NMNNMN: Curious case of self resolving Lumbar injury

Drdavid
Posts: 711
Joined: Thu Aug 15, 2019 9:59 am

Re: NMN: Curious case of self resolving Lumbar injury

Post by Drdavid » Mon Apr 13, 2020 11:54 am

Here is a great article about lumbar disc injury:

Pakistan Journal of Medical Sciences
Professional Medical Publications
Spontaneous regression of extruded lumbar disc herniation: Correlation with clinical outcome
Bilge Kesikburun, Emel Eksioglu, [...], and Aytul Cakci

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6659070/

Resolution rate with just conservative care


drkris69
Posts: 573
Joined: Tue Aug 20, 2019 2:41 pm

Re: NMN: Curious case of self resolving Lumbar injury

Post by drkris69 » Mon Apr 13, 2020 3:34 pm

Great article DrDavid, out of the 40 patients with disk injuries, 30 of them had complete resolution with conservative treatments. I find in my line of work that if you give the patient the right supplements and proper nutrition along with the conservative care they tend to do very well and have great outcomes.
Drdavid
Posts: 711
Joined: Thu Aug 15, 2019 9:59 am

Re: NMN: Curious case of self resolving Lumbar injury

Post by Drdavid » Mon Apr 20, 2020 10:20 am

Here is an article on outcomes of lumbar surgery

Spine (Phila Pa 1976). 1999 Nov 15;24(22):2313-7.
Seven- to 20-year outcome of lumbar discectomy.
Loupasis GA1, Stamos K, Katonis PG, Sapkas G, Korres DS, Hartofilakidis G.
Author information
Abstract
STUDY DESIGN:
A retrospective, follow-up study.

OBJECTIVES:
To assess the effects of conventional surgery for lumbar disc herniation over an extended period of time and to examine factors that might correlate with unsatisfactory results.

SUMMARY OF BACKGROUND DATA:
Although the short-term results of lumbar discectomy are excellent when there is a proper patient selection, the reported success rates in the long-term follow-up studies vary, and few factors have been implicated for an unsatisfactory outcome.

METHODS:
One hundred-nine patients with surgically documented herniated lumbar disc were analyzed, retrospectively, by an independent observer. Long-term follow-up (mean 12.2 years) was done by a mailed, self-report questionnaire that included items about pain relief in the back and leg, satisfaction with the results, need for analgesics, level of activity, working capacity, and reoperations. Subjective disability was measured by the Oswestry questionnaire. Radiographic review was carried out in 66% of patients. End results were assessed using the modified Stauffer-Coventry's evaluating criteria. Several variables were examined to assess their influence to the outcome.

RESULTS:
The late results were satisfactory in 64% of patients. The mean Oswestry disability score was 18.9. Of the 101 patients who had primary procedures, 28% still complained of significant back or leg pain. Sixty-five percent of patients were very satisfied with their results, 29% satisfied, and 6% dissatisfied. The reoperation rate was 7.3% (8 patients), about one-third of which was due to recurrent disc herniation. Sociodemographic factors predisposing to unsatisfactory outcome, including female gender, low vocational education, and jobs requiring significant physical strenuousness. Disc space narrowing was common at the level of discectomy, but was without prognostic significance.

CONCLUSIONS:
The long-term results of standard lumbar discectomy are not very satisfying. More than one-third of the patients had unsatisfactory results and more than one quarter complained of significant residual pain. Heavy manual work, particularly agricultural work, and low educational level were negative predictors of a good outcome. These indicators should be used preoperatively to identify patients who are at high risk for an unfavorable long-term result.
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