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Lumbar disc prolapse

Liangliang He, Jianning Yue, Liqiang Yang, Baishan Wu, Guoqing Cao, Yuna Guo, Guanghui Lai, Yuanzhang Tang, Jiaxiang Ni
A degenerative cervical disc is a pain generator for headaches, and headaches can benefit from cervical prolapse surgery. However, as an alternative intervention for open cervical surgery, no study has reported whether headaches can benefit from cervical nucleoplasty.The objective of this study was to evaluate the efficacy of cervical coblation nucleoplasty in the treatment of cervicogenic headaches.In a prospective cohort study performed between December 2013 and August 2015, 20 patients with cervicogenic headaches undergoing cervical nucleoplasty for shoulder-arm pain were recruited into group C, and 20 patients with cervicogenic headaches undergoing lumbar nucleoplasty for low back pain, matched for age and sex, were recruited into group L...
September 2016: Medicine (Baltimore)
Ritesh Arvind Pandey
INTRODUCTION: Epidural steroid is an important modality in the conservative management of prolapsed lumbar disc and is being used for over 50 years. However, controversy still persists regarding their effectiveness in reducing the pain and improving the function with literature both supporting and opposing them are available. AIM: To study the efficacy of epidural steroid injection in the management of pain due to prolapsed lumbar intervertebral disc and to compare the effectiveness between caudal, transforaminal and interlaminar routes of injection...
July 2016: Journal of Clinical and Diagnostic Research: JCDR
Pallav S Bhatia, Harvinder S Chhabra, Bibhudendu Mohapatra, Ankur Nanda, Gururaj Sangodimath, Rahul Kaul
OBJECTIVES: Various types of minimally invasive techniques have been developed for the treatment of lumbar disc herniation. The original laminectomy was refined into microdiscectomy (MD). MD is the gold standard in management of lumbar disc herniation and is used as a yardstick for comparison with newer procedures such as tubular discectomy. So far, no studies have been reported in Indian population comparing tubular discectomy and microdiscectomy. The aim of this study was to compare immediate postoperative and 1-year outcome of patients undergoing tubular discectomy with those undergoing MD and to evaluate the learning curve as well as complication rates of tubular discectomy...
July 2016: Journal of Craniovertebral Junction and Spine
Hans-Raimund Casser
Failed back surgery syndrome (FBSS) is a frequent complication (15-40 %) of lumbar disc surgery and is rarely successfully treated by surgery with the exception of a re-prolapse associated with radicular pain. Multimodal pain treatment, however, is indicated by a lack of pathoanatomical correlates, unclear cause and psychosocial risk factors.This review describes a standardized non-operative treatment starting with broad interdisciplinary clarification by medical, psychological and physiotherapeutic means (assessment)...
September 2016: Der Orthopäde
Meenakshisundaram Subbiah, Krishnan Yegumuthu
Lumbar epidural varices can also present with radiculopathy similar to acute intervertebral disc prolapse (IVDP). However as the magnetic resonance imaging (MRI) in these patients are usually normal without significant compressive lesions of the nerve roots, the diagnosis is commonly missed or delayed leading to persistent symptoms. We present a rare case of acute severe unilateral claudication with a normal MRI unresponsive to conservative management who was treated surgically. The nerve root on the symptomatic side was found to be compressed by large anterior epidural varices secondary to an abnormal cranial attachment of ligamentum flavum...
July 2016: Indian Journal of Orthopaedics
O Linhardt, J Grifka, A Benditz
Background: The correlation between disc prolapse and disc degeneration is important in the evaluation of clinical and occupational disease. The present clinical radiological study investigated whether there is a correlation between disc degeneration (chondrosis) and disc prolapses. Patients and Methods: The present study is a retrospectively trial which was performed with conservatively and surgically treated patients from 2011 till 2013 in our clinic. 100 patients with disc prolapse and chondrosis in current MRI images were recruited...
June 23, 2016: Zeitschrift Für Orthopädie und Unfallchirurgie
H S Füeßl
No abstract text is available yet for this article.
June 23, 2016: MMW Fortschritte der Medizin
Raghavendra V, Papanaik Haridas, Anand Kumar, Ajith K
INTRODUCTION: Epidural venous plexus enlargement, presenting with low back pain and radiculopathy, is an uncommon cause of nerve roots impingement. This condition commonly mimics a herniated nucleus pulposus radiologically. The radiological diagnosis is often missed and the diagnosis is made during the surgery. We are hereby presenting 2 such cases of epidural varices mimicking intervertebral disc prolapse with lumbar radiculopathy. CASE REPORT: Case 1: 43 yr old female presented with acute exacerbation of low back ache and significant right L5-S1 radiculopathy without neurological deficit...
October 2014: Journal of Orthopaedic Case Reports
N V Todd, R A Dickson
What constitutes cauda equina syndrome (CES), how it should be subclassified and how urgently to image and operate on patients with CES are all matters of debate. A structured review of the literature has led us to evaluate the science and to propose evidence-based guidelines for the management of CES. Our conclusions include this guidance: pain only; MRI negative - recommend: analgesia, ensure imaging complete (not just lumbar spine) adequate follow-up. Bilateral radiculopathy (CESS) with a large central disc prolapse - recommend: discuss with the patient and if for surgery, the next day (unless deteriorates to CESI in which case emergency surgery); CESI - recommend: the true emergency for surgery by day or night; a large central PLID with uncertainty as to whether CESI or CESR (e...
October 2016: British Journal of Neurosurgery
Babak Mirzashahi, Abbas Tafakhori, Arvin Najafi, Mahmoud Farzan
Even though intervertebral disc degeneration can be found in the natural course of alkaptonuria, detection of the disease by black disc color change in a patient without any other presentation of alkaptonuria is an exceptionally rare condition. We have reported a very rare case of alkaptonuria presented with low back pain and steppage gait in a 51-year-old male with a complaint of chronic low-back pain and steppage gait who was operated on for prolapsed lumbar disc herniation. Intraoperatively his lumbar disk was discovered to be black...
April 2016: Archives of Bone and Joint Surgery
Pragyan Sarma, Rajan Thanga Thirupathi, Dwarakanath Srinivas, Sampath Somanna
OBJECTIVE: Lumbar intervertebral disc herniation (LIVDH) is rare in children and adolescents when compared to adults. In literature, children generally constitute around 0.5-3% of surgically treated LIVDH. Though much rarer, they are less likely to respond to conservative treatment than adults. In this study, we analyze our experience in the management of adolescent LIVDH (ALIVDH) (age group 12-18 years) including the demographic, clinico-radiological features; surgical management strategies and outcome...
January 2016: Journal of Pediatric Neurosciences
Vikas Chauhan, Ankita Tiwari, Girija Prasad Rath, Sujoy Banik
Hemodynamic derangements have been reported after surgery involving upper cervical spine. Similar observations, however, are rare during a lumbar spine surgery. We share our experience in a patient who had 2 episodes of bradycardia leading to transient asystole while undergoing lumbar discectomy for prolapsed intervertebral disc. The risk of life-threatening hemodynamic disturbances during seemingly uncomplicated surgery in prone position has been emphasized.
June 2016: Journal of Clinical Anesthesia
M A Suwaid, A Ismail, M M Idris
BACKGROUND: Magnetic resonance imaging (MRI) of the spine is a powerful tool for evaluation, assessment of severity, and follow up of diseases of the spine. It is one of the most sensitive diagnostic tests for detecting anatomic abnormalities of the spine and the adjacent structures. AIM: To determine the pattern of spinal abnormalities on MRI in Kano, Nigeria. MATERIALS AND METHOD: Patients aged between 2 and 95 years who had spinal MRI with AIRIS II TOSHIBA (0...
October 2014: Journal of the West African College of Surgeons
Ujjwal Gowardhan Wankhade, Mahesh Kotehal Umashankar, B S Jayakrishna Reddy
INTRODUCTION: Low back pain affects every population and is one of world's foremost debilitating conditions. Clinically significant sciatica due to lumbar disc prolapse occurs in 4-6% of population. Fenestration discectomy as a surgical procedure is less time consuming, with lesser blood loss, lesser post-operative complications and does not compromise with stability of spine when compared to laminectomy. AIM: Present study was conducted to determine extent of functional recovery i...
March 2016: Journal of Clinical and Diagnostic Research: JCDR
Jonathan Boote, Ruth Newsome, Michael Reddington, Ashley Cole, Munyaradzi Dimairo
BACKGROUND AND PURPOSE: Sciatica is a common clinical condition that can be extremely painful, disabling and life-changing. Whether conservative or surgical treatment for sciatica secondary to an intervertebral disc prolapse is most effective is still much debated. An important component of conservative treatment is physiotherapy, which aims to promote physical and psychological health for the patient, whilst resorption of the disc takes place. This paper reports a qualitative study of patients' views and experiences of a bespoke physiotherapy intervention for the treatment of sciatica...
February 23, 2016: Physiotherapy Research International: the Journal for Researchers and Clinicians in Physical Therapy
Balaji Douraiswami, Kumanan Muthuswamy, Dilip Kumar Naidu, Sriram Thanigai, Vijay Anand
INTRODUCTION: The presentation of cauda equina syndrome (CES) varies from its classical presentation, especially in its early stages of compression. We present a case of lumbar disc prolapse causing CES in an uncharacteristic way, knowledge of which is essential for orthopaedicians to diagnose this condition early and prevent neurological complications. CASE REPORT: A 32-year-old male patient presented to us with complaints of inability to lift his left ankle and numbness over his left leg and ankle for 14 days...
January 2016: Journal of Clinical Orthopaedics and Trauma
D Claus, E Coudeyre, J Chazal, B Irthum, A Mulliez, P Givron
OBJECTIVE: We aimed to assess the impact of a booklet integrating the biopsychosocial model of chronic pain management on reducing disability among patients undergoing lumbar discetomy. METHODS: In a prospective, controlled, time-series study with an alternate-month design, we enrolled 129 patients from a tertiary care university hospital after they underwent uncomplicated lumbar discectomy for the first time. The intervention group received the biopsychosocial evidence-based booklet and the control group a biomedical-based booklet; the booklets differed only in information content...
January 6, 2016: Annals of Physical and Rehabilitation Medicine
Kivanc Topuz, Ahmet Eroglu, Hakan Simsek, Cem Atabey, Ahmet Cetinkal, Ahmet Colak
AIM: The purpose of this study was to investigate the risk factors for the development of the central large disc herniations and to compare the demographic data between central mass prolapse and broad-based central disc herniation. MATERIAL AND METHODS: Between 2002 and 2007, 1630 patients underwent surgery and a large disc herniation was the main problem in 59 patients (3.6%). We performed a retrospective analysis of the demographic data of these patients. Magnetic resonance (MR) images were evaluated according to the disc type and level...
2016: Turkish Neurosurgery
Zhirong Wang, Genlin Wang, Xuesong Zhu, Dechun Geng, Huilin Yang
Previous studies have demonstrated that the expression levels of cytokines are increased in degenerated intervertebral disc tissues, and several cytokines are associated with the pathogenesis of intervertebral disc degeneration. However, the role of interleukin (IL)-2 in the cellular functions of intervertebral disc tissues remains unreported. The present study aimed to determine the expression levels of IL-2 in the nucleus pulposus (NP) tissues of patients with a prolapsed lumbar intervertebral disc; and to observe the changes in cell proliferation, apoptosis, extracellular matrix (ECM) metabolism and p38 mitogen-activated protein kinase (MAPK) signaling in human NP cells (HNPCs) following treatment with IL-2...
December 2015: Experimental and Therapeutic Medicine
J Vaneet Kumar, Tukaram S Dudhamal, Sanjay Kumar Gupta, Vyasadev Mahanta
BACKGROUND: Lifetime incidence of low back pain is 50-70% and incidence of clinically significant sciatica due to lumbar disc prolapse occurs in 4-6% of the population. Low back pain and sciatica is major cause of morbidity throughout the world. There is only conservative treatment giving short-term relief in pain or surgical intervention with side-effect. There is need to find out quick relief from pain in today's era as it affects physical as well as mental and social life of patients...
July 2014: Ayu
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