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https://www.readbyqxmd.com/read/29780700/sporadic-nf2-mosaic-multiple-spinal-schwannomas-presenting-with-severe-intractable-pain-following-pregnancy
#1
Jeffrey H Zimering, Bryan D Choi, Matthew J Koch, John C Dewitt, Anat Stemmer-Rachamimov, John H Shin
The aim of the present paper is to report undiagnosed sporadic neurofibromatosis type 2 presenting with symptomatic compressive spinal tumors following pregnancy. A 36-year-old woman experienced progressive, severe lumbar radicular pain in the second trimester of pregnancy which became intractable soon after delivery. Magnetic resonance imaging revealed a complex heterogeneous hypointense mass lesion around the conus. There were two small punctate lesions in the cauda equina suggestive of myxopapillary ependymoma with 'drop metastases...
December 2017: Interdisciplinary Neurosurgery: Advanced Techniques and Case Management
https://www.readbyqxmd.com/read/29774200/thickening-ligamentum-flavum-mimicking-tumor-in-the-epidural-space-of-the-cervical-spine
#2
Sung Hyun Bae, Dong Wuk Son, O Ik Kwon, Su Hun Lee, Jun Seok Lee, Geun Sung Song
In patients with tumors and spinal cord lesions, inflammation and tissue infection can result in mass effect detection on imaging. As a result, surgical biopsy procedures are often performed on the lesions. We report a rare case in which the thickening ligamentum flavum (LF) appeared to be a tumor in the epidural space of the cervical spine based on imaging findings. A 52-year-old man visited our outpatient clinic with severe shoulder pain and radicular pain in his right arm that had developed gradually after a traffic accident two months earlier...
April 2018: Korean Journal of Neurotrauma
https://www.readbyqxmd.com/read/29770528/pain-one-week-after-an-ed-visit-for-acute-low-back-pain-is-associated-with-poor-three-month-outcomes
#3
Benjamin W Friedman, John Conway, Caron Campbell, Polly E Bijur, E John Gallagher
BACKGROUND: Low back pain (LBP) is responsible for more than 2.5 million visits to US emergency departments (EDs) annually. Nearly 30% of patients who present to an ED with acute LBP report functional impairment or pain three months later. These patients are at risk of chronic LBP, a highly debilitating condition. In this study, we assessed whether three variables assessable shortly after symptom onset could independently predict poor three-month outcomes among LBP patients who present to an ED...
May 16, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29763354/randomized-controlled-trial-of-pulpotomy-in-primary-molars-using-mta-and-formocresol-compared-to-3mixtatin-a-novel-biomaterial
#4
Zahra Jamali, Vajiheh Alavi, Ebrahim Najafpour, Naser Asl Aminabadi, Sajjad Shirazi
OBJECTIVE: This study was conducted to compare the efficacy of 3Mixtatin (a combination of simvastatin and 3Mix antibiotic) with MTA and Formocresol for the pulpotomy of primary molars. STUDY DESIGN: 114 children aged 3-6 years old with 150 primary molars were randomly allocated to three groups. MTA, Formocresol or 3Mixtatin were used for Pulpotomies. Hard setting zinc oxide eugenol was used to cover these materials. The teeth were restored with amalgam. Blinded radiographic and clinical examinations were conducted at 6, 12 and 24 months after treatment for the presence of pain, tenderness to palpation and percussion, sinus tract, swelling, presence of internal or external root resorption, inter-radicular radiolucency, and periapical lesion...
May 15, 2018: Journal of Clinical Pediatric Dentistry
https://www.readbyqxmd.com/read/29758372/percutaneous-endoscopic-lumbar-surgery-via-transfacet-approach-for-lumbar-synovial-cyst
#5
Hsuan-Han Wu, Lei Chu, Yong-Jian Zhu, Chun-Yuan Cheng, Chien-Min Chen
BACKGROUND: There are currently no high-quality studies on the optimal therapeutic approach for juxtafacet cyst as treatment guidelines have not been developed. Herein, a novel technique in which using an endoscopic transfacet approach to treat a patient with symptomatic lumbar synovial cyst was presented. . CASE DESCRIPTION: A 87-year-old man presented with severe dull pain in the right anterior thigh had developed. Lumbar magnetic resonance imaging (MRI) revealed disc extrusion over the central canal zone at the L2-3 and L4-L5 level, and an ovoid lesion with a hyperintense center plus a hypointense rim on the T2-weighted image...
May 11, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29756333/safe-use-of-epidural-corticosteroid-injections-recommendations-of-the-wip-benelux-workgroup
#6
REVIEW
Koen Van Boxem, Mienke Rijsdijk, Guy Hans, Jasper de Jong, Jan Willem Kallewaard, Kris Vissers, Maarten van Kleef, James P Rathmell, Jan Van Zundert
BACKGROUND: Epidural corticosteroid injections are used frequently worldwide in the treatment of radicular pain. Concerns have risen involving rare major neurologic injuries after this treatment. Recommendations to prevent these complications have been published, but local implementation is not always feasible due to local circumstances and necessitating local recommendations based on literature review. METHODS: A workgroup of 4 stakeholder pain societies in Belgium, The Netherlands and Luxembourg (Benelux) has reviewed the literature involving neurological complications after epidural corticosteroid injections and possible safety measures to prevent these major neurologic injuries...
May 14, 2018: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/29755622/serum-triamcinolone-levels-following-cervical-interlaminar-epidural-injection
#7
Tim J Lamer, Rozalin R Dickson, Halena M Gazelka, Wayne T Nicholson, Joel M Reid, Susan M Moeschler, W Michael Hooten
Background: Cervical interlaminar epidural steroid injections (ESIs) are commonly performed procedures to treat painful cervical radiculopathy, but little is known about the systemic absorption and serum levels of steroids following injection. The primary objective of this study was to investigate the pharmacokinetics of fluoroscopy-guided cervical epidural-administered triamcinolone acetonide in a cohort of patients with cervical radicular pain seeking treatment in a pain medicine clinic...
2018: Pain Research & Management: the Journal of the Canadian Pain Society
https://www.readbyqxmd.com/read/29755242/spinal-schistosomiasis-cases-in-egyptian-population
#8
Ahmed M Ashour, Tarek H Elserry, Mohamed S Nosser, Zeyad Y Fayed, Mohamed Wael Samir, Alaa Fakher, Maamoun M Ashour, Mamdouh M Salama
Background: Spinal cord involvement by schistosomiasis is considered to be rare. Clinical presentation of spinal schistosomiasis ranges from radicular pain to myelopathy causing flaccid paraplegia, bladder incontinence, and dysesthesia. We reported six cases with spinal schistosomiasis. Methodology: We did a retrospective analysis of the records in our department from March 1995 to March 2015, and we found that six cases of proved spinal schistosomiasis were documented, with follow-up period more than a year, aiming to find an assumption for a guideline for this ambiguous issue...
January 2018: Journal of Craniovertebral Junction and Spine
https://www.readbyqxmd.com/read/29751191/can-epidural-contrast-dispersal-pattern-help-to-predict-the-outcome-of-transforaminal-epidural-steroid-injections-in-patients-with-lumbar-radicular-pain
#9
M D Duygu Tecer, Emre Adiguzel, Ozlem Koroglu, Arif K Tan, Mehmet A Taskaynatan
BACKGROUND: To investigate the relationship between epidurographic contrast dispersal patterns and both immediate and short term clinical effectiveness of lumbar transforaminal epidural steroid injections (TFESIs) in patients with radicular back pain. METHODS: Digital database of 64 patients who underwent single-level lumbar TFESI for unilateral lumbar radicular pain were scanned Type of contrast pattern was analyzed by 1 physiatrist and definied as follows: type I (tubular appearance); type II (nerve root visible as a filling defect); or type III (cloudlike appearance)...
May 8, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29747017/a-novel-association-between-intrathecal-drug-administration-and-arachnoiditis-ossificans
#10
Max Ward, Antonios Mammis, Maureen T Barry, Robert F Heary
We present a case of delayed progression of adhesive arachnoiditis to arachnoiditis ossificans (AO) in a patient being treated with a high dose polypharmaceutical intrathecal regimen. The patient is a 39-year-old Caucasian male who was implanted with an intrathecal pump in 2006 to control severe low back pain and administered intrathecal pain medication for a period of 10 years. In 2016, he developed new onset radicular pain and worsened sensation in his lower extremities. A CT scan of the lumbar spine at that time demonstrated profound calcification of the arachnoid consistent with a diagnosis of AO...
May 7, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29736360/metachronous-bilateral-painless-foot-drop-secondary-to-spinal-stenosis-case-report
#11
Luis A Robles
Foot drop (FD) is an uncommon manifestation of nerve root compression secondary to lumbar degenerative disease (LDD). In most of these patients, FD is unilateral and is associated with low back pain and leg pain. A small number of cases have been described with bilateral FD, which is reported to occur simultaneously in a synchronous fashion. A 63-year-old male with a remote history of spinal surgery due to left painless FD presented with a new episode of right FD, this new FD initiated suddenly and it was not associated with low back pain or radicular pain...
March 5, 2018: Curēus
https://www.readbyqxmd.com/read/29732437/an-awake-minimally-invasive-fully-endoscopic-surgical-technique-for-treating-lumbar-radiculopathy-secondary-to-heterotopic-foraminal-bone-formation-after-a-minimally-invasive-transforaminal-lumbar-interbody-fusion-with-bmp-technical-note
#12
Albert Edward Telfeian
One complication associated with recombinant human bone morphogenetic protein (rhBMP-2) use in minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) is heterotopic bone growth at the neural foramen which results in the compression of neural structures. Here we present an awake, minimally invasive surgical approach for treating the radiculopathy that results from this excessive bone growth in the foramen. A 42-year-old male underwent a lumbar 4-sacral 1 MIS-TLIF by another surgeon. He did well in the initial postoperative period, but he began to note right leg pain and numbness in an L5 dermatomal pattern...
March 2018: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/29732417/perioperative-care-for-lumbar-microdiscectomy-a-survey-of-australasian-neurosurgeons
#13
Christopher D Daly, Kai Zheong Lim, Peter Ghosh, Tony Goldschlager
Background: Lumbar microdiscectomy is the most commonly performed spine surgery procedure. Over time it has evolved to a minimally invasive procedure. Traditionally patients were advised to restrict activity following lumbar spine surgery. However, post-operative instructions are heterogeneous. The purpose of this report is to assess, by survey, the perioperative care practices of Australasian neurosurgeons in the minimally invasive era. Methods: A survey was conducted by email invitation sent to all full members of the Neurosurgical Society of Australasia (NSA)...
March 2018: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/29707549/percutaneous-endoscopic-cervical-discectomy-a-technical-review
#14
REVIEW
Javier Quillo-Olvera, Guang-Xun Lin, Jin-Sung Kim
The treatment of cervical disc herniations has evolved in the last 2 decades. While the anterior cervical discectomy and fusion continues being the gold standard for the treatment of radicular pain triggered by cervical disc herniation, other surgical approaches have been developed. Percutaneous endoscopic cervical discectomy has demonstrated the ability to decompress the exiting nerve root and dural sac correctly and encouraging clinical outcomes has been reported in the literature. One of the most important advantages offered by the endoscopic technique is the capability to resolve the patient's symptoms without the need for interbody fusion...
March 2018: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29705169/lumbar-epidural-varix-causing-radicular-pain-a-case-report-and-differential-diagnosis-of-lumbar-cystic-lesions
#15
Il-Kyu Im, Eun-Seok Son, Du Hwan Kim
Lumbar epidural varices are a rare cause of radicular pain mimicking lumbar disc herniation or other cyst-like masses including sequestrated disc herniation, facet joint synovial cyst, or perineural cyst. We report a case of a 36-year-old woman presenting with lumbar radicular pain caused by a lumbar epidural varix. Lumbar MRI revealed a cystic lesion in the ventral epidural space posterior to the right L4 body. Surgery was conducted and histopathology confirmed the diagnosis of an epidural varix. Lumbar epidural varices and other lumbar cystic lesions can commonly cause radicular pain...
April 26, 2018: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/29696128/electromyographic-findings-after-epidural-steroid-injections-in-patients-with-radicular-low-back-pain-a-prospective-open-label-study
#16
Chrysanthi Batistaki, Athina Angelopoulou, Maria-Eleni Smyrnioti, Maria-Chrysanthi Kitsou, Georgia Kostopanagiotou
Epidural steroid injections (ESIs) are commonly used in the management of chronic lower back and leg pain. The aim of this study was to investigate the short- and long-term electromyographic and clinical outcome of patients with chronic radicular pain after ESIs. This prospective, open-label study, included patients with chronic radicular pain due to disc herniation or spinal stenosis, who underwent interlaminar, fluoroscopy-guided ESIs. Patients were assessed before ESIs, as well as after 6 and 12 months, clinically (VAS 0-10, BPI, DN4, Rolland Morris, DASS, STAI) and electromyographically for the improvement of spontaneous activity (SA) and of motor unit recruitment/interference pattern (IP/MUR)...
December 2017: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/29695262/hypericum-perforatum-to-improve-post-operative-pain-outcome-after-monosegmental-spinal-microdiscectomy-hypos-a-study-protocol-for-a-randomised-double-blind-placebo-controlled-trial
#17
Christa Raak, Wolfram Scharbrodt, Bettina Berger, Arndt Büssing, René Geißen, Thomas Ostermann
BACKGROUND: Spinal disc herniation is a frequently occurring degenerative disease of the spine. Many patients undergoing surgery suffer from radicular pain, known as memory pain, beginning from the third post-operative day. This results in the prescription of high-dose opioid medications. In homeopathy, Hypericum perforatum is known as a remedy for unbearable, shooting or jabbing pain especially when neural damage is involved. Reduction of pain after application of H. perforatum has been observed in previous studies...
April 25, 2018: Trials
https://www.readbyqxmd.com/read/29689402/intradural-lumbar-migration-of-an-intracranial-neurosurgical-hemostatic-clip-associated-with-lumbosciatic-pain
#18
Mourad Ould-Slimane, Martin Petit, Gaëtan Tesson, Jordane Mouton, Rémi Gauthé
BACKGROUND: Clips implanted during intracranial neurosurgical procedures sometimes migrate intradurally with rare cases of spinal migration. The appearance of radicular symptoms of topography concordant with the position of the foreign body leads to discussion about the optimal therapeutic strategy. CASE DESCRIPTION: We report the case of a 52-year-old woman suffering from L5 radicular pain resistant to medical treatment in the presence of L4L5 lumbar stenosis and a neurosurgical clip migrated to the L5S1 level...
April 21, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29686809/the-outcome-of-epiduroscopy-treatment-in-patients-with-chronic-low-back-pain-and-radicular-pain-operated-or-non-operated-for-lumbar-disc-herniation-a-retrospective-study-in-88-patients
#19
Derya Burcu Hazer, Arsal Acarbaş, Hans Eric Rosberg
Background: Patients with lumbar disc herniation are treated with physiotherapy/medication and some with surgery. However, even after technically successful surgery some develop a failed back syndrome with persistent pain. Our aim was to evaluate the efficacy of epiduroscopy in patients who suffer chronic low back pain and/or radicular pain with or without surgery and the gender difference in outcome. Methods: A total of 88 patients were included with a mean age of 52 years (27-82), 54 women and 34 men...
April 2018: Korean Journal of Pain
https://www.readbyqxmd.com/read/29684923/percutaneous-endoscopic-interlaminar-unilateral-ventral-dural-approach-for-symptomatic-bilateral-l5-s1-herniated-nucleus-pulposus-technical-note
#20
Sung Ho Choi, Nitin Maruti Adsul, Hyeun Sung Kim, Ki Joon Kim, Jeong Hoon Kim, Sung Kyun Chung, Jeong Hoon Choi, Jee Soo Jang, Il Tae Jang, Seong Hoon Oh
BACKGROUND:  Percutaneous endoscopic lumbar diskectomy is a good treatment modality for lumbar disk herniation. However, when a patient complains of bilateral lower limb radicular pain with severe disk protrusion at the L5-S1 level, the transforaminal approach is often unable to resolve both lesions owing to anatomical limitations. It is also very difficult to resolve both lesions in an ipsilateral direction using the percutaneous interlaminar approach. We report our surgical technique and clinical results using a ventral dural approach of percutaneous endoscopic interlaminar lumbar diskectomy for L5-S1 herniated nucleus pulposus (HNP) in patients with bilateral radiculopathy due to a severe disk protrusion...
April 23, 2018: Journal of Neurological Surgery. Part A, Central European Neurosurgery
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