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Catherine E Ferland, Diana-Luk Ye, Jean A Ouellet
This case report illustrates the value of a comprehensive perioperative pain assessment composed of quantitative sensory testing and self-reported measures that highlight the impact of pain experienced by a 14-year-old boy suffering from chronic low back pain and sciatica. Before surgery, the pain assessment revealed inefficient endogenous inhibitory pain control with presence of temporal summation of pain. The severe pain was constant and lasted for 18 months. The patient was in a high-anxiety state, and reported significant functional disability and poor sleep quality...
March 12, 2018: Journal of Pediatric Health Care
Berk Hazır, Hakan Bahadır Haberal, Devrim Akıncı, Bülent Akdoğan
INTRODUCTION: A pelvic lymphocele is a collection of lymphatic fluid that develops after extensive lymphadenectomies in surgeries such as urological malignancies or renal transplantation. Pelvic lymphoceles may cause complications such as fever, abdominal pain, leg swelling, genital swelling and flank pain. This report summarizes the management of a pelvic lymphocele after open radical retropubic prostatectomy with bilateral lymphadenectomy. PRESENTATION OF CASE: Herein, we present a case in which a pelvic lymphocele developed seven months post-radical open retropubic prostatectomy and through this patient we discussed the lymphocele following radical prostatectomy...
March 6, 2018: International Journal of Surgery Case Reports
Manuel Segura-Trepichio, Antonio Martin-Benlloch, Jose Manuel Montoza-Nuñez, David Candela-Zaplana, Andreu Nolasco
BACKGROUND: Discectomy is sometimes associated with recurrence of disc herniation and pain after surgery. The evidence to use an interspinous dynamic stabilization system (IDSS) in association with disc excision to prevent pain and re-operation, remains controversial. METHODS: Patients (age 18-50 years) presenting with lumbago/sciatica (ICD-10-CM M54.3, M54.4) due to voluminous lumbar disc herniation were eligible for participation. Patients underwent microdiscectomy plus IDSS...
February 20, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Ieva Satkeviciute, George Goodwin, Geoffrey M Bove, Andrew Dilley
Local nerve inflammation (neuritis) leads to ongoing activity and axonal mechanical sensitivity (AMS) along intact nociceptor axons, and disrupts axonal transport. This phenomenon forms the most feasible cause of radiating pain, such as sciatica. We have previously shown that axonal transport disruption without inflammation or degeneration also leads to AMS, but does not cause ongoing activity at the time point when AMS occurs, despite causing cutaneous hypersensitivity. However, there have been no systematic studies of ongoing activity during neuritis or non-inflammatory axonal transport disruption...
February 21, 2018: Journal of Neurophysiology
Maria Anna Hulens, Wim Dankaerts, Ricky Rasschaert, Frans Bruyninckx, Marie-Laure Willaert, Charlotte Vereecke, Greet Vansant
BACKGROUND: Tarlov cysts (TCs) are expanded nerve root sheaths that occur near the dorsal root ganglion and result from increased intraspinal hydrostatic pressure. TCs most frequently affect the lumbosacral plexus and therefore may cause specific symptoms such as perineal pain and neurogenic bladder, bowel, and sphincter problems. It has been estimated that 1% of the population has symptomatic Tarlov cysts (STCs). However, STCs appear to be underdiagnosed, with the pain reported by patients commonly attributed to degenerative alterations seen on MRI...
February 17, 2018: Acta Neurochirurgica
Ludwig Oberkircher, Steffen Ruchholtz, Pol Maria Rommens, Alexander Hofmann, Benjamin Bücking, Antonio Krüger
BACKGROUND: The estimated incidence of osteoporotic pelvic fractures among persons over age 60 in Germany is 224 per 100 000 persons per year, and rising. A number of surgical treatment options are available, but clinical long-term data are lacking. METHODS: This review is based on pertinent publications and guidelines retrieved by a selective literature search, and on the authors' clinical experience. RESULTS: Patients often report one or more relatively trivial traumatic incidents leading up to the fracture...
February 2, 2018: Deutsches Ärzteblatt International
Jonathan A Flug, Alissa Burge, Darius Melisaratos, Theodore T Miller, John A Carrino
Sciatica is a highly prevalent cause of morbidity, commonly resulting from intra-spinal pathological processes. Many cases can have extra-spinal etiologies and can be clinically challenging. Certain scenarios should suggest an extra-spinal etiology, particularly total and revision hip arthroplasty, surgical hip dislocation, hip arthroscopy, and surgery in the lithotomy position. We review the post-operative clinical scenarios where sciatic neuropathy may occur, along with the pertinent imaging findings.
February 8, 2018: Skeletal Radiology
Aristeidis H Zibis, Vasileios D Mitrousias, Michail E Klontzas, Theofilos Karachalios, Sokratis E Varitimidis, Apostolos H Karantanas, Dimitrios L Arvanitis
PURPOSE: The purpose of this study is to point out the difficulty of differentiating great trochanter bursitis (GTB) from sciatica and estimating the prevalence of GTΒ, in patients poorly diagnosed with sciatica in their first visit to the general practitioner and referred to a spine infirmary. METHODS: The diagnosis of GTΒ was made based on history and physical examination, and was confirmed by ultrasonography and/or response to an anesthetic plus corticosteroid injection to the trochanteric bursa...
February 1, 2018: European Spine Journal
Anfeng Xiang, Mingshu Xu, Yan Liang, Jinzi Wei, Sheng Liu
BACKGROUND: Around 90% of sciatica cases are due to a herniated intervertebral disc in the lumbar region. Ankle acupuncture (AA) has been reported to be effective in the treatment of acute nonspecific low back pain. This study aims to evaluate the efficacy of a single session of ankle acupuncture for disc-related sciatica. METHOD: This will be a double-blinded, randomized controlled clinical trial. Patients diagnosed with disc-related sciatica will be randomly divided into 3 parallel groups...
December 2017: Medicine (Baltimore)
(no author information available yet)
No abstract text is available yet for this article.
February 1, 2018: New England Journal of Medicine
Dajie Wang
Chronic pain is a common medical condition. Patients who suffer uncontrolled chronic pain may require interventions including spinal injections and various nerve blocks. Interventional procedures have evolved and improved over time since epidural injection was first introduced for low back pain and sciatica in 1901. One of the major contributors in the improvement of these interventions is the advancement of imaging guidance technologies. The utilization of image guidance has dramatically improved the accuracy and safety of these interventions...
January 26, 2018: Current Pain and Headache Reports
DeWei Song, Ming Tang, CanHui Li, DeYong Song, ChangBing Wang, TianHang Xuan
OBJECTIVE: Double-level isthmic spondylolisthesis in the lumbar spine is rare. The authors report on 21 cases of double-level isthmic spondylolisthesis treated by posterior lumbar interbody fusion (PLIF) with cage. PATIENTS AND METHODS: Between 2005 and 2015, twenty-one patients with double-level isthmic spondylolisthesis who underwent posterior lumbar interbody fusion (PLIF) with cage were reviewed retrospectively. The VAS (Visual Analogue Scale) and JOA (Japanese Orthopedic Association) score were used to evaluate preoperative and postoperative clinical outcomes...
January 23, 2018: British Journal of Neurosurgery
Kris E Radcliff, Greg Schroeder
No abstract text is available yet for this article.
January 1, 2018: Interventional Neuroradiology
Nassim Bougaci, Stephane Litrico, Fanny Burel-Vandenbos, Philippe Paquis
Myxopapillary ependymoma is a rare tumour of the central nervous system (CNS); this subtype of ependymoma occurs most frequently in cauda equina, conus medullaris or filum terminale. The treatment consists of complete removal of the tumour including its capsule when possible since it is usually a solitary lesion. Non-Hodgkin lymphoma of the CNS is found in only 1.3% of cauda equina tumours. We report the case of a 62-year-old man who presented to our institution with progressive weakness of his right lower extremity, with numbness and paresthesia of both feet...
December 2017: Journal of Spine Surgery (Hong Kong)
Yi Jiang, Ru-Jun Zuo, Lei Wu, Cheng Huang, Yan Shi, Hua-Wei Song, Yi-Wei Wang, Bin Li
OBJECTIVE: To analyze the clinical effects of percutaneous endoscopic technique via three different approaches for highly migrated lumbar disc herniation. METHODS: The clinical data of 68 patients underwent percutaneous endoscopic technique from June 2011 to June 2014 were retrospectively analyzed. There were 43 males and 25 females, aged from 11 to 77 years old with an average of (42.29±15.92) years. The patients were divided into three groups according to different operative approaches, of them, 45 cases were by transforaminal approach (group A), 15 cases by translaminar approach (group B), and 8 cases by transpedicular approach (group C)...
February 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Henry Xiao, Christopher Zaslawski, Janette Vardy, Byeongsang Oh
For women, gynaecological or obstetrical disorders are second to disc prolapse as the most common cause of sciatica. As not many effective conventional treatments can be found for sciatica following uterine cancer, patients may seek assistance from complementary and alternative medicine. Here, we present a case of a woman with severe and chronic sciatica secondary to uterine cancer who experienced temporary relief from acupuncture.
January 15, 2018: Medicines (Basel, Switzerland)
Siobhán Stynes, Kika Konstantinou, Reuben Ogollah, Elaine M Hay, Kate M Dunn
Traditionally, low back-related leg pain (LBLP) is diagnosed clinically as referred leg pain or sciatica (nerve root involvement). However, within the spectrum of LBLP, we hypothesised that there may be other unrecognised patient subgroups. This study aimed to identify clusters of patients with LBLP using latent class analysis and describe their clinical course. The study population was 609 LBLP primary care consulters. Variables from clinical assessment were included in the latent class analysis. Characteristics of the statistically identified clusters were compared, and their clinical course more than 1 year was described...
January 9, 2018: Pain
Kelvin Robertson, Laurence A G Marshman, Maria Hennessy, Linton Harriss, David Plummer
BACKGROUND: There is currently an absence of high-grade evidence regarding the treatment of chronic sciatica (CS). Whilst gabapentin (GBP) and pregabalin (PGB) are both currently used to treat CS, equipoise exists regarding their individual use. In particular, no head-to-head study of GBP and PGB in CS exists. Despite equipoise, most countries' formulary regulatory authorities typically favour one drug for subsidy over the other. This hinders interchange wherever the favoured drug is either ineffective or not tolerated...
January 9, 2018: Trials
Juan Manuel Revuelta Barbero, Anwar Saab Mazzei, Carlos Cotúa Quinteros, Laura de Reina
OBJECTIVE: To present a case of a well-differentiated primary intradural-extramedullary neuroendocrine tumor of the filum terminale and to conduct a literature review. CASE: A 68-years old patient was assessed after presenting lower back pain and sciatica with ineffective pain relief. The patient presented an intradural-extramedullary lumbar lesion arising from the filum terminale, which was partially resected. The pathology diagnosis was a well-differentiated primary neuroendocrine tumor (carcinoid tumor)...
December 30, 2017: Neurocirugía
C Ludwig, C Luthy, A F Allaz, F R Herrmann, C Cedraschi
PURPOSE: The present study aims at investigating the effects of low back pain (LBP), i.e., type of symptoms, activity limitations, frequency, duration, and severity on health-related quality of life (HRQoL) in a sample of 707 community-dwelling men and women aged ≥ 65 years living in Switzerland. METHODS: The study is part of a larger survey conducted in Switzerland on a sample of older adults selected randomly from population records, stratified by age and sex...
December 15, 2017: European Spine Journal
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