Argyris Rapsomanikis - Corfu Physio

Argyris Rapsomanikis - Corfu Physio "Corfu Physio"

Physical Therapy
Sports Rehabilitation
Musculoskeletal Rehabilitation
Gait Analysis

"Corfu Physio"

Physical Therapy
Sports Rehabilitation
Musculoskeletal Rehabilitation
Gait Analysis
Therapeutic Exercise
Functional Training
Orthotics
Massage Therapy

27/06/2025
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12/04/2025

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Prevalence, clinical predictors, and mechanisms of resorption in lumbar disc herniation (LDH) 💡: a systematic review

👉 Lumbar disc herniation (LDH) is characterized as the rupture of fibrous annulus of the intervertebral disc, resulting in herniation or prolapse of nucleus pulposus (NP), which compresses and inflames spinal nerves and cauda equina nerve roots and thus causes clinical symptoms (https://pubmed.ncbi.nlm.nih.gov/23484826/).

👉 Most of the symptoms of LDH can be relieved by conservative treatment that can shrink the herniated portion and thus reduce compression (https://pubmed.ncbi.nlm.nih.gov/24630494/).

📘 In a new systematic review, Xie and colleagues (https://pubmed.ncbi.nlm.nih.gov/39944739/) tried to uncover the following three questions:

1️⃣ What is the percentage of spontaneous resorption in the conservative management of LDH?

2️⃣ How do we predict that spontaneous resorption may occur in LDH patients?

3️⃣ What are the molecular mechanisms of NP spontaneous resorption in LDH patients?

1️⃣ Prevalence of Resorption:

▶️ The authors found that the overall incidence of NP resorption was 76.6%, and the incidence of resorption was higher in ruptured disc herniations than in inclusive disc herniations. The incidence of resorption differed significantly between countries. The resorption process occurred mainly within 3-6 months of conservative treatment. These data are based on 31 studies were included, including 2,199 patients who received conservative treatment.

2️⃣ Clinical Predictors of Resorption:

▶️ Predictors include NP size, inflammatory response, prolapse extent, and imaging features like the percentage of edge-enhancing areas and posterior longitudinal ligament (PLL) rupture on enhanced MRI.

▶️ Larger herniations ((https://pubmed.ncbi.nlm.nih.gov/36243388/), and those with disrupted PLL showed higher resorption rates, likely due to greater exposure to epidural vasculature (https://pubmed.ncbi.nlm.nih.gov/36722839/

▶️ The "bull’s-eye sign" on enhanced MRI (indicating neovascularization and inflammation) strongly predicts resorption (https://pmc.ncbi.nlm.nih.gov/articles/PMC11165499/).

▶️ Modic changes and cartilage endplate involvement were associated with lower resorption likelihood, potentially increasing recurrence risk.

3️⃣ Mechanisms of Resorption:

💡 Four main mechanisms were identified (s. illustration):

1. Inflammatory Response: Pro-inflammatory cytokines (e.g., TNF-α, IL-1β) trigger matrix degradation and immune cell recruitment.

2. Neovascularization: New blood vessel formation at herniation sites facilitates immune access and resorption.

3. Macrophage Infiltration: M1 macrophages drive inflammation and phagocytosis, while M2 macrophages promote tissue repair and anti-inflammatory effects.

4. Matrix Protease Activation: Matrix metalloproteinases (MMP-3, MMP-7) degrade NP tissue, aiding resorption.

▶️ The autoimmune response is triggered when NP is exposed to the epidural space, disrupting the blood-NP barrier.

💡 Discussion and Implications:

✅ Conservative treatment is preferred for LDH, with resorption being a key indicator of success, but NSAIDs are suspected to hinder this process by suppressing inflammation critical for resorption (https://pubmed.ncbi.nlm.nih.gov/38099946/).

✅ The review suggests that modulating macrophage activity (M1/M2 balance) and exploring autophagic pathways could enhance resorption.

✅ Imaging advancements, particularly MRI, are vital for predicting and monitoring resorption.

⭕ Limitations include the low quality of included studies, reliance on imaging for diagnosis, and limited follow-up data, which may affect result reliability.

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21/01/2025

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Γνωρίζατε ότι...
📚 Μια μελέτη που δημοσιεύθηκε στο British Journal of Sports Medicine εξέτασε την εξέλιξη της οστεοαρθρίτιδας του γόνατος 10 χρόνια μετά από αρθροσκοπική μερική μηνισκεκτομή (APM) ή θεραπεία με άσκηση για εκφυλιστικές ρήξεις μηνίσκου.
✔️ Τα αποτελέσματα έδειξαν ότι δεν υπήρχαν σημαντικές διαφορές στην πρόοδο της οστεοαρθρίτιδας μεταξύ των δύο ομάδων.
💡 Και οι δύο θεραπείες συνδέθηκαν με σημαντικές βελτιώσεις στον πόνο και τη λειτουργία του γόνατος, οι οποίες διατηρήθηκαν κατά τη διάρκεια της 10ετούς παρακολούθησης.

📖 Διαβάστε περισσότερα στο λινκ στο πρώτο σχόλιο.

Stay tuned 💪 Ακολουθήστε τη σελίδα μας για αξιόπιστη, τεκμηριωμένη ενημέρωση στον τομέα της φυσικοθεραπείας και της θεραπευτικής άσκησης!

4 λόγοι για τους οποίους τα παιδιά πρέπει να κάνουν πολλαπλά αθλήματα!
03/10/2024

4 λόγοι για τους οποίους τα παιδιά πρέπει να κάνουν πολλαπλά αθλήματα!

Με αγαπημένο φίλο Λίνο Κογεβίνα !!!
29/03/2024

Με αγαπημένο φίλο Λίνο Κογεβίνα !!!

12/02/2024

The calf, quads, glutes and hamstrings all manage high peak loads during running. They’re arguably the 4 most important muscle groups in runners 🏃‍♀️
Quads and Glute Med play a key role in load absorption alongside the calf which is also the main contributor to propulsion. Peak load for the hamstrings is at the end of the swing phase when they work eccentrically to slow the leg down prior to foot contact.
I tend to assess strength in these 4 muscle groups in the majority of injured runners I see in clinic. They’re often a priority above other muscles which typically manage smaller loads at endurance speeds (such as the hip flexors). That said, there is often value is testing other muscle groups if you feel they may be relevant for pain, pathology or performance.
Keep a look out for tomorrow’s post when I’ll be sharing a testing battery for Achilles pain which includes how we would assess these key muscles as well as testing options for plyometric ability, pain, function and psychosocial factors. 👀

Η σύγχρονη ιστορία του κερκυραϊκού τριπλούν, με διεθνούς επιπέδου διακρίσεις, τα τελευταία 10 χρόνια!Πίσω από όλα ο ομοσ...
21/02/2023

Η σύγχρονη ιστορία του κερκυραϊκού τριπλούν, με διεθνούς επιπέδου διακρίσεις, τα τελευταία 10 χρόνια!

Πίσω από όλα ο ομοσπονδιακός προπονητής Παύλος Σκορδίλης Pavlos Skordilis] .

Μεγάλη τιμή και χαρά για εμάς στο Corfu Physio, να είμαστε δίπλα όλα αυτά τα χρόνια, υποστηρίζοντας τις προσπάθειες αυτών των κοριτσιών !!

Pavlos Skordilis] .karydi

Ευχαριστούμε για την εμπιστοσύνη!!

18/02/2023

Multi-center registry reveals that pediatric & adolescent needing are more complex and more frequent in those with higher BMI and more common with concomitant . Pediatric Orthopaedic Society of North America (POSNA) http://ow.ly/aZ9H50MQfRX

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