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Lumbar radiculopathy

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https://www.readbyqxmd.com/read/28739476/severity-of-foraminal-lumbar-stenosis-and-the-relation-to-clinical-symptoms-and-response-to-periradicular-infiltration-introduction-of-the-melting-sign
#1
M Farshad, R Sutter, A Hoch
BACKGROUND CONTEXT: Nerve root compression causing symptomatic radiculopathy can occur within the intervertebral foramen. Sagittal MRI sequences are reliable in detection of nerve root contact to intraforaminal disc material, but a clinically relevant classification of degree of contact is lacking. PURPOSE: To investigate a potential relation of amount of contact between intraforaminal disc material and nerve root to clinical findings and response after periradicular corticosteroid infiltration...
July 21, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28723879/suppression-of-sympathetic-nerve-sprouting-by-local-administration-of-an-%C3%AE-antagonist-around-the-dorsal-root-ganglion-in-a-lumbar-radiculopathy-model
#2
Izaya Ogon, Tsuneo Takebayashi, Tsuyoshi Miyakawa, Takehito Iwase, Katsumasa Tanimoto, Yoshinori Terashima, Syunsuke Jimbo, Takeshi Kobayashi, Noritsugu Tohse, Toshihiko Yamashita
STUDY DESIGN: Animal experimental study with intervention OBJECTIVE.: The purpose of this study was to elucidate whether local administration of an α-antagonist around the dorsal root ganglion (DRG) suppressed sympathetic nerve sprouting, from the acute to the chronic pain development phase, in a lumbar radiculopathy model using immunohistochemical methods. SUMMARY OF BACKGROUND DATA: The abnormal sympathetic-somatosensory interaction may underlie some forms of neuropathic pain...
July 18, 2017: Spine
https://www.readbyqxmd.com/read/28720993/inserting-pedicle-screws-in-lumbar-spondylolisthesis-the-easy-bone-conserving-way
#3
Hitesh Lal, Lalit Kumar, Ramesh Kumar, Tankeshwar Boruah, Pankaj Kumar Jindal, Vinod Kumar Sabharwal
BACKGROUND: Pedicle screw fixation in high grade lumbar listhetic vertebral body has been nightmare for Orthopaedic and spine surgeons. This is because of abnormally positioned listhetic pedicles and non-visualization of pedicle in conventional image intensifier (C-Arm). This results into increased surgical time, more blood loss, radiation exposure and more chances of infection. To overcome this problem, we have devised a new Technique of putting of pedicle screw fixation in listhetic vertebrae...
April 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28720990/selective-nerve-root-blocks-vs-caudal-epidural-injection-for-single-level-prolapsed-lumbar-intervertebral-disc-a-prospective-randomized-study
#4
Sudhir Singh, Sanjiv Kumar, Gaurav Chahal, Reetu Verma
BACKGROUND: Chronic lumbar radiculopathy has a lifetime prevalence of 5.3% in men and 3.7% in women. It usually resolves spontaneously, but up to 30% cases will have pronounced symptoms even after one year. AIMS: A prospective randomized single-blind study was conducted to compare the efficacy of caudal epidural steroid injection and selective nerve root block in management of pain and disability in cases of lumbar disc herniation. METHODS: Eighty patients with confirmed single-level lumbar disc herniation were equally divided in two groups: (a) caudal epidural and (b) selective nerve root block group, by a computer-generated random allocation method...
April 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28718697/pain-drawings-predict-outcome-of-surgical-treatment-for-degenerative-disc-disease-in-the-cervical-spine
#5
Anna MacDowall, Yohan Robinson, Martin Skeppholm, Claes Olerud
INTRODUCTION: Pain drawings have been frequently used in the preoperative evaluation of spine patients. For lumbar conditions comprehensive research has established both the reliability and predictive value, but for the cervical spine most of this knowledge is lacking. The aims of this study were to validate pain drawings for the cervical spine, and to investigate the predictive value for treatment outcome of four different evaluation methods. METHODS: We carried out a post hoc analysis of a randomized controlled trial, comparing cervical disc replacement to fusion for radiculopathy related to degenerative disc disease...
July 18, 2017: Upsala Journal of Medical Sciences
https://www.readbyqxmd.com/read/28705700/incidental-primary-intradural-carcinoid-tumor-in-a-patient-with-lumbar-radiculopathy
#6
Stavros Koustais, Philip O'Halloran, Alfrazdaq Hassan, Francesca Brett, Steven Young
BACKGROUND: Carcinoid tumors are neuroendocrine neoplasms derived from enterochromaffin cells. Central nervous system involvement is rare. The reported cases include metastases to brain or spinal cord, as well as primary skeletal or extradural disease resulting in compressive myelo-radiculopathy. There are two previously reported cases of primary intradural extramedullary carcinoid tumor, presenting with compressive symptoms. We report the first case of primary incidental intradural extramedullary carcinoid tumor...
July 10, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28704909/tophaceous-gout-in-the-lumbar-spinal-canal-mimicking-epidural-spinal-tumor
#7
Taeshin Kim, Bum-Joon Kim, Se-Hoon Kim, Seung-Hwan Lee
Gout is an inflammatory arthritis characterized by deposition of monosodium urate crystals in joints. Though gout frequently involves the big toe or other extremities, it rarely occurs in the spinal canal. A 35-year-old man presented with left L5 radiculopathy. He had leg pain for 8 months and received several epidural steroid injections. Magnetic resonance imaging revealed a 1.7×1.1-cm ovoid contrast-enhancing mass, causing pressure erosion of the left L5 pedicle. Microscopic laminotomy was performed at the left L5 lamina...
June 2017: Korean Journal of Spine
https://www.readbyqxmd.com/read/28697031/epidural-injections-contraindicated-for-lumbar-radiculopathy-in-may-thurner-syndrome-a-case-report
#8
Michael Sniderman
A 59-year-old patient presented to the chronic pain clinic with a 6-week history of worsening lumbar back pain, bilateral thigh pain, and unilateral radiculopathy. Magnetic resonance imaging revealed mild discogenic and facetogenic disease, but significant epidural venous plexus engorgement compressing the thecal sac. The patient reported previous treatment by a vascular surgeon for May-Thurner Syndrome, a type of inferior vena caval obstruction, yet had not experienced these specific complaints. A discussion with the radiologist confirmed worsening of the patient's May-Thurner Syndrome was the likely cause of the patient's symptoms...
July 10, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28690952/targeted-radiofrequency-ablation-as-an-adjunct-in-treatment-of-lumbar-facet-cysts
#9
Jesse Hatgis, Michelle Granville, Aldo Berti, Robert E Jacobson
Lumbar facet cysts are frequently found in patients with facet degeneration and segmental instability. When the facet cyst is localized in the neural foramina and lateral recess or becomes large, it can cause radiculopathy or neurogenic claudication. These symptomatic cysts are typically treated interventionally with drainage and a corticosteroid injection or attempts via overinflation to rupture the cyst; however, these procedures have a significant recurrence rate (up to 50%) and often need to be repeated or lead to lumbar surgery if unsuccessful...
June 6, 2017: Curēus
https://www.readbyqxmd.com/read/28658037/investigation-of-the-effect-of-diabetes-on-radiculopathy-induced-by-nucleus-pulposus-application-to-the-drg-in-a-spontaneously-diabetic-rat-model
#10
Takuya Kameda, Miho Sekiguchi, Yoichi Kaneuchi, Shin-Ichi Konno
STUDY DESIGN: Controlled, interventional animal study. OBJECTIVE: To evaluate the effect of diabetes mellitus (DM) on radiculopathy due to lumbar disc herniation (LDH), by investigating pain-related behavior and the expression of tumor necrosis factor-alpha (TNF-α) and growth-associated protein 43 (GAP43) in type 2 diabetic rats following application of nucleus pulposus (NP) to the dorsal root ganglion (DRG). SUMMARY OF BACKGROUND DATA: Previous clinical studies suggested negative effects of DM on radiculopathy due to LDH, and that inflammation and nerve regeneration could interact with DM and radiculopathy...
June 27, 2017: Spine
https://www.readbyqxmd.com/read/28637111/spinal-epidural-cavernous-hemangioma-case-report
#11
Turgut Kuytu, Turgut Aydın, Kudret Türeyen
Pure epidural cavernous hemangiomas are quite rare. In this paper, a case of lumbar epidural cavernous hemangioma presenting as a lumbar radiculopathy is presented. The magnetic resonance imaging findings, differential diagnosis and therapy options of this rare case are discussed.
March 2, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28632645/management-of-symptomatic-lumbar-disk-herniation-an-international-perspective
#12
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/28632565/neuroforaminal-bone-growth-following-minimally-invasive-transforaminal-lumbar-interbody-fusion-with-bmp-a-computed-tomographic-analysis
#13
Junyoung Ahn, Anton Y Jorgensen, Daniel D Bohl, Ehsan Tabaraee, Vincent J Rossi, Khaled Aboushaala, Kern Singh
STUDY DESIGN: Computed tomographic analysis. OBJECTIVE: To identify radiographic patterns of symptomatic neuroforaminal bone growth (NFB) in patients who have undergone a single-level minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) augmented with bone morphogenetic proteins (BMP) utilizing computed tomography (CT). SUMMARY OF BACKGROUND DATA: BMP induces osteoblast differentiation leading to new bone formation. The association of BMP utilization and heterotopic bone formation after an MIS-TLIF has been described...
July 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28618737/effects-of-artcure-diffusional-patch-application-on-pain-and-functional-status-in-lumbar-disc-herniation-patients-a-prospective-randomized-controlled-study
#14
Mahmut Uğurlu, Mehmet Atıf Erol Aksekili, Berat Meryem Alkan, Halil Kara, Ceyhun Çağlar
BACKGROUND/AIM: The aim of this study was to assess the efficacy of the Artcure Diffusional Patch, which contains a mixture of 6 herbal oils (oleum thymi, oleum limonis, oleum nigra, oleum rosmarini, oleum chamomilla, oleum lauriexpressum) and has a hypoosmolar lipid structure, in the conservative treatment of lumbar disc herniation patients and to show the advantages and/or possibility of using this as an alternative method to surgery. MATERIALS AND METHODS: Of the 120 patients enrolled, 79 clinically diagnosed patients were included in the study...
June 12, 2017: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/28616222/a-case-report-of-an-unusual-cause-of-postoperative-leg-pain-after-posterior-lumbar-fusion
#15
R Daureeawoo, S Baliga, W Mohahmed, E B Ahmed
We report the case of a 36-year old man who underwent elective posterior lumbar spinal fusion after presenting with bilateral leg pain with associated back pain. He had undergone a L5/S1 discectomy in 2001, which provided good symptomatic relief. On this admission, he underwent elective L4-S1 posterolateral fusion and bilateral L4/5 and L5/S1 decompression. Intra-operatively a pedicle screw had to be re-inserted after fluoroscopy confirmed a lateral breech. The patient had no major postoperative complications until the sixth day when the patient re-presented with acute leg pain and weakness...
July 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28600958/the-diagnostic-accuracy-and-test-retest-reliability-of-the-dutch-paindetect-and-the-dn4-screening-tools-for-neuropathic-pain-in-patients-with-suspected-cervical-or-lumbar-radiculopathy
#16
R Epping, A P Verhagen, E A Hoebink, S Rooker, G G M Scholten-Peeters
BACKGROUND: It is important to identify neuropathic pain early to guide treatment decisions and prevent chronicity. There is lack of evidence whether the Dutch painDETECT questionnaire and Douleure Neuropathique en 4 questions (DN4) can adequately assess neuropathic pain. METHODS: Patients suspected of cervical or lumbar radiculopathy were eligible for inclusion. The Dutch painDETECT and DN4 were considered as the index tests and were compared to the reference test consisting of the consensus expert diagnosis by using the grading system for neuropathic pain...
June 1, 2017: Musculoskeletal Science & Practice
https://www.readbyqxmd.com/read/28600008/lumbar-radiculopathy-in-the-setting-of-degenerative-scoliosis-mis-decompression-and-limited-correction-are-better-options
#17
REVIEW
Ricardo B Fontes, Richard G Fessler
Surgery for adult spinal deformity (ASD) has emerged as an efficient treatment alternative, but it is fraught with potential perioperative morbidity, incompletely mitigated by emerging minimally invasive surgical techniques. In mild-to-moderate ASD balanced in the sagittal plane, there are situations in which the counterintuitive simple decompression through a foraminotomy or laminectomy, or even a short-segment fusion may be an attractive treatment. This article presents a case example and the authors' treatment rationale and reviews the limited available literature supporting it...
July 2017: Neurosurgery Clinics of North America
https://www.readbyqxmd.com/read/28591802/systemic-inflammatory-and-th17-immune-activation-among-patients-treated-for-lumbar-radiculopathy-exceeds-that-of-patients-treated-for-persistent-postoperative-neuropathic-pain
#18
Mohammed F Shamji, Daipayan Guha, Darcia Paul, Alina Shcharinsky
BACKGROUND: The pathophysiology of lumbar radiculopathy includes both mechanical compression and biochemical irritation of apposed neural elements. Inflammatory and immune cytokines have been implicated, induced by systemic exposure of immune-privileged intervertebral disc tissue. Surgical intervention provides improved symptoms and quality of life, but persistent postoperative neuropathic pain (PPNP) afflicts a significant fraction of patients. OBJECTIVE: To compare the inflammatory and immune phenotypes among patients undergoing structural surgery for lumbar radiculopathy and spinal cord stimulation for neuropathic pain...
June 7, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28567591/ribosomal-pcr-assay-of-excised-intervertebral-discs-from-patients-undergoing-single-level-primary-lumbar-microdiscectomy
#19
Todd F Alamin, Marcus Munoz, Alicia Zagel, Agnes Ith, Eugene Carragee, Ivan Cheng, Gaetano Scuderi, Indre Budvytiene, Niaz Banei
PURPOSE: To determine the presence of infectious microorganisms in the herniated discs of immunocompetent patients, using methodology that we hoped would be of higher sensitivity and specificity than has been reported in the past. Recent studies have demonstrated a significant rate of positive cultures for low virulent organisms in excised HNP samples (range 19-53%). These studies have served as the theoretical basis for a pilot trial, and then, a well done prospective randomized trial that demonstrated that systemic treatment with antibiotics may yield lasting improvements in a subset of patients with axial back pain...
May 31, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28557902/cryopreserved-amniotic-membrane-improves-clinical-outcomes-following-microdiscectomy
#20
D Greg Anderson, Victor Popov, Andrew L Raines, Julie O'Connell
STUDY DESIGN: Prospective, randomized controlled trial. OBJECTIVE: To compare pain, physical/mental functional recovery and recurrent herniation for patients following lumbar microdiscectomy with and without the use of a cryopreserved amniotic tissue graft. SUMMARY OF BACKGROUND DATA: Although microdiscectomy procedures are routinely successful for patients with lumbar radiculopathy due to herniated disc disease, residual low back pain, and recurrent herniation remain unsolved clinical problems...
May 26, 2017: Clinical Spine Surgery
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