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Leg pain

Chao Liu, Yue Zhou
OBJECTIVE: To compare the clinical outcomes of patients with recurrent lumbar disc disease undergoing percutaneous endoscopic lumbar discectomy and minimally invasive transforaminal lumbar Interbody fusion at a single clinic. METHODS: Between January 2008 to January 2014, 401 consecutive patients with first time of recurrent lumbar disc herniation which were treated with PELD or MIS-TLIF. The data collected prospectively for analysis were clinical and radiographic results after revision surgery and complications...
October 20, 2016: World Neurosurgery
William T Obremskey, Norele Cutrera, Christopher M Kidd
BACKGROUND: The purpose of this study was to determine optimal treatment of stable tibial shaft fractures using intramedullary nailing (IMN) or casting. MATERIALS AND METHODS: We performed a multi-center prospective study cohort. Patients with stable tibia shaft fractures meeting Sarmiento's criteria (isolated closed fractures with less than 12 mm of shortening and 10° of angulation) were enrolled prospectively and treated with either a reamed IMN with static interlocking screws or closed reduction followed by long-leg casting...
October 21, 2016: Journal of Orthopaedics and Traumatology: Official Journal of the Italian Society of Orthopaedics and Traumatology
Alexander A Theologis, Gregory M Mundis, Stacie Nguyen, David O Okonkwo, Praveen V Mummaneni, Justin S Smith, Christopher I Shaffrey, Richard Fessler, Shay Bess, Frank Schwab, Bassel G Diebo, Douglas Burton, Robert Hart, Vedat Deviren, Christopher Ames
OBJECTIVE The aim of this study was to evaluate the utility of supplementing long thoracolumbar posterior instrumented fusion (posterior spinal fusion, PSF) with lateral interbody fusion (LIF) of the lumbar/thoracolumbar coronal curve apex in adult spinal deformity (ASD). METHODS Two multicenter databases were evaluated. Adults who had undergone multilevel LIF of the coronal curve apex in addition to PSF with L5-S1 interbody fusion (LS+Apex group) were matched by number of posterior levels fused with patients who had undergone PSF with L5-S1 interbody fusion without LIF (LS-Only group)...
October 21, 2016: Journal of Neurosurgery. Spine
David Altschul, Andrew Kobets, Jonathan Nakhla, Ajit Jada, Rani Nasser, Merritt D Kinon, Reza Yassari, John Houten
OBJECTIVE Postoperative urinary retention (POUR) is a common problem leading to morbidity and an increased hospital stay. There are limited data regarding its baseline incidence in patients undergoing spinal surgery and the risk factors with which it may be associated. The purpose of this study was to evaluate the incidence of POUR in elective spine surgery patients and determine the factors associated with its occurrence. METHODS The authors retrospectively reviewed the records of patients who had undergone elective spine surgery and had been prospectively monitored for POUR during an 18-month period...
October 21, 2016: Journal of Neurosurgery. Spine
Finja Jockenhöfer, Katharina Herberger, Jörg Schaller, Katja Christina Hohaus, Maren Stoffels-Weindorf, Philipp Al Ghazal, Matthias Augustin, Joachim Dissemond
INTRODUCTION: Pyoderma gangrenosum (PG) is a rare neutrophilic, ulcerative skin disease of largely unknown pathophysiology. MATERIAL AND METHODS: In this study, potentially relevant cofactors and comorbidities in patients with PG from three dermatological wound care centers in Germany were evaluated. RESULTS: Of the 121 patients assessed, women (66.9 %) were more frequently affected than men. Patient age ranged from 18 to 96 years (mean 59...
October 2016: Journal der Deutschen Dermatologischen Gesellschaft, Journal of the German Society of Dermatology: JDDG
Meta N Eek, Kate Himmelmann
Spasticity and muscle weakness is common in children with cerebral palsy (CP). Spasticity can be treated with botulinum neurotoxin-A (BoNT-A), but this drug has also been reported to induce muscle weakness. Our purpose was to describe the effect on muscle strength in the lower extremities after BoNT-A injections in children with CP. A secondary aim was to relate the effect of BoNT-A to gait pattern and range of motion. Twenty children with spastic CP were included in the study, 8 girls and 12 boys (mean age 7...
2016: Frontiers in Human Neuroscience
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
Robert M Van Haren, Lee J Goldstein, Omaida C Velazquez, Jagajan Karmacharya, Arash Bornak
OBJECTIVE: Aortobifemoral bypass has been the gold standard treatment for extensive aortoiliac occlusive disease. Endovascular therapy and stenting of aortic and iliac occlusive lesions has proven to be efficacious, especially when dealing with short segment lesions. Endovascular treatment of TransAtlantic Inter-Society Consensus II (TASC) D aortoiliac occlusive lesions remains a challenge, but a valuable treatment option in poor surgical candidates. We present our operative technique and midterm results in treating TASC D aortoiliac occlusive disease using unibody bifurcated endografts...
October 17, 2016: Journal of Vascular Surgery
Kristin L Garlanger, Elena J Jelsing, Jonathan T Finnoff
A 33-year-old elite female runner presented to a tertiary care sports medicine clinic with a 2-year history of progressive anterior thigh and circumferential leg pain with associated foot paresthesias brought on by high-intensity running. She had both external iliac artery vasospasm and chronic exertional compartment syndrome. External iliac artery vasospasm is a rare cause of exertional leg pain, particularly in the running population. This case highlights the unique features of this condition, addresses the multidisciplinary approach that led to the accurate diagnoses, and demonstrates that more than 1 etiology for exertional leg pain can coexist in an athlete...
October 19, 2016: Sports Health
Emily B Devine, Rafael Alfonso-Cristancho, N David Yanez, Todd C Edwards, Donald L Patrick, Cheryl A L Armstrong, Allison Devlin, Rebecca G Symons, Mark H Meissner, Ellen L T Derrick, Danielle C Lavallee, Larry G Kessler, David R Flum
Importance: Intermittent claudication (IC) is the most common presentation of infrainguinal peripheral artery disease. Both medical and revascularization interventions for IC aim to increase walking comfort and distance, but there is inconclusive evidence of the comparative benefit of revascularization given the possible risk of limb loss. Objective: To compare the effectiveness of a medical (walking program, smoking cessation counseling, and medications) vs revascularization (endovascular or surgical) intervention for IC in the community, focusing on outcomes of greatest importance to patients...
October 19, 2016: JAMA Surgery
Anand Hari Segar, Jill P G Urban, Jeremy C T Fairbank, Andrew Judge
STUDY DESIGN: A prospective observational study. OBJECTIVE: The aim of this study was to identify the relationship between obesity, quantified by body mass index (BMI), and both back and leg pain in spinal patients. SUMMARY OF BACKGROUND DATA: Obesity and back pain are massive public health problems. Given the poor correlation between pain and a pathological change in the spine, further investigation is required into other, nonpathological predictors such as obesity...
October 15, 2016: Spine
Ru-Sen Zhu, Yi-Ming Ren, Jian-Jun Yuan, Zi-Jian Cui, Jun Wan, Bao-You Fan, Wei Lin, Xian-Hu Zhou, Xue-Li Zhang
Lumbar disc herniation (LDH) is a common disease and lumbar discectomy is the most common surgical procedure carried out for patients with low back pain and leg symptoms. Although most researchers are focusing on the surgical techniques during operation, the aim of this study is to evaluate the effect of local intervertebral lavage during microdiscectomy.In this retrospective study, 410 patients were operated on by microdiscectomy for LDH during 2011 to 2014. Retrospectively, 213 of them (group A) accepted local intervertebral irrigation with saline water before wound closure and 197 patients (group B) only had their operative field irrigated with saline water...
October 2016: Medicine (Baltimore)
Donald W Buck, Karen L Herbst
Lipedema, or adiposis dolorosa, is a common adipose tissue disorder that is believed to affect nearly 11% of adult women worldwide. It is characterized most commonly by disproportionate adipocyte hypertrophy of the lower extremities, significant tenderness to palpation, and a failure to respond to extreme weight loss modalities. Women with lipedema report a rapid growth of the lipedema subcutaneous adipose tissue in the setting of stress, surgery, and/or hormonal changes. Women with later stages of lipedema have a classic "column leg" appearance, with masses of nodular fat, easy bruising, and pain...
September 2016: Plastic and Reconstructive Surgery. Global Open
Iftah Nudel, Luis Dorfmann, Gal deBotton
Compartment syndrome (CS) occurs when the pressure in an enclosed compartment increases due to tissue swelling or internal bleeding. As the intra-compartmental pressure (ICP) builds up, the blood flow to the tissue or the organ is compromised, resulting in ischemia, necrosis and damage to the nerves and other tissues. At the present there are no established diagnostic procedures, and clinical observations such as pain, paralysis and even compartment pressure monitoring are an unreliable determinant of the presence of the syndrome...
October 18, 2016: Mathematical Medicine and Biology: a Journal of the IMA
Mark F Sommerfeldt, Christopher C Kaeding
A 22-year-old football punter complained of anterior knee pain deep to his patellar tendon that occurred every time the knee of his kicking leg reached full extension during a punt. Arthroscopy confirmed anterior impingement between a fibrous tissue eminence directly anterior to his anterior cruciate ligament (ACL) and the intercondylar roof in full extension. With the eminence removed, full extension no longer caused impingement as demonstrated arthroscopically. He resumed punting at maximal effort 6 weeks postoperatively without pain...
October 6, 2016: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
L Angius, B Pageaux, J Hopker, S M Marcora, A R Mauger
Transcranial direct current stimulation (tDCS) can increase cortical excitability of a targeted brain area, which may affect endurance exercise performance. However, optimal electrode placement for tDCS remains unclear. We tested the effect of two different tDCS electrode montages for improving exercise performance. Nine subjects underwent a control (CON), placebo (SHAM) and two different tDCS montage sessions in a randomised design. In one tDCS session, the anodal electrode was placed over the left motor cortex and the cathodal on contralateral forehead (HEAD), while for the other montage the anodal electrode was placed over the left motor cortex and cathodal electrode above the shoulder (SHOULDER)...
October 14, 2016: Neuroscience
Raghu L Motaganahalli, Matthew R Smeds, Michael P Harlander-Locke, Peter F Lawrence, Naoki Fujimura, Randall R DeMartino, Giovanni De Caridi, Alberto Munoz, Sherene Shalhub, Susanna H Shin, Kwame S Amankwah, Hugh A Gelabert, David A Rigberg, Jeffrey J Siracuse, Alik Farber, E Sebastian Debus, Christian Behrendt, Jin H Joh, Naveed U Saqib, Kristofer M Charlton-Ouw, Catherine M Wittgen
BACKGROUND: Adventitial cystic disease (ACD) is an unusual arteriopathy; case reports and small series constitute the available literature regarding treatment. We sought to examine the presentation, contemporary management, and long-term outcomes using a multi-institutional database. METHODS: Using a standardized database, 14 institutions retrospectively collected demographics, comorbidities, presentation/symptoms, imaging, treatment, and follow-up data on consecutive patients treated for ACD during a 10-year period, using Society for Vascular Surgery reporting standards for limb ischemia...
October 14, 2016: Journal of Vascular Surgery
Jennifer L Schroeck, James Ford, Erin L Conway, Kari E Kurtzhalts, Megan E Gee, Krista A Vollmer, Kari A Mergenhagen
PURPOSE: Insomnia is problematic for older adults. After behavioral modifications fail to show adequate response, pharmacologic options are used. The pharmacokinetics of agents used to treat insomnia may be altered. This review focuses on the safety and efficacy of medications used to treat insomnia. METHODS: A literature search of Medline, PubMed, and Embase was conducted (January 1966-June 2016). It included systematic reviews, randomized controlled trials, observational studies, and case series that had an emphasis on insomnia in an older population...
October 14, 2016: Clinical Therapeutics
Guoxin Fan, Xinbo Wu, Shunzhi Yu, Qi Sun, Xiaofei Guan, Hailong Zhang, Xin Gu, Shisheng He
The aim of this study was to directly compare the clinical outcomes of posterior lumbar interbody fusion (PLIF) and minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) in three-level lumbar spinal stenosis. This retrospective study involved a total of 60 patients with three-level degenerative lumbar spinal stenosis who underwent MIS-TLIF or PLIF from January 2010 to February 2012. Back and leg visual analog scale (VAS), Oswestry Disability Index (ODI), and Short Form-36 (SF-36) scale were used to assess the pain, disability, and health status before surgery and postoperatively...
2016: BioMed Research International
Bhagya Ranjan Jena, Anil Paswan, Yashpal Singh, Sandeep Loha, Anil Prasad Singh, Virendra Rastogi
BACKGROUND: Radiofrequency (RF) is a minimally invasive target-selective technique that has been used with success for many years in the treatment of different pathologies, such as low back pain, trigeminal neuralgia, and others. AIM: The aim of this study is to compare different mode of RF - continuous RF (CRF) versus pulsed RF (PRF) along with steroid in the management of low back pain of discogenic origin. SETTING AND DESIGN: Prospective, randomized, double-blind trial...
September 2016: Anesthesia, Essays and Researches
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