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Lumbar radiculopathy

Jang W Yoon, Sara Ganaha, Clarence Watridge
BACKGROUND: Congenital agenesis of the inferior vena cava (IVC) can lead to the development of a prominent venous collateral system within and around the spine due to the development of venous collaterals. Surgery on such patients can harbor the risk of catastrophic bleeding or decompensation of a delicate venous drainage pattern during spinal manipulation or even epidural exploration. CASE DESCRIPTION: A 49-year old man with a congenital agenesis of the IVC presented with signs and symptoms of an L5 radiculopathy...
March 12, 2018: World Neurosurgery
K S Yang, C S Ho, P A Tai, W M Kung
Most lumbar intradural schwannomas present initially as radiculopathies with sensory disturbances. However, neurogenic bladder dysfunction may be one of the earliest manifestations and can cause long-term disability. We present the case of a patient with a L3-4 schwannoma (newly diagnosed owing to recurrent urinary retention and urinary tract infection) who finally underwent surgical resection. Improvement of bladder sensation was documented by urodynamic study and the patient was subsequently weaned off her Foley catheter with satisfactory outcome...
March 15, 2018: Annals of the Royal College of Surgeons of England
Nancy E Epstein
Background: Spinal meningiomas are found in patients typically between the ages of 75 and 84: some report the average age to be 50. They occur with an incidence of approximately 1000 patients per year in the US, are mostly single (90%) rather than multiple (10%), and arise from the spinal meninges (arachnoid/dura). Tumors are typically posterior/posterolateral (70%) in location, leaving the remaining 30% in the anterior/anterolateral spinal canal. They produce symptoms and signs of radiculopathy (nerve root) and/or myelopathy (cord compression) depending on their site of origin...
2018: Surgical Neurology International
Nikola Vučinić, Mirela Erić, Snežana Tomašević-Todorovič, Bojana Milekić
BACKGROUND: Algometry, as a highly sensitive method, provides an objective insight into the degree of pain, while the use of questionnaires can estimate the patient's psychological status in a simple way. OBJECTIVE: This study was conducted in order to measure the pressure pain threshold in patients with cervical and lumbar radiculopathy and to find a possible association of pain with the anxiety and depression. METHODS: The study examined 60 hospitalized patients with cervical radiculopathy and 60 patients with lumbar radiculopathy before starting and after finishing kinesitherapy...
March 2, 2018: Journal of Back and Musculoskeletal Rehabilitation
Alex Sabo, Jesse Hatgis, Michelle Granville, Robert E Jacobson
Osteoporotic patients can present with either single or multiple fractures secondary to repeated falls and progressive osteoporosis. Multiple fractures often lead to additional spinal deformity and are a sign of more severe osteoporosis. In the thoracic spine, multiple fractures are associated with the development of gradual thoracic kyphosis but neurologic deficits are uncommon. In the lumbar spine, patients with multiple lumbar fractures have more constant lumbar pain, may have symptoms related to concurrent lumbar stenosis or degenerative scoliosis, and may present with radiculopathy, especially with fractures at L4 and L5...
December 19, 2017: Curēus
Mahdi Safdarian, Farshid Farzaneh, Vafa Rahimi-Movaghar
Lumbar disc herniation is the most common cause of radiculopathy. In most cases, the chief complaint is associated with radicular pain due to nerve compression on the herniated side. However, a radicular pain contralateral to the herniation side is an unusual finding rarely reported in the literature. Here, a case of right lower limb radicular pain in the presence of left extruded L4-L5 disc herniation is reported. Management of the patient is discussed in addition to a review of the literature regarding hypotheses on the mechanism of this unusual situation...
January 2018: Asian Journal of Neurosurgery
Taketoshi Yasuda, Kayo Suzuki, Yoshiharu Kawaguchi, Shoji Seki, Hiroto Makino, Kenta Watanabe, Takeshi Hori, Tohru Yamagami, Masahiko Kanamori, Tomoatsu Kimura
BACKGROUND: Lumbar epidural lipomatosis (LEL) is characterized by abnormal accumulation of unencapsulated adipose tissue in the spinal epidural space. Such accumulation compresses the dural sac and nerve roots, and results in various neurological findings. However, the pathophysiology of LEL remains unclear. This study examined the associations between imaging and clinical findings in detail, and investigated the mechanisms underlying symptom onset by measuring intraoperative epidural pressures in LEL...
March 1, 2018: BMC Musculoskeletal Disorders
Cody J Mansfield
INTRODUCTION: The patient was referred to an outpatient physical therapy clinic for lumbar radiculopathy by a primary care physician and subsequently referred for imaging due to suspicion of cervical myelopathy. The case highlights the clinical reasoning of the physical therapist differentiating between lumbar stenosis, cervical myelopathy, and upper cervical instability. To the author's knowledge, this is the only case report in the literature to describe the mechanism that could underpin a false positive Sharp-Purser test (SPT)...
February 23, 2018: Physiotherapy Theory and Practice
Shingo Miyazaki, Ashish D Diwan, Kenji Kato, Kevin Cheng, Won C Bae, Yang Sun, Junichi Yamada, Carol Muehleman, Mary E Lenz, Nozomu Inoue, Robert L Sah, Mamoru Kawakami, Koichi Masuda
PURPOSE: To elucidate the effects of growth differentiation factor-6 (GDF6) on: (i) gene expression of inflammatory/pain-related molecules and structural integrity in the rabbit intervertebral disc (IVD) degeneration model, and (ii) sensory dysfunction and changes in pain-marker expression in dorsal nerve ganglia (DRGs) in the rat xenograft radiculopathy model. METHODS: Forty-six adolescent rabbits received anular-puncture in two non-consecutive lumbar IVDs. Four weeks later, phosphate-buffered saline (PBS) or GDF6 (1, 10 or 100 µg) was injected into the nucleus pulposus (NP) of punctured discs and followed for 4 weeks for gene expression analysis and 12 weeks for structural analyses...
February 19, 2018: European Spine Journal
Dhruv Kumar Agarwal, Eswararao Thamatapu, Sugat Sanyal, Prasad Krishnan
No abstract text is available yet for this article.
January 2018: Journal of Neurosciences in Rural Practice
R Kirk Owens, Leah Y Carreon, Erica F Bisson, Mohamad Bydon, Eric A Potts, Steven D Glassman
BACKGROUND CONTEXT: Although lumbar disc herniation (LDH) classically presents with lower extremity radiculopathy, there are patients who have substantial associated back pain PURPOSE: To determine if patients with lumbar disc herniation (LDH) with substantial back pain improve with decompression alone. STUDY DESIGN: Longitudinal observational cohort PATIENT SAMPLE: Patients enrolled in the Quality and Outcomes Database (QOD) with LDH and a baseline back pain score ≥ 5 of 10 who underwent 1 or 2-level lumbar discectomy only OUTCOME MEASURES: Back and leg pain scores (0-10), Oswestry Disability Index (ODI), and EuroQoL 5D (EQ-5D)...
February 14, 2018: Spine Journal: Official Journal of the North American Spine Society
Seba Ramhmdani, Yuanxuan Xia, Risheng Xu, Thomas Kosztowski, Daniel Sciubba, Timothy Witham, Ali Bydon
OBJECTIVE: The diagnosis and surgical management of post-laminectomy spondylolisthesis in patients without pre-operative instability is presented with a review of relevant literature. METHODS: We reviewed the medical records and radiographic studies of 105 patients who underwent first-time bilateral 1-4 level open laminectomies for degenerative lumbar disease at a single academic institution. Patients who initially presented with listhesis and had additional discectomy or fusion procedures were excluded...
February 14, 2018: World Neurosurgery
Charles D Rosen, P Douglas Kiester, Thay Q Lee
We conducted a study to determine the common characteristics of patients who developed radiculopathy symptoms and corresponding heterotopic ossification (HO) from transforaminal lumbar interbody fusions (TLIF) using recombinant human bone morphogenetic protein 2 (rhBMP-2). HO can arise from a disk space with rhBMP-2 use in TLIF. Formation of bone around nerve roots or the thecal sac can cause a radiculopathy with a consistent pattern of symptoms. We identified 38 patients (26 males, 12 females) with a mean (SD) age of 50...
January 2018: American Journal of Orthopedics
Eyram Fianyo, Owonayo Oniankitan, C Tagbor Komi, Kodjo Kakpovi, Prénam Houzou, E S Koffi-Tessio Viwalé, Moustafa Mijiyawa
BACKGROUND: The cost of low back pain was the subject of few studies in black Africa. AIM: To assess the cost of common low back pain and lumbar radiculopathy in Lomé. METHODS: A six months study was realised in the rheumatologic department of CHU Sylvanus Olympio. 103 consecutive patients suffering from a common low back pain or lumbar radiculopathy were included. To assess direct, indirect and non-financial costs they were questioned about their expense during the year...
March 2017: La Tunisie Médicale
Ralph Mobbs, Ryan Campbell, Kevin Phan
To classify facet joint cysts (FJC) which will assist in identification of patient groups to best fit with a particular intervention. Sagittal T2 -weighted magnetic resonance images (MRI) of these patients are used to measure cyst size, while axial T2 -weighted MRI are used to determine the percentage of the vertebral canal occupied by the cyst. The degree of spondylolisthesis is also measured through standing X-rays or sagittal MRI. The proposed grading system is as follows. Grade I includes cysts that occupy less than 25% of the canal diameter that usually present with unilateral radiculopathy...
February 12, 2018: Orthopaedic Surgery
Daniel Albrecht, Shihab Ahmed, Norman Kettner, Ronald Borra, Julien Cohen-Adad, Hao Deng, Timothy Houle, Arissa Opalacz, Sarah Roth, Marcos Vidal Melo, Lucy Chen, Jianren Mao, Jacob Hooker, Marco L Loggia, Yi Zhang
Numerous preclinical studies support the role of spinal neuroimmune activation in the pathogenesis of chronic pain, and targeting glia (e.g., microglia/astrocyte)- or macrophage-mediated neuroinflammatory responses effectively prevents or reverses the establishment of persistent nocifensive behaviors in laboratory animals. However, thus far the translation of those findings into novel treatments for clinical use has been hindered by the scarcity of data supporting the role of neuroinflammation in human pain...
February 5, 2018: Pain
Mengchen Yin, Wen Mo, Haiyang Wu, Jinhai Xu, Jie Ye, Ni Chen, Anastasia Sulindro Marla, Junming Ma
No abstract text is available yet for this article.
February 1, 2018: World Neurosurgery
Christian Støttrup, Andreas K Andresen, Carsten Ernst, Mikkel Østergaard Andersen
The Danish Health Authority has recently published a new guideline on the treatment of lumbar disc herniation with radiculopathy. This paper goes through the surgical treatment and considers the evidence behind surgical treatment of these patients, along with the outcome reported in literature. The new guideline recommends referring patients to be assessed by a surgeon within 12 weeks in cases, where severe and debilitating pain persists despite non-surgical treatment. This is found to be well in line with literature, as many studies have shown time to be a predictive factor in surgical treatment of these patients...
January 22, 2018: Ugeskrift for Laeger
Domenico Chirchiglia, Saverio Paventi, Paolo Seminara, Erika Cione, Luca Gallelli
Palmitoyl ethanol amide (PEA) is an endogenous substance that plays a role in neuropathic pain. In this article, we evaluated both the safety and the efficacy of ultramicronized PEA (um-PEA) in the treatment of low back pain related to nonsurgical lumbar radiculopathy. In this prospective single-blind study, patients with low back pain related to nonsurgical lumbar radiculopathy received the fixed combination acetaminophen/codeine (500 mg + 30 mg/d) for 7 days, and then it was stopped and changed to um-PEA (1200 mg/d) for 30 days...
January 24, 2018: Journal of Clinical Pharmacology
Hiroyuki Oka, Ko Matsudaira, Yuichi Takano, Daichi Kasuya, Masaki Niiya, Juichi Tonosu, Masayoshi Fukushima, Yasushi Oshima, Tomoko Fujii, Sakae Tanaka, Hirohiko Inanami
BACKGROUND: Although the efficiency of conservative management for lumbar spinal stenosis (LSS) has been examined, different conservative management approaches have not been compared. We have performed the first comparative trial of three types of conservative management (medication with acetaminophen, exercise, and acupuncture) in Japanese patients with LSS. METHODS: Patients with L5 root radiculopathy associated with LSS who visited our hospital for surgical treatment were enrolled between December 2011 and January 2014...
January 19, 2018: BMC Complementary and Alternative Medicine
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