 1, 25.2 ± 10.3 for Group 2). ODI values at 6 months for Group 1 and Group 2 were as follows: 12.8 ± 9.2, 14.3 ± 7.2, respectively) (P < 0.001). However, there were no significant differences between the groups. Similarly, there was no significant difference between the 2 groups on any of these parameters. Limitations: A limited number of patients and limited follow-up time. Conclusion: This study showed that intradiscal ozone injection alone was sufficient to treat low back and leg pain caused by LDH and that periforaminal steroid injection does not provide additional benefit, which is contrary to the literature. Key words: Low back pain, intradiscal ozone, steroid, lumbar disc herniation, lumbar disc degeneration

scholarly journals Clinical Outcomes of 7 Patients with Upper Lumbar Disc Herniation.

1999 ◽  
Vol 48 (3) ◽  
pp. 726-729
Author(s):  
Tomomasa Kajikawa ◽  
Yuji Taoka ◽  
Hidehiro Yamada ◽  
Kazuo Hatada ◽  
Kazuhisa Nanamori ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Upper Lumbar Disc Herniation

Radiological analysis of upper lumbar disc herniation and spinopelvic sagittal alignment

2016 ◽  
Vol 25 (5) ◽  
pp. 1382-1388 ◽  
Author(s):  
Junseok Bae ◽  
Sang-Ho Lee ◽  
Sang-Ha Shin ◽  
Jin Suk Seo ◽  
Kyeong Hwan Kim ◽  
...  
Keyword(s):  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Sagittal Alignment ◽  
Lumbar Disc ◽  
Upper Lumbar Disc Herniation ◽  
Radiological Analysis

scholarly journals Clinical and Radiographic Characteristics of Upper Lumbar Disc Herniation: Ten-Year Microsurgical Experience

2011 ◽  
Vol 51 (6) ◽  
pp. 423-426 ◽  
Author(s):  
Motoyuki IWASAKI ◽  
Minoru AKINO ◽  
Kazutoshi HIDA ◽  
Shunsuke YANO ◽  
Takeshi AOYAMA ◽  
...  
Keyword(s):  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Upper Lumbar Disc Herniation

scholarly journals Surgical Treatment of Upper Lumbar Disc Herniation

2003 ◽  
Vol 17 (2) ◽  
pp. 113-118
Author(s):  
Kinya Nakanishi ◽  
Junya Hanakita ◽  
Yoshihiro Kawahara ◽  
Tsukasa Satou ◽  
Masashi Oda ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Upper Lumbar Disc Herniation
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