Factors that influence neurological deficit and recovery in lumbar disc prolapse—a narrative review

Nv, Ankith; Rajasekaran, Shanmuganathan; Ks, Sri Vijay Anand; Kanna, Rishi Mugesh; Shetty, Ajoy Prasad

doi:10.1007/s00264-018-4242-y

Cited by 9 publications

(6 citation statements)

References 52 publications

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“…Lumbar PIVD is one of the common causes contributing to LBP, which prompting individuals to seek medical help [31,52,53] . It has a significant effect on society in terms of epidemiology and economy, so there is a need for costeffective and evidence-based interventions in the treatment of lumbar PIVD.…”

Section: Discussionmentioning

confidence: 99%

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A systematic review and meta-analysis with radiological correlation on the efficacy of spine stabilizing exercises in chronic low backache

Rao,

Gowda

2023

Int. J. Orthop. Sci.

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The objective of this prospective study and systemic review is to analyze the efficacy of stabilizing exercises in the management of spondylolisthesis. Nonspecific low back pain (NSLBP) is a large and costly problem. It has a lifetime prevalence of 80% and results in high levels of healthcare cost. It is a major cause for long-term sickness amongst the workforce and is associated with high levels of fear avoidance. Stabilizing (or core stability) exercises have been suggested to reduce symptoms of pain and disability and form an effective treatment. Despite it being the most commonly used form of physiotherapy treatment there is a lack of positive evidence to support its treatment of NSLBP, and compare any effectiveness to other forms of exercise. Aim: The primary aim of this analysis is to systematically review the most current up to date literature to determine whether stabilization (or core stability) exercises are an effective therapeutic treatment compared to an alternative treatment for the people with Spondylolisthesis. The secondary aim is to determine if stabilization exercises are as effective as other forms of exercise, and to evaluate findings by meta-analysis if appropriate. Methods: A total of 50 non-surgically managed patients with degenerative spondylolisthesis were examined daily for a minimum of 10 days follow-up evaluation. Further follow-up was done evaluation for 1 month, 3 months, and 6 months period. Radiological changes, changes in clinical symptoms, and functional prognosis were surveyed. A comparison of pre-exercises, post exercises and a period of 6 months follow-up for Health-Related Quality of Life using Short-Form 36 Questionnaire was also done. Clinical implications: This article addresses the different phases of the assessment of a patient with SPL, including history, imaging, physical exam and questionnaires on disability and cognitive-behavioral components. Regarding conservative treatment, self-management approaches and graded supervised training, including therapeutic relationships, information and education, are explained. Primary therapeutic procedures for pain control, recovery of function and mobility through therapeutic exercise, passive mobilization and antalgic techniques are suggested. Result: A total of 10(20%) of 50 patients who had no neurological deficits at initial examination remained without neurological deficits after 6 months of follow-up. 40(80%) of the 50 patients who had neurological symptoms, such as intermittent claudication, radiating pain at initial examination experienced symptomatic relief. Conclusion:Stabilizing exercises are effective in the management of spondylolisthesis. Physiological and biomechanical factors such as correction of the displaced disc, opening of the foramina increase in intervertebral spaces and reduction in herniation size with negative intradiscal pressure may be possible mechanisms.

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Section: Discussionmentioning

confidence: 99%

“…Magnetic resonance imaging is one of the choices of examination for diagnosis, as it has high sensitivity and specificity [28,29] . Both conservative and surgical interventions can be used for the treatment [30][31][32] . In the last decade, efforts have been done to minimize the need for spinal surgery [33,34] .…”

Section: Introductionmentioning

confidence: 99%

A systematic review and meta-analysis with radiological correlation on the efficacy of spine stabilizing exercises in chronic low backache

Rao,

Gowda

2023

Int. J. Orthop. Sci.

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“…After their series study, they also concluded that PETAD could be a good alternative for the treatment of huge central/paracentral LDH. Our special issue also includes a few articles about the important complications of LDH such as those mentioned in the Bnarrative review by Ankith NV et al [24] that discusses the pathogenesis, most consistent factors associated with the occurrence of neurodeficit in LDH patients and also the factors which have a prognostic role in recovery^. The authors highlight the Bpathological mechanisms like venous congestion, neuronal ischemia and multiple root impairment act either individually or in combination to result in neurodeficit in LDH patients^.…”

Section: Mini Invasive Surgical Techniquesmentioning

confidence: 99%

Disc herniation and disc disease: the present and the future of management

Benzakour

Benzakour²

2019

International Orthopaedics (SICOT)

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“…Although previous studies have described the manifestations of foot drop and its clinical treatments, the clinical recovery of foot drop caused by LDD remains unsatisfactory [5]. Previous studies focused too much on the effects of factors such as duration of palsy and preoperative TA muscle strength on the recovery of foot drop [4][5][6]. However, disputation still exists.…”

Section: Introductionmentioning

confidence: 99%

A Novel Capsule Lumbar Interbody Fusion (CLIF) in Treating Foot Drop due to Lumbar Degenerative Diseases: a Prospective, Observational Study

Sun

Lin

Jiang

et al. 2021

Pain Research and Management

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Objective. This present study aimed to explore the clinical effects of a novel capsule lumbar interbody fusion (CLIF) on foot drop due to lumbar degenerative diseases. Methods. Between June 2018 and January 2019, a total of 27 patients admitted to our department with lumbar degenerative diseases with associated foot drop were prospectively enrolled. Given the selection of surgical technique, patients were divided into traditional TLIF group and CLIF group. We assessed patients’ neurological status using JOA and VAS score, tibialis anterior muscle strength using MMT score, diameter and hemodynamic parameters of the L5 nerve root using intraoperative ultrasonography (IoUS), and related radiological parameters of the lumbar spine. Operation time, blood loss, and surgery-associated complications were also recorded. Results. The median duration of follow-up was 150 (6–1460) months. At the final follow-up, all patients acquired satisfactory improvement of neurological function. However, patients in the CLIF group showed better early recovery of foot drop three months after operation than those in the TLIF group, with 75% excellent rate. In addition, IoUS suggested that the diameter and hemodynamic parameters of the L5 nerve root were improved better in the CLIF group, which may suggest the correlation between the recovery of foot drop and the status of L5 nerve root. No severe complications were encountered with CLIF. Conclusions. Our preliminary study revealed that the axial tension of L5 nerve root may be involved in the pathological mechanism of foot drop. The novel technique of CLIF can shorten the lumbar spine and can be effective and safe for the treatment of foot drop due to lumbar degeneration-related diseases.

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Factors that influence neurological deficit and recovery in lumbar disc prolapse—a narrative review

Cited by 9 publications

References 52 publications

A systematic review and meta-analysis with radiological correlation on the efficacy of spine stabilizing exercises in chronic low backache

A systematic review and meta-analysis with radiological correlation on the efficacy of spine stabilizing exercises in chronic low backache

Disc herniation and disc disease: the present and the future of management

A Novel Capsule Lumbar Interbody Fusion (CLIF) in Treating Foot Drop due to Lumbar Degenerative Diseases: a Prospective, Observational Study

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