The effect of spinal steroid injections for degenerative disc disease

Buttermann, Glenn R.

doi:10.1016/j.spinee.2004.03.024

Cited by 172 publications

(124 citation statements)

References 49 publications

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“…Yoshimoto et al [29] and Watkins et al [24] reported no complications, and Hsu [9] reported an 8.3% LDH recurrence frequency, which is comparable to the general population [3,4,6].…”

Section: Resultsmentioning

confidence: 64%

“…Lumbar discectomy is a successful treatment for LDH in the general population in that it relieves pain and restores function in most patients who undergo the procedure [4,26]. However, the impact on lumbar discectomy on elite athletes may vary compared with the general population because of the high postoperative demands required to reach elite athletic performance.…”

Section: Discussionmentioning

confidence: 99%

“…Lumbar discectomy for the treatment of lumbar disc herniation (LDH) has led to excellent pain relief, return-towork rates, and patient satisfaction in the general population [4,13,14,[25][26][27]. The efficacy of lumbar discectomy has traditionally been quantified by validated outcome measures such as the Oswestry Disability Index (ODI), Each author certifies that he or she, or a member of his or her immediate family, has no funding or commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.…”

Section: Introductionmentioning

confidence: 99%

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Outcomes of Lumbar Discectomy in Elite Athletes: The Need for High-level Evidence

Nair

Kahlenberg

Hsu

2015

Clinical Orthopaedics &Amp; Related Research

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Background Although lumbar discectomy for treatment of lumbar disc herniation in the general population generally improves patients' pain, function, and validated outcomes scores, results of treatment in elite athletes may differ because of the unique performance demands required of competitive athletes. Questions/purposes We performed a systematic review to answer the following questions: (1) What proportion of athletes return to play after lumbar discectomy, and what is the effect of sport? (2) What is the expected recovery time after lumbar discectomy in elite athletes? (3) What is the expected career length and performance of elite athletes after lumbar discectomy? Methods We performed a systematic literature review of articles of lumbar discectomy in the elite athlete population through the MEDLINE and EMBASE databases from 1947 to 2013. Elite athletes were defined as professional, Olympic, or National Collegiate Athletic Association Division I collegiate level. A hand search of the references of all key articles was performed to ensure inclusion of all relevant studies. Information regarding study design, types of athletes, level of sport, recovery time, return to sport, length of career after surgery, and career performance after surgery was extracted. Ten articles met the inclusion and exclusion criteria for this review. These articles consisted of levels III and IV data and were graded based on the Methodological Index for Non-Randomized Studies (MINORS) scale. Results Overall, the studies included in this review found that 75% to 100% of athletes were able to return to elite competition after operative treatment. In general, a higher proportion of baseball players returned to elite competition compared with other athletes. The reported recovery period after lumbar discectomy ranged from 2.8 to 8.7 months. The average career length after lumbar discectomy ranged from 2.6 to 4.8 years. Elite athletes reached an average of 64.4% to 103.6% of baseline preoperative statistics after lumbar discectomy with variable performance based on sport. Conclusions A high proportion of elite athletes undergoing lumbar discectomy return to play with variable performance scores on return. Future prospective studies are needed to compare the recovery time, career longevity, and performance for athletes undergoing lumbar discectomy versus nonoperative treatment for lumbar disc herniation.

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“…Yoshimoto et al [29] and Watkins et al [24] reported no complications, and Hsu [9] reported an 8.3% LDH recurrence frequency, which is comparable to the general population [3,4,6].…”

Section: Resultsmentioning

confidence: 64%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Outcomes of Lumbar Discectomy in Elite Athletes: The Need for High-level Evidence

Nair

Kahlenberg

Hsu

2015

Clinical Orthopaedics &Amp; Related Research

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“…The intradiscal corticosteroid injections have been reported in patients with Modic Type-1 changes regarding their anti-inflammatory effect [68]. The intradiscal eletrothermal therapy consists of percutaneous insertion of a thermocoil into the IVD [69].…”

Section: Treating Discogenic Painmentioning

confidence: 99%

Discogenic pain: Who cares?

Lavrador¹,

Simas²,

Oliveira³

et al. 2013

Health

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Chronic low back pain has a huge impact on daily living and a negative economic and professional effect. It is a matter of debate and concern for all health professionals involved, particularly spine surgeons. Recent discoveries on the innervation and biochemical properties of the intervertebral disc clarify the role of this structure as a possible cause of chronic low back pain. However, multiple causes may be present in the same patient making the diagnosis a challenging process. Discogenic pain is defined as a chronic low back pain induced by a degenerative disc disease. There are no specific characteristics of discogenic pain, although it has a higher incidence in younger age, it is usually localized medially in the back, worsens with axial loading and improves with recumbence. In the last decades we have assisted the emergence of multiple treatment techniques. However, neither the conservative treatment nor the interventional management has strong evidence in treating discogenic pain. Randomized control clinical trials are sought to improve patient outcome. Meanwhile, we believe each patient should be approached on an individual base. Discogenic pain: we care.

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“…However, there is no clinical evidence for the use of ESI in axial LBP except for 1 observational study that used the interlaminar approach 4 and 1 randomized study 2 and 2 observational studies that used the caudal approach. 5,6 Intervertebral disks can be a source of LBP without nerve root compression.…”

mentioning

confidence: 99%