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Low Back Pain with Radiculopathy

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https://www.readbyqxmd.com/read/27856380/t9-versus-t10-as-the-upper-instrumented-vertebra-for-correction-of-adult-deformity-rationale-and-recommendations
#1
Hwee Weng Dennis Hey, Kimberly-Anne Tan, Christabel Shao-En Neo, Eugene Tze-Chun Lau, Denise Ai-Wen Choong, Leok-Lim Lau, Gabriel Ka-Po Liu, Hee-Kit Wong
BACKGROUND CONTEXT: Adult spinal deformity correction sometimes involves long posterior pedicle screw constructs extending from the lumbosacral spine to the thoracic vertebra. As fusion obliterates motion and places supraphysiological stress on adjacent spinal segments, it is crucial to ascertain the ideal upper instrumented vertebra (UIV) to minimize risk of proximal junctional failure (PJF). The T10 vertebra is often chosen to allow bridging of the thoracolumbar junction into the immobile thoracic vertebrae on the basis that it is the lowest immobile thoracic vertebra strut by the rib cage...
November 14, 2016: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/27764056/predictive-factors-of-the-effectiveness-of-caudal-epidural-steroid-injections-in-managing-patients-with-chronic-low-back-pain-and-radiculopathy
#2
Gregory G Billy, Ji Lin, Mengzhao Gao, Mosuk X Chow
STUDY DESIGN: Retrospective clinical outcome analysis. OBJECTIVE: To evaluate and determine whether demographic, comorbid factors, or physical examination findings may predict the outcome of caudal epidural steroid injections in managing patients with chronic low back pain and radiculopathy SUMMARY OF BACKGROUND DATA:: The caudal epidural approach is commonly utilized with patients who are on anticoagulation or who have had prior lumbar surgery to treat L5 or S1 radiculopathies...
October 19, 2016: Clinical Spine Surgery
https://www.readbyqxmd.com/read/27733227/etiology-for-degenerative-disc-disease
#3
Dhungana Hemanta, Xiao-Xing Jiang, Zhen-Zhou Feng, Zi-Xian Chen, Yuan-Wu Cao
Degenerative disc disease is a multifaceted progressive irreversible condition and an inevitable part of aging, which has been found to be a contributing factor for low back pain and might cause radiculopathy, myelopathy, spinal stenosis, degenerative spondylolisthesis, and herniations. Its etiology is complex and multifactorial. Although genetics influence more dominant, the occupational and mechanical influences still persist as a major risk factor. This review emphasizes up-to-date knowledge regarding etiology of disc degeneration with special consideration on occupational, lifestyle factors, and genetic polymorphisms...
September 20, 2016: Chinese Medical Sciences Journal, Chung-kuo i Hsüeh K'o Hsüeh Tsa Chih
https://www.readbyqxmd.com/read/27712027/clinical-practice-guidelines-for-the-noninvasive-management-of-low-back-pain-a-systematic-review-by-the-ontario-protocol-for-traffic-injury-management-optima-collaboration
#4
J J Wong, P Côté, D A Sutton, K Randhawa, H Yu, S Varatharajan, R Goldgrub, M Nordin, D P Gross, H M Shearer, L J Carroll, P J Stern, A Ameis, D Southerst, S Mior, M Stupar, T Varatharajan, A Taylor-Vaisey
: We conducted a systematic review of guidelines on the management of low back pain (LBP) to assess their methodological quality and guide care. We synthesized guidelines on the management of LBP published from 2005 to 2014 following best evidence synthesis principles. We searched MEDLINE, EMBASE, CINAHL, PsycINFO, Cochrane, DARE, National Health Services Economic Evaluation Database, Health Technology Assessment Database, Index to Chiropractic Literature and grey literature. Independent reviewers critically appraised eligible guidelines using AGREE II criteria...
October 6, 2016: European Journal of Pain: EJP
https://www.readbyqxmd.com/read/27707614/extreme-lateral-interbody-fusion-relieves-symptoms-of-spinal-stenosis-and-low-grade-spondylolisthesis-by-indirect-decompression-in-complex-patients
#5
Erlick A C Pereira, Mohammad Farwana, Khai S Lam
Spinal stenosis and low-grade spondylolisthesis produce symptoms of neural compression that can be treated with extreme lateral lumbar interbody fusion (XLIF) via indirect decompression. This study aimed to investigate whether the restoration of disc dimensions would relieve symptoms of radiculopathy, claudication and back pain. In this retrospective study, patients undergoing XLIF surgery for relief of radicular symptoms or degenerative disc disease were included. Radiologically proven changes were used to assess the modes of degeneration...
October 1, 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/27683674/lumbar-interbody-fusion-techniques-indications-and-comparison-of-interbody-fusion-options-including-plif-tlif-mi-tlif-olif-atp-llif-and-alif
#6
REVIEW
Ralph J Mobbs, Kevin Phan, Greg Malham, Kevin Seex, Prashanth J Rao
Degenerative disc and facet joint disease of the lumbar spine is common in the ageing population, and is one of the most frequent causes of disability. Lumbar spondylosis may result in mechanical back pain, radicular and claudicant symptoms, reduced mobility and poor quality of life. Surgical interbody fusion of degenerative levels is an effective treatment option to stabilize the painful motion segment, and may provide indirect decompression of the neural elements, restore lordosis and correct deformity. The surgical options for interbody fusion of the lumbar spine include: posterior lumbar interbody fusion (PLIF), transforaminal lumbar interbody fusion (TLIF), minimally invasive transforaminal lumbar interbody fusion (MI-TLIF), oblique lumbar interbody fusion/anterior to psoas (OLIF/ATP), lateral lumbar interbody fusion (LLIF) and anterior lumbar interbody fusion (ALIF)...
December 2015: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/27630917/efficacy-of-epidural-steroid-injection-in-management-of-lumbar-prolapsed-intervertebral-disc-a-comparison-of-caudal-transforaminal-and-interlaminar-routes
#7
Ritesh Arvind Pandey
INTRODUCTION: Epidural steroid is an important modality in the conservative management of prolapsed lumbar disc and is being used for over 50 years. However, controversy still persists regarding their effectiveness in reducing the pain and improving the function with literature both supporting and opposing them are available. AIM: To study the efficacy of epidural steroid injection in the management of pain due to prolapsed lumbar intervertebral disc and to compare the effectiveness between caudal, transforaminal and interlaminar routes of injection...
July 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27627708/evolution-of-design-of-interbody-cages-for-anterior-lumbar-interbody-fusion
#8
REVIEW
Kevin Phan, Ralph J Mobbs
Anterior lumbar interbody fusion (ALIF) is one of the surgical procedures for the relief of chronic back pain, radiculopathy and neurogenic claudication in patients with degenerative lumbar spine disease that is refractory to conservative therapy, low-grade spondylolisthesis and pseudo arthrosis. Over the past half century, both the surgical techniques and instrumentation required for ALIF have changed significantly. In particular, the designs of ALIF cage and the materials used have evolved dramatically, the common goal being to improve fusion rates and optimize clinical outcomes...
August 2016: Orthopaedic Surgery
https://www.readbyqxmd.com/read/27559446/transforaminal-percutaneous-endoscopic-discectomy-for-lumbar-disc-herniation-in-parkinson-s-disease-a-case-control-study
#9
Stylianos Kapetanakis, Eirini Giovannopoulou, George Charitoudis, Konstantinos Kazakos
STUDY DESIGN: A case-control study. PURPOSE: To investigate the effectiveness of transforaminal percutaneous endoscopic discectomy (TPED) in Parkinson's disease (PD). OVERVIEW OF LITERATURE: Patients with PD frequently suffer from radiculopathy and low back pain. Additionally, they demonstrate higher complication rates after open spine surgery. However, the clinical outcome of minimally invasive techniques for lumbar discectomy, such as TPED, have not been established for this population...
August 2016: Asian Spine Journal
https://www.readbyqxmd.com/read/27496288/acr-appropriateness-criteria-low-back%C3%A2-pain
#10
Nandini D Patel, Daniel F Broderick, Judah Burns, Tejaswini K Deshmukh, Ian Blair Fries, H Benjamin Harvey, Langston Holly, Christopher H Hunt, Bharathi D Jagadeesan, Tabassum A Kennedy, John E O'Toole, Joel S Perlmutter, Bruno Policeni, Joshua M Rosenow, Jason W Schroeder, Matthew T Whitehead, Rebecca S Cornelius, Amanda S Corey
Most patients presenting with uncomplicated acute low back pain (LBP) and/or radiculopathy do not require imaging. Imaging is considered in those patients who have had up to 6 weeks of medical management and physical therapy that resulted in little or no improvement in their back pain. It is also considered for those patients presenting with red flags raising suspicion for serious underlying conditions, such as cauda equina syndrome, malignancy, fracture, and infection. Many imaging modalities are available to clinicians and radiologists for evaluating LBP...
September 2016: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/27488290/direct-repair-of-lumbar-pars-interarticularis-defects-by-utilizing-intraoperative-o-arm-based-navigation-and-microendoscopic-techniques
#11
Jia Min, Jian Wang, Zheng Feng Zhang, Wen Jie Zheng, Yue Zhou
STUDY DESIGN: Retrospective analysis of the clinical outcomes of eight patients with the lumbar pars interarticulars defects treated by direct repair with the aid of intraoperative O-arm based navigation and microendoscopic techniques. OBJECTIVE: To investigate the efficacy and safety of direct screw repair by using minimally invasive surgery for the lumbar pars interarticulars defects in a pilot study. SUMMARY OF BACKGROUND DATA: Direct repair of pars interarticulars defects has been used to treat young adult patients...
August 3, 2016: Spine
https://www.readbyqxmd.com/read/27449889/neurogenic-muscle-hypertrophy-in-a-12-year-old-girl
#12
Matija Zutelija Fattorini, Alenka Gagro, Tomislav Dapic, Goran Krakar, Josip Marjanovic
Muscular hypertrophy secondary to denervation is very rare, but well-documented phenomena in adults. This is the first report of a child with neurogenic unilateral hypertrophy due to S1 radiculopathy. A 12-year-old girl presented with left calf hypertrophy and negative history of low back pain or trauma. The serum creatinine kinase level and inflammatory markers were normal. Magnetic resonance imaging showed muscle hypertrophy of the left gastrocnemius and revealed a protruded lumbar disc at the L5-S1 level...
July 20, 2016: Brain & Development
https://www.readbyqxmd.com/read/27430456/low-back-pain-radiculopathy
#13
Stephen M Selkirk, Robert Ruff
Low back pain is a pervasive problem in the adult population. Most patients with low back pain will not require imaging as spontaneous recovery within 12 weeks is the rule. However, a small percentage of patients with low back pain will have serious underlying pathology requiring more intensive investigation. This chapter delineates the signs and symptoms related to potential serious underlying causes and discusses appropriate imaging modalities that should be utilized in patients with low back pain.
2016: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/27427564/imaging-studies-in-patients-with-spinal-pain-practice-audit-evaluation-of-choosing-wisely-canada-recommendations
#14
Robert Ferrari
OBJECTIVE: To evaluate an a priori threshold for advanced imaging in patients with spinal pain. DESIGN: Patients with spinal pain in any region for 6 to 52 weeks were assessed to determine if radiologic studies beyond x-ray scans were indicated, including magnetic resonance imaging (MRI), computed tomography (CT), and radionuclide bone scans. An a priori threshold was set before MRI, CT, or bone scans would be considered. Those who did not have MRI, CT, or bone scans ordered were followed for at least 1 year to determine if any of them went on to be diagnosed with a more serious spinal disorder (eg, infection, fracture, spondylitis, tumour, neurologic compression)...
March 2016: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/27401953/differentiating-radiculopathy-from-lower-extremity-arthropathy
#15
REVIEW
Steven F DeFroda, Alan H Daniels, Matthew E Deren
Low back and lower extremity pain are among the most common complaints encountered by physicians. Distinguishing pain due to primary extremity pathology versus lumbar radiculopathy can be challenging. Careful physical examination and appropriate imaging with plain radiographs and advanced studies as needed are important in determining the cause of lower extremity complaints. Over-utilization of advanced imaging may reveal otherwise asymptomatic spinal pathology and can lead to an incorrect diagnosis. In patients in whom surgical intervention is being considered by a spine or arthroplasty surgeon, intra-articular or epidural steroid injections may help to reveal the underlying cause of pain via short-term symptomatic relief...
October 2016: American Journal of Medicine
https://www.readbyqxmd.com/read/27352368/radiologic-factors-associated-with-the-dynamic-change-of-dural-sac-diameter-in-lumbar-spine-a-kinematic-mri-study
#16
Shinji Takahashi, Elizabeth L Lord, Tetsuo Hayashi, Jeremiah R Cohen, Lifeng Lao, Qingqiang Yao, Akinobu Suzuki, Hiroaki Nakamura, Jeffrey C Wang
STUDY DESIGN: This is a cross-sectional radiologic study. OBJECTIVE: The purpose of this study was to assess radiologic features related to dynamic changes of dural sac diameter using kinematic magnetic resonance imaging. SUMMARY OF BACKGROUND DATA: It is well known that the cross-sectional area of the lumbar spinal canal decreases during movement from flexion to extension. However, the radiologic characteristics related to dynamic changes of the lumbar spinal canal have not been elucidated...
June 27, 2016: Clinical Spine Surgery
https://www.readbyqxmd.com/read/27352276/imaging-of-degenerative-and-infectious-conditions-of-the-spine
#17
Lubdha M Shah, Jeffrey S Ross
UNLABELLED: : Imaging is important in the evaluation of patients with degenerative disease and infectious processes. There are numerous conditions that can manifest as low back pain (LBP) or neck pain in a patient, and in many cases, the cause may be multifactorial. Clinical history and physical examination are key components in the evaluation of such patients; however, physical examination has variable sensitivity and specificity. Although studies have demonstrated that uncomplicated acute LBP and/or radiculopathy are self-limited conditions that do not warrant any imaging, neuroimaging can provide clear anatomic delineation of potential causes of the patient's clinical presentation...
September 2016: Neurosurgery
https://www.readbyqxmd.com/read/27330199/ultrasound-versus-fluoroscopy-guided-caudal-epidural-steroid-injection-for-the-treatment-of-chronic-low-back-pain-with-radiculopathy-a-randomised-controlled-clinical-trial
#18
Arindam Kumar Hazra, Dipasri Bhattacharya, Sayantan Mukherjee, Santanu Ghosh, Manasij Mitra, Mohanchandra Mandal
BACKGROUND AND AIMS: Caudal epidural steroid administration is an effective treatment for chronic low back pain (LBP). Fluoroscopy guidance is the gold standard for pain procedures. Ultrasound guidance is recently being used in pain clinic procedures. We compared the fluoroscopy guidance and ultrasound guidance for caudal epidural steroid injection with respect to the time needed for correct placement of the needle and clinical effectiveness in patients with chronic LBP. METHODS: Fifty patients with chronic LBP with radiculopathy, not responding to conventional medical management, were randomly allocated to receive injection depot methyl prednisolone (40 mg) through caudal route either using ultrasound guidance (Group U, n = 25) or fluoroscopy guidance (Group F, n = 25)...
June 2016: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/27301238/giant-spinal-schwannoma-in-a-76-year-old-woman-a-case-report
#19
Zvonko Zadro, Ivan Frketić, Jurica Fudurić, Ana Sostarić Zadro, Rade Skarica, Anđelko Korusić, Miroslav Zupcić, Igor Nikolić, Vjekoslav Jelec, Sandra Graf Zupcić, Toni Kolak
A schwannoma is a benign nerve sheath tumor composed of Schwann cells. Spinal schwannoma originates from dorsal roots of the spinal cord, causing symptoms due to the compression of neighboring structures. We present a patient with a low back pain and left L2 and L3 radiculopathy. Neuroimaging techniques (CT, MRI) showed a large expansive mass in the left lumbar paraspinal area. The tumor was removed totally by the posterior approach and was verified to originate from the left L2 spinal nerve root. The histopathological examination revealed typical findings of a schwannoma...
April 2016: Collegium Antropologicum
https://www.readbyqxmd.com/read/27217785/a-burden-of-illness-study-for-neuropathic-pain-in-europe
#20
Hiltrud Liedgens, Marko Obradovic, Jonathan De Courcy, Timothy Holbrook, Rafal Jakubanis
PURPOSE: Neuropathic pain (NP) is often severe and represents a major humanistic and economic burden. This study aimed at providing insight on this burden across France, Germany, Italy, Spain, and the UK, considering direct and indirect costs, productivity loss, and humanistic impact on patients and their families. METHODS: Physician questionnaires provided data on patients presenting with NP covering demographics, sick leave and retirement, number of consultations, drug treatments, and surgical procedures...
2016: ClinicoEconomics and Outcomes Research: CEOR
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