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Lumbar radiculopathy

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https://www.readbyqxmd.com/read/28226408/which-regional-pain-rating-best-predicts-patient-reported-improvement-in-lumbar-radiculopathy
#1
Mark C Bicket, Paul F Pasquina, Steven P Cohen
OBJECTIVE: To determine the best regional pain score cutoff value that corresponds with patient-reported improvement in lumbosacral radiculopathy (LSR). DESIGN: Retrospective pooled data analysis from 3 randomized, controlled, multicenter trials using similar outcome assessments. All participants were exposed to interventions (epidural injections). SETTING: Military medical centers (6 U.S.A., 1 Germany) and large tertiary care hospitals (4 urban, 1 Veterans Affairs) between 2008 and 2014...
February 22, 2017: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/28207622/curve-characteristics-and-foraminal-dimensions-in-patients-with-adult-scoliosis-and-radiculopathy
#2
Andrew J Pugely, Zachary Ries, Gnanapradeep Gnanapragasam, Yubo Gao, Rachel Nash, Sergio A Mendoza-Lattes
STUDY DESIGN: Retrospective cohort study. OBJECTIVE: To demonstrate a correlation between radiculopathy symptoms, foraminal morphology, and curve types. SUMMARY OF BACKGROUND DATA: Patients with degenerative scoliosis frequently present with foraminal stenosis and radiculopathy, the origin of which is not well understood. METHODS: A total of 48 patients (384 foraminas) were included: 14 with low back pain (B); 16 with femoral nerve pain (F); and 18 with sciatic nerve pain (S)...
March 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28178992/percutaneous-transforaminal-endoscopic-surgery-ptes-for-symptomatic-lumbar-disc-herniation-a-surgical-technique-outcome-and-complications-in-209-consecutive-cases
#3
Yu-Tong Gu, Zhan Cui, Hong-Wei Shao, Yun Ye, Ai-Qun Gu
BACKGROUND: We designed an easy posterolateral transforaminal endoscopic decompression technique, termed PTES, for radiculopathy secondary to lumbar disc herniation. The purpose of the study is to describe the technique of PTES and evaluate the efficacy and safety for treatment of lumbar disc herniation including primary herniation, reherniation, intracanal herniation, and extracanal herniation and to report outcome and complications. METHODS: PTES was performed to treat 209 cases of intracanal or extracanal herniations with or without extruding or sequestrated fragment, high iliac crest, scoliosis, calcification, or cauda equina syndrome including recurrent herniation after previous surgical intervention at the index level or adjacent disc herniation after decompression and fusion...
February 8, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28168618/the-short-and-midterm-outcomes-of-lumbar-transforaminal-epidural-injection-with-preganglionic-and-postganglionic-approach-in-lumbosacral-radiculopathy-a-systematic-review-and-meta-analysis
#4
REVIEW
Saran Pairuchvej, Alisara Arirachakaran, Gun Keorochana, Komkrich Wattanapaiboon, Surapon Atiprayoon, Phoonyathorn Phatthanathitikarn, Jatupon Kongtharvonskul
The purpose of this study was to compare clinical outcomes after preganglionic versus ganglionic epidural steroid injection (ESI) using a systematic review and network meta-analysis. A systematic review and meta-regression was performed to compare postoperative outcomes between the two difference injection techniques. Relevant randomized controlled trials were identified from Medline and Scopus up to September 24, 2016. Sixteen out of 598 studies were eligible; 3, 2, and 3 studies were included in the pooling of outcomes including effectiveness, visual analog score (VAS), and complications (nerve root, injury, dural puncture, and intraneural injection)...
February 6, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28157811/one-stage-surgical-management-for-lumbar-brucella-spondylitis-by-posterior-debridement-autogenous-bone-graft-and-instrumentation-a-case-series-of-24-patients
#5
Yangbin Chen, Jun-Song Yang, Tao Li, Peng Liu, Tuan-Jiang Liu, Li-Min He, Li-Xiong Qian, Ding-Jun Hao
STUDY DESIGN: Clinical case series. OBJECTIVE: To explore the efficacy and safety of one-stage debridement, autogenous bone graft and instrumentation for lumbar brucella spondylitis (LBS) via a posterior approach. SUMMARY OF BACKGROUND DATA: Reports on LBS are sporadic, and the therapeutic effect and safety of surgical interventions have not been assessed in clinical studies. METHODS: Between January 2012 and January 2014, 24 consecutive patients with symptomatic LBS who underwent a one-stage operation that combined debridement, autogenous bone graft and instrumentation via a posterior approach were enrolled...
February 2, 2017: Spine
https://www.readbyqxmd.com/read/28153626/contralateral-interlaminar-keyhole-percutaneous-endoscopic-surgery-in-patients-with-unilateral-radiculopathy-technical-notes
#6
Jae Ha Hwang, Cheul Woong Park
OBJECTIVE: Percutaneous endoscopic surgery is increasingly used as an alternative to open microsurgery for treating lumbar spinal diseases. The purpose of this study was to determine the feasibility and efficacy of contralateral keyhole endoscopic surgery (CKES) for treating unilateral radiculopathy. METHODS: We performed percutaneous endoscopic sublaminar decompression via the contralateral interlaminar approach in 14 patients with unilateral radiculopathy. All procedures were performed under epidural anesthesia...
January 30, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28138779/outcome-of-l5-radiculopathy-after-reduction-and-instrumented-transforaminal-lumbar-interbody-fusion-of-high-grade-l5-s1-isthmic-spondylolisthesis-and-the-role-of-intraoperative-neurophysiological-monitoring
#7
Ralph T Schär, Martin Sutter, Anne F Mannion, Andreas Eggspühler, Dezsö Jeszenszky, Tamas F Fekete, Frank Kleinstück, Daniel Haschtmann
PURPOSE: To evaluate the incidence and course of iatrogenic L5 radiculopathy after reduction and instrumented fusion of high-grade L5-S1 isthmic spondylolisthesis and the role of intraoperative neurophysiological monitoring (IONM). METHODS: Consecutive patients treated for high-grade spondylolisthesis with IONM from 2005 to 2013 were screened for eligibility. Prospectively collected clinical and surgical data as well as radiographic outcomes were analyzed retrospectively...
January 31, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28137544/contralateral-approach-for-minimally-invasive-treatment-of-upper-lumbar-intervertebral-disc-herniation-technical-note-and-case-series
#8
Ribhu T Jha, Hasan R Syed, Michael Catalino, Faheem A Sandhu
BACKGROUND: Upper lumbar disc herniations comprise only 1 to 2% of all lumbar disc herniations. Patients present with non-specific signs and symptoms in comparison to predictable radiculopathies as seen in lower lumbar disc herniations. The unique anatomical characteristics of the upper lumbar spine present several challenges for safe and effective surgical treatment of disc herniations. The authors review the anatomy of the upper lumbar spine, describe a novel approach to upper lumbar disc herniations, and present three cases with a focus on clinical outcome and technical pearls...
January 27, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28127376/safety-and-efficacy-of-mini-open-transforaminal-lumbar-interbody-fusion
#9
Mohamed M Mohi Eldin, Ehab M Eissa, Haitham M Elmorsy
OBJECTIVE: Mini-transforaminal lumbar interbody fusion (Mini-TLIF) and other minimally invasive approaches introduced for the purpose of treating lumbar degenerative disc disease and instability are achieving high success and safety rates as the conventional approaches. Moreover, it has less soft tissue damage, minimal blood loss, and less hospital stay. METHODS: A prospective study was conducted from 2012 to 2014 on 28 patients who were subjected to Mini-open TLIF combined with transpedicular screw fixation for spondylolisthesis and degenerative disc disease...
December 2016: Korean Journal of Spine
https://www.readbyqxmd.com/read/28123921/relief-of-lumbar-symptoms-after-cervical-decompression-in-patients-with-tandem-spinal-stenosis-presenting-with-primarily-lumbar-pain
#10
Daniel R Felbaum, Islam Fayed, Jeffrey J Stewart, Faheem A Sandhu
OBJECTIVE: Tandem cervical and lumbar spinal stenosis (TSS) is classically described as intermittent claudication, gait disturbance, and clinical findings of mixed myelopathy and polyradiculopathy. Rarely, patients can present with TSS manifesting in isolated lumbar pain. Several reports have demonstrated improved lumbar back pain and radiculopathy after decompressive cervical spine procedures. We present six patients with dramatic resolution of lumbar spine related symptoms after decompression of the cervical spinal cord despite presenting solely with lower back complaints...
December 24, 2016: Curēus
https://www.readbyqxmd.com/read/28115269/stretching-of-roots-contributes-to-the-pathophysiology-of-radiculopathies
#11
Jean-Marie Berthelot, Jean-Denis Laredo, Christelle Darrieutort-Laffite, Yves Maugars
PURPOSE: To perform a synthesis of articles addressing the role of stretching on roots in the pathophysiology of radiculopathy. METHODS: Review of relevant articles on this topic available in the PubMed database. RESULTS: An intraoperative microscopy study of patients with sciatica showed that in all patients the hernia was adherent to the dura mater of nerve roots. During the SLR (Lasègue's) test, the limitation of nerve root movement occurs by periradicular adhesive tissue, and temporary ischemic changes in the nerve root induced by the root stretching cause transient conduction disturbances...
January 20, 2017: Joint, Bone, Spine: Revue du Rhumatisme
https://www.readbyqxmd.com/read/28097248/transpedicular-endoscopic-surgery-for-lumbar-spinal-synovial-cyst-report-of-two-cases
#12
Guntram Krzok, Albert E Telfeian, Ralf Wagner, Menno Iprenburg
BACKGROUND: Lumbar facet cysts are a benign, degenerative, and fairly uncommon cause for lumbar radiculopathy. The standard surgical treatment for lumbar facet cysts often requires a laminectomy and medial facetectomy which can further destabilize a pathological motion segment. The authors present here a novel technique for transpedicular endoscopic access to the pathology that obviates the need to violate the lamina or facet. METHODS: Two patient cases are described where the lumbar 4-5 facet cysts arise medial to the pedicle...
December 2016: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/28097246/three-year-follow-up-of-a-randomized-controlled-trial-comparing-preoperative-neuroscience-education-for-patients-undergoing-surgery-for-lumbar-radiculopathy
#13
Adriaan Louw, Ina Diener, Merrill R Landers, Kory Zimney, Emilio J Puentedura
BACKGROUND: Results from a previous multicenter randomized controlled trial (RCT) on preoperative pain neuroscience education (PNE) for lumbar radiculopathy found no significant difference in patient reported outcomes between groups. However, patients who received PNE viewed their surgical experience more favorably and utilized significantly less healthcare compared to those that did not. The purpose is to determine if the reduction in healthcare costs from 1-year would be continued at 3-year following surgery, and to explore differences (if any) in patient reported outcomes...
December 2016: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/28094428/intra-operative-results-and-post-operative-clinical-outcomes-of-lumbar-microdiscectomy-in-patients-received-transforaminal-anterior-epidural-steroid-injection-earlier-for-lumbar-radiculopathy
#14
Sait Ozturk, Bekir Akgun, Fatih Serhat Erol, Selami Ates Onal, Metin Kaplan
AIM: We have aimed to describe the intra and postoperative results of patients who received transforaminal anterior epidural steroid injection (TAESI) prior to undergoing lumbar microdiscectomy. MATERIAL AND METHODS: 64 of 2461 patients evaluated who had received minimally invasive technique (MIT) for lumbar radiculopathy and who felt no relief after the procedures. 32 patients of them treated with different techniques other than TAESI and those receiving thrombolytic or anticoagulant drugs before microdiscectomy were excluded...
December 14, 2016: Turkish Neurosurgery
https://www.readbyqxmd.com/read/28091818/lumbar-microdiscectomy-for-sciatica-in-adolescents-a-multicentre-observational-registry-based-study
#15
Sasha Gulati, Mattis A Madsbu, Tore K Solberg, Andreas Sørlie, Charalampis Giannadakis, Marius K Skram, Øystein P Nygaard, Asgeir S Jakola
BACKGROUND: Lumbar disc herniation (LDH) is rare in the adolescent population. Factors predisposing to LDH in adolescents differ from adults with more cases being related to trauma or structural malformations. Further, there are limited data on patient-reported outcomes after lumbar microdiscectomy in adolescents. Our aim was to compare clinical outcomes at 1 year following single-level lumbar microdiscectomy in adolescents (13-19 years old) compared to younger adults (20-50 years old) with LDH...
March 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28072802/efficacy-of-adjuvant-10-hypertonic-saline-in-transforaminal-epidural-steroid-injection-a-retrospective-analysis
#16
Eun Young Joo, Won Uk Koh, Seong-Soo Choi, Jae-Hyung Choi, Ho-Soo Ahn, Hye Joo Yun, Jin-Woo Shin
BACKGROUND: Chronic lower back pain with or without radiculopathy represents an important medical, social, and economic problem. Many treatment modalities and techniques, including surgery and epidural administration of steroids, have been used to manage this pain. Hypertonic saline, which has been used as an adjunct to percutaneous epidural adhesiolysis, can also be injected via a transforaminal approach in expectation of longer-lasting effects. OBJECTIVES: This study aimed to determine the effect of adding hypertonic saline to conventional transforaminal epidural steroid injections (TFEI) to provide pain relief for chronic radiculopathy patients...
January 2017: Pain Physician
https://www.readbyqxmd.com/read/28028448/a-novel-technique-to-repair-a-transverse-sacral-fracture-in-a-previously-fused-lumbosacral-spondylolisthesis
#17
Thomas Noh, Mokbel K Chedid
BACKGROUND: Transverse fractures of the sacrum are rare, and surgical treatment for these fractures ranges from conservative to challenging. Transverse stress fractures of the sacrum after placement of lumbar-to-sacral instrumentation have been previously described. We report a new technique to repair a transverse Type-2 Roy-Camille fracture with spondylolisthesis of S1 over S2 in a previously fused instrumented high-grade L4-L5, L5-S1 spondylolisthesis. CASE DESCRIPTION: A 64-year-old female who previously had an L4-L5, L5-S1 fusion for spondylolisthesis presented with excruciating lower back pain and radiculopathy for over 6 months...
2016: Surgical Neurology International
https://www.readbyqxmd.com/read/28028446/a-purely-extradural-lumbar-nerve-root-cavernoma-mimicking-acute-myeloid-leukemia-recurrence-case-report-and-literature-review
#18
Edson Oliveira, José Pedro Lavrador, Joaquim Teixeira, Alexandra Pignatelli, Sérgio Livraghi
BACKGROUND: Myeloid sarcoma (MS) is a malignant tumor that usually occurs concomitantly with or following acute myeloid leukemia (AML). Cavernomas are benign congenital malformations that are unusual in the spine and exceedingly rare in pure extradural locations. CASE DESCRIPTION: We report a 73-year-old female with a previous medical history of AML in remission for 3 years who presented with symptoms of low back pain and right lower extremity radiculopathy. A magnetic resonance scan showed an extradural, foraminal lesion centered at the L2 level involving the right L2 nerve root...
2016: Surgical Neurology International
https://www.readbyqxmd.com/read/28026727/radiological-changes-after-interspinous-dynamic-stabilisation-for-lateral-stenosis-of-lumbar-spinal-canal-a-parallel-group-randomised-trial
#19
RANDOMIZED CONTROLLED TRIAL
J Mohar, M Cimerman
PURPOSE OF THE STUDY Interspinous dynamic stabilisation devices (IDSDs) are used for stabilisation and indirect decompression of the spinal motion segment in minimally invasive treatment of degenerative conditions of lumbar spine. Good methodological quality studies on biomechanical effects of IDSDs are lacking in scientific literature. The purpose of this study was to evaluate the biomechanical effect of dynamic IDSD implantation on a spinal motion segment. MATERIAL AND METHODS We conducted a parallel group randomised trial (RT) on twelve patients, comparing radiological stabilisation and indirect decompression outcome measures between groups of patients with an isolated degenerative condition of L4-L5 motion segment and unilateral L5 nerve root radiculopathy...
2016: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
https://www.readbyqxmd.com/read/27932436/multifactorial-pathological-hip-subluxation-in-neurofibromatosis-type-1-nf1-due-to-intra-articular-plexiform-neurofibroma-lumbar-radiculopathy-and-neurofibromatous-polyneuropathy
#20
Waqar Waheed, Diego F Diego F Lemos, Nelms Nathaniel Nelms, Rup Tandan
Neurofibromatosis type-1 (NF1) is a multisystem disorder with very rare descriptions of hip instability. We report a case of a 37-year-old man with known NF1 and childhood-onset of left foot drop, who developed persistent left hip pain following a minor trauma. Physical examination revealed left-sided mild foot drop, hip abductor weakness, bilateral sensory loss in feet and an antalgic gait. Work-up revealed anterolateral subluxation of the left femoral head along with left hip plexiform neurofibroma (PN), dysplastic and degenerative changes, neurofibromatous neuropathy and chronic left L5 radiculopathy...
December 8, 2016: BMJ Case Reports
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