Herniated Disc

The impact of novel inflammation-preserving treatment towards lumbar disc herniation resorption in symptomatic patients: a prospective, multi-imaging and clinical outcomes study.

Albert HB, Sayari AJ, Barajas JN, Hornung AL, Harada G, Nolte MT · European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2024 · n=19

We performed a prospective one-year multi-imaging study to assess the clinical outcomes and rate of disc resorption in acute lumbar disc herniation (LDH) patients undergoing inflammation-preserving treatment (i.e. no NSAIDS, steroids). All patients received gabapentin to relieve leg pain, 12 sessions of acupuncture. Repeat MRI was performed, every 3 months, after 12 sessions of treatment continued for those without 40% reduction in herniated disc sagittal area. Disc herniations sizes were measured on sagittal T2W MRI sequences, pre-treatment and at post-treatment intervals. Patients were stratified to fast, medium, slow, and prolonged recovery groups in relation to symptom resolution and disc resorption. Ninety patients (51% females; mean age: 48.6 years) were assessed. Mean size of disc herniation was 119.54 ± 54.34 mm2, and the mean VAS-Leg score was 6.12 ± 1.13 at initial presentation. A total of 19 patients (21.1%) improved at

Clinical Effectiveness of Artificial Disc Replacement in Comparison With Anterior Cervical Discectomy and Fusion in the Patients With Cervical Myelopathy: Systematic Review and Meta-analysis.

Lee JH, Lee YJ, Chang MC, Lee JH · Neurospine · 2023

Cervical myelopathy (CM) describes the compressive cervical spinal cord state, often accompanied by serious clinical condition, by herniated disc or hypertrophied spurs or ligament. Anterior cervical discectomy and fusion (ACDF) has been frequently employed as conventional surgical solution for this CM despite its inherent biomechanical handicap. Alternatively, an artificial disc replacement (ADR) preserves cervical motion while still decompressing the spinal canal and neural foramen. This analysis elaborated to clarify the potential benefits of ADR application to CM over ACDF from the conglomerated results of the past references. A literature search was performed using MEDLINE, Embase, Cochrane review, and KMbase databases from the studies published until March 2023. Six studies (3 randomized controlled study [RCTs] and 3 non-RCTs) were included in a qualitative and quantitative synthesis. Data were extracted and analyzed using a random effects model to obtain effect size and its sta

Outcomes of endoscopic discectomy compared with open microdiscectomy and tubular microdiscectomy for lumbar disc herniations: a meta-analysis.

Barber SM, Nakhla J, Konakondla S, Fridley JS, Oyelese AA, Gokaslan ZL · Journal of neurosurgery. Spine · 2019 · n=2577

Endoscopic discectomy (ED) has been advocated as a less-invasive alternative to open microdiscectomy (OM) and tubular microdiscectomy (TM) for lumbar disc herniations, with the potential to decrease postoperative pain and shorten recovery times. Large-scale, objective comparisons of outcomes between ED, OM, and TM, however, are lacking. The authors' objective in this study was to conduct a meta-analysis comparing outcomes of ED, OM, and TM. The PubMed database was searched for articles published as of February 1, 2019, for comparative studies reporting outcomes of some combination of ED, OM, and TM. A meta-analysis of outcome parameters was performed assuming random effects. Twenty-six studies describing the outcomes of 2577 patients were included. Estimated blood loss was significantly higher with OM than with both TM (p = 0.01) and ED (p < 0.00001). Length of stay was significantly longer with OM than with ED (p < 0.00001). Return to work time was significantly longer in OM t

An update of the systematic assessment of mechanical lumbar disc decompression with nucleoplasty.

Manchikanti L, Falco FJ, Benyamin RM, Caraway DL, Deer TR, Singh V · Pain physician · 2013

Lumbar disc prolapse, protrusion, and extrusion account for less than 5% of all low back problems, but are the most common causes of nerve root pain and surgical interventions. The primary rationale for any form of surgery for disc prolapse is to relieve nerve root irritation or compression due to herniated disc material. The primary modality of treatment continues to be either open or microdiscectomy, although several alternative techniques are also utilized, including nucleoplasty, automated percutaneous discectomy and laser discectomy. There is a paucity of evidence for all decompression techniques, specifically alternative techniques including nucleoplasty. A systematic review of the literature of mechanical lumbar disc decompression with nucleoplasty. To determine the effectiveness and update the effectiveness of mechanical lumbar disc decompression with nucleoplasty. The available literature on mechanical lumbar disc decompression with nucleoplasty was reviewed. The quality as

An updated review of automated percutaneous mechanical lumbar discectomy for the contained herniated lumbar disc.

Manchikanti L, Singh V, Falco FJ, Calodney AK, Onyewu O, Helm S 2nd · Pain physician · 2013 · n=515

Lumbar disc prolapse, protrusion, and extrusion are the most common causes of nerve root pain and surgical interventions, and yet they account for less than 5% of all low back problems. The typical rationale for traditional surgery is that it is an effort to provide more rapid relief of pain and disability. It should be noted that the majority of patients do recover with conservative management. The primary rationale for any form of surgery for disc prolapse associated with radicular pain is to relieve nerve root irritation or compression due to herniated disc material. The primary modality of treatment continues to be either open or microdiscectomy, although several alternative techniques, including automated percutaneous mechanical lumbar discectomy, have been described. There is, however, a paucity of evidence for all decompression techniques, specifically alternative techniques including automated and laser discectomy. A systematic review of the literature of automated percutaneou

Herniated lumbar disc.

Jordan J, Konstantinou K, O'Dowd J · BMJ clinical evidence · 2011

Herniated lumbar disc is a displacement of disc material (nucleus pulposus or annulus fibrosis) beyond the intervertebral disc space. The highest prevalence is among people aged 30 to 50 years, with a male to female ratio of 2:1. There is little evidence to suggest that drug treatments are effective in treating herniated disc. We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of drug treatments, non-drug treatments, and surgery for herniated lumbar disc? We searched: Medline, Embase, The Cochrane Library, and other important databases up to June 2010 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). We found 37 systematic reviews, RCTs, or observational studies that met our inclus

Lumbar herniated disc treatment with percutaneous hydrodiscectomy.

Brazilian Medical Association, Silvinato A, Simões RS, Buzzini RF, Bernardo WM · Revista da Associacao Medica Brasileira (1992) · 2018

Lumbar herniated disc are common manifestations of degenerative spine diseases, the main cause of radiated lower back pain. This guideline followed standard of a systematic review with recovery of evidence based on the movement of evidence-based medicine. We used the structured method for formulating the question synthesized by the acronym p.I.C.O., In which the p corresponds to the lumbar herniated disc, i to the treatment intervention with percutaneous hydrodiscectomy, c comparing with other treatment modalities, o the outcome of clinical evolution and complications. From the structured question, we identify the descriptors which constituted the evidence search base in the medline-pubmed databases (636 papers) and therefore, after the eligibility criteria (inclusion and exclusion), eight papers were selected to answer to clinical question. The details of the methodology and the results of this guideline are exposed in annex i.

Lumbar herniated disc - endoscopic discectomy treatment.

Joaquim AF, Botelho RV, Mudo ML, Almeida AS, Bernardo WM · Revista da Associacao Medica Brasileira (1992) · 2018

The Guidelines Project, an initiative of the Brazilian Medical Association, aims to combine information from the medical field in order to standardize producers to assist the reasoning and decision-making of doctors. The information provided through this project must be assessed and criticized by the physician responsible for the conduct that will be adopted, depending on the conditions and the clinical status of each patient.

[Multicenter randomized controlled trial of Yiqi Huoxue formula() for the treatment of ruptured lumbar disc herniation].

Zhu Y, Wang ZQ, Lin S, Yao YY, Shen XQ, Li XC · Zhongguo gu shang = China journal of orthopaedics and traumatology · 2025 · n=80

To observe the clinical symptoms and MRI outcomes of patients with ruptured lumbar disc herniation(LDH) through a multicenter randomized controlled study, and to evaluate the clinical efficacy and safety of Yiqi Huoxue formula() in the treatment of this disease. A total of 160 outpatients and inpatients with ruptured LDH admitted to 4 medical centers from January 2023 to June 2023 were selected and randomly divided into the Yiqi Huoxue formula group and the control group, with 80 patients in each group. In the Yiqi Huoxue formula group, there were 43 males and 37 females, with an age of (41.03±9.56) years and a disease duration of (10.45±25.37) days, and the patients were treated with Yiqi Huoxue formula. In the control group, there were 34 males and 46 females, with an age of (42.14±8.73) years and a disease duration of (11.31±21.14) days;during the acute phase, patients in this group could take celecoxib capsules orally, and methylcobalamin orally at the same tim

Gabapentin versus placebo for the treatment of acute lumbosacral radicular pain caused by disc herniation: study protocol of the GRADE randomized controlled double-blind superiority trial.

Ducoulombier V, Coquerelle P, Candelier JB, Avenel G, Leroy R, Juilliard A · Trials · 2025

Acute lumbosacral radiculopathy from disc herniation is common and particularly painful. The challenge is to provide sufficient relief to patients until the natural regression of the herniated disc allows them to heal, primarily using conservative medical treatment combining physical measures, antinociceptive analgesics, and systemic anti-inflammatory drugs. Nerve root impingement is likely to cause acute neuropathic pain, which is not currently managed by standard conservative medical treatment. We hypothesised that a short course of gabapentin could improve pain management in acute lumbosacral radiculopathy from disc herniation. The GRADE (Gabapentin versus placebo for the treatment of acute lumbosacral RAdicular pain caused by Disc hErniation) study is a prospective, randomized, multicenter, double-blind, superiority phase III trial comparing a 3-day regimen of gabapentin to placebo with a 1:1 ratio. Patients with acute lumbosacral radiculopathy from disc herniation with symptoms o

Unilateral Biportal Endoscopy for Lumbar Spinal Stenosis and Lumbar Disc Herniation.

Park DK, Weng C, Zakko P, Choi DJ · JBJS essential surgical techniques · 2023

Unilateral biportal endoscopy (UBE) is a novel minimally invasive technique for the treatment of lumbar spinal stenosis and lumbar disc herniations. Uniportal endoscopy was utilized prior to the advent of UBE and has been considered the workhorse of endoscopic spine surgery (ESS) for lumbar discectomy and decompressive laminectomy. However, there are theoretical advantages to UBE compared with traditional uniportal endoscopy, including that the procedure utilizes typical spinal equipment that should be readily available, requires less capital cost and optical instrumentation, and provides greater operative flexibility as a result of utilizing both a working and a viewing portal7,8. A 0-degree arthroscope is typically utilized for discectomy and lumbar laminectomies. The use of a radiofrequency ablator is critical to help coagulate osseous and muscle bleeders. For irrigation, gravity or a low-pressure pump, typically <40 mm Hg, can be utilized9,10. Further details regarding irrigati

Spinal Stenosis(Archived).

Raja A, Patel P, Mesfin FB · 2026

Comparative-effectiveness study evaluating outcomes for transforaminal epidural steroid injections performed with 3% hypertonic saline or normal saline in lumbosacral radicular pain.

Munjupong S, Malaithong W, Chantrapannik E, Ratchano P, Tontisirin N, Cohen SP · Pain medicine (Malden, Mass.) · 2024

Transforaminal epidural steroid injections (TFESI) are commonly employed to treat lumbosacral radiculopathy. Despite anti-inflammatory properties, the addition of 3% hypertonic saline has not been studied. Compare the effectiveness of adding 0.9% NaCl (N-group) vs. 3% NaCl (H-group) in TFESI performed for lumbosacral radiculopathy. This retrospective study compared TFESI performed with lidocaine, triamcinolone and 0.9% NaCl vs. lidocaine, triamcinolone and 3% NaCl. The primary outcome was the proportion of patients who experienced a ≥ 30% reduction in pain on a verbal rating scale (VRS; 0-100) at 3 months. Secondary outcome measures included the proportion of patients who improved by at least 30% for pain at 1 and 6 months, and who experienced ≥15% from baseline on the Oswestry disability index (ODI) at follow-up. The H-group experienced more successful pain outcomes than the N-group at 3 months (59.09% vs. 41.51%; P = .002) bu

Non-cadaveric spine surgery simulator training in neurosurgical residency.

Pöser P, Schenk R, Miller H, Alghamdi A, Lavalley A, Tielking K · North American Spine Society journal · 2024

Spine surgical training faces increasing challenges due to restricted working hours and greater sub specialization. Modern simulators offer a promising approach to teaching both simple and complex spinal procedures. This study evaluated the acceptance and efficacy of spine simulator training using a lumbar herniated disc model tested by 16 neurosurgical residents (PGY-1-6), and compared 3D and 2D teaching methods. Sixteen residents utilized the Realists RealSpine L4/L5 disc simulator with both microscope and exoscope. A mixed-methods analysis assessed the efficacy and acceptance of the training. Six PGY-1 residents participated in a learning curve study, divided into exoscopic and microscopic cohorts. Each group watched a tutorial in either 3D or 2D, followed by 3 surgical sessions. Endpoints included surgical progress within 30 minutes and complication rates. Microsurgical skills and mental concepts were evaluated on a numeric Likert Scale. Participants rated the simulator training

Paravertebrally-Injected Multifunctional Hydrogel for Sustained Anti-Inflammation and Pain Relief in Lumbar Disc Herniation.

Deng W, Chen J, Wang X, Wang Q, Zhao L, Zhu Y · Advanced healthcare materials · 2024

Pain caused by lumbar disc herniation (LDH) severely compromises patients' quality of life. The combination of steroid and local anesthetics is routinely employed in clinics to alleviate LDH-induced pain. However, the approach only mediates transient efficacy and requires repeated and invasive lumbar epidural injections. Here a paravertebrally-injected multifunctional hydrogel that can efficiently co-load and controlled release glucocorticoid betamethasone and anesthetics ropivacaine for sustained anti-inflammation, reactive oxygen species (ROS)-removal and pain relief in LDH is presented. Betamethasone is conjugated to hyaluronic acid (HA) via ROS-responsive crosslinker to form amphiphilic polymer that self-assemble into particles with ropivacaine loaded into the core. Solution of drug-loaded particles and thermo-sensitive polymer rapidly forms therapeutic hydrogel in situ upon injection next to the herniated disc, thus avoiding invasive epidural injection. In a rat model of LDH, mult

Use of acupuncture as adjuvant analgesic technique in dogs undergoing thoracolumbar hemilaminectomy.

Machin H, Taylor-Brown F, Adami C · Veterinary journal (London, England : 1997) · 2020

The aim of this study was to investigate the analgesic efficacy of a preoperative acupuncture treatment in 24 client-owned dogs undergoing thoracolumbar hemilaminectomy. Dogs were randomly assigned to either group A (Acupuncture) or group C (Control). Before skin incision, group A was treated with acupuncture, performed under general anaesthesia for 30 min. Rescue intraoperative fentanyl was administered following a 20% increase in cardiovascular parameters compared to baseline values, measured before incision. An observer masked to the treatment assessed pain, pre- and postoperatively, with the Glasgow (GCPS), the Colorado (CPS) pain scales and a Visual Analogue Scale (VAS); additionally, the mechanical thresholds (MT) were measured with the Electronic von Frey Anaesthesiometer (EVF) at four points located near the herniated disc. The groups were compared with respect to intraoperative cardiovascular and respiratory variables, rescue fentanyl administered in total and at different sur

Immunomodulation of mesenchymal stem cells in discogenic pain.

Miguélez-Rivera L, Pérez-Castrillo S, González-Fernández ML, Prieto-Fernández JG, López-González ME, García-Cosamalón J · The spine journal : official journal of the North American Spine Society · 2018

Back pain is a highly prevalent health problem in the world today and has a great economic impact on health-care budgets. Intervertebral disc (IVD) degeneration has been identified as a main cause of back pain. Inflammatory cytokines produced by macrophages or disc cells in an inflammatory environment play an important role in painful progressive degeneration of IVD. Mesenchymal stem cells (MSCs) have shown to have immunosuppressive and anti-inflammatory properties. Mesenchymal stem cells express a variety of chemokines and cytokines receptors having tropism to inflammation sites. This study aimed to develop an in vitro controlled and standardized model of inflammation and degeneration of IVD with rat cells and to evaluate the protective and immunomodulatory effect of conditioned medium (CM) from the culture of MSCs to improve the conditions presented in herniated disc and discogenic pain processes. This is an experimental study. In this study, an in vitro model of inflammation and

Herniated Disk

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MedlinePlus offers a detailed overview of herniated disks, covering common questions, causes, symptoms, diagnosis, and various treatment approaches. It serves as a trusted source for general health information from the National Institutes of Health.

Slipped disc

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The NHS offers detailed information on slipped discs (herniated disks), covering symptoms, diagnosis, treatment options, and advice for recovery, aiming to guide patients through their condition.

Trial on the Effect of Ozone Therapy for Lumbar Herniated Disc With Criteria for Surgery

n=156 · NCT00566007 · TERMINATED · TERMINATED

The purpose of this study is to assess the efficacy (vs. placebo) of ozone infiltration and its effectiveness in comparison with micro discectomy in the treatment of lumbar herniated disc with criteria for surgery.

Safety and Efficacy of Electromagnetic Navigation System Assisted Percutaneous Endoscopic Lumbar Decompression

n=20 · NCT05270486 · UNKNOWN · UNKNOWN

There is a shallow learning curve with TELD (transforaminal endoscopic lumbar discectomy). The aim of this study is to assess the safety and efficacy of TELD assisted by electromagnetic navigation for treating lumbar disc herniation (LDH).

Spine Patient Outcomes Research Trial (SPORT): A Multicenter Trial for Spinal Stenosis (SpS)

n=289 · NCT00000411 · COMPLETED · COMPLETED

This study tests the effectiveness of different treatments for the three most commonly diagnosed conditions of the lower backbone (lumbar spine). The purpose is to learn which of two commonly prescribed treatments (surgery and nonsurgical therapy) works better for specific types of low back pain. Low back pain is one of the most widely experienced health problems in the United States and the world. It is the second most frequent condition, after the common cold, for which people see a doctor or lose days from work. In this part of the study, we will treat patients with spinal stenosis (a narrowing of spaces in the backbone that results in pressure on the spinal cord and/or nerve roots) with a type of surgery known as posterior decompressive laminectomy or with nonsurgical methods. This study does not cover the cost of treatment.

Search results for Herniated Disc

TRIP Database

The TRIP Database offers a comprehensive search of medical evidence, including clinical guidelines, systematic reviews, and other evidence-based resources related to herniated discs. It helps clinicians and researchers quickly find relevant and reliable information.

Herniated Disc

TRIP Database

TRIP Database is a clinical search engine designed to allow users to quickly and easily find high-quality research evidence to support their clinical practice, including for herniated disc.