BACKGROUND Low back pain is a major cause of disability worldwide,with intervertebral disc degeneration contributing to nearly 40%of cases.Conventional treatments focus on symptom relief without addressing the underly...BACKGROUND Low back pain is a major cause of disability worldwide,with intervertebral disc degeneration contributing to nearly 40%of cases.Conventional treatments focus on symptom relief without addressing the underlying degeneration.Platelet-rich plasma(PRP),a regenerative therapy rich in growth factors,offers potential therapeutic benefits through growth factor-mediated mechanisms,though clinical evidence is limited.AIM To evaluate the efficacy of intradiscal autologous PRP injection in reducing pain and improving function in patients with chronic lumbar disc prolapse.METHODS This pilot quasi-experimental study was conducted in tertiary care centre between July 2022 and June 2024.The study involved comparing the outcomes between group A(n=17)who failed to respond to conservative treatment measures and received intradiscal PRP injection with group B(n=22)who responded to conservative treatment.Visual Analogue Scale(VAS)and Functional Rating Index(FRI)scores were recorded at baseline,3 weeks,and 6 weeks for both the groups.RESULTS Forty patients were enrolled in the study.The PRP group demonstrated significant improvement in VAS and FRI scores compared to baseline.While both groups improved from their respective baselines,direct between-group comparisons are limited by baseline differences in symptom severity.Patients who failed conservative trial showed significant improvement following PRP intervention,with outcomes approaching those observed in physiotherapy responders.CONCLUSION Intradiscal PRP injection significantly improved pain and function in patients with lumbar disc disease,with clinical improvements that approached the level observed in physiotherapy responders,despite baseline differences in symptom severity.PRP shows promise as an effective treatment for lumbar disc pathology;however,these preliminary findings are limited by the small sample size and short follow-up,warranting larger trials with long-term evaluation.展开更多
Cage plus plate(CP)and zero-profile(Zero-P)devices are widely used in anterior cervical discectomy and fusion(ACDF).This study aimed to compare adjacent segment biomechanical changes after ACDF when using Zero-P devic...Cage plus plate(CP)and zero-profile(Zero-P)devices are widely used in anterior cervical discectomy and fusion(ACDF).This study aimed to compare adjacent segment biomechanical changes after ACDF when using Zero-P device and CP in different segments.First,complete C1—C7 cervical segments were constructed and validated.Meanwhile,four surgery models were developed by implanting the Zero-P device or CP into C4—C5 or C5—C6 segments based on the intact model.The segmental range of motion(ROM)and maximum value of the intradiscal pressure of the surgery models were compared with those of the intact model.The implantation of CP and Zero-P devices in C4—C5 segments decreased ROM by about 91.6%and 84.3%,respectively,and increased adjacent segment ROM by about 8.3%and 6.82%,respectively.The implantation of CP and Zero-P devices in C5—C6 segments decreased ROM by about 93.3%and 89.9%,respectively,while increasing adjacent segment ROM by about 4.9%and 4%,respectively.Furthermore,the implantation of CP and Zero-P devices increased the intradiscal pressure in the adjacent segments of C4—C5 segments by about 4.5%and 6.7%,respectively.The implantation of CP and Zero-P devices significantly increased the intradiscal pressure in the adjacent segments of C5—C6 by about 54.1%and 15.4%,respectively.In conclusion,CP and Zero-P fusion systems can significantly reduce the ROM of the fusion implant segment in ACDF while increasing the ROM and intradiscal pressure of adjacent segments.Results showed that Zero-P fusion system is the best choice for C5—C6 segmental ACDF.However,further studies are needed to select the most suitable cervical fusion system for C4—C5 segmental ACDF.Therefore,this study provides biomechanical recommendations for clinical surgery.展开更多
BACKGROUND Testicular pain caused by lumbar disease is uncommon in the clinic.Here we reported a case of discogenic low back pain with testicular pain that was successfully cured.CASE SUMMARY A 23-year-old male patien...BACKGROUND Testicular pain caused by lumbar disease is uncommon in the clinic.Here we reported a case of discogenic low back pain with testicular pain that was successfully cured.CASE SUMMARY A 23-year-old male patient presented to our department with chronic low back pain.Based on his clinical symptoms,signs and imaging,he was diagnosed with discogenic low back pain.Since conservative treatment for more than half a year did not significantly improve his low back pain,we decided to treat it with intradiscal methylene blue injection.During the course of surgery,we again identified the low back pain as originating from the degenerated lumbar disc by analgesic discography.Interestingly,the patient’s low back pain disappeared along with the testicular pain that had been present for more than 3 mo.After the operation,the patient’s low back pain improved,and the testicular pain did not reappear.CONCLUSION Intradiscal methylene blue injection is a convenient and effective surgical intervention for the treatment of discogenic low back pain.Lumbar disc degeneration may also be a possible clinical cause of testicular pain.Methylene blue injection in the diseased disc improved the low back pain,and the accom-panying testicular pain was successfully managed.展开更多
Nucleus Pulposus(NP)Replacement is a developing surgical methodology for the treatment of pathology related to degeneration of intervertebral discs(IVDs).This article provides necessary context regarding the patholo-g...Nucleus Pulposus(NP)Replacement is a developing surgical methodology for the treatment of pathology related to degeneration of intervertebral discs(IVDs).This article provides necessary context regarding the patholo-gies treated with this technology,the biomechanical structure and function of the IVD,and the procedures this technology aims to replace.Primarily,it provides an overview and discussion of commercial and experimental preformed and in situ curing prosthesis designs reported in the scientific literature and summarizes the results of biomechanical and clinical studies evaluating their efficacy.Contextual and updated information on the most recent research into NP replacement with novel hydrogel and tissue engineering(TE)strategies is described.Replacement of the NP allows for potential improvement in the treatment of degenerative spinal pathologies through minimally invasive surgical techniques.展开更多
文摘BACKGROUND Low back pain is a major cause of disability worldwide,with intervertebral disc degeneration contributing to nearly 40%of cases.Conventional treatments focus on symptom relief without addressing the underlying degeneration.Platelet-rich plasma(PRP),a regenerative therapy rich in growth factors,offers potential therapeutic benefits through growth factor-mediated mechanisms,though clinical evidence is limited.AIM To evaluate the efficacy of intradiscal autologous PRP injection in reducing pain and improving function in patients with chronic lumbar disc prolapse.METHODS This pilot quasi-experimental study was conducted in tertiary care centre between July 2022 and June 2024.The study involved comparing the outcomes between group A(n=17)who failed to respond to conservative treatment measures and received intradiscal PRP injection with group B(n=22)who responded to conservative treatment.Visual Analogue Scale(VAS)and Functional Rating Index(FRI)scores were recorded at baseline,3 weeks,and 6 weeks for both the groups.RESULTS Forty patients were enrolled in the study.The PRP group demonstrated significant improvement in VAS and FRI scores compared to baseline.While both groups improved from their respective baselines,direct between-group comparisons are limited by baseline differences in symptom severity.Patients who failed conservative trial showed significant improvement following PRP intervention,with outcomes approaching those observed in physiotherapy responders.CONCLUSION Intradiscal PRP injection significantly improved pain and function in patients with lumbar disc disease,with clinical improvements that approached the level observed in physiotherapy responders,despite baseline differences in symptom severity.PRP shows promise as an effective treatment for lumbar disc pathology;however,these preliminary findings are limited by the small sample size and short follow-up,warranting larger trials with long-term evaluation.
基金the National Natural Science Foundation of China(Nos.32260235 and 82260446)。
文摘Cage plus plate(CP)and zero-profile(Zero-P)devices are widely used in anterior cervical discectomy and fusion(ACDF).This study aimed to compare adjacent segment biomechanical changes after ACDF when using Zero-P device and CP in different segments.First,complete C1—C7 cervical segments were constructed and validated.Meanwhile,four surgery models were developed by implanting the Zero-P device or CP into C4—C5 or C5—C6 segments based on the intact model.The segmental range of motion(ROM)and maximum value of the intradiscal pressure of the surgery models were compared with those of the intact model.The implantation of CP and Zero-P devices in C4—C5 segments decreased ROM by about 91.6%and 84.3%,respectively,and increased adjacent segment ROM by about 8.3%and 6.82%,respectively.The implantation of CP and Zero-P devices in C5—C6 segments decreased ROM by about 93.3%and 89.9%,respectively,while increasing adjacent segment ROM by about 4.9%and 4%,respectively.Furthermore,the implantation of CP and Zero-P devices increased the intradiscal pressure in the adjacent segments of C4—C5 segments by about 4.5%and 6.7%,respectively.The implantation of CP and Zero-P devices significantly increased the intradiscal pressure in the adjacent segments of C5—C6 by about 54.1%and 15.4%,respectively.In conclusion,CP and Zero-P fusion systems can significantly reduce the ROM of the fusion implant segment in ACDF while increasing the ROM and intradiscal pressure of adjacent segments.Results showed that Zero-P fusion system is the best choice for C5—C6 segmental ACDF.However,further studies are needed to select the most suitable cervical fusion system for C4—C5 segmental ACDF.Therefore,this study provides biomechanical recommendations for clinical surgery.
文摘BACKGROUND Testicular pain caused by lumbar disease is uncommon in the clinic.Here we reported a case of discogenic low back pain with testicular pain that was successfully cured.CASE SUMMARY A 23-year-old male patient presented to our department with chronic low back pain.Based on his clinical symptoms,signs and imaging,he was diagnosed with discogenic low back pain.Since conservative treatment for more than half a year did not significantly improve his low back pain,we decided to treat it with intradiscal methylene blue injection.During the course of surgery,we again identified the low back pain as originating from the degenerated lumbar disc by analgesic discography.Interestingly,the patient’s low back pain disappeared along with the testicular pain that had been present for more than 3 mo.After the operation,the patient’s low back pain improved,and the testicular pain did not reappear.CONCLUSION Intradiscal methylene blue injection is a convenient and effective surgical intervention for the treatment of discogenic low back pain.Lumbar disc degeneration may also be a possible clinical cause of testicular pain.Methylene blue injection in the diseased disc improved the low back pain,and the accom-panying testicular pain was successfully managed.
文摘Nucleus Pulposus(NP)Replacement is a developing surgical methodology for the treatment of pathology related to degeneration of intervertebral discs(IVDs).This article provides necessary context regarding the patholo-gies treated with this technology,the biomechanical structure and function of the IVD,and the procedures this technology aims to replace.Primarily,it provides an overview and discussion of commercial and experimental preformed and in situ curing prosthesis designs reported in the scientific literature and summarizes the results of biomechanical and clinical studies evaluating their efficacy.Contextual and updated information on the most recent research into NP replacement with novel hydrogel and tissue engineering(TE)strategies is described.Replacement of the NP allows for potential improvement in the treatment of degenerative spinal pathologies through minimally invasive surgical techniques.
