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https://www.readbyqxmd.com/read/28632561/early-postoperative-magnetic-resonance-imaging-in-detecting-radicular-pain-after-lumbar-decompression-surgery-retrospective-study-of-the-relationship-between-dural-sac-cross-sectional-area-and-postoperative-radicular-pain
#1
Toshimasa Futatsugi, Jun Takahashi, Hiroki Oba, Shota Ikegami, Yuji Mogami, Syunichi Shibata, Yoshihito Ohji, Hirotaka Tanikawa, Hiroyuki Kato
STUDY DESIGN: A retrospective analysis. OBJECTIVE: To evaluate the association between early postoperative dural sac cross-sectional area (DCSA) and radicular pain. SUMMARY OF BACKGROUND DATA: The correlation between postoperative magnetic resonance imaging (MRI) findings and postoperative neurological symptoms after lumbar decompression surgery is controversial. METHODS: This study included 115 patients who underwent lumbar decompression surgery followed by MRI within 7 days postoperatively...
July 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28606606/potential-risks-of-using-cement-augmented-screws-for-spinal-fusion-in-patients-with-low-bone-quality
#2
M Martín-Fernández, A López-Herrradón, A R Piñera, F Tomé-Bermejo, J M Duart, M D Vlad, M G Rodríguez-Arguisjuela, L Álvarez-Galovich
BACKGROUND CONTEXT: Dramatic increases in the average life expectancy have led to increases in the variety of degenerative changes and deformities observed in the aging spine. The elderly population can present challenges for spine surgeons, not only because of increased comorbidities, but also because of the quality of their bones. Pedicle screws are the implants used most commonly in spinal surgery for fixation, but their efficacy depends directly on bone quality. While PMMA-augmented screws represent an alternative for patients with osteoporotic vertebrae, their use has raised some concerns due to the possible association between cement leakages (CLs) and other morbidities...
June 9, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28600230/cytokine-and-chemokine-profile-changes-in-patients-with-lower-segment-lumbar-degenerative-spondylolisthesis
#3
Juraj Sutovsky, Martin Benco, Martina Sutovska, Michaela Kocmalova, Lenka Pappova, Juraj Miklusica, Andrej Frano, Egon Kurca
BACKGROUND: Lumbar degenerative spondylolisthesis (DS) develops as a result of inflammatory and remodeling processes in facet joints (FJs). Several inflammatory cytokines are involved in the osteoarthritic and remodeling changes that occur and in low-back and/or radicular pain, the most prevalent clinical symptom of disease. This study improves knowledge related to the roles that 27 cytokines, chemokines and growth factors play in the pathophysiology of lumbar DS. MATERIAL AND METHODS: Cytokine levels were examined using capture sandwich immunoassay using the Bio-Plex(®) 200 System and the Bio-PlexTM Human Cytokine Standard 27-Plex, Group I (Bio-Rad, Hercules, California, USA) separately in intervertebral discs (IVDs) and FJ bone tissue...
June 6, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28586588/outcome-analysis-of-two-different-injection-solutions-for-epidural-injection-in-radicular-lumbar-backache-syndromes
#4
Muhammad Saqib, Sajid Nazir Bhatti, Muhammad Ayaz Khan, Khalid Samad, Muhammad Mukhtar Khan, Ehtisham Mukhtar Khan Afridi, Rubaiqa Khan, Muhammad Imran Khan
OBJECTIVE: Backache is a significant source of disability and suffering in our society. The treatment modalities need continued enhancement in order to achieve the desired goals of lowering morbidity and financial losses while improving the response of the patient. METHODS: This prospective comparative study was conducted at the department of Orthopaedics and Spine Surgery, Khyber Teaching Hospital Peshawar from July 2013 to June 2015. Two interventional groups were designated; Group 1 was comprised of 54 patients who were injected with epidural bupivacaine plus methylprednisolone while Group 2 included 55 patients who were injected with bupivacaine only...
October 2016: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28575334/characterization-of-peripheral-and-central-sensitization-after-dorsal-root-ganglion-intervention-in-patients-with-unilateral-lumbosacral-radicular-pain-a-prospective-pilot-study
#5
V Mehta, S Snidvongs, B Ghai, R Langford, T Wodehouse
Background.: Quantitative sensory testing (QST) has been used to predict the outcome of epidural steroid injections in lumbosacral radicular pain and has the potential to be an important tool in the selection of appropriate treatment (such as epidural steroid injections vs surgery) for patients with chronic radicular pain. In addition, QST assists in identification of the pain pathways of peripheral and central sensitization in selected groups of patients. Methods.: Twenty-three patients were given dorsal root ganglion (DRG) infiltration with local anaesthesia and steroid ('DRG block'), and those who demonstrated at least 50% pain relief were offered pulsed radiofrequency (PRF) to the DRG...
June 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28567591/ribosomal-pcr-assay-of-excised-intervertebral-discs-from-patients-undergoing-single-level-primary-lumbar-microdiscectomy
#6
Todd F Alamin, Marcus Munoz, Alicia Zagel, Agnes Ith, Eugene Carragee, Ivan Cheng, Gaetano Scuderi, Indre Budvytiene, Niaz Banei
PURPOSE: To determine the presence of infectious microorganisms in the herniated discs of immunocompetent patients, using methodology that we hoped would be of higher sensitivity and specificity than has been reported in the past. Recent studies have demonstrated a significant rate of positive cultures for low virulent organisms in excised HNP samples (range 19-53%). These studies have served as the theoretical basis for a pilot trial, and then, a well done prospective randomized trial that demonstrated that systemic treatment with antibiotics may yield lasting improvements in a subset of patients with axial back pain...
May 31, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28551736/back-pain-with-leg-pain
#7
REVIEW
Simon Vulfsons, Negev Bar, Elon Eisenberg
PURPOSE OF REVIEW: The clinical diagnostic dilemma of low back pain that is associated with lower limb pain is very common. In relation to back pain that radiates to the leg, the International Association for the Study of Pain (IASP) states: "Pain in the lower limb should be described specifically as either referred pain or radicular pain. In cases of doubt no implication should be made and the pain should be described as pain in the lower limb." RECENT FINDINGS: Bogduks' editorial in the journal PAIN (2009) helps us to differentiate and define the terms somatic referred pain, radicular pain, and radiculopathy...
July 2017: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/28533868/-rare-medico-surgical-emergency-spinal-epidural-abscess-about-3-cases
#8
Abderrazzak El Saqui, Mohamed Aggouri, Mohamed Benzagmout, Khalid Chakour, Mohamed El Faiz Chaoui
The awareness about infections in the epidural space is increasing thanks to the development of neurosurgery, including MRI. Spinal epidural abscess is a rare pathology but extremely serious from a functional point of view and potentially life threatening. We report three cases of male patients (the first one aged 52 years, the second 57 years and the third 63 years) with diagnosed spinal epidural abscess. Two patients were admitted to the Neurosurgical Emergencies with slow progressive spinal cord compression evolving in the context of infection...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28491486/crest-calcinosis-affecting-the-lumbar-and-cervical-spine-and-the-use-of-minimally-invasive-surgery
#9
Kassem Faraj, Kristin Perez-Cruet, Mick Perez-Cruet
Calcinosis in CREST (calcinosis, Raynaud's phenomenon, esophageal dysmotility, sclerodactyly, and telangiectasia) syndrome can affect the spinal and paraspinal areas. We present the first case to our knowledge where a CREST syndrome patient required surgery for spinal calcinosis in both the cervical and lumbar areas. A 66-year-old female with a history of CREST syndrome presented with right-sided lower extremity radicular pain. A computed tomography (CT) scan showed bilateral lumbar masses (5.8 cm on the right, 3...
April 8, 2017: Curēus
https://www.readbyqxmd.com/read/28486232/osthole-a-coumadin-analog-from-cnidium-monnieri-l-cusson-ameliorates-nucleus-pulposus-induced-radicular-inflammatory-pain-by-inhibiting-the-activation-of-extracellular-signal-regulated-kinase-in-rats
#10
Hai-Xuan Wu, Yi-Min Wang, Hui Xu, Ming Wei, Qiu-Lan He, Mei-Na Li, Lai-Bao Sun, Ming-Hui Cao
AIM: This study was aimed at assessing the role of extracellular signal regulated kinase (ERK) in mechanical allodynia resulting from lumbar disc herniation (LDH) and exploring the osthole's anti-nociceptive effect on ERK activation. METHODS: Radicular pain was generated by applying nucleus pulposus (NP) to the L5 dorsal root ganglion (DRG). Allodynia was measured using Von Frey filaments to calculate the mechanical pain threshold. Phosphorylated ERK and total ERK protein in the lumbar spinal dorsal horn was detected by using the Western blot technique...
2017: Pharmacology
https://www.readbyqxmd.com/read/28483706/clinical-classification-criteria-for-radicular-pain-caused-by-lumbar-disc-herniation-the-rapidh-criteria-radicular-pain-caused-by-disc-herniation
#11
Stéphane Genevay, Delphine S Courvoisier, Kika Konstantinou, Francisco M Kovacs, Marc Marty, James Rainville, Michael Norberg, Jean-François Kaux, Thomas D Cha, Jeffrey N Katz, Steven J Atlas
CONTEXT: Classification criteria are recommended for diseases that lack specific biomarkers in order to improve homogeneity in clinical research studies. Since imaging evidence of lumbar disc herniations (LDH) may not be associated with symptoms, clinical classification criteria based upon patient symptoms and physical examination findings are required. PURPOSE: This study aimed to produce clinical classification criteria to identify patients with radicular pain caused by LDH...
May 5, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28473069/acr-appropriateness-criteria-%C3%A2-back-pain-child
#12
Timothy N Booth, Ramesh S Iyer, Richard A Falcone, Laura L Hayes, Jeremy Y Jones, Nadja Kadom, Abhaya V Kulkarni, John S Myseros, Sonia Partap, Charles Reitman, Richard L Robertson, Maura E Ryan, Gaurav Saigal, Bruno P Soares, Aylin Tekes-Brady, Andrew T Trout, Nicholas A Zumberge, Brian D Coley, Susan Palasis
It is now generally accepted that nontraumatic back pain in the pediatric population is common. The presence of isolated back pain in a child has previously been an indication for imaging; however, recently a more conservative approach has been suggested using clinical criteria. The presence of constant pain, night pain, and radicular pain, alone or in combination, lasting for 4 weeks or more, constitute clinical red flags that should prompt further imaging. Without these clinical red flags, imaging is likely not indicated...
May 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28471875/genetic-predictors-of-recovery-in-low-back-and-lumbar-radicular-pain
#13
Siri Bjorland, Cecilie Røe, Aurora Moen, Elina Schistad, Aqsa Mahmood, Johannes Gjerstad
Previous data suggest that persistent back pain may be associated with genetic variability. In this study, we assessed the correlation between 8 genetic polymorphisms (VDR, COL11, MMP1, MMP9, IL-1α, IL-1RN, OPRM1, COMT) and pain recovery in patients with low back pain (LBP) and lumbar radicular pain (LRP). In total, 296 patients with LBP or LRP were followed for 5 years. The patients underwent standardized clinical examination and completed pain and function questionnaires. Univariate linear regression associations with P values <0...
April 27, 2017: Pain
https://www.readbyqxmd.com/read/28466022/ultrasonography-guided-lumbar-periradicular-injections-for-unilateral-radicular-pain
#14
Qing Wan, Shaoling Wu, Xiao Li, Caina Lin, Songjian Ke, Cuicui Liu, Wenjun Xin, Chao Ma
Objective. The aim of this study was to compare the accuracy and efficacy of sonographically guided lumbar periradicular injections through in-plane or out-of-plane approach techniques for patients with unilateral lower lumbar radicular pain. The feasibility and accuracy of these techniques were studied by means of computed tomography (CT). Methods. A total of 46 patients with chronic unilateral lumbar radicular pain were recruited and randomly assigned to either the in-plane or out-of-plane injection group...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28460630/microrna-223-demonstrated-experimentally-in-exosome-like-vesicles-is-associated-with-decreased-risk-of-persistent-pain-after-lumbar-disc-herniation
#15
Aurora Moen, Daniel Jacobsen, Santosh Phuyal, Anna Legfeldt, Fred Haugen, Cecilie Røe, Johannes Gjerstad
BACKGROUND: Previous findings have demonstrated that lumbar radicular pain after disc herniation may be associated with up-regulation of inflammatory mediators. In the present study we examined the possible role of extracellular microRNAs (miRs) in this process. METHODS: Single unit recordings, isolation of exosome-like vesicles, electron microscopy, nanoparticle tracking analysis, western blot analysis and qPCR were used in rats to demonstrate the effect of nucleus pulposus (NP) applied onto the dorsal nerve roots...
May 1, 2017: Journal of Translational Medicine
https://www.readbyqxmd.com/read/28460342/anterior-lumbar-interbody-fusion-with-percutaneous-pedicle-screw-fixation-for-multiple-level-isthmic-spondylolisthesis
#16
Chang-Sheng Hsieh, Hyung Chang Lee, Hyeong-Seok Oh, Sang-Joon Park, Byeong-Wook Hwang, Sang-Ho Lee
OBJECTIVE: Multiple-level lumbar isthmic spondylolisthesis is rarely reported. Here, we report 23 consecutive patients who underwent anterior lumbar interbody fusion (ALIF) with percutaneous pedicle screw fixation (PPF) for multiple-level isthmic spondylolisthesis. PATIENTS AND METHODS: From June 2008 through December 2014, multiple-level lumbar isthmic spondylolisthesis was diagnosed in 23 patients (6 men, 17 women) at Wooridul Spine Hospital (Busan, South Korea)...
April 13, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28456675/stability-preserving-decompression-in-degenerative-versus-congenital-spinal-stenosis-demographic-patterns-and-patient-outcomes
#17
Philip K Louie, Justin C Paul, Jonathan Markowitz, Joshua A Bell, Bryce A Basques, Alem Yacob, Howard S An
BACKGROUND: Context: Although lumbar spinal stenosis often presents as a degenerative condition, some patients present with symptoms from lifelong narrowing of the spinal canal. These patients have congenital stenosis (CS) and present with symptoms of stenosis at a younger age. CS patients often have a distinct pathophysiology with fewer degenerative changes but present with multi-level involvement. In the setting of neurological symptoms, decompression-alone while preserving stability, has been proposed for both patient populations...
April 26, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28454187/combination-of-transforaminal-and-interlaminar-percutaneous-endoscopic-lumbar-diskectomy-for-extensive-down-migrated-disk-herniation
#18
Kyung-Chul Choi, Jung Hyun Lee, Jin-Sung Kim, Dong Chan Lee, Choon Keun Park
Background and Study Aims The technique and instrumentation of percutaneous endoscopic lumbar diskectomy (PELD) have significantly improved. Thus its indications have been gradually expanding. Down-migrated disk, in particular, is regarded inaccessible by rigid instrumentation due to poor visualization and limited accessibility. We introduce a combination of transforaminal and interlaminar PELD for extensive down-migrated disk herniation at the L4-L5 level. Patients and Methods In the first case, a 48-year-old man had left L5 radicular pain...
April 28, 2017: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/28438284/intradiscal-o2o3-rationale-injection-technique-short-and-long-term-outcomes-for-the-treatment-of-low-back-pain-due-to-disc-herniation
#19
REVIEW
Francesco Giurazza, Gianluigi Guarnieri, Kieran J Murphy, Mario Muto
The management of low back pain should always start with a conservative approach; however, when it fails, intervention is required and at that moment the most appropriate choice remains unclear. Before invasive surgery, minimally invasive techniques can be adopted. In European trials and in a trans-Canadian clinical trial 03 ozone has been used successfully. In total over 50,000 patients have been treated safely. Ozone is a gas normally present in the atmosphere with potent oxidizing power; it has been used for percutaneous intradiscal injection combined with oxygen (O2O3) at very low concentrations for 15 years in Europe...
May 2017: Canadian Association of Radiologists Journal, Journal L'Association Canadienne des Radiologistes
https://www.readbyqxmd.com/read/28436275/total-lumbar-facetectomy-without-fusion-short-and-long-term-follow-up-in-a-single-surgeon-series
#20
Mark A Pichelmann, John L D Atkinson, Nicolee C Fode-Thomas, Michael J Yaszemski
BACKGROUND: Total lumbar facetectomy may be advantageous for exposure or to completely free a constricted nerve root. OBJECTIVE: We retrospectively reviewed a single surgeon series without fusion for short and long term outcomes regarding radicular pain relief, subsequent relevant surgeries, and any identifiable instability. METHODS: All operations in which a single, total lumbar facetectomy was performed were reviewed. A total of 222 patients were identified with a minimal follow-up of 3 months; 187 (84...
April 24, 2017: British Journal of Neurosurgery
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