Skip to main content
Top
Published in: Journal of Orthopaedic Surgery and Research 1/2020

01-12-2020 | Discography | Research article

Reoccurring discogenic low back pain (LBP) after discoblock treated by oblique lumbar interbody fusion (OLIF)

Authors: Junhui Liu, Yongqing He, Bao Huang, Xuyang Zhang, Zhi Shan, Jian Chen, Shunwu Fan, Fengdong Zhao

Published in: Journal of Orthopaedic Surgery and Research | Issue 1/2020

Login to get access

Abstract

Objective

To determine the efficacy of OLIF in the treatment of reoccurring discogenic low back pain (LBP) after discoblock

Methods

We included 108 patients with LBP that was suspected to be discogenic (such as high intensity zone, Schmorl’s nodes, Modic changes Type I, etc.), from August 2015 to August 2017. All patients underwent discography, and patients whose LBP was confirmed to be discogenic received discoblock. Patients who had reoccurring pain after discoblock underwent OLIF. Perioperative parameters and complications were recorded. The VAS and Oswestry Disability Index (ODI) were assessed at preoperation, and 1 week and 1, 3, 6, and 12 months after the surgery. The fusion rate was evaluated.

Results

Of 108 patients, 89 were confirmed to have discogenic LBP, and 32/89 patients with reoccurring LBP pain after discoblock underwent OLIF. Twenty-eight patients were followed up for ≥ 1 year. The OLIF operation lasted for 92 ± 34 min. Blood loss during the operation was 48 ± 15 ml. The mean incision length was 3.0 ± 0.6 cm. The average length of stay was 4.8 ± 1.9 days. The VAS and ODI scores decreased from 8.1 ± 1.7 preoperatively to 0.9 ± 0.4, and from 71.2 ± 11.3 to 9.3 ± 3.1, 12 months postoperatively, respectively. The total incidence of complications was 15.6%, including 2 cases of cage subsidence, 2 cases of ipsilateral hip flexor weakness, and 1 case of ipsilateral anterior thigh pain. All symptoms relieved or disappeared during follow-up. The fusion rate was 96.9%.

Conclusions

Reoccurring discogenic LBP after discoblock should be considered as a suitable group for treatment by OLIF.
Literature
1.
go back to reference Yakovlev A, Tamimi MA, Liang H, Eristavi M. Outcomes of percutaneous disc decompression utilizing nucleoplasty for the treatment of chronic discogenic pain. Pain physician. 2007;10(2):319–28.PubMed Yakovlev A, Tamimi MA, Liang H, Eristavi M. Outcomes of percutaneous disc decompression utilizing nucleoplasty for the treatment of chronic discogenic pain. Pain physician. 2007;10(2):319–28.PubMed
6.
go back to reference Helm Ii S, Simopoulos TT, Stojanovic M, Abdi S, El Terany MA. Effectiveness of thermal annular procedures in treating discogenic low back pain. Pain Physician. 2017;20(6):447–70.PubMed Helm Ii S, Simopoulos TT, Stojanovic M, Abdi S, El Terany MA. Effectiveness of thermal annular procedures in treating discogenic low back pain. Pain Physician. 2017;20(6):447–70.PubMed
14.
go back to reference Cassinelli EH, Hall RA, Kang JD. Biochemistry of intervertebral disc degeneration and the potential for gene therapy applications. Spine J. 2001;1(3):205–14.CrossRef Cassinelli EH, Hall RA, Kang JD. Biochemistry of intervertebral disc degeneration and the potential for gene therapy applications. Spine J. 2001;1(3):205–14.CrossRef
15.
go back to reference Crock HV. Internal disc disruption. A challenge to disc prolapse fifty years on. Spine. 1986;11(6):650–3.CrossRef Crock HV. Internal disc disruption. A challenge to disc prolapse fifty years on. Spine. 1986;11(6):650–3.CrossRef
16.
go back to reference Bogduk N. The lumbar disc and low back pain. Neurosurg Clin N Am. 1991;2(4):791–806.CrossRef Bogduk N. The lumbar disc and low back pain. Neurosurg Clin N Am. 1991;2(4):791–806.CrossRef
17.
go back to reference Schwarzer AC, Aprill CN, Derby R, Fortin J, Kine G, Bogduk N. The prevalence and clinical features of internal disc disruption in patients with chronic low back pain. Spine. 1995;20(17):1878–83.CrossRef Schwarzer AC, Aprill CN, Derby R, Fortin J, Kine G, Bogduk N. The prevalence and clinical features of internal disc disruption in patients with chronic low back pain. Spine. 1995;20(17):1878–83.CrossRef
18.
go back to reference Chen ZY, Ma L, Li T. Imaging of low back pain: comparative role of high intensity zone in diagnosing the discogenic low back pain with evidence-based radiology. Chin Med J. 2009;122(24):3062–5.PubMed Chen ZY, Ma L, Li T. Imaging of low back pain: comparative role of high intensity zone in diagnosing the discogenic low back pain with evidence-based radiology. Chin Med J. 2009;122(24):3062–5.PubMed
19.
go back to reference Schellhas KP, Pollei SR, Gundry CR, Heithoff KB. Lumbar disc high-intensity zone. Correlation of magnetic resonance imaging and discography. Spine. 1996;21(1):79–86.CrossRef Schellhas KP, Pollei SR, Gundry CR, Heithoff KB. Lumbar disc high-intensity zone. Correlation of magnetic resonance imaging and discography. Spine. 1996;21(1):79–86.CrossRef
22.
go back to reference Deyo RA, Gray DT, Kreuter W, Mirza S, Martin BI. United States trends in lumbar fusion surgery for degenerative conditions. Spine. 2005;30(12):1441–5 discussion 6-7.CrossRef Deyo RA, Gray DT, Kreuter W, Mirza S, Martin BI. United States trends in lumbar fusion surgery for degenerative conditions. Spine. 2005;30(12):1441–5 discussion 6-7.CrossRef
Metadata
Title
Reoccurring discogenic low back pain (LBP) after discoblock treated by oblique lumbar interbody fusion (OLIF)
Authors
Junhui Liu
Yongqing He
Bao Huang
Xuyang Zhang
Zhi Shan
Jian Chen
Shunwu Fan
Fengdong Zhao
Publication date
01-12-2020
Publisher
BioMed Central
Published in
Journal of Orthopaedic Surgery and Research / Issue 1/2020
Electronic ISSN: 1749-799X
DOI
https://doi.org/10.1186/s13018-020-1554-6

Other articles of this Issue 1/2020

Journal of Orthopaedic Surgery and Research 1/2020 Go to the issue