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Cauda equina

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https://www.readbyqxmd.com/read/29137917/radiation-exposure-with-hybrid-image-guidance-based-minimally-invasive-transforaminal-lumbar-interbody-fusion
#1
Michael M Safaee, Taemin Oh, Murat Pekmezci, Aaron J Clark
The transforaminal lumbar interbody fusion (TLIF) is used for the treatment of back and leg pain secondary to spinal stenosis, degenerative disc disease, and spondylolisthesis. Minimally invasive surgery (MIS) is associated with less estimated blood loss (EBL), decreased length of stay, lower infection rates, and similar outcomes compared to the traditional TLIF. Fluoroscopy time has been reported with MIS-TLIF, but there are limited data on specific radiation dosages. We performed a retrospective analysis of a prospectively acquired cohort of patients undergoing MIS-TLIF...
November 11, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29137416/analysis-of-clinical-and-neurological-outcomes-in-patients-with-cauda-equina-syndrome-caused-by-acute-lumbar-disc-herniation-a-retrospective-prospective-study
#2
Si-Dong Yang, Feng Zhang, Wen-Yuan Ding
Objectives: In this research we analyzed the results of surgical treatment of cauda equina syndrome (CES) caused by acute lumbar disc herniation. We emphasize the early treatment for good neurological recovery. Methods: A retrospective-prospective, non randomized, clinical study was performed between Jan 2010 and Dec 2014. We retrospectively collected medical records of 18 patients who suffered from CES due to acute lumbar disc herniation and followed up them regularly...
October 13, 2017: Oncotarget
https://www.readbyqxmd.com/read/29119044/nursing-review-of-diagnosis-and-treatment-of-lumbar-degenerative-spondylolisthesis
#3
Nancy E Epstein, Renee D Hollingsworth
Background: In the lumbar spine, degenerative spondylolisthesis or degenerative (not traumatic) slippage of one vertebral body over another is divided into 4 grades - grade I (25%), grade II (50%), grade III (75%), and grade IV (100%). Dynamic X-rays, magnetic resonance (MR), and computed tomography (CT) scans document the slip secondary to arthritic changes of the facet joint plus stenosis, ossification of the yellow ligament, disc herniations, and synovial cysts. MR best demonstrates soft tissue pathology whereas CT better delineates ossific/calcified disease...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/29114289/conus-medullaris-arachnoid-cyst-presenting-as-cauda-equina-syndrome
#4
Salman Sharif, Afifa Afsar, Mohsin Qadeer
Intradural arachnoid cysts are a rare cause of spinal cord and nerve root compression. Primarily, they are present in the thoracic region posteriorly. We report a 25-year-old man who had an intradural arachnoid cyst at the level of conus medullaris presenting with cauda equina syndrome, which is very rare.
October 2017: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/29113923/effects-of-spinal-non-viral-interleukin-10-gene-therapy-formulated-with-d-mannose-in-neuropathic-interleukin-10-deficient-mice-behavioral-characterization-mrna-and-protein-analysis-in-pain-relevant-tissues
#5
Arden G Vanderwall, Shahani Noor, Melody S Sun, Jacob E Sanchez, Xuexian O Yang, Lauren L Jantzie, Nikolaos Mellios, Erin D Milligan
Studies show that spinal (intrathecal; i.t.) interleukin-10 (IL-10) gene therapy reverses neuropathic pain in animal models, and co-administration with the mannose receptor (MR; CD206) ligand d-mannose (DM) greatly improves therapeutic efficacy. However, the actions of endogenous IL-10 may be required for enduring pain control observed following i.t. IL-10 gene therapy, potentially narrowing the application of this non-viral transgene delivery approach. Here, we show that i.t. application of naked plasmid DNA expressing the IL-10 transgene co-injected with DM (DM/pDNA-IL-10) for the treatment of peripheral neuropathic pain in IL-10 deficient (IL-10 KO) mice results in a profound and prolonged bilateral pain suppression...
November 4, 2017: Brain, Behavior, and Immunity
https://www.readbyqxmd.com/read/29107720/sporadic-intradural-extramedullary-hemangioblastoma-of-the-cauda-equina-case-report-and-literature-review
#6
Douglas Blaty, Michael Malos, Thomas Palmrose, Stephen McGirr
BACKGROUND: The purpose of this case report is to present a rare finding of an intradural extramedullary hemangioblastoma of the cauda equina, with literature review. Spinal hemangioblastomas account for 1-5% of all spinal cord tumors. While spinal hemangioblastomas are rare, it is exceedingly rare to have a case of intradural extramedullary hemangioblastoma of the spine, especially in isolation without von-Hippel-Lindau syndrome. Only 20 previous cases have been reported. CASE DESCRIPTION: An 82-year-old male presented with MRI evidence of an intradural mass at the L4 spinal level...
October 28, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29097954/redundant-nerve-root-in-a-patient-with-chronic-lumbar-degenerative-canal-stenosis
#7
Federico E Villafañe, Allison Harvey, Norman Kettner
Objective: The purpose of this case report is to describe the diagnostic imaging features of redundant nerve roots caused by chronic lumbar degenerative canal stenosis (CLDCS). Clinical Features: A 56-year-old male presented with severe low back pain. He experienced pain during minimal active lumbar range of motion. The patient demonstrated weakness of the right iliopsoas and hypoesthesia of the L-2 dermatome. A working diagnosis of CLDCS was established. The patient's worsening severe low back pain warranted magnetic resonance imaging of the lumbar spine, which was performed for further evaluation...
September 2017: Journal of Chiropractic Medicine
https://www.readbyqxmd.com/read/29057364/pemlif-a-tale-of-two-stories
#8
Raja K Kutty, Balakrishnan Sreemathyamma Sunilkumar, Anilkumar Peethambaran, Sourabh Kumar Jain, Shailesh Kumar
Intervertebral disc prolapse is a common cause of both acute and chronic low back pain. This can result in differential grades of motor and sensory disturbances in lower limbs and even cauda equina syndrome (CES). The neurological manifestations are a result of compression of the spinal cord and roots ventrally in the spinal canal due to the prolapsed disc. However, neurologic deficits owing to compression of the spinal cord dorsally as a result of migration of sequestrated disc fragments are very rare. We present two different cases of back pain with severe neurologic deficit referred to us within a short span of one month...
September 2017: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/29055285/delayed-spontaneous-resorption-of-lumbar-intervertebral-disc-herniation-a-case-report
#9
You Jin Jung, Joon-Shik Shin, Jinho Lee, Yoon Jae Lee, Me-Riong Kim, In-Hyuk Ha
Background • Large intervertebral disc herniation is often managed with surgery, but it is not uncommon for spontaneous resorption of herniated disc material to occur. Although the majority of spontaneous disc resorption occurs in the acute phase, an unusual case of delayed intervertebral disc regression at 18 mo postonset is presented. Case Presentation • A 32-y-old female patient presented with acute low-back pain and pain in both legs a Korean medicine hospital specializing in spinal disorders. Massive intervertebral disc herniation was found on lumbar magnetic resonance imaging (MRI), and inguinal and genital pain and numbness was suggestive of risk of cauda equina syndrome...
October 21, 2017: Alternative Therapies in Health and Medicine
https://www.readbyqxmd.com/read/29038738/a-case-of-infective-endocarditis-and-spinal-epidural-abscess-caused-by-streptococcus-mitis-bacteremia
#10
Victoria S Byrd, Attila S Nemeth
A 57-year-old man presented with abdominal pain, hematemesis, and melena. He reported taking high-dose ibuprofen for back pain and drinking several 24-ounce beers daily. Examination was remarkable for icteric sclera, poor dentition, tachycardia, and crescendo-decrescendo murmur at right upper sternal border, radiating to the carotids. Labs revealed leukocytosis, anemia, thrombocytopenia, and elevated liver function tests and INR. Endoscopy demonstrated antral ulcers, duodenitis, and esophagitis. Blood cultures were obtained and broad-spectrum antibiotics started; cultures later grew Streptococcus mitis, and antibiotic coverage was narrowed...
2017: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/29023556/lumbar-spinal-canal-mri-diameter-is-smaller-in-herniated-disc-cauda-equina-syndrome-patients
#11
Nina S Korse, Mark C Kruit, Wilco C Peul, Carmen L A Vleggeert-Lankamp
INTRODUCTION: Correlation between magnetic resonance imaging (MRI) and clinical features in cauda equina syndrome (CES) is unknown; nor is known whether there are differences in MRI spinal canal size between lumbar herniated disc patients with CES versus lumbar herniated discs patients without CES, operated for sciatica. The aims of this study are 1) evaluating the association of MRI features with clinical presentation and outcome of CES and 2) comparing lumbar spinal canal diameters of lumbar herniated disc patients with CES versus lumbar herniated disc patients without CES, operated because of sciatica...
2017: PloS One
https://www.readbyqxmd.com/read/29021888/a-good-short-term-outcome-in-delayed-decompression-of-cauda-equina-syndrome-in-klebsiella-pneumoniae-spinal-epidural-abscess-a-case-report
#12
J Hanifah, J Joehaimey, M I Yusof
Spinal epidural abscess is a severe, generally pyogenic, infection of the epidural space of spinal cord or cauda equina. The swelling caused by the abscess leads to compression or vascular disruption of neurological structures that requires urgent surgical decompression to avoid significant permanent disability. We share a rare case of Klebsiella pneumoniae spinal epidural abscess secondary to haematogenous spread of previous lung infection that presented late at our centre with cauda equina syndrome that showed good short-term outcome in delayed decompression...
July 2017: Malaysian Orthopaedic Journal
https://www.readbyqxmd.com/read/29019641/spine-conditions-lumbar-spinal-stenosis
#13
Steven D Trigg, Zachary Devilbiss
Lumbar spinal stenosis (LSS) is a frequent cause of chronic low back and lower extremity pain in older patients. Symptomatic LSS typically is described as neurogenic claudication consisting of pain, weakness, numbness, and/or fatigue arising in the back and radiating into the buttock, thigh, or lower leg. The diagnosis is complicated by lack of reliable clinical or x-ray criteria. North American Spine Society guidelines recommend magnetic resonance imaging study without contrast to confirm anatomic narrowing of the spinal canal or nerve root impingement...
October 2017: FP Essentials
https://www.readbyqxmd.com/read/29019640/spine-conditions-mechanical-and-inflammatory-low-back-pain
#14
Christopher Ledford
Mechanical low back pain (LBP) is an injury or derangement of an anatomic structure in the low back. When evaluating patients with LBP, clinicians should maintain clinical suspicion for vertebral fracture, cancer, and cauda equina syndrome. Management includes patient education focused on exercise, massage, and behavioral approaches such as cognitive behavioral therapy. Acupuncture can be an effective alternative and specific herbal supplements may provide short-term pain relief. The prognosis for patients with mechanical LBP is good...
October 2017: FP Essentials
https://www.readbyqxmd.com/read/28993994/efficacy-and-factors-determining-the-outcome-of-dorsal-root-entry-zone-lesioning-procedure-drezotomy-in-the-treatment-of-intractable-pain-syndrome
#15
Nontaphon Piyawattanametha, Bunpot Sitthinamsuwan, Pramote Euasobhon, Nantthasorn Zinboonyahgoon, Pranee Rushatamukayanunt, Sarun Nunta-Aree
BACKGROUND: Chronic pain is a disabling condition that adversely affects patient quality of life. The dorsal root entry zone lesioning procedure (DREZotomy) is a modality used to treat intractable pain caused by insults to neural structures. This study aimed to investigate the efficacy of and the factors that determine the outcome of microsurgical DREZotomy (MDT). METHOD: All consecutive patients who underwent MDT for treatment of intractable pain during September 2008 to December 2016 were enrolled...
October 9, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28969225/cauda-equina-syndrome-in-a-lactating-mother-a-safe-treatment-approach
#16
Ajay Kothari, Ketan Khurjekar, Shailesh Hadgaonkar, Himanshu Kulkarni, Parag Sancheti
Cauda equina syndrome is widely considered as a surgical emergency. The cause of cauda equina syndrome usually is a large central lumbar disc herniation, prolapse or sequestration. Decompression at the earliest has been suggested by many authors but the planning of surgical management becomes challenging when the patient is a breastfeeding mother. Fear of harmful effects of the drugs (administered in the mother) on the infant, always confuses clinicians regarding the treatment approach. So the multidisciplinary approach is necessary with involvement of anaesthetist, paediatrician and also a gynaecologist if necessary...
August 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28967358/causes-of-pain-in-patients-with-axial-spondyloarthritis
#17
REVIEW
Uta Kiltz, Xenofon Baraliakos, Andrea Regel, Bjoern Bühring, Juergen Braun
Back pain, most frequently of the inflammatory type, is the leading symptom in patients with axial spondyloarthritis (axSpA). Back pain in these patients is usually either due to axial inflammation or structural changes based on new bone formation. However, there are other possible causes of pain in these patients. There is, for example, a strongly increased risk of vertebral fractures, and, especially in patients with longstanding disease, degenerative spinal changes may play an additional role as a cause of pain...
September 2017: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/28952182/effects-of-duloxetine-on-pain-and-walking-distance-in-neuropathic-pain-models-via-modulation-of-the-spinal-monoamine-system
#18
K Minami, R Tamano, E Kasai, H Oyama, M Hasegawa, S Shinohara, T Asaki
BACKGROUND: Approximately 40% of patients with chronic low back pain have a neuropathic component. In this study, we assessed the effects of analgesics on tactile hypersensitivity and walking distance in the rat cauda equina compression (CEC) model of neuropathic low back pain. METHODS: The effects of analgesics on tactile hypersensitivity were examined using the von Frey test in CEC and partial sciatic nerve ligation (pSNL) models. Effects on walking distance were assessed using a treadmill test...
September 26, 2017: European Journal of Pain: EJP
https://www.readbyqxmd.com/read/28951353/-delayed-decompression-for-cauda-equina-syndrome-secondary-to-lumbar-disc-herniation-long-term-follow-up-results
#19
Xun-Wei Lai, Wei Li, Ji-Xing Wang, Hui-Jian Zhang, Hong-Mei Peng, De-Hong Yang
OBJECTIVE: To assess the impact of delayed decompression on long-term neurological and bladder function recovery in patients with cauda equina syndrome (CES) secondary to lumbar disc herniation (LDH). METHODS: The clinical data of 35 patients receiving delayed decompression surgery for CES secondary to LDH were reviewed. The bladder empty function, bowel control, sexual ability and neurological functions of the lower limbs were evaluated after the operation, and the urodynamic changes were assessed in 6 patients with urodynamic data before and after the operation...
September 20, 2017: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
https://www.readbyqxmd.com/read/28948120/oxidized-cellulose-surgicel-causing-postoperative-cauda-equine-syndrome
#20
Tarush Rustagi, Kunal Patel, Sujit Kadrekar, Akshay Jain
Hemostatic agents are often used in spine surgery to control excessive bleeding. Oxidized cellulose (OC) is a common hemostatic agent used for this purpose. We present a case of postoperative cauda equina syndrome caused by Surgicel (Johnson & Johnson, New Jersey, US). An emergent decompression led to complete recovery. All attempts should be made to remove OC before closure after hemostasis has been achieved.
July 21, 2017: Curēus
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