Lumbar Disc Replacement Surgery

By Jaimig Aljorna

Lumbar disc replacement is a surgical option for some people with degenerative disc disease. When do doctors recommend it? The 24 bones of the spine (called vertebrae) distribute in the form of a column. The vertebrae support and protect the spinal cord and its numerous nerves. The soft discs between each vertebral bone allow your…

High success rate with new modified endoscopic treatment for high-grade VUR: A pilot study with preliminary report.

By London Spine
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High success rate with new modified endoscopic treatment for high-grade VUR: A pilot study with preliminary report.

J Pediatr Urol. 2015 Sep 25;

Authors: Asgari SA, Asl AS, Safarinejad MR, Ghanaei MM

Abstract
PURPOSE: Despite the benefits of the minimally invasive endoscopic treatment for vesicoureteral reflux (VUR) it has a major drawback which is low success rate in high grade VUR. For overcoming this problem, we introduce a new modified technique of endoscopic treatment called periureteral injection technique (PIT).
MATERIALS AND METHODS: In a prospective study a total of 37 ureters in 19 boys and 14 girls were treated, including 3 bilateral cases. Of 37 units, 30 (81.1%) had grade IV and 7 (18.9%) had grade V primary VUR (18 right, 13 left and 3 bilateral units). Subureteral injection of Vantris(®) was done at the 5-o’clock and 7-o’clock positions in which the direction of injecting needles were almost parallel. Pre- and post-operative evaluation included urinalysis, urinary tract ultrasonography, voiding cystourethrography (VCUG), dimercaptosuccinic acid scan and urodynamic studies.
RESULTS: The median age was 38 months (range 8-125). At 6 months follow up period confirmed with VCUG, the VUR has been disappeared in 34 (91.8%) units and 3 units [2 (5.4%) grade II and 1 (2.7%) had grade III)] had downgraded VUR. Complications included early fever due to urinary tract infection in 1 children, transient dysuria in 2 patients and low back pain in one patient (Summary Table).
CONCLUSION: The success rate of PIT for treatment of high grade VUR is high. However, further studies with more patients and longer follow up periods are needed to draw final conclusion.

PMID: 26549873 [PubMed – as supplied by publisher]

Depression impacts the course of recovery in patients with acute low-back pain.

By London Spine
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Depression impacts the course of recovery in patients with acute low-back pain.

Behav Med. 2013;39(3):80-9

Authors: Melloh M, Elfering A, Käser A, Salathé CR, Barz T, Aghayev E, Röder C, Theis JC

Abstract
Little is known about the course of recovery of acute low back pain (LBP) patients as a function of depression. In a prospective study, 286 acute LBP patients were assessed at baseline and followed up over 6 months. Recovery was defined as improvement in the Oswestry Disability Index (ODI). Repeated-measures analysis of covariance was employed with ODI as repeated factor, age, sex, and body mass index as covariates, depression and all other potential prognostic factors as between-subject factors. Of study participants, 18% were classified as depressive (>33 points on the Zung Self-Rating Depression Scale). Of 286 participants, 135 were lost to follow-up. In the longitudinal sample of 151 patients the course of recovery was slower in depressive patients. Depression was associated with LBP especially after 6 weeks and should therefore be included in screening instruments for acute LBP patients to identify those at risk of delayed recovery at an early stage.

PMID: 23930900 [PubMed – indexed for MEDLINE]