Incidence Of Lumbar Disc Herniation Research Articles

Enhancing treatment of lumbar disc herniation with Erxian decoction and auricular acupoint pressure: A randomized controlled trial.

The incidence of lumbar disc herniation (LDH) is on the rise annually, with an emerging trend of affecting younger age groups. This study aims to investigate the clinical effectiveness of combining Erxian decoction with auricular acupoint pressure therapy in treating LDH. Our objective is to furnish evidence supporting the incorporation of traditional Chinese medicine (TCM) rehabilitation techniques in clinical settings. This randomized controlled trial enrolled 102 patients diagnosed with LDH and allocated them into Control and Intervention groups. The Control group underwent a 2-week rehabilitation regimen, whereas the Intervention group received an augmented treatment comprising Erxian decoction along with auricular acupoint pressure therapy based on the Control group. Main outcome measures included 3 scales - visual analog scale (VAS), Japanese Orthopedic Association (JOA), and Oswestry Disability Index - as well as 3 inflammatory markers: C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α). Additionally, pressure pain threshold and pain tolerance threshold values were evaluated. Participants were assessed at baseline, on 14-day, and on 28-day posttreatment. After 2 weeks of treatment, both the Control and Intervention groups exhibited significant improvements in the VAS, JOA, ODI, CRP, IL-6, TNF-α, pressure pain threshold, and pain tolerance threshold (P < .05). These improvements persisted at the 28-day in the VAS, JOA, and ODI scores (P < .05). On 14-day, the Intervention group showed significantly better outcomes compared to the Control group in terms of the VAS, JOA, ODI, CRP, TNF-α, and pressure pain threshold (P < .05). Compared to conventional rehabilitation therapy, the combination of Erxian decoction and auricular acupoint pressure therapy demonstrates clear benefits in alleviating symptoms in patients with LDH. This approach offers fresh perspectives and substantiates evidence for future treatment strategies in managing LDH.

From hyperglycemia to intervertebral disc damage: exploring diabetic-induced disc degeneration.

The incidence of lumbar disc herniation has gradually increased in recent years, and most patients have symptoms of low back pain and nerve compression, which brings a heavy burden to patients and society alike. Although the causes of disc herniation are complex, intervertebral disc degeneration (IDD) is considered to be the most common factor. The intervertebral disc (IVD) is composed of the upper and lower cartilage endplates, nucleus pulposus, and annulus fibrosus. Aging, abnormal mechanical stress load, and metabolic disorders can exacerbate the progression of IDD. Among them, high glucose and high-fat diets (HFD) can lead to fat accumulation, abnormal glucose metabolism, and inflammation, which are considered important factors affecting the homeostasis of IDD. Diabetes and advanced glycation end products (AGEs) accumulation- can lead to various adverse effects on the IVD, including cell senescence, apoptosis, pyroptosis, proliferation, and Extracellular matrix (ECM) degradation. While current research provides a fundamental basis for the treatment of high glucose-induced IDD patients. further exploration into the mechanisms of abnormal glucose metabolism affecting IDD and in the development of targeted drugs will provide the foundation for the effective treatment of these patients. We aimed to systematically review studies regarding the effects of hyperglycemia on the progress of IDD.

Analysis of the therapeutic effect and postoperative complications associated with 3-dimensional computed tomography navigation-assisted intervertebral foraminoscopic surgery in lumbar disc herniation in the elderly: a retrospective cohort study.

With the increasing aging of the population, the incidence of lumbar disc herniation (LDH) is gradually increasing. The 3-dimensional (3D) computed tomography (CT) navigation-assisted intervertebral foraminoscopic surgery for LDH is minimally invasive, and due to its localization and guidance features, it can precisely reach the target location. This study sought to investigate the treatment effect and the incidence of postoperative complications of 3D CT navigation-assisted intervertebral foraminoscopic surgery in elderly patients with LDH to provide a reference basis for improving patient prognosis. We retrospectively included 213 elderly patients with LDH admitted to our hospital from October 2017 to October 2021 in this study and followed them up for 1 year. Among them, 103 patients (Group A) underwent conventional C-arm fluoroscopy-assisted system alone intervertebral foraminoscopic surgery, and 110 patients (Group B) underwent 3D CT navigation-assisted intervertebral foraminoscopic surgery. The general characteristics of the participants were compiled using a general information questionnaire designed by the investigator. The t-test and chi-square test were used to analyze the relationship between the treatment outcomes and surgical modalities. Binary logistics regression was used to analyze the independent risk factors affecting patient outcomes. The patients who underwent 3D CT navigation-assisted intervertebral foraminoscopic surgery had significantly better outcomes than those who underwent conventional C-arm fluoroscopy-assisted system alone intervertebral foraminoscopic surgery. The binary logistic regression analysis results showed that in addition to the surgical method [odds ratio (OR) =0.258, P=0.042], the history of lumbar trauma (OR =11.001, P=0.005), usual work intensity (OR =4.589, P=0.002), disease duration (OR =3.587, P=0.017), the presence of diabetes (OR =3.315, P=0.026), the presence of a ruptured annulus fibrosus (OR =3.485, P=0.012), the degree of disc degeneration (OR =3.899, P=0.009), and the number of punctures (OR =0.412, P=0.034) were independent risk factors affecting patient outcomes. 3D CT navigation-assisted intervertebral foraminoscopic surgery for LDH effectively reduced the number of punctures, decreased intraoperative bleeding and postoperative drainage volumes, shortened the length of hospitalization, bed rest time and operative time, reduced stress reactions, decreased the degree of low-back pain, and the risk of complications, had better overall efficacy, and significantly improved patient prognosis.

Surgical outcomes of percutaneous endoscopic lumbar discectomy in obese adolescents with lumbar disc herniation

In recent years, with improved living standards, adolescent obesity has been increasingly studied. The incidence of lumbar disc herniation (LDH) in obese adolescents is increasing yearly. No clinical studies have reported the use of percutaneous endoscopic lumbar discectomy (PELD) in obese adolescent lumbar disc herniation (ALDH) patients. This study evaluated the preliminary surgical outcomes of PELD in obese ALDH patients. Fifty-one ALDH patients underwent single-level PELD surgery between January 2014 and January 2020. Patients were divided into an obese group and a normal group. Patient characteristics and surgical variables were compared between the two groups. The VAS, ODI, and SF-36 scales were used preoperatively and postoperatively to evaluate the clinical efficacy. In this study, 19 patients were included in the obese group, and 28 were included in the normal group. There was no significant difference in age, sex, duration of low back pain, duration of leg pain, or operative level between the obese and normal groups preoperatively. The obese group had a longer operative time (OT) (101.9 ± 9.0 min vs. 84.3 ± 11.0 min, P < 0.001), more fluoroscopy exposures (41.0 ± 5.8 vs. 31.6 ± 7.0, P < 0.001) and a longer time to ambulation (29.9 ± 4.0 vs. 25.0 ± 2.9, p < 0.001) than the normal group. The groups did not significantly differ in complications. The VAS score for back and leg pain and the ODI and SF-36 score for functional status improved significantly postoperatively. The PELD procedure is a safe and feasible method for treating LDH in obese adolescents. Obese ALDH patients require a longer OT, more fluoroscopy exposures and a longer time to get out of bed than normal ALDH patients. However, PELD yields similar clinical outcomes in obese and normal ALDH patients.

Correlation between spinous process deviation and lumbar disc herniation in young patients

To explore the relationship between spinous process deviation and lumbar disc herniation in young patients. From March 2015 to January 2022, 30 treated young (under the age of 30) patients with lumbar disc herniation were included as the young group. In addition 30 middle-aged patients (quinquagenarian group) with lumbar disc herniation and 30 patients with non-degenerative spinal diseases (young non-degenerative group) were selected as control groups. The angle of the spinous process deviation was measured on CT and statistically analyzed by various groups. All the data were measured twice and the average value was taken and recorded. The average angle of spinous process deviation in the degenerative lumbar vertebra of young patients were (3.89±3.77) degrees, similar to the (3.72±2.98) degrees of quinquagenarian patients(P=0.851). The average angle of s spinous process deviation young non-degenerative group were (2.20±2.28) degrees, significantly less than young group(P=0.040). The spinous process deviation angle of the superior vertebral of the degenerative lumbar in the young group was (4.10±3.44) degrees, which similar to the (3.47±2.87) degrees in the quinquagenarian group (P=0.447). A total of 19 young patients had the opposite deviation direction of the spinous process of the degenerative lumbar vertebra and upper vertebra, while only 7 quinquagenarian patients had this condition(P=0.02). The type of lumbar disc herniation in young patients had no significant relationship with the direction of spinous process deflection of the degenerative or upper lumbar vertebra (P>0.05). Spinous process deviation is a risk factor of young lumbar disc herniation patients. If the deviation directions of adjacent lumbar spinous processes are opposite, it will increase the incidence of lumbar disc herniation in young patients. There was no significant correlation between the type of disc herniation and the deviation direction of the spinous process of the degenerative or upper lumbar vertebra. People with such anatomical variation can strengthen the stability of spine and prevent lumbar disc herniation through reasonable exercise.

Relationship between Body Mass Index and Lumbar Disc Herniation in UKI General Hospital Jakarta, Indonesia

Background: Nucleus Pulposus Herniation (NPH) is a disease in which the annulus fibrosus ruptures, causing the nucleus pulposus to protrude or bulge and press against the spinal canal, causing sciatic pain. One of the risk factors for Nucleus pulposus herniation was Body Mass Index (BMI).&#x0D; Objective: This study aim the relationship between BMI and the incidence of Lumbar Disc Herniation (LDH) patients at UKI General Hospital from January to June 2020.&#x0D; Methods: The subjects of the study were 24 patients with lumbar disc herniation who were treated at UKI General Hospital from January to June 2020 that were taken from medical records.&#x0D; Results: 63 samples were analyzed that obtained 24 (38.0%) patients with lumbar disc herniation, and patients with lumbar disc herniation with BMI ≥ 23 as many as 18 subjects (75.0%).&#x0D; Conclusion: There is no significant relationship between BMI and LDH patients at UKI General Hospital.

COMMON CHARACTERISTICS OF PATIENTS TREATED WITH OZONE THERAPY THROUGH THE SKIN UNDER THE GUIDANCE OF CT SCAN FOR LUMBAR DISC HERNIATION TREATMENT

Objectives: To describe the common characteristics of patients undergoing intervention for lumbar disc herniation treatment using ozone therapy through the skin under the guidance of CT scan, to serve as a basis for intervention studies. Methods: The study describes the common characteristics and assesses pain scores of 147 patients with lumbar disc herniation (100 patients in the intervention group and 47 patients in the control group). Results: Lumbar disc herniation typically occurs in individuals over 30 years of age, with the majority being between the ages of &gt;50 (49.7%) and 30-50 (44.2%). The average age of the study group was 48.8 ± 12.1, lower than the control group (57.4 ± 14.8), (p&lt;0.05). Females had a higher incidence of lumbar disc herniation than males (1.5 times), but p&gt;0.05. Unilateral pain was predominant in both groups, mostly on the left side. The average VAS score before intervention in the study group was 8.0 ± 0.7, with no significant difference between the groups. Patients with pain symptoms before treatment had a high and severe level of pain, with no significant difference between the two groups. The average ODI score indicating functional disability of the study group was 70.3±9, p&gt;0.05. Conclusion: The study provides important information on the common characteristics of patients with lumbar disc herniation and pain symptoms. These results serve as a basis for implementing intervention treatment for patients with lumbar disc herniation.

Development process and clinical application of collagenase chemonucleolysis in the treatment of lumbar disc herniation: a narrative review in China.

Lumbar disc herniation (LDH) is one of the most common causes of lumbocrural pain. In the past 20 years, the incidence of LDH has increased dramatically. There are many treatments for LDH, including conservative treatment (such as acupuncture and physiotherapy), minimally invasive interventional treatment (such as collagenase chemonucleolysis and radiofrequency ablation) and surgical treatment. The main purpose of this paper is to review the development process and application status of collagenase chemonucleolysis in the treatment of LDH at home and abroad and provide a reference for clinical treatment.

Clinical Observation of Gongshi Naoacupuncture Combined with Shentongzhuyu Decoction in the Treatment of Intervertebral DISC Herniation

Background: Our country gradually entered an aging society, the incidence of lumbar disc herniation increases year by year, the clinical symptoms such as the pain, seriously affect the elderly's daily life movement, long-term pain will also lead to psychological barriers, seriously affect patient's daily life and work. The purpose of this study was to investigate the clinical efficacy and safety of Gongshi Naoacupuncture combined with Shentongzhuyu Decoction in the treatment of lumbar disc herniation, and to provide a treatment method for the clinical treatment of lumbar disc herniation. Objective: To observe the clinical effect of Gongshi Naoacupuncture combined with Shentongzhuyu Decoction in the treatment of disc herniation. Methods: 120 cases were randomly divided into treatment group (60 cases) and control group (60 cases). Both groups were given Shentongzhuyu decoction, and the observation group was given Gongshi brain needle. The observation period of both groups was 30 days, and the curative effect was evaluated after the treatment. Results: After treatment, VAS score of 2 groups was decreased compared with before treatment (p<0.05), observation group was significantly lower than control group (P<0.05); The score of JOA low back pain scale in 2 groups was higher than before treatment (p<0.05), and the observation group was higher than the control group (P<0.05). The improvement effect (significant efficiency, effective rate) of clinical symptoms in the observation group was better than that in the control group (p<0.05). Conclusion: In the treatment of lumbar intervertebral disc herniation, Gongshi Naoacupuncture combined with Shantong Zhuyu Decoction can significantly improve clinical efficacy, shorten the time of pain relief, significantly reduce the pain symptoms of patients, improve lumbar function, improve the quality of life of patients, with low recurrence rate, remarkable effect and innovation, and solve the dilemma of poor long-term therapeutic effect of lumbar intervertebral disc herniation. With the characteristics of "simple, fast, standard, safe, effective", it is worth trying a kind of treatment method, worthy of clinical promotion and application.

Effects of a microgravity SkinSuit on lumbar geometry and kinematics

PurposeAstronauts returning from long ISS missions have demonstrated an increased incidence of lumbar disc herniation accompanied by biomechanical and morphological changes associated with spine elongation. This research describes a ground-based study of the effects of an axial compression countermeasure Mk VI SkinSuit designed to reload the spine and reduce these changes before return to terrestrial gravity.MethodsTwenty healthy male volunteers aged 21–36 without back pain participated. Each lay overnight on a Hyper Buoyancy Flotation (HBF) bed for 12 h on two occasions 6 weeks apart. On the second occasion participants donned a Mk VI SkinSuit designed to axially load the spine at 0.2 Gz during the last 4 h of flotation. Immediately after each exposure, participants received recumbent MRI and flexion–extension quantitative fluoroscopy scans of their lumbar spines, measuring differences between spine geometry and intervertebral kinematics with and without the SkinSuit. This was followed by the same procedure whilst weight bearing. Paired comparisons were performed for all measurements.ResultsFollowing Mk VI SkinSuit use, participants evidenced more flexion RoM at L3–4 (p = 0.01) and L4–5 (p = 0.003), more translation at L3–4 (p = 0.02), lower dynamic disc height at L5–S1 (p = 0.002), lower lumbar spine length (p = 0.01) and greater lordosis (p = 0.0001) than without the Mk VI SkinSuit. Disc cross-sectional area and volume were not significantly affected.ConclusionThe MkVI SkinSuit restores lumbar mobility and lordosis following 4 h of wearing during hyper buoyancy flotation in a healthy control population and may be an effective countermeasure for post space flight lumbar disc herniation.

How does the side of lumbar disc herniation influence the psoas muscle size at the L4-5 level in patients operated for unilateral hip arthroplasty?

Study Design: Retrospective study. Objection: There can be a relationship between degenerative diseases in the spine and hip. Summary of Background Data: Degenerative diseases in the spine and hip may occur concomitantly. This study was done to investigate the cross-sectional area of psoas muscle size and incidence of lumbar disc herniation after unilateral hip arthroplasty. Methods: The data files of patients who were operated on for unilateral hip arthroplasty between January 2014- and 15 May 2021 at the Recep Tayyip Erdogan University Hospital were retrospectively analysed for the relationship between the psoas muscle volume and the incidence of lumbar disc herniation. The patients were divided according to their operated sides. Results: The data files of 48 patients were retrospectively analysed. The patients were divided into two groups according to the operated side of their hip joints. Gender and age differences were not significant, and the mean ages were 68,68 years old in the right hip arthroplasty group, and 69,39 in the left hip arthroplasty group. Conclusions: A complex interaction between the development of lumbar disc herniations and increased contralateral cross-sectional area of the psoas muscle at the L4-5 level was observed in patients operated for unilateral hip arthroplasty. This interaction can be a compensatory mechanism to counteract the spinal imbalance.

Guideline for diagnosis, treatment and rehabilitation of lumbar disc herniation

Recent years,the incidence of lumbar disc herniation is increasing annually,trending to younger age.There is a lack of clinical guideline for the management of lumbar disc herniation.Considering various problems in the management of lumbar disc herniation under different occasions,based on a systematic literature review,Basic Research and Transformation Society,Professional Committee of Spine and Spinal Cord organized experts to make this consensus jointly.This guideline aims to provide a standardized management of lumbar disc herniation with scientific principle and practical feasibility.Evidence-based medicine,and scientific suggestions are put forward specially for the management of lumbar disc herniation to standardize the diagnosis and treatment,promote the prognosis as well as improve the quality of life of patients.

Biomechanical changes in the lumbar spine following spaceflight and factors associated with postspaceflight disc herniation

For chronic low back pain, the causal mechanisms between pathological features from imaging and patient symptoms are unclear. For instance, disc herniations can often be present without symptoms. There remains a need for improved knowledge of the pathophysiological mechanisms that explore spinal tissue damage and clinical manifestations of pain and disability. Spaceflight and astronaut health provides a rare opportunity to study potential low back pain mechanisms longitudinally. Spaceflight disrupts diurnal loading on the spine and several lines of evidence indicate that astronauts are at a heightened risk for low back pain and disc herniation following spaceflight.To examine the relationship between prolonged exposure to microgravity and the elevated incidence of postflight disc herniation, we conducted a longitudinal study to track the spinal health of twelve NASA astronauts before and after approximately 6 months in space. We hypothesize that the incidence of postflight disc herniation and low back complaints associates with spaceflight-included muscle atrophy and pre-existing spinal pathology.This is a prospective longitudinal study.Our sample included a cohort of twelve astronaut crewmembers.From 3T MRI, we quantified disc water content (ms), disc degeneration (Pfirrmann grade), vertebral endplate irregularities, facet arthropathy and/ fluid, high intensity zones, disc herniation, multifidus total cross-sectional area (cm2), multifidus lean muscle cross-sectional area (cm2), and muscle quality/composition (%). From quantitative fluoroscopy we quantified, maximum flexion-extension ROM (°), maximum lateral bending ROM (°), and maximum translation (%). Lastly, patient outcomes and clinical notes were used for identifying postflight symptoms associated with disc herniations from 3T MRI.Advanced imaging data from 3T MRI were collected at three separate time points in relation to spending six months in space: (1) within a year before launch ("pre-flight"), (2) within a week after return to Earth ("post-flight"), and (3) between 1 and 2 months after return to Earth ("recovery"). Fluoroscopy of segmental kinematics was collected at preflight and postflight timepoints. We assessed the effect of spaceflight and postflight recovery on longitudinal changes in spinal structure and function, as well as differences between crew members who did and did not present a symptomatic disc herniation following spaceflight.Half of our astronauts (n=6) experienced new symptoms associated with a new or previously asymptomatic lumbar disc protrusion or extrusion following spaceflight. We observed decreased multifidus muscle quality following spaceflight in the lower lumbar spine, with a reduced percentage of lean muscle at L4L5 (-6.2%, p=.009) and L5S1 (-7.0%, p=.006) associated with the incidence of new disc herniation. Additionally, we observed reduced lumbar segment flexion-extension ROM for L2L3 (-17.2%, p=.006) and L3L4 (-20.5%, p=.02) following spaceflight, and furthermore that reduced ROM among the upper three lumbar segments (-24.1%, p=.01) associated with the incidence of disc herniation. Existing endplate pathology was most prevalent in the upper lumbar spine and associated with reduced segmental ROM (-20.5%, p=.02).In conclusion from a 10-year study investigating the effects of spaceflight on the lumbar spine and risk for disc herniation, we found the incidence of lumbar disc herniation following spaceflight associates with compromised multifidus muscle quality and spinal segment kinematics, as well as pre-existing spinal endplate irregularities. These findings suggest differential effects of spinal stiffness and muscle loss in the upper versus lower lumbar spine regions that may specifically provoke risk for symptomatic disc herniation in the lower lumbar spine following spaceflight. Results from this study provide a unique longitudinal assessment of mechanisms and possible risk factors for developing disc herniations and related low back pain. Furthermore, these findings will help inform physiologic countermeasures to maintain spinal health in astronauts during long-duration missions in space.

Evaluation of Lumbar Disc Herniation on Magnetic Resonance Imaging (MRI)

OBJECTIVE : To evaluate the lumbar disc herniation on magnetic resonance imaging (MRI) BACK GROUND: Lumbar disk herniation (LDH) is a common cause of low back pain in the world. The evidence has shown that the incidence of lumbar disc herniation (LDH) increases with age, weight lift and also depend on gender. In this cross-sectional descriptive study of LDH has been conducted to investigate the role of age in the incidence of LDH in elderly. The aim of the study is to investigate the relationship between the process of aging and the occurrence of LDH in old adults. Clinical studies have indicated that morphological characteristics of lumbar discs and signal intensity of patient’s MRI image have close relationship with clinical outcome Keywords: Intervertebral Disc, Herniated Disc, Protrusion, Degenerative Disc DOI: 10.7176/JHMN/90-07 Publication date: June 30 th 2021

Effect of Huangqi Guizhi Wuwu Decoction on rats with prolapse of lumbar intervertebral disc

Purpose: This study aims to study the effect of Huangqi Guizhi Wuwu Decoction on the serum interleukin-β1 (TFG-β1) and tumor necrosis of experimental rats with lumbar disc herniation under the guidance of traditional Chinese medicine theory and modern scientific research methods. The influence of tumor necrosis factor -α (TNF-α) content. After establishing the rat lumbar disc herniation model, through 4 weeks of experimental intervention, the serum of various rats was collected, and the ELISA method was used to detect the content of TFG-β1 and TNF-α in the serum of each group of rats to obtain data Use statistical methods to analyze and process the data, explore the inflammatory factors that cause lumbar intervertebral disc herniation and the possible mechanism of action of Huangqi Guizhi Wuwu Decoction on the treatment of lumbar intervertebral disc herniation, and provide the prescription for the treatment of lumbar intervertebral disc herniation in the future Scientific experimental basis. Methods: The 48 SD male rats used in the experiment, weighing between 160-200g, were randomly divided into 4 groups, namely, A is the blank control group, B is the model, C is the Huangqi Guizhi Wuwu Decoction experimental group, and D It is the western medicine group of ibuprofen suspension, the blank group does not do any treatment, the other 3 groups of rats under aseptic conditions cut the skin (about 4cm in length) and subcutaneous tissue in the middle of the back, and bluntly separated the paravertebral tissue from the left spine Muscles, with bilateral iliac spine as anchor points, remove the spinous processes, left lamina and articular processes of the two vertebrae above the iliac spine. Expose the dura mater on the left side under an operating microscope to confirm the left spinal nerve. Take the jelly-like intervertebral disc nucleus pulposus from the excised tail of the mouse and place it gently around the dorsal side of the left nerve root. 3d intraperitoneal injection of penicillin sodium 2×105U/kg, once a day. Two weeks after modeling, imaging and histopathology showed obvious inflammatory cell infiltration. The infiltrating inflammatory cells were mainly neutrophils and macrophages. The nerve tissue was swollen and the nerve myelin sheath was swollen, ruptured, and axons. Swelling or disappearance, Schwann cells autolyzed and softened, and successfully established a rat lumbar disc herniation model. The administration was started on the first day after successful modeling. The frequency of administration in each group was once a day. The dosage was as follows: the blank group and the model group were given normal saline (1ml|100g) respectively, and the experimental group was given Huangqi Guizhi Wuwu Decoction was given by intragastric administration (1ml|100g), the western medicine group was given ibuprofen suspension (1ml|100g) by intragastric administration, and 1/4 animals were randomly sacrificed on the 7, 14, 21 and 28 days after intragastric administration. Three rats per group each time, blood was taken from the heart, centrifuged at 3000 r/min for 15 minutes, and the supernatant was drawn. The serum TFG-β1 and TNF-α contents of each group of rats were detected by ELISA. Results: 1. Changes in the level of TFG-β1 in serum: 7th, 14th, 21st, and 28th days after intragastric administration, the detection of serum TFG-β1 levels in each group showed that there was no significant change in TFG-β1 levels in group A; group B Compared with group A, the level of TFG-β1 increased abnormally; group C and group D decreased the level of TFG-β1, but group C dropped more significantly than group D, and the difference between the two groups was statistically significant (P<0.05). 2. Changes in serum TNF-α levels: There was no significant change in serum TNF-α levels in group A rats; serum TNF-α levels in group B rats were significantly increased, and serum TNF-α levels in group C and D rats Compared with group B, the levels of TNF-α in group C decreased more significantly than those in group D. The difference in serum TNF-α levels between the two groups of rats was statistically significant (P <0.05). Conclusions: 1. An animal model of rat lumbar disc herniation can be established by rat autologous nucleus pulposus transplantation;2. Before treatment, the serum TFG-β1/TNF-α content in rats in group C and D increased significantly, suggesting that the content of serum TFG-β1/TNF-α may be related to the incidence of lumbar disc herniation;3. Huangqi Guizhi Wuwu Decoction can significantly reduce the content of TFG-β1 and TNF-α in the serum of rats with lumbar disc herniation, and the effect is better than that of the western medicine group.Tabled 1Serum TFG-β1 levels (pg/ml) of rats in each group on 7, 14, 21, 28 days after gavageGroup7d14d21d28dB Group58.31±23.7959.60±24.5861.12±12.9363.17±13.38C Group43.11±22.8438.27±34.3226.35±11.9815.86±24.47*D Group57.26±13.1149.33±23.7435.46±23.0926.12±22.83* Open table in a new tab Tabled 1Serum levels of TNF-α (ng.L-1) in rats of each group at 7, 14, 21, 28 days after gavageGroup7d14d21d28dB Group89.67±28.8288.64±32.0890.32±22.3391.17±13.78C Group69.44±40.7957.73±32.8850.60±15.4339.25±21.58*D Group76.86±33.0165.23±33.4658.26±22.8947.52±26.13* Open table in a new tab

Relationship between obesity and lumbar disc herniation in adolescents

To explore the relationship between obesity and lumbar disc herniation in adolescents. From January 2018 to July 2019, 581 patients (337 males, 244 females) with lumbar disc herniation were included in the surgical treatment. According to the age classification standard of the World Health Organization, they were divided into two groups:the adolescent group, 235 cases (145 males, 90 females), age 14 to 44 years old with an average of (32.2±7.3) years. The middle-aged and elderly group, 346 cases (192 males, 154 females), age 45 to 85 years old with an average age of (58.7± 9.8) years. At the time of admission, the same trained investigator measured height, waist circumference and hip circumference with tape measure and weight with electronic scale. All the data were measured twice and the average value was taken and recorded. The body mass index and the waist-hip ratio were calculated. According to each parameter standard, the patients were divided into normal, overweight and obese. The proportion of obese people in different age groups was calculated and analyzed statistically. The normal of the BMI, waist circumference and waist-hip ratio of the young patients were 78(33.2%), 91 (38.7%) and 85(36.2%) respectively;104(44.3%), 95(40.4%), 99(42.1%) were overweight, 53(22.5%), 49(20.9%), 51 (21.7%) were obese. The normal of the BMI, waist circumference and waist-hip ratio of the middle-aged and old patients were 145 (41.9%), 138 (39.9%) and 147 ( 42.5%) respectively;153 (44.2%), 162 (46.8%), 155 (44.8%) were overweight, 48 (13.9%), 46 (13.3%), 44 (12.7%) were obese. Among the three parameters, the proportion of obese people in the adolescent group was higher than that in the middle-aged group, and the difference was significant (χ2 was 8.836, 6.228 7, 8.536 3 respectively, P<0.05). For adolescent patients, obesity may increase the load of lumbar disc, affect its metabolism and accelerate its degeneration. For adolescent, obesity is a more significant risk factor of lumbar disc herniation, so it is more important to control weight and prevent obesity in adolescent to reduce the incidence of lumbar disc herniation.

Differences in the Incidence of Symptomatic Cervical and Lumbar Disc Herniation According to Age, Sex and National Health Insurance Eligibility: A Pilot Study on the Disease's Association with Work.

The aim of this research was to identify the differences in the incidence of symptomatic cervical and lumbar disc herniation according to age, sex, and national health insurance eligibility. We evaluated the hospital documents of patients who received medical treatment for symptomatic cervical and lumbar disc herniation between 2004 and 2010 and excluded those who claimed to have expenses at oriental medical clinics or pharmacies. Furthermore, any duplicate documents from the labor force population aged 20–69 years were excluded from the analysis. The results showed that the number of individuals diagnosed with symptomatic cervical and lumbar disc herniation increased with age, and the incidence of these diseases was higher in women than in men. Additionally, the incidence differed depending on the subject’s qualification for health insurance. The incidence of lumbar disc herniation showed differences depending on the degree of the lumbar burden. The present study findings may help determine whether lumbar disc herniation is associated with tasks performed at the patient’s workplace. Further research is needed to classify the risk of lumbar disk herniation in the workplace into detailed categories such as types of business, types of occupation, and lumbar compression force.

Trend of the incidence of lumbar disc herniation: decreasing with aging in the elderly

BackgroundCompelling evidence has shown that the incidence of lumbar disc herniation (LDH) increases with age. In this study, retrospective clinical analysis of 601 cases of LDH has been conducted to investigate the role of age in the incidence of LDH in the elderly. The aim of the study is to investigate the relationship between the process of aging and the occurrence of LDH in old adults.MethodsClinical cases (n = 601) of LDH were retrospectively analyzed.ResultsThe imaging examination with computed tomography and/or magnetic resonance imaging showed the occurrence of degeneration in LDH patients over 65 years of age. The most common site of LDH is toward the bottom of the spine at L4–L5 and/or L5–S1. The incidence of LDH drops with age in the elderly, especially after the age of 80 years. There is an obvious decrease in LDH in the elderly female.ConclusionA decreasing incidence of LDH with aging occurs in the elderly. This investigation indicates that aging is not a contributor to the performance of LDH in the elderly although the incidence of LDH is proportional to age.

Acupuntura de compensación (balance): un estudio experimental sobre su eficacia en el tratamiento de los dolores radiculares en un modelo de rata con hernia discal

Background Lumbar disc herniation (LDH) is a common clinical disease accounting for lumbocrural pain in the majority of the patients. The incidence of LDH has risen quickly in the past years. The theory of balance acupuncture is a new method firstly established by Dr. Wang Wenyuan and further developed according to a large amount of clinical studies which have come to emphasize its immediate therapeutic effects. Swiftness of effect as well as an easy point selection and handling are among the advantages of this technique. Objectives By applying balance acupuncture in a clinical setting, we have obtained data reporting a significant effect on LDH. However, the mechanisms are still unknown. The clinical symptoms of radicular pain are mainly induced by pathological changes due to mechanical compression and the chemical inflammation process. With this theoretical background, we used a rat lumbar disc herniation model with radiculopathy which resembled the pathological situation of radicular pain in LDH of humans. We observed the beneficial effect of balance acupuncture on LDH with radiculopathy and tried to decipher its working mechanism for clinical treatments. Methods Male SD (Sprague-Dawley) rats were randomly and evenly assigned to a blank group, a sham-operation group, a model group and a treatment group, respectively. In the model group, radiculopathy of LDH was simulated by cerclaging the L5 nerve root, followed by a detection of the change of claw-latency after thermally stimulated withdrawal. Moreover, the histological changes were judged by haematoxylin-eosin (HE) staining, whereby the physiological marker IL-1β was detected, showing stimulation by the balance acupoints “lumbago” and “hip pain”. Results 1) Radiculopathy caused by LDH-nerve compression can cause hyperalgesia of the lower limbs, reduction of the pain tolerance threshold, edema of the nerve root tissue, disappearance of the axon, and infiltration of inflammatory cells. 2) Radiculopathy caused by LDH can cause an increase of IL-1β. There was a positive correlation between IL-1β and the inflammatory response of the nerve root as well as the amount of pain. 3) Balance acupuncture can diminish fiber edema of the nerve root and demyelination, reduce the responses of the inflammation and stress, and promote healing of the injured nerve root. Conclusion Balance acupuncture can regulate the responses to the hyperalgesia in radiculopathy caused by LDH. It can influence the expression level of some cytokines, and eventually repair the disordered functions of the nerve root to some extent, all of which might be regulated through neuroendocrinal-immune system related cascades and pathways. Therefore, balance acupuncture is a novel method for treatment of disease like LDH with radicular pain, which is worthy to be tested extensively in clinical surroundings.

Balance Acupuncture: An Experimental Study on the Effectiveness of Treating Radicular Pain in a Lumbar Disc Herniation Rat Model

Background Lumbar disc herniation (LDH) is a common clinical disease accounting for lumbocrural pain in the majority of the patients. The incidence of LDH has risen quickly in the past years. The theory of balance acupuncture is a new method firstly established by Dr. Wang Wenyuan and further developed according to a large amount of clinical studies which have come to emphasize its immediate therapeutic effects. Swiftness of effect as well as an easy point selection and handling are among the advantages of this technique. Objectives By applying balance acupuncture in a clinical setting, we have obtained data reporting a significant effect on LDH. However, the mechanisms are still unknown. The clinical symptoms of radicular pain are mainly induced by pathological changes due to mechanical compression and the chemical inflammation process. With this theoretical background, we used a rat lumbar disc herniation model with radiculopathy which resembled the pathological situation of radicular pain in LDH of humans. We observed the beneficial effect of balance acupuncture on LDH with radiculopathy and tried to decipher its working mechanism for clinical treatments. Methods Male SD (Sprague-Dawley) rats were randomly and evenly assigned to a blank group, a sham-operation group, a model group and a treatment group, respectively. In the model group, radiculopathy of LDH was simulated by cerclaging the L5 nerve root, followed by a detection of the change of claw-latency after thermally stimulated withdrawal. Moreover, the histological changes were judged by haematoxylin-eosin (HE) staining, whereby the physiological marker IL-1β was detected, showing stimulation by the balance acupoints “lumbago” and “hip pain”. Results (1) Radiculopathy caused by LDH-nerve compression can cause hyperalgesia of the lower limbs, reduction of the pain tolerance threshold, edema of the nerve root tissue, disappearance of the axon, and infiltration of inflammatory cells. (2) Radiculopathy caused by LDH can cause an increase of IL-1β. There was a positive correlation between IL-1β and the inflammatory response of the nerve root as well as the amount of pain. (3) Balance acupuncture can diminish fiber edema of the nerve root and demyelination, reduce the responses of the inflammation and stress, and promote healing of the injured nerve root. Conclusion Balance acupuncture can regulate the responses to the hyperalgesia in radiculopathy caused by LDH. It can influence the expression level of some cytokines, and eventually repair the disordered functions of the nerve root to some extent, all of which might be regulated through neuroendocrinal–immune system related cascades and pathways. Therefore, balance acupuncture is a novel method for treatment of disease like LDH with radicular pain, which is worthy to be tested extensively in clinical surroundings.