scholarly journals Impact of Obesity and Underweight on Surgical Outcome of Lumbar Disc Herniation

2014 ◽  
Vol 2014 ◽  
pp. 1-5
Author(s):  
Farzad Omidi-Kashani ◽  
Ebrahim Ghayem Hasankhani ◽  
Ehsan Rafeemanesh ◽  
Parham Seyf ◽  
Hassan Attarchi ◽  
...  

Background. The relationship between underweight and lumbar spine surgery is still unknown. Aim. To evaluate the effect of underweight versus obesity based on surgical outcome of lumbar disc herniation. Material and Method. In this retrospective study, we evaluated 206 patients (112 male and 94 female) with a mean age of 37.5±3.1 years old (ranged 20–72) who have been surgically treated due to the refractory simple primary L4-L5 disc herniation. We followed them up for a mean period of 42.4±7.2 months (ranged 24–57). We used Body Mass Index (BMI), Oswestry Disability Index (ODI), and Visual Analogue Scale (VAS) for categorization, disability, and pain assessment, respectively. We used Wilcoxon and Mann-Whitney U tests for statistics. Results. Surgical discectomy in all weight groups was associated with significant improvement in pain and disability, but intergroup comparison showed these improvements in both underweight and obese groups and they were significantly lower than in normal weight group. Excellent and good satisfaction rate was also somewhat lower in both these ends of weight spectrum, but statistically insignificant. Conclusion. Both obesity and underweight may have adverse prognostic influences on the surgical outcome of lumbar disc herniation, although their impact on subjective satisfaction rate seems to be insignificant.

Diagnostics ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 938
Author(s):  
Jian Geng ◽  
Ling Wang ◽  
Qing Li ◽  
Pengju Huang ◽  
Yandong Liu ◽  
...  

Little is known about the effect of lumbar intervertebral disc herniation (LDH) on lumbar bone mineral density (BMD), and few previous studies have used quantitative computed tomography (QCT) to assess whether the staging of LDH correlates with lumbar vertebral trabecular volumetric bone mineral density (Trab.vBMD). To explore the relationship between lumbar Trab.vBMD and LDH, seven hundred and fifty-four healthy participants aged 20–60 years were enrolled in the study from an ongoing study on the degeneration of the spine and knee between June 2014 and 2017. QCT was used to measure L2–4 Trab.vBMD and lumbar spine magnetic resonance images (MRI) were performed to assess the incidence of disc herniation. After 9 exclusions, a total of 322 men and 423 women remained. The men and women were divided into younger (age 20–39 years) and older (age 40–60 years) groups and further into those without LDH, with a single LDH segment, and with ≥2 segments. Covariance analysis was used to adjust for the effects of age, BMI, waistline, and hipline on the relationship between Trab.vBMD and LDH. Forty-one younger men (25.0%) and 59 older men (37.3%) had at least one LDH segment. Amongst the women, the numbers were 46 (22.5%) and 80 (36.4%), respectively. Although there were differences in the characteristics data between men and women, the difference in Trab.vBMD between those without LDH and those with single and ≥2 segments was not statistically significant (p > 0.05). These results remained not statistically significant after further adjusting for covariates (p > 0.05). No associations between lumbar disc herniation and vertebral trabecular volumetric bone mineral density were observed in either men or women.


2020 ◽  
Author(s):  
Cai Chen ◽  
Dandan Wang ◽  
Fanjie Liu ◽  
Hao Qin ◽  
Xiyuan Li ◽  
...  

AbstractPurposeThis paper was designed to critically provide empirical evidence for the relationship between temperature and intensity of back pain among people with lumbar disc herniation (LDH).MethodsDistributed lag linear and non-linear models (DLNM) was used to evaluate the relationship between lag-response and exposure to ambient temperature. Stratification was based on age and gender.ResultsWhen daily average temperature was on the rage of 15-23□, the risk of hospitalization was at the lowest level for men group. About below 10□, risk for male hospitalization could keep increase when lag day were during lag0-lag5 and lag20-lag28. 40<age≤50 group was little affected when they exposed to ambient temperature.


2021 ◽  
pp. 1-9
Author(s):  
Joel Beck ◽  
Olof Westin ◽  
Helena Brisby ◽  
Adad Baranto

OBJECTIVESciatica is the hallmark symptom of a lumbar disc herniation (LDH). Up to 90% of LDH patients recover within 12 weeks regardless of treatment. With continued deteriorating symptoms and low patient quality of life, most surgeons recommend surgical discectomy. However, there is not yet a clear consensus regarding the proper timing of surgery. The aim of this study was to evaluate how the duration of preoperative leg pain (sciatic neuralgia) is associated with patient-reported levels of postoperative leg pain reduction and other patient-reported outcome measures (PROMs) in a prospectively collected data set from a large national cohort.METHODSAll patients aged 18–65 years undergoing a lumbar discectomy during 2013–2016 and registered in Swespine (the Swedish national spine registry) with 1 year of postoperative follow-up data were included in the study (n = 6216). The patients were stratified into 4 groups according to preoperative pain duration: < 3, 3–12, 12–24, or > 24 months. Patient results assessed with the numeric rating scale (NRS) for leg pain (rated from 0 to 10), global assessment of leg pain, EQ-5D, Oswestry Disability Index (ODI), and patient satisfaction with the final surgical outcome were analyzed and compared with preoperative values and between groups.RESULTSA significant improvement was seen 1 year postoperatively regardless of preoperative pain duration (change in NRS score: mean −4.83, 95% CI −4.73 to −4.93 in the entire cohort). The largest decrease in leg pain NRS score (mean −5.59, 95% CI −5.85 to −5.33) was seen in the operated group with the shortest sciatica duration (< 3 months). The patients with a leg pain duration in excess of 12 months had a significantly higher risk of having unchanged radiating leg pain 1 year postoperatively compared with those with < 12-month leg pain duration at the time of surgery (OR 2.41, 95% CI 1.81–3.21, p < 0.0001).CONCLUSIONSPatients with the shortest leg pain duration (< 3 months) reported superior outcomes in all measured parameters. More significantly, using a 12-month pain duration as a cutoff, patients who had a lumbar discectomy with a preoperative symptom duration < 12 months experienced a larger reduction in leg pain and were more satisfied with their surgical outcome and perception of postoperative leg pain than those with > 12 months of sciatic leg pain.


2020 ◽  
Author(s):  
Han Ye ◽  
Wang Xiaodong ◽  
Zhang zepei ◽  
Deepak shrestha ◽  
Li Kepeng ◽  
...  

Abstract Purpose The relationship between facet tropism (FT) and lumbar disc herniation (LDH) is not clear. In the present study, MRI was used to assess the relationship between lumbar facet joint tropism and disc herniation. This paper is the first to assess the relationship between facet joint tropism and LDH from the sagittal view. Methods 122 patients (154 segments) with lumbar disc herniation and 102 normal subjects (306 segments) who visited our hospital from 01-Jan-2020 to 01-Apr-2020 were included in this study. The axial and sagittal angles of facet joints were measured using an MRI scan. The difference of 10° in facet angles between left and right was defined as lumbar facet tropism. The relationship between the two was analyzed. Results In the axial, 95/154 segments with lumbar disc herniation had FT whereas, 48/258 segments had FT in the normal segments(p<0.01). In the sagittal, 61/154 segments with lumbar disc herniation had FT and 48/306 had FT in the control(p<0.01). Conclusion The proportion of FT is better in patients with lumbar disc herniation, and there is a significant correlation between FT and lumbar disc herniation.


2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Ghassan S. Skaf ◽  
Chakib M. Ayoub ◽  
Nathalie T. Domloj ◽  
Massud J. Turbay ◽  
Cherine El-Zein ◽  
...  

It has been previously suggested in the literature that with aging, degenerative changes as well as disc herniation start at the lower lumbar segments, with higher disc involvement observed in an ascending fashion in older age groups. We conducted a study to investigate this correlation between age and level of disc herniation, and to associate it with the magnitude of the Lumbar Lordotic Angle (LLA), as measured by Cobb’s method. We followed retrospectively lumbosacral spine MRI’s of 1419 patients with symptomatic disc herniation. Pearson’s correlation was used in order to investigate the relationship between LLA, age, and level of disc herniation. Student’s -test was applied to assess gender differences. Young patients were found to have higher LLA (, ) and lower levels of disc herniation (, ), whereas older patients had higher level herniation in lower LLA group (mean LLA 28.6° and 25.4°) and lower level herniation in high LLA group (mean LLA 33.2°). We concluded that Lumbar lordotic Cobb’s angle and age can be predictors of the level of lumbar disc herniation. This did not differ among men and women (, ).


Author(s):  
Anuj D. Bharuka ◽  
Rajendra Phunde ◽  
Hiren B. Patel

<p class="abstract"><strong>Background:</strong> Cauda equina syndrome (CES) is a rare but severe neurological disorder most commonly due to lumbar disc herniation. The role of urgent surgery in improving the outcome of patients with CES remains controversial.</p><p class="abstract"><strong>Methods:</strong> In the present study retrospective evaluation of 44 patients with CES secondary to lumbar disc herniation treated at our hospital between 2009 and 2017 has been done. The patients were categorized into complete (CES-R) and incomplete (CES-I) types of CES and the relationship between timing of surgery and outcome were evaluated.<strong></strong></p><p class="abstract"><strong>Results:</strong> Out of 44 patients, 28 patients presented with CES-I and 16 patients presented with CES-R. In patients with CES-I there was statistically significant difference (p=0.0001) in all observed surgical outcome between the patients operated within 48 hrs and those operated after 48 hrs. In patients with CES-R, no correlation was found between onset of symptoms and timing of surgery as recovery was partial in all the patients except 3 who completely recovered, irrespective of their operative times. (p=0.494).</p><p><strong>Conclusions:</strong> Early diagnosis and treatment in form of emergency decompressive surgery done within 48 hours of onset of autonomic symptoms in CES-I patients can prevent further neurological damage and deterioration to CES-R. For CES-R patients operating within 48 hours made no difference to their outcome. However, necessary investigations and planned surgery by skilful surgeon should be arranged as soon as is reasonably possible for patients with CES-R. </p>


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