Adolescent lumbar disc herniation: Impact, diagnosis, and treatment

Karademir, Mustafa; Eser, Olcay; Karavelioğlu, Ergün

doi:10.3233/bmr-160572

Cited by 50 publications

(46 citation statements)

References 18 publications

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“…Significant lifestyle changes in recent decades have increased the incidence of LDH worldwide, especially in the young to middle‐aged population 25 . Not all patients with LDH are associated with surgical treatment.…”

Section: Discussionmentioning

confidence: 99%

Dexamethasone Suppresses Radicular Pain Through Targeting the L‐PGDS/PI3K/Akt Pathway in Rats With Lumbar Disc Herniation

Ding

Sheng

et al. 2020

Pain Practice

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PurposeLumbar disc herniation (LDH) is a frequently occurring disease with unknown etiology, which makes treatment a challenge. The aim of this study was to analyze the effects of dexamethasone on LDH and elucidate the underlying mechanisms.General MethodsAn LDH rat model was established by nucleus pulposus implantation. The activity of the lipocalin type prostaglandin D synthase (L‐PGDS)/phosphoinositide 3‐kinase (PI3K)/protein kinase B (Akt) axis was evaluated by Western blotting. Paw withdrawal threshold and paw withdrawal latency were assessed by the Von Frey hairs method and the thermal dolorimeter of Hargreaves, respectively. The 21‐point Basso‐Beattie‐Bresnahan scale was used to assess the locomotor function of rats. Pathological changes in the affected region were analyzed by hematoxylin‐eosin staining. Immunofluorescence was used to measure the expression of microtubule‐associated protein (MAP‐2).FindingsLumbar disc herniation markedly increased thermo‐mechanical allodynia and induced dorsal root ganglion (DRG) degeneration by inactivating the L‐PGS/PI3K/Akt pathway. Dexamethasone restored the L‐PGDS/PI3K/Akt pathway and relieved LDH‐induced thermo‐mechanical allodynia. Furthermore, overexpression and knockdown of L‐PGDS respectively attenuated and worsened LDH‐triggered thermo‐mechanical allodynia and tissue degeneration by modulating the PI3K/Akt pathway. Pretreatment with dexamethasone partially abrogated the effect of L‐PGDS knockdown through PI3K/Akt activation.ConclusionsDexamethasone relieves LDH‐mediated radicular pain by exerting anti‐inflammatory effects and reducing the suppression of L‐PGDS induced by LDH. Meanwhile, the activity of the PI3K/Akt pathway was decreased, possibly due to the attenuated inflammation induced by dexamethasone. Our results revealed the underlying mechanism of dexamethasone, which might be helpful in reducing the side effects of dexamethasone and provide more focused therapy in LDH.

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Section: Discussionmentioning

confidence: 99%

Dexamethasone Suppresses Radicular Pain Through Targeting the L‐PGDS/PI3K/Akt Pathway in Rats With Lumbar Disc Herniation

Ding

Sheng

et al. 2020

Pain Practice

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“…Selten sind auch Bandscheibenprotrusionen beschrieben, wobei sich die Diagnostik wie im Erwachsenenalter an der entsprechenden Klinik, dem Schmerzniveau und ggf. neurologischen Ausfällen orientiert [54]. Schmerzen jedoch, die immer vorhanden sind, sich nicht bewegungsabhängig verschlechtern und das Kind oder den Jugendlichen nachts aus dem Schlaf aufwecken, sind hochsuspekt für proliferative oder maligne Knochenprozesse und müssen mittels MRT abgeklärt werden.…”

Section: Nussknacker Syndromunclassified

Akute Flankenschmerzen im Kindes- und Jugendalter

Ebert¹

2017

Aktuel Urol

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“…The pathogenesis of LDH is associated with gender, age, body mass, smoking, heavy loading of spine, and physical activity ( Perera et al, 2017 ). With the change of working and living habits during the development of society, LDH affects an increasing number of young patients ( Karademir et al, 2017 ). The main symptoms of LDH include weakening of muscle strength, lower back pain, radiation pain on one side or in the lower extremities, and sensory disturbances ( Pinto et al, 2012 ; Yang et al, 2015 ).…”

Section: Introductionmentioning

confidence: 99%

Urine Metabolomics Profiling of Lumbar Disc Herniation and its Traditional Chinese Medicine Subtypes in Patients Through Gas Chromatography Coupled With Mass Spectrometry

Shan

Yang

Meng

et al. 2021

Front. Mol. Biosci.

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Lumbar disc herniation (LDH) possesses complex pathogenesis, which has not been well elucidated yet. To date, specific or early diagnosis of LDH remains unavailable, resulting in missed opportunity for effective treatment. According to Traditional Chinese medicine (TCM) theory, LDH can be divided into two subtypes (reality syndrome and deficiency syndrome). The purpose of this study was to analyze the metabolic disorders of LDH and its TCM subtypes and screen out potential biomarkers for LDH diagnosis. Gas chromatography coupled with mass spectrometry (GC-MS) was applied to test the urine samples from 66 participants (30 healthy volunteers, 18 LDH patients with deficiency syndrome and 18 patients with reality syndrome). PCA analysis showed a distinct separation tendency between the healthy subjects and LDH patients but no obvious separation between the different syndromes (reality syndrome and deficiency syndrome) of LDH patients. As a result, 23 metabolites were identified significantly altered in the LDH patients, as compared with the healthy subjects. The altered metabolites belong to amino acid metabolism, nucleic acid metabolism, carbohydrate metabolism, and vitamin metabolism, which are related to osteoporosis and inflammation. Our results indicate metabolic disorders of LDH and thereby propose a group of metabolic biomarkers for potential application in early diagnosis of LDH in clinic, which provide a reasonable explanation for the pathogenesis of LDH.

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Adolescent lumbar disc herniation: Impact, diagnosis, and treatment

Cited by 50 publications

References 18 publications

Dexamethasone Suppresses Radicular Pain Through Targeting the L‐PGDS/PI3K/Akt Pathway in Rats With Lumbar Disc Herniation

Dexamethasone Suppresses Radicular Pain Through Targeting the L‐PGDS/PI3K/Akt Pathway in Rats With Lumbar Disc Herniation

Akute Flankenschmerzen im Kindes- und Jugendalter

Urine Metabolomics Profiling of Lumbar Disc Herniation and its Traditional Chinese Medicine Subtypes in Patients Through Gas Chromatography Coupled With Mass Spectrometry

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