PURPOSE To carry out a systematic review and meta-analysis of the efficacy of chemonucleolysis in the treatment of lumbar disc herniation. METHODS Clinical trials were selected from 3 electronic databases (The Cochrane Controlled Trials Register, MEDLINE, and EMBASE). Data were analyzed with the software STATA, using the meta command. RESULTS Twenty-two clinical trials were eligible. For ch...

Objective. The goal of the present study was to examine the clinical results of percutaneous endoscopic lumbar discectomy (PELD) and open lumbar surgery for patients with adjacent segment degeneration (ASD) and recurrence of disc herniation. Methods. From December 2011 to November 2013, we collected forty-three patients who underwent repeated lumbar surgery. These patients, either received PELD...

Although there is a substantial literature on the subject of lumbar hernia, a study of it discloses disagreement over interpretation of the terms 'congenital' and 'acquired' and, indeed, over the word 'hernia' itself. This confusion is by no means confined to lumbar hernia and it has been usual for the writers of the surgical classics of the nineteenth and early twentieth centuries to devote se...

We reviewed two comparable groups of patients who had been treated for lumbar disc herniation by chymopapain chemonucleolysis (145) or conventional surgical discectomy (91). They were reviewed 10 years after treatment by questionnaire, followed by a personal interview by an independent observer. The results of the surgically treated groups were slightly better than those treated with chymopapai...

We investigated the surgical results of lumbar disc herniation in the elderly. Ten elderly patients underwent surgical treatment between 1990 and 1999. There were 7 males and 3 females with a mean age of 68.2 years (range: 60~85 years). Thirteen patients in their 20s and 30s were used as a control. Preoperatively, severe leg pain and gait disturbance, and higher rates of negative straight leg-r...

STUDY DESIGN  Systematic review. STUDY RATIONALE  Disc degeneration is a common process starting early in life. Often disc herniation is an early step in disc degeneration, which may cause pain or stenosis. How quickly this subsequent disc degeneration occurs following a disc herniation and subsequent surgical treatment and whether certain spinal procedures increase the rate of degeneration r...

STUDY DESIGN Concurrent prospective randomized and observational cohort studies. OBJECTIVE To assess the 8-year outcomes of surgery versus nonoperative care. SUMMARY OF BACKGROUND DATA Although randomized trials have demonstrated small short-term differences in favor of surgery, long-term outcomes comparing surgical with nonoperative treatment remain controversial. METHODS Surgical candid...

OBJECT The current cross-sectional observational MR imaging study aimed to investigate the prevalence and risk factors of lumbar disc degeneration in a healthy population and to establish the baseline data for a prospective longitudinal study. METHODS Two hundred healthy volunteers participated in this study after providing informed consent. The status of lumbar disc degeneration was assessed...

INTRODUCTION Disc herniation is a complex spinal disorder associated with disability and high healthcare cost. Lumbar disc herniation is strongly associated with disc degeneration. Candidate genes of the aggrecan metabolic pathway may associate with the severity of lumbar disc herniation. OBJECTIVES This study evaluated the association of single nucleotide variants (SNVs) of the candidate gen...

OBJECT In patients with long-standing lumbar degenerative disc disease (DDD) conventional surgical therapy of a herniated disc may worsen back pain due to further destabilization of the affected motion segment. In recent years, total-disc arthroplasty has been introduced to treat DDD while maintaining segmental mobility. To the best of the authors' knowledge, this is the first report involving ...