Torn disc

BACKGROUND: Shoulder pain in general and acromioclavicular joint (ACJ) pain specifically is common after acceleration-deceleration injury following road traffic accident (RTA). The outcome of surgical treatment in this condition is not described in the literature. The aim of the present study was to report the outcome of arthroscopic resection of the ACJ in these cases. MATERIALS AND METHODS: Nine patients with localized ACJ pain, resistant to nonoperative treatment were referred on an average 18 months after the injury...

PURPOSE: To analyze the main causes of temporomandibular joint (TMJ) ankylosis from condylar fracture in adults through a retrospective study. MATERIALS AND METHODS: The history and computed tomographic (CT) scans of patients diagnosed with ankylosis caused by mandibular condyle fracture treated in a closed fashion from 2010 to 2012 were reviewed in the department of oral surgery. According to the relation between the stump of the ramus and the TMJ fossa, condylar fractures were divided into 3 grades: grade 0, in which the ramus stump is in the fossa but without contact to it; grade 1, in which the stump of the ramus is in the fossa and attached to it; and grade 2, in which the stump of the ramus is laterally displaced out of the fossa...

PURPOSE: To investigate the structural abnormalities of optic disc pits and colobomas by swept-source optical coherence tomography (OCT). METHODS: Sixteen eyes with congenital optic disc pits, and seven eyes with optic disc colobomas were studied. Papillary and peripapillary areas were examined with swept-source OCT. The entire course of the pit or cavity and the spatial relationship between pits and retrobulbar subarachnoid space (SAS) were examined. RESULTS: Optical coherence tomography images showed the entire course of the pits from their openings to the bottom in 12 eyes...

Four patients underwent lumbar surgery. In all four patients, the dura was minimally torn during the operation. However, none exhibited signs of postoperative cerebrospinal fluid leakage. In each case, a few days after the operation, the patient suddenly experienced severe recurring pain in the leg. Repeat magnetic resonance imaging showed transdural nerve rootlets entrapped in the intervertebral disc space. On exploration, ventral dural tears and transdural nerve rootlet entrapment were confirmed. Midline durotomy, herniated rootlet repositioning, and ventral dural tear repair were performed, and patients' symptoms improved after rootlet repositioning...

In order to visualize dynamic variations related to ulnar-sided wrist pain, animation was reconstructed from T2* coronal-sectioned magnetic resonance imaging in each of the four phases of grip motion for nine wrists in patients with ulnar pain. Eight of the nine wrists showed a positive ulnar variance of less than 2 mm. Ulnocarpal impaction and triangular fibrocartilage complex injury were assessed on the basis of animation and arthroscopy, respectively. Animation revealed ulnocarpal impaction in four wrists...

BACKGROUND: Unilateral cervical spine facet injuries encompass a wide spectrum, including subluxations, dislocations, and fractures, and the instability produced varies greatly. The extent of anatomical disruption secondary to a unilateral facet injury is poorly understood, and few biomechanical studies have quantified the associated kinematics. The purpose of this study was to develop an experimental method that reliably produces an impending unilateral facet dislocation (perched facet) in cadaveric cervical spines and to identify the soft-tissue damage and resulting changes in cervical spine range of motion and neutral zone associated with this injury...

STUDY DESIGN: Molecular biological and immunohistological examinations. OBJECTIVE: To clarify whether nondegenerated and degenerated discs produce inflammatory agents such as prostaglandin (PG)E2, interleukin (IL)-6, IL-1β, and tumor necrosis factor (TNF)α, which have been reported to play pivotal roles in lumbar disc diseases, in the presence or absence of macrophages. SUMMARY OF BACKGROUND DATA: A recent study reported discogenic low back pain might be caused by annular disruption followed by vascularized granulation formation extending from the outer layer of the annulus fibrosus into the nucleus pulposus along the torn fissure...

BACKGROUND: Laser-assisted spinal endoscopy (LASE) kit has been used for percutaneous intradiscal decompression to evaporate and shrink the posterior and central nucleus for improvement of leg and radicular pain due to contained disc herniation. Percutaneous endoscopic laser annuloplasty (PELA), a new minimally invasive technique, uses LASE to directly coagulate the inflamed disc granulation tissue associated with annular tears. The small diameter of the endoscope including Ho:YAG laser, irrigation, and light, plus the extreme posterolateral approach into the posterior annulus, enables one to minimize damage to normal nuclear tissue...

Based on a retrospective review of 101 injuries of the thoracolumbar spine operated at the Orthopaedic and Traumatological Clinic of the Third Medical Faculty, Charles University in 1991-1995 the authors followed up a group so-called pincer fractures. A typical feature of these fractures is a comminuted zone of the median portion of the vertebral body, dislocation of the anterior fragment of the vertebral body in a forward direction and filling of the gap which thus arises with material from the torn intervertebral disc...

PURPOSE OF THE STUDY: The triangular fibrocartilaginous complex (TFCC) can be injured either due to trauma or by chronic strain. Based on these findings, Palmer devised a classification system distinguishing traumatic (I) and degenerative (II) TFCC lesions. Traumatic TFCC injury may be single or involved in a combined injury of the distal radius. The aim of this study was to evaluate the results of surgical treatment in patients with traumatic TFCC injury at six-month follow-up. MATERIAL AND METHODS: In the years 2000 to 2004, 23 patients with injury to the wrist were treated...

We report on a 9-year-old girl who was involved in a car accident. She suffered severe polytrauma with torn abdominal muscles, rupture of the mesenteric arteries, bowel and bladder, hematoma at the right colonic flexure and disruption of the intervertebral ligaments L2/L3, including the intervertebral disc, typical of Chance fracture. The abdominal bleeding was stopped, the bowel resected and the fracture fixed by internal fixation. The patient developed a postoperative enterocutaneous fistula in the right flank and paraplegia...

PURPOSE: Ulnar shortening is a widely used procedure for various conditions associated with ulnar wrist pain, including triangular fibrocartilage complex (TFCC) injury; however, few reports have examined the condition of the TFCC after osteotomy. The central avascular zone of the TFCC generally is considered to have no potential to heal. This study investigated whether the avascular zone of the TFCC has any potential for repair, and whether repair of the torn disc proper correlates with clinical findings...

Spinal pain is an important public health problem affecting the population indiscriminately. The structures responsible for pain in the spine include the vertebrae, intervertebral discs, spinal cord, nerve roots, facet joints, ligaments, muscles, atlanto-occipital joints, atlanto-axial joints, and sacroiliac joints. Even though disc herniation, facet joints, strained muscles, and torn ligaments have been attributed to be the cause of most spinal pain, either in the neck and upper extremities, upper and mid back, or low back and lower extremities, disorders of the disc other than disc herniation have been implicated more frequently than any other disorders...

Controversy exists regarding management of cervical facet injuries. Previous literature has focused on associated disc herniations reported to cause neurologic injury upon reduction. Although rupture of the ligamentum flavum has been noted with these injuries, its clinical significance has not been examined. In this case report, we present two patients in whom neurologic deterioration occurred due to infolding of the torn ligamentum flavum with spinal cord compression after reduction of cervical facet subluxations...

OBJECTIVE: It is generally accepted that cervical spine bilateral facet dislocation results in complete disruption of the posterior longitudinal ligament. The goal of this study was to evaluate the integrity of numerous spine-stabilizing structures by MRI, and to determine if any associations between injury patterns exist with respect to the posterior longitudinal ligament status. DESIGN: Retrospective case series. PATIENTS: A retrospective review was performed of 30 cervical spine injury subjects with bilateral facet dislocation...

STUDY DESIGN: We collected the specimens of lumbar intervertebral disc (i.e., the symptomatic degenerative disc) from patients with discogenic low back pain to study the histopathologic features and growth factor expressions. OBJECTIVES: To study the pathogenesis of disc degeneration, meanwhile discriminating between common disc degeneration (aging disc) (i.e., black asymptomatic disc, not clinically relevant) and painful disc degeneration (i.e., symptomatic disc, clinically relevant)...

BACKGROUND CONTEXT: Discogram studies have shown that pain reproduction correlates with the extent of annular disruption. However, it has not been assessed if pressure changes in the annulus fibrosus vary incrementally with intradiscal pressure. PURPOSE: To determine the relationship between intradiscal pressure and outer annular pressure during discography in intervertebral discs with and without annular tears. STUDY DESIGN: Intradiscal and periannular pressures were measured simultaneously in vitro during intradiscal injection in porcine cadaver spines...

STUDY DESIGN: The correlation between magnetic resonance imaging and discography of the cervical spine in degenerative disc disease was studied. In addition, the results of cervical discectomy and fusion were evaluated. OBJECTIVES: To compare the value of cervical magnetic resonance imaging versus discography in selecting the level for discectomy and fusion and to evaluate the surgical outcome. SUMMARY OF BACKGROUND DATA: The value of magnetic resonance imaging and discography in patients with cervical discogenic pain is less clear...

The interventional procedures for disk herniation and protrusion by percutaneous techniques are decompressive such as chemodiscolysis with chimopapain, nucleo-discectomy introduced by Onik, LASER discectomy, and recently nucleoplasty, and decompressive and direct antinflammatory such as chemiodiscolysis with an Oxygen-ozone mixture. These techniques have minimized the invasive nature of surgery and avoid or decrease complications like infection linked to surgery. Reducing intervertebral disc size by mechanical aspiration of a part of the disc or partially dissolving the herniation by drying reduces the conic pressure on the torn annulus and creates the space necessary for retropulsion whenever the circular fibres of the annulus regain a minimum capacity to contain the disc under tension...

A 56-year-old woman was referred for severe pain and restricted jaw movements with a duration of more than 10 years. In the early 1990s a discectomy on the left side had been performed where the disc was extirpated and replaced with a polymeric implant. Due to infection and pain the implant was removed about 2 months later. In the 10-year period thereafter she suffered pain from the joint, pain from the left ear, tinnitus and restricted mouth opening.A computer tomography scan revealed a foreign body, approximately 4mm in size, situated in the medial part of the glenoid fossa...