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Bulging Disc

Duygu Tecer, Emre Adiguzel, Arif Kenan Tan, Mehmet Ali Taskaynatan
OBJECTIVE:  To explore the outcome differences of lumbar transforaminal epidural steroid injection (TFESI) according to magnetic resonance imaging (MRI) findings in patients with lumbar radicular pain. DESIGN:  Retrospective study. SETTING:  Single university-based interventional pain management unit. PATIENTS:  Fifty-nine patients who had lumbar radicular pain with a recent lumbar MRI and three-month follow-up were included...
October 2, 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Masatoshi Teraguchi, Dino Samartzis, Hiroshi Hashizume, Hiroshi Yamada, Shigeyuki Muraki, Hiroyuki Oka, Jason Pui Yin Cheung, Ryohei Kagotani, Hiroki Iwahashi, Sakae Tanaka, Hiroshi Kawaguchi, Kozo Nakamura, Toru Akune, Kenneth Man-Chee Cheung, Noriko Yoshimura, Munehito Yoshida
INTRODUCTION: High intensity zones (HIZ) of the lumbar spine are a phenotype of the intervertebral disc noted on MRI whose clinical relevance has been debated. Traditionally, T2-weighted (T2W) magnetic resonance imaging (MRI) has been utilized to identify HIZ of lumbar discs. However, controversy exists with regards to HIZ morphology, topography, and association with other MRI spinal phenotypes. Moreover, classification of HIZ has not been thoroughly defined in the past and the use of additional imaging parameters (e...
2016: PloS One
Natalie Ullman, Lydia Gregg, Daniel Becker, Carlos Pardo, Philippe Gailloud
INTRODUCTION: This article describes anterior disco-osteo-arterial conflict as an insofar unsuspected mechanism of arterial flow impairment potentially leading to spinal cord ischemia and infarction. METHODS: The anterior disco-osteo-arterial conflict described in this report is illustrated with angiographic observations of patients presenting with spinal cord ischemia documented by MRI, and radiculomedullary flow impairment diagnosed by spinal digital subtraction angiography and spinal CTA...
September 10, 2016: Neuroradiology
J C Le Huec, A Cogniet, S Mazas, A Faundez
UNLABELLED: Degenerative de novo scoliosis is commonly present in older adult patients. The degenerative process including disc bulging, facet arthritis, and ligamentum flavum hypertrophy contributes to the appearance of symptoms of spinal stenosis. Idiopathic scoliosis has also degenerative changes that can lead to spinal stenosis. PURPOSE: The aetiology, prevalence, biomechanics, classification, symptomatology, and treatment of idiopathic and degenerative lumbar scoliosis in association with spinal stenosis are reviewed...
October 2016: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Rogerio Carlos Sanfelice Nunes, Elenir Rose Jardim Cury Pontes, Izaias Pereira da Costa
OBJECTIVE: Sciatic pain secondary to lumbar disc herniation is a complex condition that is often highly limiting. The causes of pain in disc herniation are multifactorial. Two physiopathological mechanisms are involved in discogenic pain: mechanical deformation of nerve roots and a biochemical inflammatory component resulting from contact between the intervertebral disc and neural tissue, by way of the nucleus pulposus. The aim of this study was to evaluate the efficacy and safety of epidural blockade as therapy for bulging lumbar disc herniation...
July 2016: Revista Brasileira de Ortopedia
S Rajasekaran, Rishi Mugesh Kanna, Ranjani Raja Reddy, Senthil Natesan, Muthuraja Raveendran, Kenneth Mc Cheung, Danny Chan, Patrick Yp Kao, Anita Yee, Ajoy Prasad Shetty
STUDY DESIGN: Prospective genetic association study OBJECTIVE.: To document the variations in the genetic associations, when different MRI phenotypes, age stratification, cohort size and sequence of cohort inclusion are varied in the same study population. SUMMARY OF BACKGROUND DATA: Genetic associations with disc degeneration have shown high inconsistency, generally attributed to hereditary factors and ethnic variations. However the effect of different phenotypes, size of the study population, age of the cohort etc have not been documented clearly...
August 10, 2016: Spine
Atul Goel, Abhidha Shah, Neeraj Patni, Raghvendra Ramdasi
The authors report four patients who presented with symptoms of cervical myelopathy. Investigations revealed a single level large cervical disc herniation that extended on the posterior surface of adjoining vertebral bodies and resulted in severe cord and root compression. From the investigations it was apparent that the posterior longitudinal ligament was essentially intact in all these cases. The patients underwent a facetal distraction-fixation surgery using Goel facetal spacers. Investigations in the immediate postoperative phase revealed a near complete disappearance of the disc bulge, restoration of the cervical cord girth and distraction-fixation-arthrodesis of the spinal segment...
July 14, 2016: World Neurosurgery
Lin Ou-Yang, Guang-Ming Lu
STUDY DESIGN: Cross-sectional study. OBJECTIVE: To explore the underlying anatomy of MTS using CT and discuss its clinical significance for typing diagnosis. SUMMARY OF BACKGROUND DATA: Because the anatomical position of the corpse cannot fully illustrate the actual clinical situation in vivo, the diversity of MTS has not been fully elucidated yet. METHODS: Retrospectively analysed the data of 69 patients with MTS. By CT showing, patients were categorized to simple MTS (sMTS, 22), lumbar degeneration-related MTS (dMTS, 33) and other causes MTS (oMTS, 14); meanwhile, a healthy control group were set...
July 1, 2016: Spine
Derick D Jones, Robert E Watson, Heather A Heaton
BACKGROUND: Fibrocartilaginous embolism is an exceedingly rare condition that was formerly a clinical diagnosis based on mechanism of injury, physical examination findings, and older magnetic resonance imaging (MRI) technologies without a specific histologic diagnosis. Spinal cord MRI diffusion-weighted imaging allows for a more specific diagnosis. CASE REPORT: A 14-year-old male felt a sudden pop in his back while running sprints in his gym class. He slowly developed bilateral lower extremity weakness and urinary incontinence, prompting an emergency department evaluation...
September 2016: Journal of Emergency Medicine
Sadhanandham Shrinuvasan, Ranganathan Chidambaram
BACKGROUND: Low back pain (LBP) is the most common symptom which is associated with limitation of normal activities and work-related disability. Imaging techniques are often essential in making the correct diagnosis for prompt management. Plain Radiography though remain a first imaging modality, magnetic resonance imaging (MRI) due to its inherent softtissue contrast resolution and lack of ionizing radiation remains invaluable modality in the evaluation of LBP. AIM: To find the common causes of LBP in different age groups and the role of MRI in detecting the spectrum of various pathological findings...
July 2016: Journal of Neurosciences in Rural Practice
Atul Goel
STUDY DESIGN: Four patients had C2-3 vertebral fusion and radiologically demonstrated cord compression at C3-4 level related to disc bulge with or without association of osteophytes and C1-2 posterior facetal dislocation. The outcome of treatment by atlantoaxial and subaxial facetal fixation is discussed. PURPOSE: The article evaluates the significance of atlantoaxial facetal instability in cases having C2-3 vertebral fusion and cord compression at the level of C3-4 disc...
June 2016: Asian Spine Journal
Akinobu Suzuki, Michael D Daubs, Tetsuo Hayashi, Monchai Ruangchainikom, Chenjie Xiong, Kevin Phan, Trevor P Scott, Jeffery C Wang
STUDY DESIGN: Retrospective analysis of kinetic magnetic resonance images (kMRIs). OBJECTIVE: (1) To analyze the changes seen on MRI related to disc degeneration and to develop a new grading system for cervical disc degeneration. (2) To evaluate the reliability and validity of the grading system. SUMMARY OF BACKGROUND DATA: Few have studied the relationship between changes seen on MRI with cervical disc degeneration and the chronological order of disc degeneration...
June 20, 2016: Clinical Spine Surgery
Seiji Okada, Charles Chang, Geraldine Chang, James J Yue
BACKGROUND CONTEXT: Venous hypertensive myelopathy (VHM) results from spinal vascular malformations of arteriovenous shunting that increases spinal venous pressure, leading to congestive edema and neurologic dysfunction. There has been no report of VHM associated with cervical spondylotic myelopathy (CSM). PURPOSE: The aim of this study was to report an extremely rare case of VHM likely due to CSM. STUDY DESIGN: This study is a case report and review of the literature...
June 9, 2016: Spine Journal: Official Journal of the North American Spine Society
Steffen Folkvardsen, Erland Magnussen, Jaro Karppinen, Juha Auvinen, Rasmus Hertzum Larsen, Christian Wong, Tom Bendix
PURPOSE: The aim was to elucidate elite swimming's possible influence on lumbar disc degeneration (DD) and low back pain (LBP). METHODS: Lumbar spine MRI was performed on a group of elite swimmers and compared to a matched Finnish population-based no-sport group. RESULTS: One hundred elite swimmers and 96 no-sport adults, mean age 18.7/20.8, respectively, participated. Overall, the two groups had similar prevalence of DD. Swimmers had more DD in the upper lumbar spine but tended to have less DD at the lowest level...
September 2016: European Spine Journal
Jinyoung Oh, Daehyun Jo, Koohyun Kim, Jungwoo Shim, Misun Roh
UNLABELLED: Lumbar spinal stenosis is one of most common pathologic conditions affecting the lumbar spine. Pain and/or disability in the low back and lower extremities with or without neurogenic claudication may occur as a result of compression of dural sac contents or nerve roots in the narrowed space. Bulging and protrusion, facet joint hypertrophy, and disc herniation combined with osteophytes and arthritic changes of facet joints can be the cause of lumbar spinal stenosis. Medical/interventional treatment may be considered as an initial treatment for patients with mild symptoms of lumbar spinal stenosis...
May 2016: Pain Physician
Mario Muto, Francesco Giurazza, Gianluigi Guarnieri, Rossana Senese, Emiliano Schena, Fabio Zeccolini, Alvaro Diano
INTRODUCTION: This study aimed to determine changes in size of lumbar spinal canal and related articular structures, during dynamic MR scans acquired in symptomatic patients standing upright using a new open MR system. METHODS: Forty patients (mean age 58.4 years) affected by lumbar back pain associated with claudication, referring symptoms since more than 6 months. No one underwent to previous spine surgery. MR scans were performed with a novel open 0.5-T scanner, patient supine and upright (90°)...
August 2016: Neuroradiology
Yan Li, Dino Samartzis, Desmond D Campbell, Stacey S Cherny, Kenneth M C Cheung, Keith D K Luk, Jaro Karppinen, Youqiang Song, Kathryn S Cheah, Danny Chan, Pak C Sham
BACKGROUND CONTEXT: Lumbar disc degeneration (LDD) is a major cause of low back pain, and is a common and disabling condition worldwide. It has been defined and measured by multiple spine magnetic resonance imaging (MRI) features, but the heterogeneity among them has never been fully addressed. PURPOSE: This study examined the intercorrelations, risk factor associations, and single nucleotide polymorphism (SNP) heritabilities of lumbar disc MRI features in a large-scale sample to classify the different intervertebral disc phenotypes associated with LDD...
September 2016: Spine Journal: Official Journal of the North American Spine Society
Min A Yoon, Suk-Joo Hong, Chang Ho Kang, Kyung-Sik Ahn, Baek Hyun Kim
PURPOSE: To assess regional variations of T1rho (T1ρ) and T2 rates within lumbar intervertebral discs and to evaluate the correlation of T1ρ and T2 rates in different disc regions with Pfirrmann grades of degeneration and morphologic changes. MATERIALS AND METHODS: We retrospectively evaluated 105 lumbar discs in 22 subjects who were examined at 3.0-T MRI. T1ρ and T2 relaxation rates (1/T1ρ and 1/T2) were measured in five segmented regions of discs: anterior annulus fibrosus (AF), anterior junction, nucleus pulposus (NP), posterior junction, and posterior AF...
September 2016: Magnetic Resonance Imaging
Xiao Deng, Feng Zhao, Baolin Kang, Xin Zhang
The present study aimed to investigate whether serum interleukin-6 (IL-6) expression levels were associated with the onset and progression of intervertebral disc degeneration (IDD). A comprehensive meta-analysis of the scientific literature from numerous electronic databases was performed, in order to obtain published studies associated with the topic of interest. Relevant case-control studies that had previously assessed a correlation between IL-6 expression levels and IDD were identified using predetermined inclusion and exclusion criteria...
April 2016: Experimental and Therapeutic Medicine
Michael Robinson
The medical management of low back pain (LBP) can be approached in a multitude of ways. Classification via subgrouping is increasingly common in orthopedic literature. Clinical diagnosis and treatment of LBP using the patient response model (PRM) can assist clinicians in hypothesizing the origin of pain and providing beneficial interventions unlike the widely used pathoanatomical model. This case report involved a 52-year-old female with sudden onset of right-sided LBP that radiated to the foot. These symptoms were accompanied by occasional paresthesias in bilateral lower extremities...
May 2016: Physiotherapy Theory and Practice
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