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Lumbar radiculopathy

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https://www.readbyqxmd.com/read/27915069/systematic-review-of-the-efficacy-of-particulate-vs-non-particulate-corticosteroids-in-epidural-injections
#1
REVIEW
Priyesh Mehta, Isaac Syrop, Jaspal Ricky Singh, Jonathan Kirschner
OBJECTIVE: To systematically analyze published studies in regards to the comparative efficacy of particulate versus non-particulate corticosteroids for cervical and lumbosacral epidural steroid injections (ESI) in reducing pain and improving function. TYPE: Systematic Review LITERATURE SURVEY: MEDLINE (Ovid), EMBASE, and Cochrane databases were searched from the period of 1950 to December 2015. METHODOLOGY: Criteria for inclusion in this review were: 1) Randomized controlled trials and 2) Retrospective studies comparing particulate versus non-particulate medication in fluoroscopically guided injections using a transforaminal (TF) or interlaminar (IL) approach...
November 30, 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/27906952/conus-medullaris-infarction-after-a-right-l4-transforaminal-epidural-steroid-injection-using-dexamethasone
#2
Christopher G Gharibo, Michael Fakhry, Sudhir Diwan, Alan D Kaye
BACKGROUND: For decades, epidural steroid injections have been an effective tool in the management of many pain related conditions, including lumbar radiculopathy. Transforaminal epidural steroid injections in particular have been reported to potentially result in central nervous system infarctions which have not been reported with interlaminar epidural steroid injections, while providing comparable efficacy. This rare, catastrophic complication has been attributed by some authors to be due to vascular injury secondary to vasospasm, thrombus formation, dissection, as well as concerns with placing the needle at the so-called "safe triangle...
November 2016: Pain Physician
https://www.readbyqxmd.com/read/27896457/the-value-of-quantitative-sensory-testing-in-spine-research
#3
Anja Tschugg, Wolfgang N Löscher, Sara Lener, Sebastian Hartmann, Matthias Wildauer, Sabrina Neururer, Claudius Thomé
The improvement of pain and functionality is the major goal of a surgical intervention. Thus, the purpose of the present prospective study was to evaluate whether subjective sensory deficits in patients with lumbar radiculopathy caused by a lumbar disc herniation are related to clinical status, using several outcome scores and the quantitative sensory testing (QST) pre- and 12 months postoperatively. We applied the QST in 52 patients with a single lumbar disc herniation treated by lumbar sequestrectomy pre- and 12 months postoperatively...
November 28, 2016: Neurosurgical Review
https://www.readbyqxmd.com/read/27885470/a-randomised-controlled-trial-of-transforaminal-endoscopic-discectomy-vs-microdiscectomy
#4
J N Alaistair Gibson, Ashok S Subramanian, Chloe E H Scott
PURPOSE: Transforaminal endoscopic discectomy (TED) minimises paraspinal muscle damage. The aim of this trial was to compare clinical outcomes of TED to Microdiscectomy (Micro). METHODS: 143 patients, age 25-70 years and <115 kg, with single level lumbar prolapse and radiculopathy, were recruited and randomised. 70 received TED under conscious sedation and 70 Micro under general anaesthesia. Oswestry Disability Index (ODI), visual analogue scores (VAS) of back and leg pain, and Short Form Health Survey indices (SF-36) were measured preoperatively and at 3, 12 and 24 months...
November 24, 2016: European Spine Journal
https://www.readbyqxmd.com/read/27867129/interventions-for-lumbar-synovial-facet-joint-cysts-a-comparison-of-percutaneous-surgical-decompression-and-fusion-approaches
#5
Ryan J Campbell, Ralph J Mobbs, Prashanth J Rao, Kevin Phan
OBJECTIVE: Facet joint cysts (FJC) of the lumbar spine are an increasingly reported cause of radiculopathy, lower back pain and neurological deficits. Currently, there is a lack of conclusive evidence outlining when a particular treatment should be undertaken, nor what patient indications suit a particular approach. The present systematic review and meta-analysis aims to evaluate the efficacy of percutaneous treatment and surgical decompression with or without fusion. METHODS: A systematic literature search of scientific databases from their inception to February 2016 was performed by two reviewers...
November 17, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27856380/t9-versus-t10-as-the-upper-instrumented-vertebra-for-correction-of-adult-deformity-rationale-and-recommendations
#6
Hwee Weng Dennis Hey, Kimberly-Anne Tan, Christabel Shao-En Neo, Eugene Tze-Chun Lau, Denise Ai-Wen Choong, Leok-Lim Lau, Gabriel Ka-Po Liu, Hee-Kit Wong
BACKGROUND CONTEXT: Adult spinal deformity correction sometimes involves long posterior pedicle screw constructs extending from the lumbosacral spine to the thoracic vertebra. As fusion obliterates motion and places supraphysiological stress on adjacent spinal segments, it is crucial to ascertain the ideal upper instrumented vertebra (UIV) to minimize risk of proximal junctional failure (PJF). The T10 vertebra is often chosen to allow bridging of the thoracolumbar junction into the immobile thoracic vertebrae on the basis that it is the lowest immobile thoracic vertebra strut by the rib cage...
November 14, 2016: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/27843689/transition-of-a-herniated-lumbar-disc-to-lumbar-discal-cyst-a-case-report
#7
Rohit Bansil, Yoshitaka Hirano, Hideo Sakuma, Kazuo Watanabe
BACKGROUND: Another rare cause of lower back pain with radiculopathy is the discal cyst. It is believed to arise from degeneration of a herniated disc, although many other theories of its origin have been proposed. Here, we report a patient with lower back pain/radiculopathy attributed originally to a herniated lumbar disc, which transformed within 6 months into a discal cyst. CASE DESCRIPTION: A 42-year-old male had a magnetic resonance (MR) documented herniated lumbar disc at the L4-5 level...
2016: Surgical Neurology International
https://www.readbyqxmd.com/read/27818870/spontaneous-chronic-epidural-hematoma-in-the-lumbar-spine-associated-with-warfarin-intake-a-case-report
#8
Axel Sandvig, Håkan Jonsson
INTRODUCTION: Spontaneous spinal epidural hematomas are rare. However, in patients on anticoagulant treatment the risk may increase. Symptomatically patients may present with radiculopathy and even progressive neurological deficits. CASE DESCRIPTION: We present a case of a warfarin treated patient with left L5 radiculopathy. MRI was evaluated as showing a lumbar disc prolapse or synovial cyst at L4-L5 level. The patient was operated and an organized material was removed and analysed as a hematoma...
2016: SpringerPlus
https://www.readbyqxmd.com/read/27799997/postlaminectomy-bilateral-lumbar-intraspinal-synovial-cysts
#9
Sung Ik Cho, Jung Hwan Lee, Chung Kee Chough
Lumbar intraspinal synovial cysts are included in the difference diagnosis of lumbar radiculopathy. Developing imaging modalities has result in increased reporting about these lesions. However, the case of bilateral new lumbar intraspinal synovial cysts after laminectomy has been rarely reported. We report of a rare case with bilateral lumbar intraspinal synovial cysts after laminectomy, requiring surgical excision.
September 2016: Korean Journal of Spine
https://www.readbyqxmd.com/read/27799994/increased-prevalence-of-ossification-of-posterior-longitudinal-ligament-and-increased-bone-mineral-density-in-patients-with-ossification-of-nuchal-ligament
#10
Ki-Wan Kim, Young-Min Oh, Jong-Pil Eun
OBJECTIVE: There are also few studies demonstrating the relationship between ossification of nuchal ligament (ONL) and ossification of posterior longitudinal ligament (OPLL). We compared the prevalence, location, and type of OPLL between patients with ONL and matched patients without ONL.We also compared the bone mineral densities (BMDs) between the 2 groups. METHODS: total of 124 cervical ONL patients were enrolled in this study. The control group of 124 patients was matched with 124 patients with ONL by age and sex on a 1:1 basis to minimize confounding factors...
September 2016: Korean Journal of Spine
https://www.readbyqxmd.com/read/27792054/evaluation-and-treatment-of-lumbar-facet-cysts
#11
Barrett S Boody, Jason W Savage
Lumbar facet cysts are a rare but increasingly common cause of symptomatic nerve root compression and can lead to radiculopathy, neurogenic claudication, and cauda equina syndrome. The cysts arise from the zygapophyseal joints of the lumbar spine and commonly demonstrate synovial herniation with mucinous degeneration of the facet joint capsule. Lumbar facet cysts are most common at the L4-L5 level and often are associated with spondylosis and degenerative spondylolisthesis. Advanced imaging studies have increased diagnosis of the cysts; however, optimal treatment of the cysts remains controversial...
December 2016: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/27790553/efficacy-of-platelet-rich-plasma-via-lumbar-epidural-route-in-chronic-prolapsed-intervertebral-disc-patients-a-pilot-study
#12
Rohan Bhatia, Gaurav Chopra
INTRODUCTION: Lumbar radiculopathy is a major health problem often treated by surgery or guided lumbar epidural steroids for pain relief. We have used Platelet Rich Plasma (PRP) a novel therapeutic tool of autologous nature that has emerged strongly in recent years to treat patients of prolapsed intervertebral disc. AIM: To evaluate the efficacy of PRP via interlaminar epidural route in treatment of pain in patients with prolapsed inter vertebral disc. MATERIALS AND METHODS: Ten patients were injected with five ml of autologous platelet rich plasma under fluoroscopic guidance via interlaminar lumbar epidural injection into area of affected nerve root...
September 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27790311/serum-levels-of-the-inflammatory-cytokines-in-patients-with-lumbar-radicular-pain-due-to-disc-herniation
#13
Bo Zu, Hong Pan, Xiao-Jun Zhang, Zong-Sheng Yin
STUDY DESIGN: Cohort study. PURPOSE: This study primarily aimed to evaluate the serum levels of tumor necrosis factor-alpha (TNF-α) and interleukin (IL)-4 in patients with lumbar radiculopathy 1 and 12 months after microdiscectomy. OVERVIEW OF LITERATURE: Lumbar radiculopathy is possibly caused by inflammatory changes in the nerve root. The intraneural application of pro-inflammatory cytokines induces behavioral signs associated with pain...
October 2016: Asian Spine Journal
https://www.readbyqxmd.com/read/27765714/individualized-functional-restoration-as-an-adjunct-to-advice-for-lumbar-disc-herniation-with-associated-radiculopathy-a-pre-planned-subgroup-analysis-of-a-randomized-controlled-trial
#14
Andrew J Hahne, Jon J Ford, Rana S Hinman, Matthew C Richards, Luke D Surkitt, Alexander Yp Chan, Sarah L Slater, Nicholas F Taylor
BACKGROUND CONTEXT: Physical therapy is commonly sought by people with lumbar disc herniation and associated radiculopathy. It is unclear whether physical therapy is effective for this population. PURPOSE: To determine the effectiveness of physical therapist delivered individualized functional restoration as an adjunct to guideline-based advice in people with lumbar disc herniation and associated radiculopathy. DESIGN: Pre-planned subgroup analysis of a multicenter parallel group randomized controlled trial...
October 17, 2016: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/27765560/the-incidence-of-adjacent-segment-disease-after-lumbar-discectomy-a-study-of-751-patients
#15
Mohamad Bydon, Mohamed Macki, Panagiotis Kerezoudis, Daniel M Sciubba, Jean-Paul Wolinsky, Timothy F Witham, Ziya L Gokaslan, Ali Bydon
INTRODUCTION: The objective of this study is to determine the incidence and prognostic factors of adjacent segment disease (ASD) following first-time lumbar discectomy (LD). METHODS: We retrospectively reviewed all neurosurgical patients who underwent first-time LD for degenerative lumbar disease from 1990 to 2012. ASD was defined as a clinical and radiographic progression of degenerative spinal disease that required surgical decompression (with or without fusion) at the level above or below the index discectomy...
October 17, 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/27764056/predictive-factors-of-the-effectiveness-of-caudal-epidural-steroid-injections-in-managing-patients-with-chronic-low-back-pain-and-radiculopathy
#16
Gregory G Billy, Ji Lin, Mengzhao Gao, Mosuk X Chow
STUDY DESIGN: Retrospective clinical outcome analysis. OBJECTIVE: To evaluate and determine whether demographic, comorbid factors, or physical examination findings may predict the outcome of caudal epidural steroid injections in managing patients with chronic low back pain and radiculopathy SUMMARY OF BACKGROUND DATA:: The caudal epidural approach is commonly utilized with patients who are on anticoagulation or who have had prior lumbar surgery to treat L5 or S1 radiculopathies...
October 19, 2016: Clinical Spine Surgery
https://www.readbyqxmd.com/read/27751929/intraoperative-loss-of-tibialis-anterior-tcemep-predicted-postoperative-foot-drop-a-case-report
#17
Qing Yue, Tyson Hale, Aaron Knecht, Jennifer Laidacker
BACKGROUND: Foot drop secondary to L5 root injury is a rare complication associated with lumbar surgery. To date, it is still not clear whether intraoperative neuromonitoring can detect such an injury. CASE DESCRIPTION: A 54-year-old man who had had bilateral chronic L5 radiculopathy underwent L4-S1 lumbosacral decompression and fusion. During the surgery, the patient lose transcranial electrical motor evoked potential (tceMEPs) from left tibialis anterior (TA) at the time of L5-S1 intervertebral cage placement...
October 14, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27751507/-spinal-extradural-arachnoid-cyst-a-case-report-and-review-of-literature
#18
Javier Quillo-Olvera, Javier Quillo-Reséndiz, Carlos-Francisco Gutiérrez-Partida, Manuel Rodríguez-García
BACKGROUND: Arachnoid cysts of spine are a very rare occurrence. The aetiology still remains unclear, but the most accepted explanation is the existence of areas of weakness in the spinal dura. Symptoms depend on the location in the spine. Magnetic resonance imaging is used for its diagnosis. Management depends of clinical presentation, and the surgery is reserved for patients with neurological impairment. CLINICAL CASE: A case is described of 67 year-old male with myelopathy and radiculopathy symptoms, both diagnosed simultaneously...
October 14, 2016: Cirugia y Cirujanos
https://www.readbyqxmd.com/read/27712027/clinical-practice-guidelines-for-the-noninvasive-management-of-low-back-pain-a-systematic-review-by-the-ontario-protocol-for-traffic-injury-management-optima-collaboration
#19
J J Wong, P Côté, D A Sutton, K Randhawa, H Yu, S Varatharajan, R Goldgrub, M Nordin, D P Gross, H M Shearer, L J Carroll, P J Stern, A Ameis, D Southerst, S Mior, M Stupar, T Varatharajan, A Taylor-Vaisey
: We conducted a systematic review of guidelines on the management of low back pain (LBP) to assess their methodological quality and guide care. We synthesized guidelines on the management of LBP published from 2005 to 2014 following best evidence synthesis principles. We searched MEDLINE, EMBASE, CINAHL, PsycINFO, Cochrane, DARE, National Health Services Economic Evaluation Database, Health Technology Assessment Database, Index to Chiropractic Literature and grey literature. Independent reviewers critically appraised eligible guidelines using AGREE II criteria...
October 6, 2016: European Journal of Pain: EJP
https://www.readbyqxmd.com/read/27707614/extreme-lateral-interbody-fusion-relieves-symptoms-of-spinal-stenosis-and-low-grade-spondylolisthesis-by-indirect-decompression-in-complex-patients
#20
Erlick A C Pereira, Mohammad Farwana, Khai S Lam
Spinal stenosis and low-grade spondylolisthesis produce symptoms of neural compression that can be treated with extreme lateral lumbar interbody fusion (XLIF) via indirect decompression. This study aimed to investigate whether the restoration of disc dimensions would relieve symptoms of radiculopathy, claudication and back pain. In this retrospective study, patients undergoing XLIF surgery for relief of radicular symptoms or degenerative disc disease were included. Radiologically proven changes were used to assess the modes of degeneration...
October 1, 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
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