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[Percutaneous endoscopic discectomy with lateral approach and dual-channel method for the treatment of highly free lumbar disc herniation].

OBJECTIVE: To explore clinical efficacy of percutaneous endoscopic discectomy with a lateral approach and dual-channel method in treating hi … and dual-channel method could be performed under local anesthesia, allowing for the removal of the nucleus pulposus under direct vision. It is simpler, more efficient.

Effects of Complex Rehabilitation Program on Reducing Pain and Disability in Patients with Lumbar Disc Protrusion-Is Early Intervention the Best Recommendation?

(1) Background: Due to its frequency and possible complications, low back pain (LBP) has a high social impact, it is a common problem of the active population and the second reason for visiting a physician. In patients with lumbar disc protrusion (LDP), one of the most common causes of LBP, the nucleus pulposus bulges against the disc and then protrudes into the spinal cord, but the annulus fibrosus remains intact; (2) Objectives: The primary objective of this study was to determine the efficacy of a rehabilitation treatment (RT) comprising electrotherapy (ET), hydrotherapy (HT) and individual…

The impact of four common lumbar spine diagnoses upon overall health status.

BACKGROUND CONTEXT: The Short Form 36 (SF-36) health survey has been shown to be a valid instrument when used to measure the self-reported p … ng the Health Status Questionnaire 2.0. A database search identified patients with either herniated nucleus pulposus with radicular pain (HNP), lumbar spinal stenosis without deformity (SPS), degenerative spondylolisthesis (DS), and painful disc degeneration/spondylosis (DDD). The mean SF-36 scale scores were generated for each of the diagnostic groups. The impact …

Transforaminal Full-Endoscopic Ventral Facetectomy: Midterm Results and Factors Associated with Poor Surgical Outcomes.

BACKGROUND: Full-endoscopic spine surgery (FESS) is a well-established procedure for herniated nucleus pulposus. It is a minimally invasive surgery that can be performed under local anesthesia through only an 8-mm skin incision. With improvements in surgical equipment such as high-speed drills, the indications for FESS have expanded to include lumbar spinal stenosis (LSS). We perform a transforaminal full-endoscopic ventral facetectomy (TF-FEVF) for unilateral nerve root-type lateral recess stenosis (LRS) using a transforaminal approach under local anesthesia.The aim of this study was to exami…

Retrolisthesis and lumbar disc herniation: a postoperative assessment of outcomes at 8-year follow-up.

BACKGROUND CONTEXT: Lumbar disc herniation and retrolisthesis have been shown to be significant degenerative changes that can be associated … ibute to low back pain and dysfunction in patients undergoing lumbar discectomy for L5-S1 herniated nucleus pulposus in early follow-up, no significant difference was found in postoperative outcomes after 3 years. Additionally, retrolisthesis was not found to be associated with different reoperation rates at 8 years postoperatively.

Unique Complications of Percutaneous Endoscopic Lumbar Discectomy and Percutaneous Endoscopic Interlaminar Discectomy.

BACKGROUND: Percutaneous endoscopic discectomy (PED) includes 2 main procedures: percutaneous endoscopic lumbar discectomy (PELD) and percutaneous endoscopic interlaminar discectomy (PEID), both of which are minimally invasive surgical procedures that effectively deal with lumbar degenerative disorders. Because of the challenging learning curve for the surgeon and the individual characteristics of each patient, preventing and avoiding complications is difficult. The most common complications, such as nucleus pulposus omission, nerve root injury, dural tear, visceral injury, nerve root induced …

[Key genes of intervertebral disc degeneration with ferroptosis and prediction of potential traditional Chinese medicine based on bioinformatics and machine learning].

This study aimed to identify key ferroptosis-related genes associated with intervertebral disc degeneration(IDD) through bioinformatics and … remine Medical database and validated through molecular docking. For experimental validation, mouse nucleus pulposus cells were divided into a normal control group, an erastin(1 μmol·L~(-1))-induced model group, and an icariin(10 μmol·L~(-1)) intervention group. Cell viability, oxidative stress indicators [reactive oxygen species(ROS), lipid peroxides(LPO), reduce …

[Effectiveness analysis of single-incision treatment for adjacent two-segmental lumbar disc herniation using uni-portal non-coaxial spinal endoscopic surgery].

OBJECTIVE: To investigate the feasibility and effectiveness of uni-portal non-coaxial spinal endoscopic surgery (UNSES) via a single incisio … fair, and the excellent and good rate was 87.9%. Postoperative lumbar MRI showed that the herniated nucleus pulposus tissue had been removed in all patients, the cross-sectional area of the spinal canal was significantly increased, and the nerve root was not significantly compressed. At last follow-up, there was no significant difference in lumbar lordosis angle, …

Lumbar arthroplasty for treatment of primary or recurrent lumbar disc herniation.

PURPOSE: Microdiscectomy is the current gold standard surgical treatment for primary lumbar disc herniations that fail non-surgical measures. Herniated nucleus pulposus is the manifestation of underlying discopathy that remains unaddressed with microdiscectomy. Therefore, risk remains of recurrent disc herniation, progression of the degenerative cascade, and on-going discogenic pain. Lumbar arthroplasty allows for complete discectomy, complete direct and indirect decompression of neural elements, restoration of alignment, restoration of foraminal height, and preservation of motion. In addition…

Transforaminal Percutaneous Endoscopic Discectomy and Foraminoplasty after Lumbar Spinal Fusion Surgery.

BACKGROUND: The most common causes of pain following lumbar spinal fusions are residual herniation, or foraminal fibrosis and foraminal sten … effective for patients with back or leg pain after lumbar spinal fusions due to residual/recurrent nucleus pulposus and foraminal stenosis. Failed initial index surgery may involve failure to recognize patho-anatomy in the axilla of the foramen housing the traversing and the exiting nerve. The transforaminal endoscopic approach effectively decompresses the forame …

Influence of lumbar intervertebral disc degeneration on the outcome of total lumbar disc replacement: a prospective clinical, histological, X-ray and MRI investigation.

INTRODUCTION: The role of fusion of lumbar motion segments for the treatment of axial low back pain (LBP) from lumbar degenerative disc dise … ngoing prospective clinical trial with ProDisc II (Synthes, Paoli, U.S.A.). MATERIALS AND METHODS: Nucleus pulposus (NP) and annulus fibrosus (AF) changes were evaluated according to a previously validated quantitative histological degeneration score (HDS). X-ray evaluation included assessment of the mean, anterior and posterior disc space height (DSH). MRI inves …

A phase 3, randomized, double-blind, sham-controlled trial of SI-6603 (condoliase) in patients with radicular leg pain associated with lumbar disc herniation.

BACKGROUND CONTEXT: SI-6603 (condoliase) is a chemonucleolytic agent approved in Japan in 2018 for the treatment of lumbar disc herniation (LDH) associated with radicular leg pain. Condoliase, a mucopolysaccharidase with high substrate specificity for glycosaminoglycans (GAGs), offers a unique mechanism of action through the degradation of GAGs in the nucleus pulposus. As LDH management is currently limited to conservative approaches and surgical intervention, condoliase could offer a less invasive treatment option than surgery for patients with LDH. PURPOSE: The Discovery 6603 study (NCT0360…

Anterior transcorporeal approach of percutaneous endoscopic cervical discectomy for disc herniation at the C4-C5 levels: a technical note.

BACKGROUND CONTEXT: With the continuous development of the spinal endoscopic technique in recent years, percutaneous endoscopic cervical discectomy (PECD) has emerged, which bridges the gap between conservative therapy and traditional surgery and has been mainly divided into the anterior transdiscal approach and the posterior interlaminar access. Because of the relatively greater violation to the anterior nucleus pulposus, there is a higher potential of postoperative intervertebral space decrease in the anterior transdiscal approach than in the posterior interlaminar access. In addition, when …

[Lumbar spinal stenosis. Symptomatology and methods of treatment].

INTRODUCTION: Lumbar spinal stenosis (LSS) may be defined as any type of the narrowing of the spinal nerve root canal (the lateral recess), … 4 were iatrogenic (3 after disc extirpation and one after laminectomy) (Fig. 1). Herniation of the nucleus pulposus in combination with LSS was found in 12 patients (31.57%). Local segmental stenosis was identified in 16 patients (42.10%). (Graph. 1) (Fig. 2); the others had the generalized type of stenosis involving two levels (17 patients-44.7%); three levels ( …

The advancement and utility of multimodal imaging in the diagnosis of degenerative disc disease.

Degenerative disc disease (DDD) is a common spinal condition characterized by the deterioration of intervertebral discs, leading to chronic back pain and reduced mobility. While magnetic resonance imaging (MRI) has long been the standard for late-stage DDD diagnosis, its limitations in early-stage detection prompt the exploration of advanced imaging methods. Positron emission tomography/computed tomography (PET/CT) using 18F- fluorodeoxyglucose (FDG) and 18F-sodium fluoride (NaF) has shown promise in identifying metabolic imbalances and age-related spinal degeneration, thereby complementing CT

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… These discs consist of two layers: an inner soft structure known as the nucleus pulposus, and an outer firm layer called the annulus fibrosus ( 1 ). … The classification grades DDD on a scale of I (best) to V (worst) based on disc structure, disc height, quality of distinction between the nucleus pulposus and annulus fibrosus, and T2 signal intensity, where a reduction in signal of the nucleus pulposus, increased heterogeneity, and loss of disc height …

Minimally invasive interventional therapy for pain.

Pain interventional therapy, known as the most promising medical technology in the 21st century, refers to clinical treatment technology based on neuroanatomy, neuroimaging, and nerve block technology to treat pain diseases. Compared with traditional destructive surgery, interventional pain therapy is considered a better and more economical choice of treatment. In recent years, a variety of minimally invasive pain interventional therapy techniques, such as neuroregulation, spinal cord electrical stimulation, intervertebral disc ablation, and intrasheath drug infusion systems, have provided eff

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… Minimally invasive interventional therapy for discogenic pain Nucleus pulposus ablation Nucleus pulposus ablation refers to the treatment of herniated intervertebral discs through physical and chemical methods under the guidance of DSA, CT, ultrasound, etc., to reduce the pressure in the intervertebral … At present, NP ablation is performed using low-temperature plasma radiofrequency ablation, 42 targeted disc decompression, 43 laser ablation, 44 and collagenase chemonucleolysis. 45 Nucleus pulposus ablation is widely used clinically because of its advantages such as low trauma, few complications, no …

Advances in the mechanism and therapies of achondroplasia.

Achondroplasia (ACH), is the prevailing type of genetic dwarfism in humans, caused by mutations in fibroblast growth factor receptor 3 (FGFR3) that are inherited in an autosomal dominant manner. FGFR3 is mainly expressed in condensed mesenchyme, chondrocytes, and mature osteoblasts and osteoclasts, in which it regulates the formation, development, growth, and remodeling of the skeletal system. Mutations in FGFR3 causing ACH result in enhanced FGFR3 signaling through combined mechanisms including enhancing FGF dimerization and tyrosine kinase activity and stabilizing FGF receptors. In ACH, supp

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… During postnatal growth, it was noticed in a fate-mapping study that nucleus pulposus cells expressing FGFR3 (FGFR3 positive) experienced proliferation from the outer to inner areas of the nucleus pulposus. … Expansion of FGFR3-positive nucleus pulposus cells plays important roles in postnatal nucleus pulposus growth and regeneration. Stem Cell Res Ther. 2022;13(1):227. doi: 10.1186/s13287-022-02903-2. 100. Song H., Du H., Li J., et al. …

Minimally Invasive Transforaminal Versus Lateral Lumbar Interbody Fusion for Degenerative Spinal Pathology: Clinical Outcome Comparison in Patients With Predominant Back Pain.

STUDY DESIGN: Retrospective review. OBJECTIVE: To compare perioperative and postoperative clinical outcomes between minimally invasive tran … nificantly greater proportion of patients with preoperative spinal pathology of recurrent herniated nucleus pulposus, whereas a significantly greater proportion of patients in the LLIF cohort demonstrated isthmic spondylolisthesis ( P < 0.046, all). No significant differences were noted between cohorts for operative duration, estimated blood loss, 1-year rate of a …

Novel Insights into the Links between N6-Methyladenosine and Regulated Cell Death in Musculoskeletal Diseases.

Musculoskeletal diseases (MSDs), including osteoarthritis (OA), osteosarcoma (OS), multiple myeloma (MM), intervertebral disc degeneration (IDD), osteoporosis (OP), and rheumatoid arthritis (RA), present noteworthy obstacles associated with pain, disability, and impaired quality of life on a global scale. In recent years, it has become increasingly apparent that N6-methyladenosine (m6A) is a key regulator in the expression of genes in a multitude of biological processes. m6A is composed of 0.1-0.4% adenylate residues, especially at the beginning of 3'-UTR near the translation stop codon. The m

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… RCD can occur in a variety of cells including chondrocytes, synoviocytes, osteocytes, bone marrow stromal cells, hematopoietic stem cells, disc cells, and nucleus pulposus cells. … In this condition, RCD can occur in various types of cells within the intervertebral disc, including disc cells, chondrocytes, and nucleus pulposus cells. The death of these cells can be triggered by apoptosis or other forms of the RCD pathway. …

Resveratrol: Molecular Mechanisms, Health Benefits, and Potential Adverse Effects.

Resveratrol (RES), a naturally occurring polyphenolic compound, has garnered significant attention due to its diverse biological activities, which include anti-inflammatory, antioxidant, and antiaging properties. This review synthesizes current evidence concerning the molecular mechanisms, therapeutic efficacy, and safety profile of RES across a variety of pathologies, with an emphasis on the latest research conducted in recent years. Mechanistically, RES is known to modulate critical signaling pathways such as the activation of sirtuin 1. These actions collectively contribute to the attenuati

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… AKT, protein kinase B; ECM, extracellular matrix; ERK, extracellular signal‐regulated kinase; IVDD, intervertebral disc degeneration; NP cell, nucleus pulposus cell. … Intervertebral Disc Degeneration （IVDD） Intervertebral discs consist of three major components: the inner nucleus pulposus (NP), the outer annulus fibrosus (AF), and the cartilaginous endplates (CEP) [ 71 ]. …