Displaying publications 1 - 20 of 22 in total

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  1. Tamburrelli FC, Perna A, Oliva MS, Giannelli I, Genitiempo M
    Malays Orthop J, 2018 Nov;12(3):47-49.
    PMID: 30555647 DOI: 10.5704/MOJ.1811.012
    Disc herniation is one of most common causes of spine surgery. Because of the presence of posterior longitudinal ligaments, disc fragments often migrate into the ventral epidural space. A posterior epidural herniation of a disc fragment is a rare occurrence. We report two cases of posterior migrated disc fragments, with, radiological and clinical findings. Because of the rarity of a posterior migration of the intervertebral disc fragments, a differential diagnosis can be challenging. This painful syndrome associated with neurological lower limb deficits can be confused initially, with other posterior epidural space-occupying lesions such as tumours, abscess or hematomas. A gadolinium-enhanced MRI scan is the gold standard for a correct diagnosis. Early surgical decompression of the spine with a posterior approach remains the optimal technique in ensuring the best possible outcome for the patient.
    Matched MeSH terms: Intervertebral Disc; Intervertebral Disc Displacement; Intervertebral Disc Degeneration
  2. Pallie W, Manuel JK
    Med J Malaya, 1968 Dec;23(2):96-7.
    PMID: 4240828
    Matched MeSH terms: Intervertebral Disc Displacement/diagnosis; Intervertebral Disc Displacement/pathology*
  3. Lee D, Loh E, Kueh C, Poi J, Francis T, Koh KC, et al.
    Malays Orthop J, 2013 Jul;7(2):18-20.
    PMID: 25722820 MyJurnal DOI: 10.5704/MOJ.1307.009
    We set out to assess the efficacy of radiofrequency-induced intradiscal nucleoplasty in reducing pain in symptomatic patients with MRI-defined lumbar disc herniation and their satisfaction with the procedure. We compared the patients' pain intensity and severity of disability scores before and after undergoing the procedure in a retrospective questionnaire. These patients reported statistically significant reduction of pain intensity and disability level after the procedure. We conclude that radiofrequencyinduced intradiscal nucleoplasty is an acceptable alternative minimally invasive procedure in relieving the symptoms of patients with lumbar disc herniation.
    Matched MeSH terms: Intervertebral Disc Displacement; Intervertebral Disc Degeneration
  4. Masni-Azian, Tanaka M
    Comput Biol Med, 2018 07 01;98:26-38.
    PMID: 29758454 DOI: 10.1016/j.compbiomed.2018.05.010
    Intervertebral disc degeneration involves changes in its material properties that affect the mechanical functions of the spinal system. However, the alteration of the biomechanics of a spinal segment through specific material degradation in a specific region is poorly understood. In this study, the influence of the constitutive material degeneration of disc tissues on the mechanics of a lower lumbar spinal unit was examined using a three-dimensional nonlinear finite element model of the L4-L5 functional spinal unit. Different grades of disc degeneration were simulated by introducing a degeneration factor to the corresponding material properties to represent fibrous nucleus, increased fibre and ground substance laxity, increased fibre stiffness and total annular fracture along posterior and posterolateral regions. The model was loaded with an axial compression of 500 N and pure moments of up to 10 Nm to simulate extension, flexion, lateral bending and axial rotation. To validate the model, the spinal motion and intradiscal pressure of healthy and degenerated discs with existing in vitro data were compared. The disc with a fibrous nucleus and the presence of intradiscal pressure increase the spinal instability during flexion and axial rotation, and the absence of intradiscal pressure increases the spinal instability in all directions. Bulging displacement and shear strains in the disc with total fracture and ground substance laxity are high in all of the loading cases. Our study could provide useful information to enhance our understanding of the influence of each constitutive component of the intervertebral disc on the mechanics of the spinal segment.
    Matched MeSH terms: Intervertebral Disc/physiology*; Intervertebral Disc Degeneration/physiopathology*
  5. Marliana A, Yudianta S, Subagya DW, Setyopranoto I, Setyaningsih I, Tursina Srie C, et al.
    Med J Malaysia, 2020 03;75(2):124-129.
    PMID: 32281592
    INTRODUCTION: In recent years, pulsed radiofrequency (PR) has been used as a minimally invasive pain intervention. However, various studies on the efficacy of PR as modalities for the treatment of radicular pain in lumbar disc herniation have had varied results.

    OBJECTIVE: This study aims to determine the efficacy of PR in reducing radicular pain among lumbar disc herniation patients compared with conservative treatment.

    METHODS: This study was conducted using the before-andafter quasi experimental design. There were 50 subjects that fulfilled the inclusion and exclusion criteria and they were divided into an intervention group (n=25) and control group (n=25). The intervention group was given once PR in the dorsal root ganglion. All subjects were assessed for Visual Analog Scale (VAS) and Oswestry Disability Index (ODI) before treatment, at 1- , 2- and 4-week after treatment.

    RESULTS: At1-, 2- and 4-week, the VAS reduction in the intervention group was statistically significant compared to the control group. Four weeks after the intervention, the VAS score decreased in the intervention group (mean VAS -78.5, SD 16.8) more significantly compared to the control group (p<0.001). The ODI score decreased in the intervention group (mean ODI -61.8, SD 20.1) more significantly than in the control group (p<0.001).

    CONCLUSION: Finding showed that at1- , 2- and 4-weekPR was more efficacious in reducing radicular pain among lumbar disc herniation patients compared to the conservative therapy.

    Matched MeSH terms: Intervertebral Disc Displacement; Intervertebral Disc Degeneration
  6. Chiu CK, Tan CS, Chung WH, Mohamad SM, Kwan MK, Chan CYW
    Eur Spine J, 2021 07;30(7):1978-1987.
    PMID: 34023966 DOI: 10.1007/s00586-021-06874-5
    PURPOSE: To investigate mid-long-term effects of the lowest instrumented vertebra (LIV) selection on adolescent idiopathic scoliosis (AIS) patients who had posterior spinal fusion (PSF) surgery.

    METHODS: Forty-eight patients were recruited. Inclusion criteria were AIS patients who have had PSF surgery more than 10 years ago. Patients were divided into G1: LIV L3 or higher and G2: LIV L4 or lower. MRI evaluation was classified using Pfirrmann grades. Pfirrmann scores were average of Pfirrmann grades for all unfused discs below LIV. SRS-22r, SF-36, Oswestry Disability Index (ODI) and Modified Cincinnati Sports Activity Scale (MCSAS) were used.

    RESULTS: There were 19 patients in G1 and 29 patients in G2. Demographic parameters showed no significant differences. We found no significant differences in Pfirrmann grades or scores between G1 and G2. There was significant correlation between age and mean Pfirrmann scores (r = 0.546, p disc + 1 below LIV (r = 0.475, p = 0.001) and adjacent disc below LIV (r = 0.365, p = 0.011). G2 had significantly lower scores for SRS-22r pain (G1: 4.3 ± 0.5, G2: 4.0 ± 0.6, p = 0.044) and the SF-36 bodily pain (G1: 88.7 ± 12.3, G2: 77.8 ± 18.7, p = 0.018) domains. There were no significant differences in ODI and MCSAS between the two groups.

    CONCLUSIONS: Patients with fusion to L4 or lower had more significant back pain. However, both groups had similar physical function, self-image, satisfaction with treatment, mental health, and functional sports activity. We did not find any significant association between lumbar discs degeneration and the selection of LIV.

    Matched MeSH terms: Intervertebral Disc*
  7. Subhan RA, Puvanan K, Murali MR, Raghavendran HR, Shani S, Abdullah BJ, et al.
    ScientificWorldJournal, 2014;2014:818502.
    PMID: 24983002 DOI: 10.1155/2014/818502
    This study was conducted to develop a technique for minimally invasive and accurate delivery of stem cells to augment nucleus pulposus (NP) in damaged intervertebral discs (IVD). IVD damage was created in noncontiguous discs at L4-L5 level; rabbits (N = 12) were randomly divided into three groups: group I treated with MSCs in HyStem hydrogel, group II treated with HyStem alone, and group III received no intervention. MSCs and hydrogel were administered to the damaged disc under guidance of fluoroscopy. Augmentation of NP was assessed through histological and MRI T2 mapping of the NP after eight weeks of transplantation. T2 weighted signal intensity was higher in group I than in groups II and III (P < 0.05). Disc height index showed maximum disc height in group I compared to groups II and III. Histological score of the degenerative index was significantly (P < 0.05) lower in group I (8.6 ± 1.8) than that in groups II (11.6 ± 2.3) and III (18.0 ± 5.7). Immunohistochemistry staining for collagen type II and aggrecan staining were higher in group I as compared to other groups. Our results demonstrate that the minimally invasive administration of MSCs in hyaluronan hydrogel (HyStem) augments the repair of NP in damaged IVD.
    Matched MeSH terms: Intervertebral Disc/pathology*; Intervertebral Disc Degeneration/pathology*; Intervertebral Disc Degeneration/therapy*
  8. Choy WJ, Phan K, Diwan AD, Ong CS, Mobbs RJ
    BMC Musculoskelet Disord, 2018 Aug 16;19(1):290.
    PMID: 30115053 DOI: 10.1186/s12891-018-2213-5
    BACKGROUND: Lumbar intervertebral disc herniation is a common cause of lower back and leg pain, with surgical intervention (e.g. discectomy to remove the herniated disc) recommended after an appropriate period of conservative management, however the existing or increased breach of the annulus fibrosus persists with the potential of reherniation. Several prosthesis and techniques to reduce re-herniation have been proposed including implantation of an annular closure device (ACD) - Barricaid™ and an annular tissue repair system (AR) - Anulex-Xclose™. The aim of this meta-analysis is to assist surgeons determine a potential approach to reduce incidences of recurrent lumbar disc herniation and assess the current devices regarding their outcomes and complications.

    METHODS: Four electronic full-text databases were systematically searched through September 2017. Data including outcomes of annular closure device/annular repair were extracted. All results were pooled utilising meta-analysis with weighted mean difference and odds ratio as summary statistics.

    RESULTS: Four studies met inclusion criteria. Three studies reported the use of Barricaid (ACD) while one study reported the use of Anulex (AR). A total of 24 symptomatic reherniation were reported among 811 discectomies with ACD/AR as compared to 51 out of 645 in the control group (OR: 0.34; 95% CI: 0.20,0.56; I2 = 0%; P disc reherniation with low post-operative complication rates. Long-term studies are required to further investigate the efficacy of such devices.

    Matched MeSH terms: Intervertebral Disc/physiopathology; Intervertebral Disc/surgery*; Intervertebral Disc Displacement/physiopathology; Intervertebral Disc Displacement/surgery*
  9. Wong, C.C., Loke, W.P.
    Malays Orthop J, 2007;1(1):1-4.
    MyJurnal
    Percutaneous endoscopic spinal surgery performed in the awake state offers a new paradigm for treatment of symptomatic lumbar disc prolapse. We report the outcome of 23 patients who underwent this procedure. Visual analogue scale for pain improved from 7.3 to 2.1; 19 of the 23 patients achieved good to excellent results according to the MacNab criteria. Patient acceptance of the procedure was 91.3%. All but one patient were discharged from hospital within 24 hours. One patient developed foot drop post-operatively. There was no incidence of dural tear, post-operative infection or worsening of symptoms. We conclude that this is a safe, effective, and well-tolerated procedure.
    Matched MeSH terms: Intervertebral Disc Displacement
  10. Yusof MI, Hassan MN, Abdullah MS
    Malays Orthop J, 2018 Mar;12(1):21-25.
    PMID: 29725508 MyJurnal DOI: 10.5704/MOJ.1803.004
    Introduction: The vertical diameter of the foramen is dependent upon the vertical diameter of the corresponding intervertebral disc. A decrease in disc vertical diameter has direct anatomic consequences to the foraminal diameter and area available for the nerve root passing through it. This study is to establish the relationship amongst the intervertebral disc vertical diameter, lateral foramen diameters and nerve root compression in the lumbar vertebra. Materials and Methods: Measurements of the study parameters were performed using sagittal MRI images. The parameters studied were: intervertebral disc vertical diameter (DVD), foraminal vertical diameter (FVD), foraminal transverse diameter (FTD) and nerve root diameter (NRD) of both sides. The relationship between the measured parameters were then analyzed. Results: A total of 62 MRI images were available for this study. Statistical analysis showed moderate to strong correlation between DVD and FVD at all the lumbar levels except at left L23 and L5S1 and right L3L4 and L4L5. Correlation between DVD and FTD were not significant at all lumbar levels. Regression analysis showed that a decrease of 1mm of DVD was associated with 1.3, 1.7, 3.3, 3.3 and 1.3mm reduction of FVD at L1L2, L2L3, L3L4, L4L5 and L5S1 respectively. Conclusion: Reduction of DVD was associated with reduction of FVD. However, FVD was relatively wide for the nerve root even with complete loss of DVD. FTD was much narrower than the FVD making it more likely to cause nerve root compression at the exit foramina. These anatomical details should be given consideration in treating patients with lateral canal stenosis.
    Matched MeSH terms: Intervertebral Disc
  11. Farina MY, Harunarashid H, Faridzal F, Jegan T, Das S
    Clin Ter, 2012 Nov;163(6):491-3.
    PMID: 23306743
    The availability of multiple investigating modalities should be utilized to arrive at the correct diagnosis of the spinal arteriovenous malformation (AVM). We hereby report the case of a 21-year-old, obese female, who presented with paraplegia and impaired bowel control two years after an episode of the fall. The Magnetic Resonance Imaging (MRI) of her spine not only revealed disc prolapse at T11-T12, but also tortuous dilated spinal veins and cord oedema. A diagnosis of a spinal arterio-venous fistula was confirmed after a spinal angiogram. The dilemma of treating the right pathology for the clinical signs and symptoms are being discussed.
    Matched MeSH terms: Intervertebral Disc Displacement/etiology*
  12. Arumugasamy N
    Med J Malaya, 1969 Jun;23(4):250-2.
    PMID: 4242169
    Matched MeSH terms: Intervertebral Disc Displacement/complications*
  13. Masni-Azian, Tanaka M
    Comput Methods Biomech Biomed Engin, 2017 Aug;20(10):1066-1076.
    PMID: 28532164 DOI: 10.1080/10255842.2017.1331345
    In the biomechanics field, material parameters calibration is significant for finite element (FE) model to ensure a legit estimation of biomechanical response. Determining an appropriate combination of calibration factors is challenging as each constitutive component responds differently. This study proposes a statistical factorial analysis approach using L16(4(5)) orthogonal array to evaluate material nonlinearity and applicable calibration factor of the intervertebral disc FE model in pure moment. The calibrated model exhibits improved agreement to the experimental findings for all directions. Appropriate combination of calibration parameter reduces the estimation gap to the experimental findings, ensuring agreeable biomechanical responses.
    Matched MeSH terms: Intervertebral Disc/physiology*
  14. Kaliya-Perumal AK, Yeh YC, Luo CA, Joey-Tan KY
    Clin Orthop Surg, 2017 Mar;9(1):71-76.
    PMID: 28261430 DOI: 10.4055/cios.2017.9.1.71
    BACKGROUND: The technique used to administer a selective nerve root block (SNRB) varies depending on individual expertise. Both the anteroposterior (AP) subpedicular approach and oblique Scotty dog subpedicular approach are widely practiced. However, the literature does not provide a clear consensus regarding which approach is more suitable. Hence, we decided to analyse the procedural parameters and clinical outcomes following SNRBs using these two approaches.

    METHODS: Patients diagnosed with a single lumbar herniated intervertebral disc (HIVD) refractory to conservative management but not willing for immediate surgery were selected for a prospective nonrandomized comparative study. An SNRB was administered as a therapeutic alternative using the AP subpedicular approach in one group (n = 25; mean age, 45 ± 5.4 years) and the oblique Scotty dog subpedicular approach in the other group (n = 22; mean age, 43.8 ± 4.7 years). Results were compared in terms of the duration of the procedure, the number of C-arm exposures, accuracy, pain relief, functional outcome and the duration of relief.

    RESULTS: Our results suggest that the oblique Scotty dog subpedicular approach took a significantly longer duration (p = 0.02) and a greater number of C-arm exposures (p = 0.001). But, its accuracy of needle placement was 95.5% compared to only 72% using the AP subpedicular approach (p = 0.03). There was no significant difference in terms of clinical outcomes between these approaches.

    CONCLUSIONS: The AP subpedicular approach was simple and facile, but the oblique Scotty dog subpedicular approach was more accurate. However, a brief window period of pain relief was achieved irrespective of the approaching technique used.

    Matched MeSH terms: Intervertebral Disc Displacement/complications
  15. Zahari SN, Latif MJA, Rahim NRA, Kadir MRA, Kamarul T
    J Healthc Eng, 2017;2017:9618940.
    PMID: 29065672 DOI: 10.1155/2017/9618940
    The present study was conducted to examine the effects of body weight on intradiscal pressure (IDP) and annulus stress of intervertebral discs at lumbar spine. Three-dimensional finite element model of osseoligamentous lumbar spine was developed subjected to follower load of 500 N, 800 N, and 1200 N which represent the loads for individuals who are normal and overweight with the pure moments at 7.5 Nm in flexion and extension motions. It was observed that the maximum IDP was 1.26 MPa at L1-L2 vertebral segment. However, the highest increment of IDP was found at L4-L5 segment where the IDP was increased to 30% in flexion and it was more severe at extension motion reaching to 80%. Furthermore, the maximum annulus stress also occurred at the L1-L2 segment with 3.9 MPa in extension motion. However, the highest increment was also found at L4-L5 where the annulus stress increased to 17% in extension motion. Based on these results, the increase of physiological loading could be an important factor to the increment of intradiscal pressure and annulus fibrosis stress at all intervertebral discs at the lumbar spine which may lead to early intervertebral disc damage.
    Matched MeSH terms: Intervertebral Disc/physiology*
  16. Yusof MI, Hassan E, Rahmat N, Yunus R
    Spine (Phila Pa 1976), 2009 Apr 1;34(7):713-7.
    PMID: 19333105 DOI: 10.1097/BRS.0b013e31819b2159
    Pedicle involvement in spinal tuberculosis (TB), the prevertebral abscess formation, severity of vertebral body, and disc collapse were evaluated from magnetic resonance imaging (MRI) of the patients.
    Matched MeSH terms: Intervertebral Disc Displacement/etiology; Intervertebral Disc Displacement/pathology; Intervertebral Disc Displacement/physiopathology
  17. Jain P, Sing Ngie DC, Lim SF, Lim BH
    Int J Artif Organs, 2020 Oct 13.
    PMID: 33045876 DOI: 10.1177/0391398820964483
    Pedicular arthrodesis is the traditional procedure in terms of increase in the biomechanical stability with higher fixation rate. The current work aims to identify the effect of three spinal pedicle screws considering cortical and cancellous degeneracy condition. Lumbar section L2-L3 is utilized and various load and moment conditions were applied to depict the various biomechanical parameters for selection of suitable screw. Three dimensional model is considered in finite element analysis to identify the various responses of pedicle screw at bone screw juncture. Computed tomography (CT) images of a healthy male were considered to generate the finite element vertebral model. Generated intact model was further utilized to develop the other implanted models of degenerated cortical and cancellous bone models. The three fused instrumented models with different cortical and cancellous degeneracy conditions were analyzed in finite element analysis. The results were obtained as stress pattern at bone screw boundary and intervertebral disc stress. FE simulated results represents significant changes in the von Mises stress due to various load and moment conditions on degenerated bones during different body movement conditions. Results have shown that among all pedicle screws, the 6.0 mm diameter screw reflects very less stress values at the juncture. Multiple results on biomechanical aspects obtained during the FE study can be considered to design a new stabilization device and may be helpful to plan surgery of critical sections.
    Matched MeSH terms: Intervertebral Disc
  18. Sureisen M, Tan BB, Teo YY, Wong CC
    Malays Orthop J, 2015 Nov;9(3):58-60.
    PMID: 28611913 MyJurnal DOI: 10.5704/MOJ.1511.009
    Breakage of the tip of the micropituitary forceps during spine surgery is a rare occurrence. Retrieval of the broken tip could be a challenge in minimally invasive surgeries due to limitation of access and retrieval instruments. We describe our experience in handling such a situation during percutaneous radiofrequency discectomy. The removal was attempted, without converting into open surgery, by utilising percutaneous endoscopic lumbar discectomy working cannula and guided by image intensifier. We were able to remove the fragment without any significant morbidity to the patient. This technique for removal has not been reported previously in the literature.
    Matched MeSH terms: Intervertebral Disc Displacement
  19. Gunduz OH, Sencan S, Ercalik T, Suhaimi A
    Pain Med, 2017 08 01;18(8):1594-1597.
    PMID: 28087843 DOI: 10.1093/pm/pnw303
    Matched MeSH terms: Intervertebral Disc Displacement/complications
  20. Sha'ban M, Yoon SJ, Ko YK, Ha HJ, Kim SH, So JW, et al.
    J Biomater Sci Polym Ed, 2008;19(9):1219-37.
    PMID: 18727862 DOI: 10.1163/156856208785540163
    Previously, we have proven that fibrin and poly(lactic-co-glycolic acid) (PLGA) scaffolds facilitate cell proliferation, matrix production and early chondrogenesis of rabbit articular chondrocytes in in vitro and in vivo experiments. In this study, we evaluated the potential of fibrin/PLGA scaffold for intervertebral disc (IVD) tissue engineering using annulus fibrosus (AF) and nucleus pulposus (NP) cells in relation to potential clinical application. PLGA scaffolds were soaked in cells-fibrin suspension and polymerized by dropping thrombin-sodium chloride (CaCl(2)) solution. A PLGA-cell complex without fibrin was used as control. Higher cellular proliferation activity was observed in fibrin/PLGA-seeded AF and NP cells at each time point of 3, 7, 14 and 7 days using the MTT assay. After 3 weeks in vitro incubation, fibrin/PLGA exhibited a firmer gross morphology than PLGA groups. A significant cartilaginous tissue formation was observed in fibrin/PLGA, as proven by the development of cells cluster of various sizes and three-dimensional (3D) cartilaginous histoarchitecture and the presence of proteoglycan-rich matrix and glycosaminoglycan (GAG). The sGAG production measured by 1,9-dimethylmethylene blue (DMMB) assay revealed greater sGAG production in fibrin/PLGA than PLGA group. Immunohistochemical analyses showed expressions of collagen type II, aggrecan core protein and collagen type I genes throughout in vitro culture in both fibrin/PLGA and PLGA. In conclusion, fibrin promotes cell proliferation, stable in vitro tissue morphology, superior cartilaginous tissue formation and sGAG production of AF and NP cells cultured in PLGA scaffold. The 3D porous PLGA scaffold-cell complexes using fibrin can provide a vehicle for delivery of cells to regenerate tissue-engineered IVD tissue.
    Matched MeSH terms: Intervertebral Disc/cytology*
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