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Zhou C, Zhou N, Zheng Y, Si H, Wang Y, Yin J. The efficacy of 3D gait analysis to evaluate surgical (and rehabilitation) outcome after degenerative lumbar surgery. BMC Surg 2024; 24:197. [PMID: 38926745 PMCID: PMC11202385 DOI: 10.1186/s12893-024-02486-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 06/18/2024] [Indexed: 06/28/2024] Open
Abstract
BACKGROUND Lumbar degenerative conditions are a major cause of back pain and disability in individuals aged 45 and above. Gait analysis utilizes sensor technology to collect movement data, aiding in the evaluation of various gait aspects like spatiotemporal parameters, joint angles, neuromuscular activity, and joint forces. It is widely used in conditions such as cerebral palsy and knee osteoarthritis. This research aims to assess the effectiveness of 3D gait analysis in evaluating surgical outcomes and postoperative rehabilitation for lumbar degenerative disorders. METHODS A prospective self-controlled before-after study (n = 85) carried out at our Hospital (Sep 2018 - Dec 2021) utilized a 3D motion analysis system to analyze gait in patients with lumbar degenerative diseases. The study focused on the multifidus muscle, a crucial spinal muscle, during a minimally invasive lumbar interbody fusion surgery conducted by Shandong Weigao Pharmaceutical Co., Ltd. Pre- and postoperative assessments included time-distance parameters (gait speed, stride frequency, stride length, stance phase), hip flexion angle, and stride angle. Changes in 3D gait parameters post-surgery and during rehabilitation were examined. Pearson correlation coefficient was employed to assess relationships with the visual analog pain scale (VAS), Oswestry Disability Index (ODI), and Japanese Orthopedic Association (JOA) scores. Patient sagittal alignment was evaluated using "Surgimap" software from two types of lateral radiographs to obtain parameters like pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), lumbar lordosis (LL), intervertebral space height (DH), posterior height of the intervertebral space (PDH) at the operative segment, and anterior height of the intervertebral space (ADH). RESULTS By the 6th week post-operation, significant improvements were observed in the VAS score, JOA score, and ODI score of the patients compared to preoperative values (P < 0.05), along with notable enhancements in 3D gait quantification parameters (P < 0.05). Pearson correlation analysis revealed a significant positive correlation between improvements in 3D gait quantification parameters and VAS score, JOA score, and ODI value (all P < 0.001). CONCLUSION 3D gait analysis is a valuable tool for evaluating the efficacy of surgery and rehabilitation training in patients.
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Affiliation(s)
- Chao Zhou
- Department of Spine Surgery, Cheeloo College of Medicine, Qingdao Medical Engineering Interdisciplinary Key Laboratory, Qilu Hospital (Qingdao), Shandong University, No.758, Heifei Road, Qingdao, Shandong, 266000, China
| | - Ning Zhou
- Intensive Care Unit, Binzhou Central Hospital, No. 108, Huancheng South Road, Huimin, Binzhou, Shandong, 251700, China
| | - Yanping Zheng
- Department of Spine Surgery, Cheeloo College of Medicine, Qingdao Medical Engineering Interdisciplinary Key Laboratory, Qilu Hospital (Qingdao), Shandong University, No.758, Heifei Road, Qingdao, Shandong, 266000, China
| | - Haipeng Si
- Department of Spine Surgery, Cheeloo College of Medicine, Qingdao Medical Engineering Interdisciplinary Key Laboratory, Qilu Hospital (Qingdao), Shandong University, No.758, Heifei Road, Qingdao, Shandong, 266000, China
| | - Yanguo Wang
- Department of Spine Surgery, Cheeloo College of Medicine, Qingdao Medical Engineering Interdisciplinary Key Laboratory, Qilu Hospital (Qingdao), Shandong University, No.758, Heifei Road, Qingdao, Shandong, 266000, China
| | - Jun Yin
- Department of Spine Surgery, Cheeloo College of Medicine, Qingdao Medical Engineering Interdisciplinary Key Laboratory, Qilu Hospital (Qingdao), Shandong University, No.758, Heifei Road, Qingdao, Shandong, 266000, China.
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Wang Z, Liu X, Gao K, Tuo H, Zhang X, Liu W. Clinical effects and biological mechanisms of exercise on lumbar disc herniation. Front Physiol 2024; 15:1309663. [PMID: 38292068 PMCID: PMC10824856 DOI: 10.3389/fphys.2024.1309663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 01/04/2024] [Indexed: 02/01/2024] Open
Abstract
Lumbar Disc Herniation (LDH) is a syndrome in which lumbar disc degeneration, rupture of the annulus fibrosus, and herniation of the nucleus pulposus irritate and compress the nerve roots and cauda equina, resulting in the main manifestations of lumbar pain and/or lower extremity pain. There is evidence in various clinical areas that exercise is effective in treating LDH, and exercise intervention for more than 2 weeks reduces disease activity in LDH. However, the mechanism of exercise's action in reducing disease activity in LDH is unclear. In this article, we first summarize and highlight the effectiveness of exercise in treating LDH and provide guideline recommendations regarding exercise type, intensity, frequency, and duration. Then, we integrate the existing evidence and propose biological mechanisms for the potential effects of exercise on neuromechanical compression, inflammatory chemical stimuli, and autoimmune responses from the perspective of LDH pathogenesis as an entry point. However, a large body of evidence was obtained from non-LDH populations. Future research needs to investigate further the proposed biological mechanisms of exercise in reducing disease activity in LDH populations. This knowledge will contribute to the basic science and strengthen the scientific basis for prescribing exercise therapy for the routine clinical treatment of LDH.
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Affiliation(s)
- Ziwen Wang
- College of Physical Education and Health, Guangxi Normal University, Guilin, China
| | - Xindai Liu
- College of International Culture and Education, Guangxi Normal University, Guilin, China
| | - Ke Gao
- College of Physical Education and Health, Guangxi Normal University, Guilin, China
| | - Haowen Tuo
- College of Physical Education and Health, Guangxi Normal University, Guilin, China
| | - Xinxin Zhang
- College of Physical Education and Health, Guangxi Normal University, Guilin, China
| | - Weiguo Liu
- College of Physical Education and Health, Guangxi Normal University, Guilin, China
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Healthcare Engineering JO. Retracted: Curative Effect of Foraminal Endoscopic Surgery and Efficacy of the Wearable Lumbar Spine Protection Equipment in the Treatment of Lumbar Disc Herniation. JOURNAL OF HEALTHCARE ENGINEERING 2023; 2023:9892756. [PMID: 37829382 PMCID: PMC10567173 DOI: 10.1155/2023/9892756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 10/03/2023] [Indexed: 10/14/2023]
Abstract
[This retracts the article DOI: 10.1155/2022/6463863.].
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Zhang Y, Chu J, Xia Y, Xie Y, Zhang R, Chen X, Chen Z, Yao X. Research Trends of Percutaneous Endoscopic Lumbar Discectomy in the Treatment of Lumbar Disc Herniation Over the Past Decade: A Bibliometric Analysis. J Pain Res 2023; 16:3391-3404. [PMID: 37814606 PMCID: PMC10560474 DOI: 10.2147/jpr.s421837] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 09/27/2023] [Indexed: 10/11/2023] Open
Abstract
Objective This study aimed to explore the research trends of percutaneous endoscopic lumbar discectomy in treating lumbar disc herniation using bibliometrics over the past ten years. Methods Relevant publications on the clinical application of percutaneous endoscopic lumbar discectomy in lumbar disc herniation were searched in the Web of Science Core Collection. Subsequently, the characteristics of all these articles were collected. Visualizing data of annual publications, journals, cited journals, authors, cited authors, countries, institutions, keywords, and cited references was performed by using CiteSpace (6.1.R6). Results A total of 642 publications were extracted between 2013 and 2022. The number of publications peaked in the year 2020. The most prolific journal was World Neurosurgery (81), and Spine (597) as the cited journal was the most popular one. China (393) was the most prolific country, followed by South Korea (100). The institution with the most productivity was Tongji University (35). Yue Zhou (20) was the most prolific author, and Sebastian Ruetten (310) was the most cited author. The keyword "interlaminar" was top of research developments with the highest citation burst (8.69). "Lumbar disc herniation", "surgical technique", and "complication" were popular keywords. The surgical procedures and complications of percutaneous endoscopic lumbar discectomy have been the hot topics of recent research. Conclusion This study summarized the current situation and development trends of percutaneous endoscopic lumbar discectomy clinical research in the form of visualization, and these findings may help researchers explore new directions in the future.
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Affiliation(s)
- Yang Zhang
- The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People’s Republic of China
- The Third Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People’s Republic of China
| | - Jiahao Chu
- The Third Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People’s Republic of China
| | - Yunfan Xia
- The Third Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People’s Republic of China
| | - Yuepeng Xie
- The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People’s Republic of China
| | - Ruikun Zhang
- The Third Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People’s Republic of China
| | - Xiaogang Chen
- The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People’s Republic of China
| | - Zhineng Chen
- The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People’s Republic of China
| | - Xinmiao Yao
- The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People’s Republic of China
- The Third Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People’s Republic of China
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Zhu Y, Xia S, Yang W, Shi F, Ji H. Early efficacy of postoperative rehabilitation training for lumbar disc herniation. BMC Sports Sci Med Rehabil 2023; 15:97. [PMID: 37553676 PMCID: PMC10408232 DOI: 10.1186/s13102-023-00704-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 07/21/2023] [Indexed: 08/10/2023]
Abstract
OBJECTIVE To investigate the early clinical efficacy of rehabilitation training after unilateral biportal endoscopy for lumbar disc herniation and to analyze the prognostic factors. METHODS A total of 100 patients with lumbar disc herniation who underwent unilateral biportal endoscopy at The Sixth Affiliated Hospital of Nantong University from January 2019 to January 2021 were retrospectively analyzed. The control group was given a standard home-based exercise program, while the intervention group was given a substituted rehabilitation training opposed to a standard home-based exercise program. The early postoperative pain relief and quality of life values were compared between the two groups, and the independent risk factors affecting the prognosis of patients were analyzed. RESULTS There were no significant differences in sex, age, smoking, drinking, BMI, course of disease, type of disc herniation, preoperative VAS, ODI or SF-36 between the two groups (P > 0.05). There was no significant difference in preoperative and postoperative VAS and ODI scores at 3 months between the two groups (P > 0.05), yet there were significant differences in postoperative VAS and ODI at 12 months (P < 0.05). The SF-36 score of the intervention group was lower than that of the control group at 12 months, and the difference was statistically significant (P < 0.05). The excellent rate of the Macnab standard modification used in the intervention group was 88.00% at 12 months, and that in the control group was 62.00%. The difference between the two groups was considered to indicate a statistically significant (P < 0.05). The results of logistic multivariate regression model analysis showed that rehabilitation training (95% CI: 1.360-12.122, P = 0.012), the type of intervertebral disc (95% CI: 0.010-0.676, P = 0.020), and age (95% CI: 1.056-8.244, P = 0.039) were independent risk factors affecting the prognosis of patients. CONCLUSION Postoperative rehabilitation training can effectively relieve pain and improve quality of life; thus, it is highly recommended in the clinic. Postoperative rehabilitation training, intervertebral disc type and age are independent risk factors for the postoperative prognosis of lumbar intervertebral disc herniation.
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Affiliation(s)
- Yuwei Zhu
- Department of Orthopedics, The Sixth Affiliated Hospital of Nantong University, Yancheng Third people's Hospital, Yancheng, Jiangsu, 224001, China
| | - Shuang Xia
- Department of Orthopedics, The Sixth Affiliated Hospital of Nantong University, Yancheng Third people's Hospital, Yancheng, Jiangsu, 224001, China
| | - Weihang Yang
- Department of Orthopedics, The Sixth Affiliated Hospital of Nantong University, Yancheng Third people's Hospital, Yancheng, Jiangsu, 224001, China
| | - Fengchao Shi
- Department of Orthopedics, The Sixth Affiliated Hospital of Nantong University, Yancheng Third people's Hospital, Yancheng, Jiangsu, 224001, China.
| | - Hongjian Ji
- Jiangsu Vocational College of Medicine, Yancheng, Jiangsu, 224005, China.
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Chu ECP, Yau KHY, Bellin DL. An L2/3 Disc Herniation-Related L5 Radiculopathy. CURRENT HEALTH SCIENCES JOURNAL 2023; 49:129-133. [PMID: 37780195 PMCID: PMC10541075 DOI: 10.12865/chsj.49.01.129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 12/12/2022] [Indexed: 10/03/2023]
Abstract
The key factors contributing to radiculopathy caused by lumbar disc herniation include mechanical compression. It was commonly believed that the disc herniation causes the compression on the nerve root exiting under the pedicle of the vertebral body at the adjacent inferior level. However, a disc herniation might occasionally result in non-adjacent, isolated radicular symptoms. We report the case of a 74-year-old female who presented with a 2-years history of progressive low back pain associated with L5 radiculopathy and reduced quality of life. The patient had undergone a magnetic resonance image showing a large L2/3 disc herniation. Symptoms had progressively worsened and failed to respond to conservative treatments including pain medication, exercise rehabilitation, and acupuncture at the lower lumbar region. The patient was diagnosed with L5 radiculopathy caused by L2/3 disc herniation. Consequently, her symptoms improved with chiropractic rehabilitation which involved spinal manipulative therapy and intermittent motorized traction at the L2/3 level to reduce herniated disc. Therefore, an L2/3 Disc herniation-related L5 radiculopathy should be considered in the differential diagnosis of cases of inconsistency of level of disc herniation and nerve root pattern.
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