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lumbar herniated disk

A Spallone, M Çelniku
A 49 years-old man came to our attention with severe flaccid paraparesis occurring 10 days before, almost immediately after he had immerged his legs in boiling water for treating his severe left lombo-crural pain. This was known to be due to a right L3-L4 herniated disk diagnosed by MRI. At the examination he showed severe motor paresis and absent reflexes of his lower limbs, whilst crural pain was very mild and sensation and urinary function were unaffected. The results of his neurological examination led us to suspect an acute motor axon degeneration related to the heating shock...
October 11, 2016: World Neurosurgery
Daniele Vanni, Renato Galzio, Anna Kazakova, Matteo Guelfi, Andrea Pantalone, Vincenzo Salini, Vincenzo Magliani
Lumbar disk herniation (LDH) is a degenerative pathology. Although LDH generally occurs without migration of the fragment to the levels above or below, in 10% of the cases, this circumstance might happen. In these cases, the standard interlaminar approach, described by Caspar cannot be performed without laminotomies, interlaminectomies, or partial or total facetectomies. The translaminar approach is the only "tissue-sparing" technique viable in cases of cranially migrated LDH encroaching on the exiting nerve root in the preforaminal zones, for the levels above L2-L3, and in the preforaminal and foraminal zones, for the levels below L3-L4 (L5-S1 included, if a total microdiscectomy is unnecessary)...
December 2015: J Spine Surg
Samia Frioui Mahmoudi, Emna Toulgui, Sonia Jemni, Khalil Ben Jeddou, Mariem Gaddour, Afif Zaoui, Faycel Khachnaoui
OBJECTIVE: To talk through our observation and a review of the literature about radiological features and diagnostic difficulties of this particular form of disk migration. OBSERVATIONS: We report the case of a 29 year-old patient who presented following the wearing of a heavy load bilateral acute lombosciatalgies associated with a deficit of both lower limbs and urinary incontinence. Clinical examination revealed a motor deficit of sural triceps and foot relievers estimated1 in bilateral, hypoesthesia of the anterolateral side of the two legs and the feet, low bone tendon reflexes were abolished, anesthesia in the saddle, hypotonic anal sphincter and bladder distension...
September 2016: Annals of Physical and Rehabilitation Medicine
Mohamed Hussein
BACKGROUND: Highly migrated intracanal disk herniation is not among the exclusion criteria of the interlaminar microendoscopic diskectomy (MED) procedure. The goal of this prospective, randomized, controlled study was to compare the effect of the size of the skin incision and the method of handling the multifidus muscle on the results of the interlaminar MED procedure versus conventional microdiskectomy in retrieving highly migrated intracanal disk herniations. METHODS: Seventy-three patients with highly migrated intracanal lumbar disk herniations treated with either minimal incision, multifidus-sparing MED or conventional microdiskectomy were observed for 2 years...
November 2016: Journal of the American Academy of Orthopaedic Surgeons
Siena N Ona, Raymund V Millan
No abstract text is available yet for this article.
September 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
Ning-ning Shi, Guo-quan Shen, Shui-yong He, Ru-bao Guo
OBJECTIVE: To study the biomechanical relationship between iliac rotation displacement and L(4,5) disc degeneration, and to provide clinical evidences for the prevention and treatment of L(4,5) disc degeneration and herniation. METHODS: From March 2012 to February 2014,68 patients with lumbar disc herniation combined with sacroiliac joint disorders were selected. Among them, 42 patients with L(4,5) disc herniation combined with sacroiliac joint disorders included 22 males and 20 females, ranging in age from 19 to 63 years old, with an average of (51...
May 2016: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Mario Muto, Francesco Giurazza, Ricardo Pimentel Silva, Gianluigi Guarnieri
Radicular lumbar back pain is an important public health problem not yet benefiting from a unequivocal treatment approach. Medical and physical therapies represent the first solution; however, when these fail, the second therapeutic step is still controversial and mini-invasive treatments may play an important role. In these cases oxygen-ozone therapy has been proved to be a very safe and effective option that is widely used with different modalities. This paper, by reviewing oxygen-ozone therapy literature data, aims to describe the rationale of oxygen-ozone therapy for the treatment of lumbar disk herniations, propose an effective procedural technique and clarify patient selection criteria; furthermore, complications and follow-up management are also considered...
August 2, 2016: Interventional Neuroradiology
Tayfun Hakan, Serkan Gürcan
Spontaneous regression of herniated lumbar discs was reported occasionally. The mechanisms proposed for regression of disc herniation are still incomplete. This paper describes and discusses a case of spontaneous regression of herniated lumbar discs with a new disc protrusion in the adjacent level. A 41-year-old man was admitted with radiating pain and numbness in the left lower extremity with a left posterolateral disc extrusion at L5-S1 level. He was admitted to hospital with low back pain due to disc herniation caudally immigrating at L4-5 level three years ago...
2016: Case Reports in Orthopedics
Maria Ester I Mendes de Carvalho, Reynaldo Mendes de Carvalho, Amélia Pasqual Marques, Lorena Mendes de Carvalho Lucio, Antonio César Almeida de Oliveira, Osmar Pinto Neto, Antonio Balbin Villaverde, Carlos José de Lima
UNLABELLED: The objective of this study is to evaluate the effectiveness of laser and LED therapies, associated with lateral decubitus position and flexion exercises of the lower limbs in patients with lumbar disk herniation (LDH). It is a randomized blinded clinical trial. Fifty-four subjects with LDH L4-L5 and L5-S1 were selected and randomly allocated into groups: laser 904 nm, placebo, and LED 945 nm. The numbers of subjects for each group that completed the treatment were 18, 13, and 18, respectively...
September 2016: Lasers in Medical Science
Toshiyuki Sawai, Junko Nakahira, Toshiaki Minami
Total paraplegia after epidural or spinal anesthesia is extremely rare. We herein report a case of total paraplegia caused by a giant intradural herniation of a lumbar disk at the L3-L4 level after total hip arthroplasty for coxarthrosis. The patient had no preoperative neurologic abnormalities. Intraoperative anesthetic management involved combined spinal-epidural anesthesia at the L3-L4 level with continuous intravenous propofol administration. Postoperatively, the patient complained of numbness and total paraplegia of the lower extremities...
August 2016: Journal of Clinical Anesthesia
Anousheh Sayah, Ann K Jay, Jacob S Toaff, Erini V Makariou, Frank Berkowitz
OBJECTIVE: Reducing lumbar spine MRI scanning time while retaining diagnostic accuracy can benefit patients and reduce health care costs. This study compares the effectiveness of a rapid lumbar MRI protocol using 3D T2-weighted sampling perfection with application-optimized contrast with different flip-angle evolutions (SPACE) sequences with a standard MRI protocol for evaluation of lumbar spondylosis. MATERIALS AND METHODS: Two hundred fifty consecutive unenhanced lumbar MRI examinations performed at 1...
September 2016: AJR. American Journal of Roentgenology
Kaveh Haddadi, Hamid Reza Ganjeh Qazvini
Disk fragment relocation is commonly limited to the anterior epidural space, although posterior epidural movement of a sequestrated disk piece to the posterior epidural space is infrequent. We present an uncommon case of dorsal extradural sequestration of lumbar disk herniation. A 77-year-old man presented with severe leg pain, low back pain, and urinary incontinence. Deep tendon reflexes were inattentive at the knee and ankle, and the motor power in terms of ankle dorsiflexion and great toe dorsiflexion was 2/5 in both lower limbs...
2016: Clinical Medicine Insights. Case Reports
Babak Mirzashahi, Abbas Tafakhori, Arvin Najafi, Mahmoud Farzan
Even though intervertebral disc degeneration can be found in the natural course of alkaptonuria, detection of the disease by black disc color change in a patient without any other presentation of alkaptonuria is an exceptionally rare condition. We have reported a very rare case of alkaptonuria presented with low back pain and steppage gait in a 51-year-old male with a complaint of chronic low-back pain and steppage gait who was operated on for prolapsed lumbar disc herniation. Intraoperatively his lumbar disk was discovered to be black...
April 2016: Archives of Bone and Joint Surgery
Ashwin Bhadresha, Owen John Lawrence, Michael J H McCarthy
Study Design Retrospective study. Objectives To assess the fatty atrophy of the lumbar paraspinal muscles (LPMs) as determined using magnetic resonance imaging in patients with lumbar degenerative disk disease (DDD) and focal disk herniation and to determine if fatty atrophy is associated with patient-reported outcome measures (PROMS). Methods One hundred sixty-five patients with lumbar DDD were identified from a PROMS database of >1,500 patients. These patients were divided into two study groups: DDD alone (n = 58) and DDD with disk herniation (n = 107)...
June 2016: Global Spine Journal
Leila Asadian, Kaveh Haddadi, Mohsen Aarabi, Amirhossein Zare
OBJECTIVES: This study aimed to determine the prevalence of diabetes mellitus in patients with spinal stenosis and lumbar vertebral disk degeneration, and the correlation of diabetes with these diseases. STUDY DESIGN: This is a cross-sectional study. METHODS: This case-control study was performed during 2012-2014 with 110 patients suffering from lumbar spinal stenosis and 110 patients with lumbar disk herniation, who were diagnosed using clinical and radiological evidences...
2016: Clinical Medicine Insights. Endocrinology and Diabetes
Richard A Deyo, Sohail K Mirza
No abstract text is available yet for this article.
May 5, 2016: New England Journal of Medicine
Richard Bostelmann, Hans-Jakob Steiger, Jan Frederick Cornelius
Background Integrity of intervertebral disks may influence, and be influenced by, the maintenance of hydrostatic pressures inside the nucleus pulposus. Disk degeneration causes decreased pressures, leading to overload and injury of the annulus fibrosus, increasing the risk of disk herniation. Diskectomies to treat disk herniation can cause further loss of hydrostatic pressures resulting in worsening degeneration. This study investigated the impact of opening the annulus on intradiscal pressure and whether implantation of an annular closure device (ACD) can restore physiologic pressures...
April 28, 2016: Journal of Neurological Surgery. Part A, Central European Neurosurgery
Jennifer Hong, Perry A Ball
A 29-year-old woman presented to the spine clinic with new-onset pain in her right leg, accompanied by paresthesia. There were no bowel or bladder symptoms. Magnetic resonance imaging (MRI) of the lumbar spine revealed a lumbar disk herniation resulting in substantial spinal stenosis and nerve-root..
April 21, 2016: New England Journal of Medicine
Felix E Diehn, Timothy P Maus, Jonathan M Morris, Carrie M Carr, Amy L Kotsenas, Patrick H Luetmer, Vance T Lehman, Kent R Thielen, Ahmad Nassr, John T Wald
Beyond the familiar disk herniations with typical clinical features, intervertebral disk pathologic conditions can have a wide spectrum of imaging and clinical manifestations. The goal of this review is to illustrate and discuss unusual manifestations of intervertebral disk pathologic conditions that radiologists may encounter, including disk herniations in unusual locations, those with atypical imaging features, and those with uncommon pathophysiologic findings. Examples of atypical disk herniations presented include dorsal epidural, intradural, symptomatic thoracic (including giant calcified), extreme lateral (retroperitoneal), fluorine 18 fluorodeoxyglucose-avid, acute intravertebral (Schmorl node), and massive lumbar disk herniations...
May 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Matteo Bonetti, Alessio Zambello, Marco Leonardi, Ciro Princiotta
The spontaneous regression of disk herniation secondary to dehydration is a much-debated topic in medicine. Some physicians wonder whether surgical removal of the extruded nucleus pulposus is really necessary when the spontaneous disappearance of a herniated lumbar disk is a well-known phenomenon. Unfortunately, without spontaneous regression, chronic pain leads to progressive disability for which surgery seems to be the only solution. In recent years, several studies have demonstrated the utility of oxygen-ozone therapy in the treatment of disk herniation, resulting in disk shrinkage...
August 2016: Interventional Neuroradiology
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