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Three-dimensional intraoperative imaging with O-arm to establish a working trajectory in percutaneous endoscopic lumbar discectomy
摘要： Introduction: Successful percutaneous endoscopic lumbar discectomy (PELD) requires an appropriate working trajectory. Due to the complexity of spinal anatomy, this is difficult to verify with conventional 2-dimensional fluoroscopy. Aim: Here we assessed the feasibility and utility of the O-arm for establishing the working trajectory for PELD. Material and methods: We retrospectively reviewed the records of 89 patients with lumbar disc herniation who underwent PELD using the O-arm. The working trajectory was evaluated with standard fluoroscopic images or 3-dimensional, volumetric computed tomography scan. Based on the detail provided by the multiplanar view, we confirmed the ideal working trajectory and adjusted the surgical approach accordingly. Results: At the 12-month follow-up, based on MacNab’s criteria, 85.9% of patients showed an excellent or good outcome. There were no major complications. Conclusions: The O-arm provides detailed multiplanar intraoperative high-quality imaging for PELD, and enables the surgeon to ascertain the surgical anatomy, determine the optimal working trajectory, and improve the accuracy of surgery.
关键词： O-arm,disc herniation,intraoperative imaging,percutaneous endoscopic lumbar discectomy,low back pain
更新于2025-09-23 15:21:21
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Photobiomodulation Therapy is Able to Modulate PGE <sub/>2</sub> Levels in Patients With Chronic Nona??Specific Low Back Pain: A Randomized Placeboa??Controlled Trial
摘要： Background and Objectives: Non‐specific low back pain (LBP) is responsible for triggering increased biomarkers levels. In this way, photobiomodulation therapy (PBMT) may be an interesting alternative to treat these patients. One of the possible biological mechanisms of PBMT involved to decrease pain intensity in patients with musculoskeletal disorders is modulation of inflammatory mediators’ levels. The aim of this study was to evaluate the effects of PBMT compared with placebo on inflammatory mediators’ levels and pain intensity in patients with chronic non‐specific LBP. Study Design/Materials and Methods: A prospectively registered, randomized triple‐blinded (volunteers, therapists, and assessors), placebo‐controlled trial was performed. Eighteen patients with chronic non‐specific LBP were recruited and treated with a single session of active PBMT or placebo PBMT. The primary outcome of the study was serum prostaglandin E2 levels and the secondary outcomes were tumor necrosis factor‐α, interleukin‐6 levels, and pain intensity. All outcomes were measured before and after 15 minutes of treatment session. Results: PBMT was able to decrease prostaglandin E2 levels at post‐treatment compared with placebo, with a mean difference of ?1470 pg/ml, 95% confidence interval ?2906 to ?33.67 in patients with LBP. There was no difference between groups in the other measured outcomes. Patients did not report any adverse events. Conclusion: Our results suggest that PBMT was able to modulate prostaglandin E2 levels, indicating that this may be one of the mechanisms involved in the analgesic effects of PBMT in patients with LBP.
关键词： low‐level laser therapy,inflammatory mediators,low back pain,physical therapy,rehabilitation,musculoskeletal disorders
更新于2025-09-23 15:19:57
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High Intensity Laser Therapy for Treatment of Spinal Disorders
摘要： The aim of this systematic review was to evaluate the effectiveness of high intensity laser therapy (HILT) on pain and function in individuals with spinal disorders. Six Electronic databases were searched up to the end of February 2018. In addition, the reference lists of all included studies were searched for any relevant studies. Studies were eligible for inclusion if they met the following criteria: randomised controlled trials (RCTs) assessing the effectiveness of HILT in adult individuals (<18 years old) with spinal disorders, studies must have at least one primary outcome measure of pain and function, and all included studies must be written in English language. PRISMA guidelines were followed to prepare this review. The number in CRD42018090019. PEDro scale and GRADE system were performed to assess the quality of studies. A meta-analysis was conducted to calculate the overall effect size. A total of ten RCTs met the inclusion criteria, with four studies of the ef?cacy of HILT on neck pain (NP) and six on low back pain (LBP). Forest plots showed that HILT with exercise was signi?cantly more effective than placebo HILT with exercise in terms of pain reduction (SMD -1.42 to -0.80; P<0.00001; I2 0%) and functional improvement (SMD -1.03; 95% CI -1.33 to -0.72; P<0.00001; I2 0%). Meta-analyses also showed that HILT alone or HILT with conventional physiotherapy (CPT) signi?cantly provided better outcomes than CPT alone. HILT is considered as a complementary modality for pain reduction and function improvement in individuals with spinal disorders. However, the quality of the body of evidence was rated from ‘very low’ to ‘low’ quality.
关键词： Neck Pain,Rehabilitation,High Intensity Laser Therapy,Low Back Pain,Spinal Disorders
更新于2025-09-16 10:30:52
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Comparison of the effects of low-level laser and pulsed and continuous ultrasound on pain and physical disability in chronic non-specific low back pain: a randomized controlled clinical trial
摘要： Objective: To compare the short-term effects of pulsed laser and pulsed and continuous ultrasound on pain and functional disability in women with chronic non-specific low back pain. Methods: The sample was composed of 100 volunteers randomly allocated into four groups: The Pulsed Laser Group (n = 26) was treated with 3 J/cm2; the Pulsed Ultrasound Group (n = 24; 3 MHz) was treated with 1 W/cm2; the Continuous Ultrasound Group (n = 26; 1 MHz) was treated with 1 W/cm2; and a Control Group (n = 24), where the patients were still waiting for treatment. Before and after 10 sessions of treatment, the intensity of pain was assessed using the visual analogue scale (VAS), the quality of pain was evaluated using the McGill pain questionnaire and functional disability was investigated using the Roland–Morris questionnaire. Results: The three treated groups exhibited a decrease in pain (p < 0.001); the Pulsed Laser Group showed the greater relative gain (91.2%), Meanwhile, the Control Group exhibited a worsening of ? 5.8%. The three treated groups demonstrated improvement in the quality of pain (McGill) in the total, sensory and affective dimensions (p < 0.005; p < 0.002; p < 0.013, respectively). All treated groups showed a decrease in functional disability (p < 0.001), but the Pulsed Ultrasound Group showed the highest relative gain (83.3%). Conclusions: The three modalities have significant effects to decreasing low back pain and improving functional disability in women with non-specific chronic low back pain, but the pulsed low-level laser had the best results on pain while the pulsed ultrasound had the best results on improve the functional disability.
关键词： Laser therapy and ultrasound therapy,Low back pain
更新于2025-09-12 10:27:22