Can you rehydrate a herniated disc

A limited discectomy should be performed in patients with Pfirrmann grade 1—2 degeneration because of the high risk of recurrence. It is likely that aggressive subtotal discectomy led to fusion in the patient shown in Fig. Our study was mainly limited by the short follow-up period. A longer follow-up period may provide more consistent conclusions. In addition, further randomized clinical trials are needed to prove that DSSs can facilitate disc regeneration. We conclude that there are three possible results after DSS application: 1 disc rehydration, 2 no change, and 3 fusion.

We observed no relationship between radiological and clinical results. Conflict of Interest: No potential conflict of interest relevant to this article was reported. National Center for Biotechnology Information , U. Journal List Asian Spine J v. Asian Spine J. Published online Jun Find articles by Atilla Yilmaz. Find articles by Salim Senturk. Find articles by Mehdi Sasani. Find articles by Tunc Oktenoglu. Find articles by Onur Yaman.

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Corresponding author. Corresponding author: Ali Fahir Ozer. This article has been cited by other articles in PMC. Abstract Study Design A retrospective study investigating decrease in the nucleus pulposus signal intensity or disc height on magnetic resonance imaging MRI and disc degeneration.

Purpose Although a degenerated disc cannot self-regenerate, distraction or stabilization may provide suitable conditions for rehydration and possible regeneration.

Methods Fifty-nine patients mean age, Conclusions Our observations support the theory that physiological movement and a balanced load distribution are necessary for disc regeneration. Keywords: Intervertebral disc degeneration, Instrumentation, Regeneration, Rehydration. Introduction The intervertebral disc IVD is the most important stabilizing and load-bearing structure in the spinal column and is also among the main causes of back pain [ 1 ].

Materials and Methods 1. Study design Fifty-nine patients 33 females and 26 males with segmental instability and DDD painful black disc who underwent a DSS procedure between and and participated in follow-up MRI scans were included in the study.

Table 1 Demographic data of the 59 patients. Open in a separate window. Radiological examinations MRI was performed on a 1-T scanner Siemens Magnetom Espree; Siemens AG, Erlangen, Germany , using the following parameters for sagittal plain T2-weighted imaging: repetition time, 3, millieconds; echo time, milliseconds; and slice thickness, 4 mm.

Clinical evaluation The patients' quality of life and back pain scores were evaluated using the Oswestry disability index ODI and visual analog pain scale VAS; 0, no pain; 10, worst pain , respectively, preoperatively and at 6 and 12 months postoperatively.

Surgical technique For patients with a loose annulus without rupture, we only performed a dynamic stabilization procedure via the Wiltse approach. Results No adhesion, fibrosis, infection, or chronic inflammation was observed during the long-term follow-up period. Table 2 Clinical outcome.

MRI We compared disc degeneration at the implantation segments on preoperative and 1-year postoperative T2-weighted sagittal MRI scans according to the Pfirrmann lumbar IVD degeneration classification. Table 3 Comparison of disc signal change between preoperative and postoperative period.

Representative case of rehydration. A patient with severe back pain with attacks three or four times a year. The patient has painfull degenerative disc disease. Decreased signal intensity in the disc space at the L4—L5 level Pfirrmann grade 4.

An increase in signal intensity indicative of rehydration is observed at the same level after 12 months Pfirrmann grade 2. Representative case of fusion in a female patient with back pain caused by an extensive posterior annulus rupture. Decreased signal intensity in the disc space at the L4—L5 level Pfirrmann grade 3. Fusion at the same level is visible after 12 months postoperatively Pfirrmann grade 5.

Representative case of no change in a male patient with severe, chronic episodes of back pain and recent leg pain caused by a foraminal disc herniation. Decreased signal intensity in the disc space at the L5—S1 level Pfirrmann grade 4. No change in signal intensity at the same level after 12 months postoperatively Pfirrmann grade 4.

Disc signal change between preoperative and postoperative period. Discussion A decreases in the fluid content of NP leads to a decrease in hydrostatic pressure [ 7 ], which can directly affect the degeneration and regeneration cascade [ 8 ]. Footnotes Conflict of Interest: No potential conflict of interest relevant to this article was reported. References 1. X-ray diffraction studies of the arrangement of collagenous fibres in human fetal intervertebral disc.

J Anat. However, this brings us back to the moral of the story, that is; there needs to be enough free water available in the body for the ELDOAs to be effective. It is often said to drink about 8 cups a day. However, this may not be true because drinking levels usually depend on the different needs of each individual.

For example, an athlete will need to drink lots more water than someone who is not an athlete. The athlete loses more water while exercising so will have lots more to replenish. Another example is two individuals of the same lifestyle but different weight will also differ in the amount of drinking levels. The heavier individual will need more water to stay hydrated. So, to make it more simple drink at least half your body weight in fluid ounces and more with increased exercise and heat.

For example, a pound person who does not exercise or work in hot climates needs 1. This means one 1. These drinks are filled with artificial sweeteners and caffeine that will dehydrate you further. Could, for example, stem cells survive the ph levels, the compressive and stress forces or avascular nature of the nucleus?

Then later that same year September 10 a sheep study was presented at the Osteoarthritis Research Society International meeting in Montreal which seemed to show that a single, direct low-dose injection of allogeneic or "off-the-shelf" adult stem cells into the degenerated disc nucleus could rehydrate or regenerate the disc. Earlier this month, at the BioSpine3 meeting in Amsterdam several researchers presented goat and canine studies that deconstructed the mechanisms of action for disc degeneration and then looked at strategies for rehydrating or regenerating the degenerated disc.

Is disc rehydration or regeneration a fantasia or a potential reality? There are four not-so-easy steps to successfully rehydrating the disc. Of course, back pain is the whole point. Or back inflammation. One very strong correlation she discussed in her presentation was between active MMP-2 and human intervertebral disc degeneration. Other degeneration accelerators Dr. Creemers mentioned were MMP and Interluken 6, 10 or In other words, Dr. Creemers and many other researchers have been rather successful at identifying the chemical signals that support if not contribute to disc degeneration.

These markers are up-regulators of inflammation inside the disc. So, Step One, is to inhibit those chemical signals and other factors that support, if not also stimulate, disc degeneration—and to do so in a sustained manner—perhaps with microbeads or hydrogels, which would elute inhibitor compounds over time. Easier said than done, of course!.

Here is one area where progenitor cells, like mesenchymal cells, may have an impact since they are immune privileged and can down regulate inflammation. But other strategies are also called for and this, it seems to us, represents a major clinical opportunity. Clearing out the chemical signals that support degeneration of the spinal disc lays the foundation for steps 2, 3 and 4.

As the cascade of degeneration progresses, the typical disc will move from a wet, spongy, healthy material Grade 1 to a tough, dry and fibrous Grade 5 material.

The Grade 5 disc space has very different sheer forces, load-bearing tensions and other biomechanical attributes than the healthy, spongy, proteoglycan-rich Grade 1 disc. What do biomechanics have to do with a healthy disc? These cookies will be stored in your browser only with your consent. You also have the option to opt-out of these cookies.

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