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Sciatica pain

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https://www.readbyqxmd.com/read/28632645/management-of-symptomatic-lumbar-disk-herniation-an-international-perspective
#1
Pravesh S Gadjradj, Mark P Arts, Maurits W van Tulder, Wim J R Rietdijk, Wilco C Peul, Biswadjiet S Harhangi
STUDY DESIGN: A questionnaire survey. OBJECTIVE: To evaluate the current practice patterns of surgeons regarding both the surgical and nonsurgical management of lumbar disk herniation (LDH) worldwide and to compare this with the current literature. SUMMARY OF BACKGROUND DATA: Sciatica is a common diagnosis in the general population. Sciatica is most frequently caused by LDH. Multiple surgical techniques and treatment modalities are available to treat LDH, albeit some with small effect sizes or without compelling evidence...
June 19, 2017: Spine
https://www.readbyqxmd.com/read/28632548/are-modic-changes-able-to-help-us-in-our-clinical-practice-a-study-of-the-modic-changes-in-young-adults-during-working-age
#2
José V Martínez-Quiñones, José Aso-Escario, Laura González-García, Fabián Consolini, Ricardo Arregui-Calvo
STUDY DESIGN: Modic changes [vertebral endplate spinal changes (VESC)] have been related to degenerative disk disease, and in past decades it was thought that their presence justified the surgical treatment, in particular spinal fusion. OBJECTIVE: The aim of the present study is to investigate its prevalence and features in a population of young workers suffering from low back pain, and explore the eventual relationship with the treatment applied in each case. BACKGROUND DATA: We conducted a retrospectively review of 450 magnetic resonance images from our hospital, in patients with low back pain or sciatica and age below 40...
July 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28615337/accumulation-of-methylglyoxal-increases-the-advanced-glycation-end-products-levels-in-drg-and-contributes-to-lumbar-disc-herniation-induced-persistent-pain
#3
Cui-Cui Liu, Xin-Sheng Zhang, Yu-Ting Ruan, Zhu-Xi Huang, Su-Bo Zhang, Meng Liu, Hai-Jie Luo, Shao-Ling Wu, Chao Ma
Lumbar disc herniation (LDH) with discogenic low back pain and sciatica is a common and complicated musculoskeletal disorder. The underlying mechanisms are poorly understood and there are no effective therapies for LDH-induced pain. In the present study, we found that the patients who suffered from LDH-induced pain had elevated plasma methylglyoxal (MG) levels. In rats, implantation of autologous nucleus pulposus (NP) to the left lumbar 5 spinal nerve root, which mimicked LDH, induced mechanical allodynia and increased MG level in plasma and dorsal root ganglion (DRG) and enhanced the excitability of small DRG neurons (< 30μm in diameter)...
June 14, 2017: Journal of Neurophysiology
https://www.readbyqxmd.com/read/28567214/surgical-treatment-of-piriformis-syndrome
#4
Suk Ku Han, Yong Sik Kim, Tae Hyeon Kim, Soo Hwan Kang
BACKGROUND: Piriformis syndrome (PS) is an uncommon disease characterized by symptoms resulting from compression/irritation of the sciatic nerve by the piriformis muscle. Uncertainty and controversy remain regarding the proper diagnosis and most effective form of treatment for PS. This study analyzes the diagnostic methods and efficacy of conservative and surgical treatments for PS. METHODS: From March 2006 to February 2013, we retrospectively reviewed 239 patients who were diagnosed with PS and screened them for eligibility according to our inclusion/exclusion criteria...
June 2017: Clinics in Orthopedic Surgery
https://www.readbyqxmd.com/read/28566052/buttock-pain-and-sciatica-caused-by-a-femoral-osteochondroma
#5
Olaoye A Akinyemi, Lance M Mabry, Sonja I Dardenelle
A 26-year-old woman was referred to physical therapy with lower back pain extending into the right buttock. Palpation of the right buttock revealed a firm, immobile mass of considerable size, which the patient identified as her locus of symptoms. Due to the noted palpable mass, her pain, her inability to sit normally, and the longevity of symptoms, the physical therapist ordered radiographs, which identified multiple osteochondromas. J Orthop Sports Phys Ther 2017;47(6):442. doi:10.2519/jospt.2017.6877.
June 2017: Journal of Orthopaedic and Sports Physical Therapy
https://www.readbyqxmd.com/read/28550071/tubular-discectomy-versus-conventional-microdiscectomy-for-the-treatment-of-lumbar-disc-herniation-long-term-results-of-a-randomised-controlled-trial
#6
Gijsbert M Overdevest, Wilco C Peul, Ronald Brand, Bart W Koes, Ronald Hma Bartels, Wee F Tan, Mark P Arts
BACKGROUND: The reference surgical procedure for the treatment of lumbar disc herniation is open microdiscectomy. Minimal invasive discectomy with tubular retractors is hypothesised to cause less tissue damage and result in lower blood loss, less postoperative pain and faster recovery. We previously reported our 1 and 2-year results, and found no better outcomes of tubular discectomy compared with open microdiscectomy. Until now, no studies on tubular discectomy have reported results with more than 2 years of follow-up...
May 26, 2017: Journal of Neurology, Neurosurgery, and Psychiatry
https://www.readbyqxmd.com/read/28545491/treatment-of-acute-sciatica-with-transforaminal-epidural-corticosteroids-and-local-anesthetic-design-of-a-randomized-controlled-trial
#7
Bastiaan C Ter Meulen, Esther T Maas, Amrita Vyas, Marinus van der Vegt, Koo de Priester, Michiel R de Boer, Maurits W van Tulder, Henry C Weinstein, Raymond W J G Ostelo
BACKGROUND: Transforaminal epidural injections with steroids (TESI) are used increasingly for patients with sciatica. However there is much debate about their safety and effectiveness. It is important to identify patients that benefit most from TESI and only few trials have yet evaluated the effects in patients with acute sciatica. METHODS: We describe a prospective, randomized controlled trial (RCT), with the aim to evaluate the hypothesis that TESI plus Levobupivacaine (TESI-plus) added to oral pain medication is more effective compared to pain medication alone or compared to transforaminal injection with a local anesthetic of short duration among patients with acute sciatica...
May 25, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28533868/-rare-medico-surgical-emergency-spinal-epidural-abscess-about-3-cases
#8
Abderrazzak El Saqui, Mohamed Aggouri, Mohamed Benzagmout, Khalid Chakour, Mohamed El Faiz Chaoui
The awareness about infections in the epidural space is increasing thanks to the development of neurosurgery, including MRI. Spinal epidural abscess is a rare pathology but extremely serious from a functional point of view and potentially life threatening. We report three cases of male patients (the first one aged 52 years, the second 57 years and the third 63 years) with diagnosed spinal epidural abscess. Two patients were admitted to the Neurosurgical Emergencies with slow progressive spinal cord compression evolving in the context of infection...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28512052/cystic-dilation-of-the-ventriculus-terminalis-cdvt-report-of-six-surgical-cases-treated-with-cyst-subarachnoid-shunting-using-t-catheter
#9
Liang Zhang, Zhifeng Zhang, Wuyang Yang, Wenqing Jia, Yulun Xu, Jun Yang
OBJECT: Cystic dilation of the ventriculus terminalis (CDVT) is a rare anatomical variation and may become symptomatic. Existing literature regarding CDVT is limited, and as a result, the clinical characteristics and management strategy of CDVT is unclear. We report in this study six cases of CDVT in our institution, and provide a review of current literature. METHODS: We included six patients with CDVT in Beijing Tiantan Hospital between September 2010 and June 2015...
May 13, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28491116/a-randomized-clinical-trial-comparing-the-effectiveness-of-electroacupuncture-versus-medium-frequency-electrotherapy-for-discogenic-sciatica
#10
Xue Zhang, Yang Wang, Zhao Wang, Chao Wang, Wentao Ding, Zhishun Liu
Objective. To investigate the short- and long-term effects of electroacupuncture (EA) compared with medium-frequency electrotherapy (MFE) on chronic discogenic sciatica. Methods. One hundred participants were randomized into two groups to receive EA (n = 50) or MFE (n = 50) for 4 weeks. A 28-week follow-up of the two groups was performed. The primary outcome measure was the average leg pain intensity. The secondary outcome measures were the low back pain intensity, Oswestry Disability Index (ODI), patient global impression (PGI), drug use frequency, and EA acceptance...
2017: Evidence-based Complementary and Alternative Medicine: ECAM
https://www.readbyqxmd.com/read/28454511/percutaneous-laser-disc-decompression-versus-conventional-microdiscectomy-for-patients-with-sciatica-two-year-results-of-a-randomised-controlled-trial
#11
Patrick A Brouwer, Ronald Brand, M Elske van den Akker-van Marle, Wilco Ch Jacobs, Barry Schenk, Annette A van den Berg-Huijsmans, Bart W Koes, Mark A Arts, M A van Buchem, Wilco C Peul
Background Percutaneous laser disc decompression is a minimally invasive treatment, for lumbar disc herniation and might serve as an alternative to surgical management of sciatica. In a randomised trial with two-year follow-up we assessed the clinical effectiveness of percutaneous laser disc decompression compared to conventional surgery. Materials and methods This multicentre randomised prospective trial with a non-inferiority design, was carried out according to an intent-to-treat protocol with full institutional review board approval...
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28441971/the-clinical-and-cost-effectiveness-of-stratified-care-for-patients-with-sciatica-the-scopic-randomised-controlled-trial-protocol-isrctn75449581
#12
Nadine E Foster, Kika Konstantinou, Martyn Lewis, Reuben Ogollah, Kate M Dunn, Danielle van der Windt, Ruth Beardmore, Majid Artus, Bernadette Bartlam, Jonathan C Hill, Sue Jowett, Jesse Kigozi, Christian Mallen, Benjamin Saunders, Elaine M Hay
BACKGROUND: Sciatica has a substantial impact on patients, and is associated with high healthcare and societal costs. Although there is variation in the clinical management of sciatica, the current model of care usually involves an initial period of 'wait and see' for most patients, with simple measures of advice and analgesia, followed by conservative and/or more invasive interventions if symptoms fail to resolve. A model of care is needed that does not over-treat those with a good prognosis yet identifies patients who do need more intensive treatment to help with symptoms, and return to everyday function including work...
April 26, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28438457/-tophaceous-gout-of-the-lumbar-spine-in-a-patient-without-systemic-gout-or-normouricaemia
#13
Alejandro Lorente, Rafael Lorente, Jorge Romero
Gout is a common metabolic disorder typically diagnosed in peripheral joints. Tophaceous deposits in the lumbar spine is a very rare condition with very few cases reported in the literature. We present a case of tophaceous gout that originated in the lumbar spine in a patient with normal uric acid blood levels. The following case report concerns a 52-year-old patient with low back pain, left sciatica and numbness in the left leg. Serum uric acid levels were within normal range. MRI and bone scan images suggested an inflammatory-infectious process focussed at L4...
April 21, 2017: Neurocirugía
https://www.readbyqxmd.com/read/28429339/observational-multicentric-study-on-chronic-sciatic-pain-clinical-data-from-44-italian-centers
#14
G A Checchia, G Letizia Mauro, G Morico, A Oriente, C Lisi, V Polimeni, M Lucia, M Ranieri
OBJECTIVE: To provide information on the clinical presentation of sciatic neuropathy and its management in a real-world setting, and to analyze the effects of a multimodal approach based on the association of physical and pharmacological therapy. PATIENTS AND METHODS: A multicentric observational prospective study was conducted in 44 Italian tertiary centers specialized in Physical Medicine and Rehabilitation, Orthopedics, Neurology, Neurosurgery, and Rheumatology...
April 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28414677/a-rare-case-of-tropical-pyomysitis-acquired-on-vacation-in-a-healthy-male
#15
K Poole, T Tran
INTRODUCTION: Pyomyositis has traditionally been considered a tropical disease. Increasing prevalence has been observed in more northern climates, especially with HIV, immunosuppression, and IV drug abuse as predisposing factors. Pyomyositis has the tendency to mimic other conditions, such as muscle contusion, necrotizing fasciitis, or septic arthritis. The rarity of this disease and non-specificity of its symptoms often lead to delay in appropriate diagnosis and treatment. CASE: 24-year-old man, seen 2 days prior in orthopedics clinic and the Emergency Department for persistent gluteal pain thought to be due to right-sided sciatica, was admitted following worsening pain, diffuse generalized weakness with polyarthralgias and myalgias These symptoms were associated with night sweats, shaking chills, and difficulty walking...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28412162/incidence-and-clinical-features-of-sacral-insufficiency-fracture-in-the-emergency-department
#16
Yasuaki Tamaki, Akihiro Nagamachi, Kazumasa Inoue, Makoto Takeuchi, Kosuke Sugiura, Yasuyuki Omichi, Shunsuke Tamaki, Takashi Chikawa, Koichi Sairyo, Keisuke Adachi
INTRODUCTION: A sacral insufficiency fracture (SIF) often manifests as low back pain or sciatica in the absence of any antecedent trauma. These fractures may be missed because of lack of appropriate imaging. The purpose of this study was to clarify the incidence and clinical features of SIF as well as the characteristic findings on magnetic resonance imaging (MRI) of the lumbar spine. MATERIALS AND METHODS: The study participants comprised 250 patients (132 male, 118 female; mean age 58...
March 18, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28401158/histological-identification-of-propionibacterium-acnes-in-nonpyogenic-degenerated-intervertebral-discs
#17
Ye Yuan, Zezhu Zhou, Yucheng Jiao, Changwei Li, Yuehuan Zheng, Yazhou Lin, Jiaqi Xiao, Zhe Chen, Peng Cao
Purpose. Low-virulence anaerobic bacteria, especially the Propionibacterium acnes (P. acnes), have been thought to be a new pathogeny for a series of disc diseases. However, until now, there has been no histological evidence to confirm this link. The purpose of this study was to confirm the presence of P. acnes in nonpyogenic intervertebral discs via histological observation. Method. Degenerated intervertebral discs were harvested from 76 patients with low back pain and/or sciatica but without any symptoms of discitis or spondylodiscitis...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28399072/nonsteroidal-anti-inflammatory-drugs-for-sciatica-an-updated-cochrane-review
#18
Eva Rasmussen-Barr, Ulrike Held, Wilhelmus J A Grooten, Pepijn D D M Roelofs, Bart W Koes, Maurits W van Tulder, Maria M Wertli
STUDY DESIGN: Systematic review and meta-analysis. OBJECTIVE: To determine the efficacy of nonsteroidal anti-inflammatory drugs (NSAIDs) on pain reduction, overall improvement, and reported adverse effects in people with sciatica. SUMMARY OF BACKGROUND DATA: NSAIDs are one of the most frequently prescribed drugs for sciatica. METHODS: We updated a 2008 Cochrane Review through June 2015. Randomized controlled trials that compared NSAIDs with placebo, with other NSAIDs, or with other medication were included...
April 15, 2017: Spine
https://www.readbyqxmd.com/read/28384946/a-randomized-controlled-clinical-trial-to-determine-the-effectiveness-of-caudal-epidural-steroid-injection-in-lumbosacral-sciatica
#19
Jaydeep Nandi, Abhishek Chowdhery
INTRODUCTION: Caudal epidural steroid injection have been a part of nonsurgical management of lumbosacral sciatica since last half a century but various randomized controlled trials fail to provide convincing evidence in favour of its effectiveness. AIM: To assess the efficacy of caudal epidural steroid injection in patients of lumbosacral sciatica in comparison to placebo. MATERIALS AND METHODS: The study consisted of patients of sciatica caused by lumbosacral disc prolapse (observed on Magnetic Resonance Imaging (MRI) scan)...
February 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28377548/solitary-osteochondroma-of-the-proximal-femur-causing-sciatic-nerve-compression
#20
Fahad Aldashash, Muhamed Elraie
Osteochondromas (OC) are the most common benign tumors of the bones. They are most frequently found near the knee joint and are typically asymptomatic. The presence of OC near the hip joint is rare. In addition, OC is an extremely uncommon cause of sciatica. We present a rare case of OC of the proximal femur. The patient presented with left hip pain and manifestations of sciatic nerve compression. Surgical excision was performed. The diagnosis was confirmed postoperatively by histopathology. SIMILAR CASES PUBLISHED: 1...
March 2017: Annals of Saudi Medicine
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