Subscribe to the ChiroACCESS RSS Feed

News at ChiroACCESS

Predicting Repeat of Disc Herniations: Chiropractic Implications



Published on November 27, 2009

Text Size:   (-) Decrease the text size for the main body of this article    (+) Increase the text size for the main body of this article
Share this:  Add to TwitterAdd to DiggAdd to del.icio.usAdd to FacebookAdd to GoogleAdd to LinkedInAdd to MixxAdd to MySpaceAdd to NewsvineAdd to RedditAdd to StumbleUponAdd to Yahoo
A retrospective study from the November 15th issue of Spine evaluated radiographs for biomechanical and other markers that would help identify patients at risk for repeat lumbar disc herniation.  A repeat was defined as a herniation of the same disc after a “successful” first surgery where the patient was asymptomatic for a period of at least six months.  The study analyzed a group of 157 disc surgery patients to determine risk factors that might help predict which patients would have repeat herniations.

Low Back PainVery similar to the co-morbidities seen with low back pain in chiropractic practice, risk factors for repeat herniation included lifestyle factors; the most significant were smoking and obesity.  The smoking rate of recurring disc herniation patients was 71.4% and the smoking rate for patients who did not have recurring herniation was only 38.5%.  Previous studies have demonstrated that smoking promotes disc degeneration and decreases circulation that is necessary to nurture the disc and facilitate healing when there is disc damage.  

In addition to smoking, disc height, reduced range of motion, and disc degeneration were significant risk factors for patients with repeat lumbar disc herniation.   Patients who have had previous disc surgery are common in chiropractic practice.  Educating patients about these risk factors and aiding them in making the appropriate lifestyle changes can help prevent recurrent herniation and future surgery.

Disc height and segmental motion as risk factors for recurrent lumbar disc herniation.

Spine (Phila Pa 1976). 2009 Nov 15;34(24):2674-8.

Kim KT, Park SW, Kim YB.
Department of Neurosurgery, College of Medicine, Chung-Ang University, Chung-Ang University Hospital, Seoul, Korea.

STUDY DESIGN: Retrospective review and multivariate analysis.

OBJECTIVES: Recurrent lumbar disc herniation (rLDH) is a repeated disc herniation at a previously operated disc level in patients who experienced a pain-free interval of at least 6 months after surgery. We investigated whether the preoperative radiologic biomechanical factors (disc height index [DHI] and sagittal range of motion [sROM]) have any effect on rLDH.

SUMMARY OF BACKGROUND DATA: rLDH has been reported in 5% to 15% of patients. There have been many studies suggesting various risk factors for rLDH, such as disc degeneration, trauma, age, smoking, gender, and obesity. However, these factors did not reflect a biomechanical effect on the affected joint directly. Investigation of DHI and sROM would be helpful to understand the biomechanical impact on the occurrence of rLDH.

METHODS: This study enrolled 157 patients who underwent surgery for L4-L5 LDH. We divided the patients into the recurrent and the nonrecurrent group and compared their clinical parameters (age, sex, body-mass index, symptom duration, diabetes, smoking, herniation type, preoperative visual analogue scale) and preoperative radiologic parameters (disc degeneration, DHI, sROM).

RESULTS: rLDH occurred at 40.8+/-15.5 months (7-70 months) after primary surgery. Mean DHI was 0.37+/-0.09 and 0.29+/-0.09 in the recurrent and the nonrecurrent group, respectively (P<0.05). Mean sROM was 11.3 degrees+/-2.9 degrees and 5.9 degrees+/-3.7 degrees in the recurrent and the nonrecurrent group, respectively (P<0.05). Both smoking and disc degeneration were related with the development of rLDH (P<0.05).

CONCLUSION: Together with our data, DHI and sROM showed a significant correlation with the incidence of recurrent lumbar disc herniation, suggesting that preoperative biomechanical conditions of the spine can be an important pathogenic factor in the site of lumbar disc surgery.
Share this:  Add to TwitterAdd to DiggAdd to del.icio.usAdd to FacebookAdd to GoogleAdd to LinkedInAdd to MixxAdd to MySpaceAdd to NewsvineAdd to RedditAdd to StumbleUponAdd to Yahoo

Other Chiropractic News

ChiroACCESS News Chiropractic Institution News Organization News
Most recent news at ChiroACCESS RSS Feed
TIHC is dedicated to advancing the integration of multiple disciplines, both complementary and mainstream, into diverse health care settings in order to provide optimal patient care.

No Affiliation - April 6, 2015

TIHC is dedicated to advancing the integration of multiple disciplines, both complementary and mainstream, into diverse health care settings in order to provide optimal patient care.

No Affiliation - January 19, 2015

TIHC is dedicated to advancing the integration of multiple disciplines, both complementary and mainstream, into diverse health care settings in order to provide optimal patient care.

ChiroACCESS - September 30, 2014

TIHC is dedicated to advancing the integration of multiple disciplines, both complementary and mainstream, into diverse health care settings in order to provide optimal patient care.

ChiroACCESS - June 30, 2014

TIHC is dedicated to advancing the integration of multiple disciplines, both complementary and mainstream, into diverse health care settings in order to provide optimal patient care.

ChiroACCESS - March 27, 2014



Recently Published Articles

Survey Attributes, Development, Utilization, and Interpretation in Healthcare Research

Surveys are critical to discovering data trends and encouraging modifications in clinical treatment guidelines. The questions should focus on set domains, but be capable of accommodating all relevant answers. Survey questions should be tested to ensure they....

ChiroACCESS - January 14, 2016

Traditional Versus a Modified Problem-based Learning Activity: Is There a Difference in Student Knowledge Retention?

Objective: This comparative study of a modified problem based learning activity examined the knowledge retention immediately after instruction and at six weeks post-instruction in two groups of students who were....

ChiroACCESS - July 8, 2014

Supportive Pad Impact on Upper Extremity Blood Flow While Wearing a Military Backpack

Introduction: The Spine Buddy® supportive pad was developed to be inserted underneath military backpacks to help disperse heavy loads.

Purpose: The purpose of this....

ChiroACCESS - July 8, 2014

Recommendations to the Musculoskeletal Health Network, Health Department of Western Australia related to the Spinal Pain Model of Care made on behalf of the Chiropractors Association of Australia (Western Australian Branch)

The 2009 Spinal Model of Care published by the Western Australian Health Department via the Musculoskeletal Health Network would benefit from an update.

ChiroACCESS - July 8, 2014

The Impact of the Laser Gym® Device on Limits of Stability, Functional Mobility, Standing Balance, and Gait of Older Females

Preliminarily the results suggest that the action of the pelvic exercises performed using the Laser Gym® device may marginally improve limits of stability of older women. The implications of repeated training on the Laser Gym® device compared to other fall....

ChiroACCESS - January 10, 2014



Subscribe to the ChiroACCESS RSS Feed
ChiroACCESS on Facebook
Follow ChiroACCESS on Twitter