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https://www.readbyqxmd.com/read/28637111/spinal-epidural-cavernous-hemangioma-case-report
#1
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/28637110/guidelines-for-cauda-equina-syndrome-red-flags-and-white-flags-systematic-review-and-implications-for-triage
#2
Nicholas V Todd
INTRODUCTION: Patients with cauda equina syndrome (CES) are frequently referred late when neurological damage cannot be reversed. National Guidelines for emergency referral, imaging and treatment of CES contain symptoms and/or signs that are those of late often, irreversible CES. Referral at this stage may be too late for that patient. METHODS: Seven sources were reviewed. Advice re emergency referral/imaging/treatment were reviewed. Symptoms/signs were compared with a standard classification of CES...
March 2, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28635877/-a-neuropathic-component-of-lumboischialgia-mechanisms-of-development-and-treatment-approaches
#3
M V Churyukanov, G E Shevtsova, O I Zagorulko
Low back pain (LBP) is accompanied by the development of pain syndrome that spreads into the leg in 25-57% of patients. This is an important factor predicting the risk of transition of pain from acute to chronic and is an indirect indicator of disease severity. It is often impossible to specify the primary mechanism facilitated pain irradiation in lumboischialgia because many structures can cause analogous symptoms. Mechanisms of development of LBP are represented by nociceptive, neuropathic and psychogenic components...
2017: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
https://www.readbyqxmd.com/read/28632645/management-of-symptomatic-lumbar-disk-herniation-an-international-perspective
#4
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/28632590/comparison-of-anterior-and-posterior-surgery-for-degenerative-cervical-myelopathy-an-mri-based-propensity-score-matched-analysis-using-data-from-the-prospective-multicenter-aospine-csm-north-america-and-international-studies
#5
So Kato, Aria Nouri, Dongjin Wu, Satoshi Nori, Lindsay Tetreault, Michael G Fehlings
BACKGROUND: Surgeons often choose between 2 different approaches (anterior and posterior) for surgical treatment of degenerative cervical myelopathy on the basis of imaging features of spinal cord compression, the number of levels affected, and the spinal alignment. However, there is a lack of consensus on which approach is preferable. The objective of the present study was to use magnetic resonance imaging (MRI)-based propensity-score-matched analysis to compare postoperative outcomes between the anterior and posterior surgical approaches for degenerative cervical myelopathy...
June 21, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28632565/neuroforaminal-bone-growth-following-minimally-invasive-transforaminal-lumbar-interbody-fusion-with-bmp-a-computed-tomographic-analysis
#6
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
#7
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
#8
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/28608175/reliability-and-validity-of-clinical-tests-to-assess-the-anatomical-integrity-of-the-cervical-spine-in-adults-with-neck-pain-and-its-associated-disorders-part-1-a-systematic-review-from-the-cervical-assessment-and-diagnosis-research-evaluation-cadre-collaboration
#9
REVIEW
Nadège Lemeunier, S da Silva-Oolup, N Chow, D Southerst, L Carroll, J J Wong, H Shearer, P Mastragostino, J Cox, E Côté, K Murnaghan, D Sutton, P Côté
OBJECTIVE: To determine the reliability and validity of clinical tests to assess the anatomical integrity of the cervical spine in adults with neck pain and its associated disorders. METHODS: We updated the systematic review of the 2000-2010 Bone and Joint Decade Task Force on Neck Pain and its Associated Disorders. We also searched the literature to identify studies on the reliability and validity of Doppler velocimetry for the evaluation of cervical arteries. Two independent reviewers screened and critically appraised studies...
June 12, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28605749/radiculopathy-in-a-patient-with-chronic-tophaceus-gout-vertebral-imaging
#10
Joana Borges, Cláudia Miguel, Susana Fernandes, Rui Leitão, Augusto Faustino
INTRODUCTION: Spinal involvement is infrequent in chronic gout. However, some cases of back pain with radiculopathy secondary to this etiology have been reported. CASE REPORT: 56-year old male patient, with history of arterial hypertension, hypertriglyceridemia, obesity, glucose intolerance and alcohol abuse, diagnosed with gout in his fifth decade of life. The patient was started on urate lowering therapy, with poor compliance, and evolved with sustained hyperuricemia, recurrent episodes of arthritis, and growth of gouty tophi on the elbows, wrists, hands and knees...
June 2, 2017: Acta Reumatológica Portuguesa
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
#11
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/28600009/the-case-for-deformity-correction-in-the-management-of-radiculopathy-with-concurrent-spinal-deformity
#12
REVIEW
Sigurd Berven, Anthony DiGiorgio
The management of adult deformity varies significantly. Options range from nonoperative care to limited decompression to decompression with limited or extensive fusion. The appropriate surgical management is the approach that optimizes the likelihood of improvement in health-related quality of life, while limiting risks of complications and costs. Decompression alone is unreliable in the setting of significant deformity contributing to radiculopathy. Decompression with limited fusion is most appropriate for patients with age-appropriate global alignment of the spine, and decompression with more extensive fusion is most appropriate for patients with progressive deformity or with global sagittal or coronal malalignment...
July 2017: Neurosurgery Clinics of North America
https://www.readbyqxmd.com/read/28600008/lumbar-radiculopathy-in-the-setting-of-degenerative-scoliosis-mis-decompression-and-limited-correction-are-better-options
#13
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
#14
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/28591077/progressive-bone-formation-after-cervical-disc-replacement-minimum-of-5-year-follow-up
#15
Feifei Zhou, Kevin L Ju, Yanbin Zhao, Fengshan Zhang, Shengfa Pan, John G Heller, Yu Sun
OBJECTIVE: Our objective was to examine the prevalence, clinical significance, ramifications, and possible etiology of postoperative bone formation at the index level after Cervical Disc Replacement (CDR) with a minimum of five years of follow-up. SUMMARY OF BACKGROUND DATA: CDR can be complicated by postoperative ossification and unwanted ankylosis at the index level, which some authors have termed "heterotopic ossification". This terminology may be inaccurate as it assumes the postoperative bone formation is unnatural and a consequence of the CDR surgery...
June 6, 2017: Spine
https://www.readbyqxmd.com/read/28587505/chronic-cervical-radiculopathic-pain-is-associated-with-increased-excitability-and-hyperpolarization-activated-current-ih-in-large-diameter-dorsal-root-ganglion-neurons
#16
Da-Lu Liu, Xu Wang, Wen-Guang Chu, Na Lu, Wen-Juan Han, Yi-Kang Du, San-Jue Hu, Zhan-Tao Bai, Sheng-Xi Wu, Rou-Gang Xie, Ceng Luo
Cervical radiculopathic pain is a very common symptom that may occur with cervical spondylosis. Mechanical allodynia is often associated with cervical radiculopathic pain and is inadequately treated with current therapies. However, the precise mechanisms underlying cervical radiculopathic pain-associated mechanical allodynia have remained elusive. Compelling evidence from animal models suggests a role of large-diameter dorsal root ganglion neurons and plasticity of spinal circuitry attached with Aβ fibers in mediating neuropathic pain...
January 2017: Molecular Pain
https://www.readbyqxmd.com/read/28581034/the-clinical-features-risk-factors-and-surgical-treatment-of-cervicogenic-headache-in-patients-with-cervical-spine-disorders-requiring-surgery
#17
Keiko Shimohata, Kazuhiro Hasegawa, Osamu Onodera, Masatoyo Nishizawa, Takayoshi Shimohata
OBJECTIVE: To clarify the clinical features and risk factors of cervicogenic headache (CEH; as diagnosed according to the International Classification of Headache Disorders-Third Edition beta) in patients with cervical spine disorders requiring surgery. BACKGROUND: CEH is caused by cervical spine disorders. The pathogenic mechanism of CEH is hypothesized to involve a convergence of the upper cervical afferents from the C1, C2, and C3 spinal nerves and the trigeminal afferents in the trigeminocervical nucleus of the upper cervical cord...
June 5, 2017: Headache
https://www.readbyqxmd.com/read/28574927/altered-functional-connectivity-of-the-periaqueductal-gray-in-chronic-neck-and-shoulder-pain
#18
Cheng-Xin Yu, Bo Li, Ya-Ka Xu, Ting-Ting Ji, Liang Li, Chang-Jiang Zhao, Long Chen, Zhi-Zheng Zhuo
Chronic neck and shoulder pain with cervical spondylotic radiculopathy (CNSP-CSR) is one of the most common clinical chronic pain diseases. This study aimed to investigate the abnormal patterns in functional connectivity (FC) pertaining to the periaqueductal gray matter (PAG) in patients with CNSP-CSR. A seed-based FC analysis was carried out for the right ventrolateral PAG and a correlation analysis was carried out with pain intensity, duration, and the extracted mean z scores. The PAG FC was significantly positively associated with the right orbital inferior frontal gyrus, supramarginal gyrus/postcentral gyrus, putamen, and the left anterior cingulate cortex, and significant negative FC was observed in the right lingual gyrus/occipital cortex in patients with CNSP-CSR...
June 1, 2017: Neuroreport
https://www.readbyqxmd.com/read/28570879/acute-onset-of-paraganglioma-of-filum-terminale-a-case-report-and-surgical-treatment
#19
Domenico Murrone, Bruno Romanelli, Giuseppe Vella, Aldo Ierardi
INTRODUCTION: Paragangliomas of filum terminale are rare benign tumors, arising from the adrenal medulla or extra-adrenal paraganglia. These lesions usually present with chronic back pain and radiculopathy and only two cases of acute neurological deficit have been reported in literature. PRESENTATION OF CASE: A case with an acute paraplegia and cauda equina syndrome due to an hemorrhagic paraganglioma of the filum terminale is described. Magnetic resonance imaging showed an intradural tumor extending from L1 to L2 compressing the cauda equina, with an intralesional and intradural bleed...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28567591/ribosomal-pcr-assay-of-excised-intervertebral-discs-from-patients-undergoing-single-level-primary-lumbar-microdiscectomy
#20
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
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