scholarly journals Lumbopelvic Biomechanics in Patients with Lumbar Disc Herniation—Prospective Cohort Study

Symmetry ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 602
Author(s):  
Tomasz Kuligowski ◽  
Tomasz Sipko

Low back pain (LBP) is the most frequent cause of adult disability. One of the main reasons can be a herniated disc (lumbar disc herniation—LDH), potentially disturbing spinal movement patterns. Its influence on gait and lumbopelvic biomechanics still remains unclear. Little to no evidence was found on lumbopelvic kinematics and gait in young LDH adults. The purpose of this study was to analyze the lumbopelvic biomechanics in young adult individuals with lumbar disc herniation diagnosed by MRI. Forty-three participants (18–35 years) were divided into two groups: an LDH group (n = 19) and a control group (n = 24). All participants underwent dynamic lumbopelvic and gait measures by a G-Walk wearable device in a 6-m walking test (6MWT). The Oswestry Disability Index (ODI) questionnaire was used for subjective disability assessment. The LDH group showed higher speed (p = 0.02), lower symmetry of pelvis tilt (p = 0.01), and lower pelvis rotation (p = 0.04) compared to the healthy controls. Correlation calculations showed significance between pelvis obliquity and pelvis rotation (r = 0.53) but only in healthy controls. The lumbopelvic biomechanics shows differences in pelvis tilt and symmetry index of rotation parameters between LDH and healthy controls. In conclusion, LDH affects the gait kinematics, causing three-dimensional disorders and lack of synergy. This is probably due to pain avoidance behaviors and the compensation mechanisms of the adjacent body region.

2019 ◽  
Vol 9 (8) ◽  
pp. 1776-1781
Author(s):  
Zhaowen Peng ◽  
Wenwen Zhao ◽  
Shaohua Hu

Objective: Lumbar disc herniation leads the numbness and pain in the waist and lower limbs. Intervertebral foramen endoscopy is a minimally invasive procedure for the treatment of disc herniation. Adequate preoperative evaluation is conducive to this percutaneous skin surgery. The purpose of this study is to improve the efficacy of intervertebral foramen endoscopy in the treatment of lumbar disc herniation by preoperative computer three-dimensional reconstruction combined with pain management. Method: Fifty patients with lumbar disc herniation who met the indications of intervertebral foramen endoscopy were randomly divided into experimental group and control group. The control group was operated according to experience based on the common axial image. The experimental group was punctured according for three-dimensional visualization model of lumbar spine. Preoperative simulated puncture catheterization and perioperative pain management was applied. The catheterization time, operation time under endoscopy, fluoroscopy times during operation, the Visual Analogue Scale (VAS) and Japanese Orthopaedic Association (JOA) scores before and 1 d, 1 m and 3 m after operation were compared between two groups. Result: The three-dimensional visualization model of lumbar spine was reconstructed based on thin-layer data. According to the results of software measurement, the skin puncture point was located and the puncture angle was obtained. Compared with the control group, the catheterization time, operation time under endoscopy, fluoroscopy times during operation in experimental group were significantly reduced. There was no statistical difference in VAS and JOA scores between two groups before operation. Compared with control group, the VAS scores in experimental group at 1 d, and 1 m after operation were decreased statistically, while the JOA scores were increased statistically. Conclusion: Three-dimensional visualization model of lumbar spine and virtual operation planning can directly judge the feasibility of intervertebral foramen endoscopy in the treatment of lumbar disc herniation, improve the efficiency of operation, and further improve postoperative efficacy with pain management.


2018 ◽  
Vol 2018 ◽  
pp. 1-8
Author(s):  
Britta K. Krautwurst ◽  
Jürgen R. Paletta ◽  
Sylvia Mendoza ◽  
Adrian Skwara ◽  
Melvin Mohokum

Objective. Detection of a lateral shift (LS) in patients with diagnosed disc herniation compared to healthy controls. Summary of Background Data. A specific lateral shift (LS) pattern is observed in patients with disc herniation and low back pain, as shown in earlier studies. Methods. Rasterstereography (RS) was used to investigate the LS. Thirty-nine patients with lumbar disc herniation diagnosed by radiological assessment and low back pain and/or leg pain (mean age 48.2 years, mean BMI 28.5, 28 males and 11 females) and 36 healthy controls (mean age 47.4 years, mean BMI 25.7, 25 males and 11 females) were analysed. LS, pelvic tilt, pelvic inclination, lordotic angle, and trunk torsion were assessed. Results. The patient group showed a nonsignificant increase in LS, that is, 5.6 mm compared to the healthy controls with 5.0 mm (p = 0.693). However, significant differences were found between groups regarding pelvic tilt in degrees (patients 5.9°, healthy controls 2.0°; p = 0.016), trunk torsion (patients 7.5°, controls 4.5°; p = 0.017), and lordotic angle (patients 27.5°, healthy controls 32.7°; p = 0.022). The correlation between pain intensity and the FFbH-R amounted 0.804 (p = < 0.01), and that between pain intensity and the pain disability index was 0.785 (p < 0.01). Discussion. Although some studies have illustrated LS with disc herniation and low back pain, the present findings demonstrate no significant increase in LS in the patient group compared to healthy controls. Conclusion. The patients with lumbar disc herniation did not demonstrate an increased LS compared to healthy controls. Other parameters like pelvic tilt and inclination seemed to be more suitable to identify changes in posture measured by RS in patients with low back pain or disc herniation.


2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Jess Rollason ◽  
Andrew McDowell ◽  
Hanne B. Albert ◽  
Emma Barnard ◽  
Tony Worthington ◽  
...  

The anaerobic skin commensalPropionibacterium acnesis an underestimated cause of human infections and clinical conditions. Previous studies have suggested a role for the bacterium in lumbar disc herniation and infection. To further investigate this, five biopsy samples were surgically excised from each of 64 patients with lumbar disc herniation.P. acnesand other bacteria were detected by anaerobic culture, followed by biochemical and PCR-based identification. In total, 24/64 (38%) patients had evidence ofP. acnesin their excised herniated disc tissue. UsingrecAand mAb typing methods, 52% of the isolates were type II (50% of culture-positive patients), while type IA strains accounted for 28% of isolates (42% patients). Type III (11% isolates; 21% patients) and type IB strains (9% isolates; 17% patients) were detected less frequently. The MIC values for all isolates were lowest for amoxicillin, ciprofloxacin, erythromycin, rifampicin, tetracycline, and vancomycin (≤1mg/L). The MIC for fusidic acid was 1-2 mg/L. The MIC for trimethoprim and gentamicin was 2 to ≥4 mg/L. The demonstration that type II and III strains, which are not frequently recovered from skin, predominated within our isolate collection (63%) suggests that the role ofP. acnesin lumbar disc herniation should not be readily dismissed.


2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Qingyuan Wang ◽  
Hao Zhang ◽  
Jinxin Zhang ◽  
Hanqi Zhang ◽  
Hui Zheng

Abstract Background The aim of this study was to find out whether the shear wave elastography (SWE) findings of patients with unilateral lumbar disc herniation (LDH) were related to clinical characteristics. Methods For this purpose, the study group included patients (N = 20; 13 male, 7 female) with complaints of unilateral sciatica, with foraminal stenosis caused by one level of LDH (L4-L5 or L5-S1). An gender-and age-matched control group (N = 27; 16 male, 11 female) was included. All the patients were examined on both the axial and longitudinal planes bilaterally at the same level using a convex array probe (1- 6 MHz, Supersonic Imagine, Aix en Provence, France). Results The sciatic nerve stiffness measured on longitudinal planes of the affected side was significantly higher than unaffected side (p < 0.001) and the control group (P < 0.05). Furthermore, the symptom duration of unilateral LDH is positively correlated with the stiffness the sciatic nerve (r = 0.52, p = 0.019). Conclusion According to these findings, ultrasound imaging can be considered as a useful tool to detect changes in the sciatic nerve due to disc herniation. This technique will have a promising prospect for many patients with unilateral LDH in monitoring stiffness during rehabilitation and before or after surgery.


2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Wei Wang ◽  
Hui Wei ◽  
Runxiu Shi ◽  
Leitong Lin ◽  
Lechi Zhang ◽  
...  

AbstractThis study aimed to investigate lower-limb muscle activities in gait phases and co-contraction of one gait cycle in patients with lumbar disc herniation (LDH). This study enrolled 17 LDH patients and 17 sex- and age-matched healthy individuals. Bilateral muscle activities of the rectus femoris (RF), biceps femoris long head (BL), tibialis anterior (TA), and lateral gastrocnemius (LG) during walking were recorded. The gait cycle was divided into four phases by the heel strike and top off according to the kinematics tracks. Root mean square (RMS), mean frequency (MF), and co-contraction of surface electromyography signals were calculated. The LDH patients showed enhanced BL RMS during the single support phase (SS), second double support phase, and swing phase (SW) as well as decreased MF of RF during SS and of TA and LG during SW (p < 0.05). The co-contraction of the TA-LG was increased in LDH patients than in the control group (p < 0.05). Positive correlations were observed between TA-LG co-contraction (affected side, r = 0.557, p = 0.020; contralateral side, r = 0.627, p = 0.007) and the Oswestry disability index scores in LDH patients. LDH patients have increased BL firing rate and insufficient motor unit recruitment in specific phases in the lower limbs during walking. Dysfunction in LDH patients was associated with immoderate intermuscular co-contraction of the TA-LG during walking.


2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Wei An Yuan ◽  
Shi Rong Huang ◽  
Kai Guo ◽  
Wu Quan Sun ◽  
Xiao Bing Xi ◽  
...  

Low back pain due to lumbar disc herniation (LDH) is very common in clinic. This randomized controlled trial was designed to investigate the effects of integrative TCM conservative therapy for low back pain due to LDH. A total of 408 patients with low back pain due to LDH were randomly assigned to an experimental group with integrative TCM therapy and a control group with normal conservative treatment by the ratio of 3 : 1. The primary outcome was the pain by the visual analogue scale (VAS). The secondary outcome was the low back functional activities by Chinese Short Form Oswestry Disability Index (C-SFODI). Immediately after treatment, patients in the experimental group experienced significant improvements in VAS and C-SFODI compared with the control group (between-group difference in mean change from baseline, −16.62 points,P<0.001in VAS; −15.55 points,P<0.001in C-SFODI). The difference remained at one-month followup, but it is only significant in C-SFODI at six-month followup (−7.68 points,P<0.001). No serious adverse events were observed. These findings suggest that integrative TCM therapy may be a beneficial complementary and alternative therapy for patients with low back pain due to LDH.


2022 ◽  
Vol 2022 ◽  
pp. 1-11
Author(s):  
Shiyuan Wan ◽  
Bin Xue ◽  
Yanhao Xiong

Lumbar intervertebral disc protrusion disease refers to the degeneration of intervertebral disc, rupture of fibrous ring, nucleus pulpous protrusion and stimulation or compression of nerve root. The import command in Mimics medical 3D reconstruction software was used to erase the irrelevant image data and obtain vertebral body images. The original 3D model of each vertebral body was built by 3D computing function. A three-dimensional finite element model was established to analyze the effect of different surgical methods on the mechanical distribution of the spine after disentomb. The stress distribution of the spine, intervertebral disc, and left and right articular cartilage at L4/L5 stage and the position shift of the fourth lumbar vertebra were analyzed under 7 working conditions of vertical, forward flexion, extension, left and right flexion, and left and right rotation. The results showed that the established model was effective, and the smaller the area of posterior laminar decompression was, the lesser the impact on spinal stability was. The PELD treatment of lumbar disc herniation had little impact on spinal biomechanics and could achieve good long-term biomechanical stability. Combining the clinical experiment method and finite element simulation, using the advantages of finite element software to optimize the design function can provide guidance for the design and improvement of medical devices and has important significance for the study of clinical mechanical properties and biomechanics.


2019 ◽  
Author(s):  
qingyuan wang ◽  
jinxin zhang ◽  
hanqi zhang ◽  
hui zheng ◽  
Hao Zhang

Abstract Abstract Background The aim of this study was to find out whether the shear wave elastography (SWE) findings of patients with unilateral lumbar disc herniation (LDH)were related to clinical characteristics . Methods For this purpose,the study group included patients(N=20; 13 male, 7 female) with complaints of unilateral sciatica , with foraminal stenosis caused by one level of LDH (L4-L5 or L5-S1).An gender-and age-matched control group(N=27; 16 male, 11 female) was included.All the patients were examined on both the axial and longitudinal planes bilaterally at the same level using a convex array probe(1- 6MHz,Supersonic Imagine,Aix en Provence,France). Results The sciatic nerve stiffness measured on longitudinal planes of the affected side was significantly higher than unaffected side (p < 0.001)and the control group (P<0.05).Furthermore,the symptom duration of unilateral LDH is positively correlated with the stiffness the sciatic nerve(r=0.52,p=0.019). Conclusion According to these findings, ultrasound imaging can be considered as a useful tool to detect changes in the sciatic nerve due to disc herniation. This technique will have a promising prospect for many patients with unilateral LDH in monitoring stiffness during rehabilitation and before or after surgery. Keywords Ultrasound 、Sciatic nerve、Shear wave elastography、lumbar disc herniation


2019 ◽  
Author(s):  
qingyuan wang ◽  
jinxin zhang ◽  
hanqi zhang ◽  
hui zheng ◽  
Hao Zhang

Abstract Abstract Background The aim of this study was to find out whether the shear wave elastography (SWE) findings of patients with unilateral lumbar disc herniation (LDH)were related to clinical characteristics . Methods For this purpose,the study group included patients(N=20; 13 male, 7 female) with complaints of unilateral sciatica , with foraminal stenosis caused by one level of LDH (L4-L5 or L5-S1).An gender-and age-matched control group(N=27; 16 male, 11 female) was included.All the patients were examined on both the axial and longitudinal planes bilaterally at the same level using a convex array probe(1- 6MHz,Supersonic Imagine,Aix en Provence,France). Results The sciatic nerve stiffness measured on longitudinal planes of the affected side was significantly higher than unaffected side (p < 0.001)and the control group (P<0.05).Furthermore,the symptom duration of unilateral LDH is positively correlated with the stiffness the sciatic nerve(r=0.52,p=0.019). Conclusion According to these findings, ultrasound imaging can be considered as a useful tool to detect changes in the sciatic nerve due to disc herniation. This technique will have a promising prospect for many patients with unilateral LDH in monitoring stiffness during rehabilitation and before or after surgery. Keywords Ultrasound 、Sciatic nerve、Shear wave elastography、lumbar disc herniation


2019 ◽  
pp. 15-21
Author(s):  
Van Hung Nguyen ◽  
Truc Quynh Nguyen ◽  
Thi Tan Nguyen

Background: Sciatica due to lumbar disc herniation is one of the most common diseases in the world as well as in Viet Nam, sciatica impact on patient’s quality of life, ability to work and social interaction. Currently there are many methods of treatment with modern medicine and traditional medicine. Objectives: To investigate some clinical and paraclinical characteristics of sciatica due to herniated disc without surgery and to evaluate the effects of electronic acupuncture combined of with “Than thong truc u thang” remedy in the treatment of sciatica due to lumbar disc herniation. Methods: The sample is 27 patients diagnosed sciatica due to lumbar disc herniation. We examined and treated at Traditional Medicine Department of Hue Central Hospital. A prospective study, assess the results before and after the treatment. Results: Good level occupied 44.4%; fair good level occupied 37.0%; averge good level occupied 18.5%. Conclusion: This combination is effective treatment for sciatica due to lumbar disc herniation. Key words: Sciatica, lumbar disc herniation, electronic – acupuncture, “Than thong truc u thang” remedy


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