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Article
HISTOLOGICAL AND STRUCTURAL STUDY OF PROLAPSED INTERVERTEBRAL DISC

Authors: Khalida K Jbara --- Thamer A Hamdan
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2006 Volume: 12 Issue: 1 Pages: 2
Publisher: Basrah University جامعة البصرة

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Abstract

The research of the etiology of low back pain and right leg pain has been focused on the study of histological degenerative changes of human intervertebral disc prolapse. In patients with low back pain & right leg pain and disc prolapsed according to magnetic resonance imaging (MRI), histological and histochemical studies have demonstrated several histological degenerative changes in the structure of the prolapsed intervertebral disc. Surgically excised intervertebral disc from 105 patients with lumber disc prolapsed were studied by histomorphology aided with histochemistry this include patients with prolapsed disc due to several causes. 5 control intervertebral discs were studied for comparison. Our result indicated that their was a degenerative structural changes of the intervertebral disc prolapse. Chondrocytes cloning, invasion of blood vessels into the disc matrix, disorganisation and disorientation of collagen fibers, matrix depletion and many other changes were observed.

Keywords

HISTOLOGICAL --- PROLAPSED --- INTERVERTEBRAL --- DISC


Article
Y Risk Factors of Recurrent Lumbar Disk Herniation

Author: Isam Ali Alsudany
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2015 Volume: 12 Issue: 4 Pages: 1168 -1172
Publisher: Babylon University جامعة بابل

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Abstract

Recurrent intervertebral disc prolapsed (RDP) is a major cause of poor result after lumbar discectomy surgery. The aim of current study is to assess risk factors of recurrent disc prolapse in Iraqian population in Hilla teaching hospital from 2002-2013. The study reviewed 40 patients with recurrent disc prolapsed and 100 patients without recurrence retrospectively. To evaluate possible risk factors for herniation recurrence A clinically significant recurrent herniation was defined as a disc herniation causing lower limb pain (sciatica) and (MRI) evidence of disc material at the same level of the previous surgery. Other 100 patients without recurrence were used just for compares to identify possible risk factors for recurrent RDP. There was important variation between groups with and without RDP in sex, smoking, height, weight and occupational characteristic. By putting these differences in logistic regression analysis, it showed that gender (male), height, heavy workers and heavy smoker could expected in lumbar disc prolapsed recurrence(RDP). Taking into consideration sex, heavy smoking and heavy workers as predictors of recurrent RPD, surgeons should advice their patients to limit hard work and put away smoking especially in tall and male ones to prevent RDP recurrence.


Article
Percutaneous endoscopic spinal surgery for lumbar disc prolapse in Erbil city of Iraq: A study on 60 patients
جراحة العمود الفقري بالمنظار عن طريق الجلد بأزالة القرص القطني في مدينة اربيل في العراق:دراسة على 60 مريض

Author: Emad Kh Hammood عماد خليل حمود
Journal: Diyala Journal of Medicine مجلة ديالى الطبية ISSN: 97642219 Year: 2018 Volume: 15 Issue: 2 Pages: 1-8
Publisher: Diyala University جامعة ديالى

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Abstract

Background: As an alternative to back surgeries, endoscopic spinal operations is the most effective and safe procedure that does not impose the fear reaction to the patients. Objective: In this study the results, complications, and outcomes of 60 patients complaining from prolapsed lumbar inter-vertebral discs who experienced prolapsed endoscopic lumbar discectomy (PELD) were reported.Patients and Methods: This is a prospective study conducted in three sentinel hospitals over a period of 3 years (2013-2015) in Erbil city of Iraq. Clinical findings in addition to pre-operative MRI were the main diagnostic methods used for including patients who were suffering from lumbar disc herniation at different levels. Clinical appraisal was done utilizing the modified Macnab criteria. The Storz lens spinoscope was utilized to perform PELD.Results: Sixty patients (37 males and 23 females) with lumbar disc herniation were included in the study. The mean operative time was 50 minutes. Patients were discharged during 1st 24 hours post-operatively. After surgery, patients were followed up for two months to three years with a mean of 18 months. Seven (11.7%) patients developed complications including one (1.7%) instance of shallow nerve injury, three (5%) with dural tears, two (3.3%) instances of intermittent delayed disc prolapse and one patient (1.7%) had post-operative discitis. Modified Macnab criteria (excluding patients with long dural tear) showed excellence results for 36 patients, while good results were observed for 17 patients, reasonable results for 3 patients and poor results for 2 patients. The achievement rate was 91.4% .Conclusion:Although endoscopic spinal discectomy is a compelling procedure for management of lumbar disc prolapse, and although its final outcome is reasonable it is not devoid from complications.

خلفية الدراسة: تعتبر عملية جراحة الفقرات عن طريق المنظار طريقة أمنة ومؤثرة وبديلة للطرق الاخرى لعمليات الظهر الجراحية المفتوحة والتي تزيد من التوتر والخوف لدى المريض في اغلب الاحيان . اهداف الدراسة: هدفت هذه الدراسة لتسجيل الطرق والاستنتاجات و الصعوبات التى تم رصدها عند 60 حالة لخلع الفقرات القطنية والتي تتضمن ازاحة اقراص الغضاريف وفيها تم ازالة الغضروف عن طريق المنظار (PELD).المرضى والطرائق: اجريت البحث في قسم الجراحة العصبية في ثلاثة مستشفيات في مدينة اربيل في كردستان العراق خلال ثلاث سنوات ، جميع المرضى الذين اخضعوا للدراسة كان لديهم فتق للقرص القطني في مستويات مختلفة مع الام شعاعية نموذجية ، تم اعتبار الفحص السريري والفحص عن طريق جهاز الرنين المغناطيسي كاساس لتشخيص الحالات ، تم اجراء التقييم السريري مستخدما معيار ماكناب المعدل. تم استخدام عدسات Storz لاجراء عملية ازالة القرص القطني المنظاري المخترقة للجلد (PELD).النتائج: كان معدل زمن العمليات 50 دقيقة . جميع المرضى تم اخضاعهم للمشي خلال 6 ساعات من اجراء العملية وتم اخراجهم من المستشفى خلال 24 ساعة . مدة المتابعة بعد العملية تراوحت بين شهرين الى 34 شهر و بمعدل 18 شهر . تم رصد سبعة (11.7%) مضاعفات بضمنها واحد (1.7%) حالة اصابة عصب shallow nerve ، ثلاثة (5%) تمزق الغشاء الخارجي ، اثنان (3.3%) حالة لفتق القرص المؤقت المتاخر و حالة واحدة (1.7%) لالتهاب القرص مابعد العملية . اظهر تقييم النتائج باستخدام معيار ماكناب المعدل مستثنيا المرض الذين لديهم تمزق للاغشية الخارجية الطويلة اظهرت بان 36 مريض كانت لديهم نتائج ممتازة ، 17 مريض كانت لديهم نتائج جيدة ، ثلاثة منهم كانت لديهم نتائج معقولة ، في حين كانت هناك حالتان بنائج ضعيفة . مع كل ذلك كانت نسبة الانجاز 91.4% .الاستنتاجات : مع ان عملية ازالة القرص القطني المنظاري المخترق للجلد هي طريقة قهرية لعلاج حالات الفتق القطني للاقراص مابين الفقرات و نتائجها معقولة ولكنها لاتخلو من مضاعفات .

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