Disc Herniation

Lumbar disc herniation is one of the most common causes of low back pain and is associated with substantial functional limitations and reduced quality of life, particularly among working-age individuals. Displacement of disc material toward the spinal canal may result in mechanical compression and inflammation of the nerve roots, leading to pain, restricted movement, and reduced functional performance. The course of low back pain cannot be explained solely by biomechanical and anatomical factors. Psychosocial factors also play an important role in symptom persistence and functional outcomes. Within this context, the fear-avoidance model provides an important theoretical framework, suggesting that individuals may develop fear of movement and avoid physical activities because they believe these activities may increase pain or cause further injury. Over time, avoidance behaviors may contribute to physical deconditioning, reduced muscle function, and increased functional impairment. The Fear-Avoidance Beliefs Questionnaire is commonly used to assess individuals' beliefs regarding the relationship between pain, physical activity, and work-related activities. Higher levels of fear-avoidance beliefs have been associated with greater pain severity, increased disability, and poorer physical performance in individuals with low back pain. Trunk muscle endurance plays a key role in maintaining spinal stability. Adequate endurance of the paraspinal and abdominal muscles supports mechanical stability of the spine and contributes to the safe performance of functional movements. The Biering-Sørensen Test and plank test are commonly used to assess trunk muscle endurance in clinical and research settings. The Biering-Sørensen Test evaluates the endurance of the trunk extensor muscles, whereas plank-based tests assess the endurance of the anterior and lateral trunk musculature. Functional impairment in individuals with low back pain can be evaluated using the Oswestry Disability Index, a self-reported questionnaire that assesses limitations experienced during activities of daily living. Functional mobility and performance may also be evaluated using the Timed Up and Go test, which involves standing up from a chair, walking a short distance, turning, returning to the chair, and sitting down. This test reflects mobility, dynamic balance, and functional performance during daily activities. Postural control and balance may also be affected in individuals with low back pain. Reduced static balance performance can negatively influence functional activities and mobility. The Single-Leg Stance Test is a practical clinical measure used to assess postural stability and static balance. Although previous studies have examined associations between psychosocial factors and functional status in individuals with low back pain, studies evaluating the relationship between fear-avoidance beliefs, trunk muscle endurance, balance, and functional performance together remain limited. Identifying these relationships may contribute to the development of more comprehensive rehabilitation programs for individuals with lumbar disc herniation.

RCT investigating postoperative activity restriction after lumbar discectomy in patients treated with annular closure.

This study will be a double-blinded, two-arm, prospective, randomized controlled pilot feasibility study in 40 evaluable subjects (20 in each arm) at one study site within the United States. Subjects in Arm 1 will receive unilateral Discogen treatment; subjects in Arm 2 will receive unilateral sham treatment (control). Treatment in both arms can include medications, e.g. NSAIDs or muscle relaxants for axial or radicular pain.

The goal of this clinical investigation is to learn about DISC Care, an Hernia Blocking System, in patients who have undergone lumbar disc hernia surgery. The main questions it aims to answer are: * if the implant (DISC Care) prevents disc herniation recurrence * if DISC Care is a safe device Participants will be implanted with DISC Care and followed up for two years (7 visits).

Evaluating the superiority of caudal neuroplasty using epidural catheter (Perifix® Complete Set 16 G) combined with Pulsed Radiofrequency (PRF) versus Pulsed Radiofrequency (PRF) alone targeting the dorsal root ganglion In patients with lumbar radicular pain on pain reduction and quality of life within six months follow up.

The present study aims to adapt and modify a brief presurgical Acceptance and Commitment Therapy (ACT) intervention aimed at preventing the transition to Chronic Post-Surgical Pain (CPSP) and reducing long-term opioid use. Investigators will then assess the acceptability, feasibility, and preliminary efficacy of the finalized intervention to prevent the transition to CPSP and reduce post-surgical opioid use six months following lumbar spine surgery. Finally, investigators will identify psychosocial and psychophysical phenotypes associated with response to this intervention.

LDH is a common phenomenon that is often described in association with various pathological processes affecting the neuromuscular and locomotor systems. It is not only associated with pathology but it can also be observed in healthy individuals with no evidence of any dysfunction. Since LDH is observed in such a large percentage of healthy subjects, it is probably more appropriate to perceive it as a physiological phenomenon with silent clinical biomechanical changes

This study is a prospective, single-center, randomized controlled trial to compare whether applying cognitive intervention therapy before and after surgery in elderly patients aged 65 years or older undergoing non-cardiac surgery can reduce the incidence of postoperative delirium compared to conservative treatment.