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Low Back Pain with Radiculopathy

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https://www.readbyqxmd.com/read/28521343/tarlov-cyst-causing-sacral-insufficiency-fracture
#1
Ross C Puffer, Marcus J Gates, William Copeland, William E Krauss, Jeremy Fogelson
BACKGROUND AND IMPORTANCE: Tarlov cysts, also known as perineural cysts, have been described as meningeal dilations of the spinal nerve root sheath between the peri- and endoneurium at the dorsal root ganglion. Most often they are found in the sacrum involving the nerve roots. Normally asymptomatic, they have been reported to present with radiculopathy, paresthesias, and even urinary or bowel dysfunction. Sacral insufficiency has not been a well-documented presentation. CLINICAL PRESENTATION: The patient is a 38-year-old female who started to develop left low back pain and buttock pain that rapidly progressed into severe pain with some radiation down the posterior aspect of her left leg...
June 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28503982/anxiety-and-depression-affect-pain-drawings-in-cervical-degenerative-disc-disease
#2
Anna MacDowall, Yohan Robinson, Martin Skeppholm, Claes Olerud
INTRODUCTION: Pain drawings have been frequently used in the preoperative evaluation of spine patients. Until now most investigations have focused on low back pain patients, even though pain drawings are used in neck pain patients as well. The aims of this study were to investigate the pain drawing and its association to preoperative demographics, psychological impairment, and pain intensity. METHODS: We carried out a post hoc analysis of a randomized controlled trial, comparing cervical disc replacement to fusion for radiculopathy related to degenerative disc disease...
May 15, 2017: Upsala Journal of Medical Sciences
https://www.readbyqxmd.com/read/28458818/lumbar-vertebral-body-and-pars-fractures-following-laminectomy
#3
Akshay Yadhati, Swamy Kurra, Richard A Tallarico, William F Lavelle
A 56-year-old alcoholic male incurred L5 vertebral body and bilateral L4 pars fractures with progressive L4 on L5 anterolisthesis following low-energy falls while intoxicated. Recently, he had a L3-S1 laminectomy for lumbar spinal stenosis with claudication. Preoperative imaging and radiographs were negative for pars defects and instability, so an isolated decompressive surgery was performed. Following low-energy falls, his outpatient work-up revealed fractures through the bilateral L4 pedicles and posterior third of L5 vertebral body, with recurrence of axial back pain and bilateral lower extremity radiculopathy...
February 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28457932/the-role-of-conventional-myelography-in-the-diagnosis-and-treatment-of-degenerative-spine-diseases-in-low-income-communities-a-prospective-study
#4
David Kitya, Maria Punchak, Francis Bajunirwe
INTRODUCTION: Chronic back pain is a common problem and imaging is crucial for effective diagnosis and treatment. In low-resource settings conventional myelography is a cheap alternative to MRI and CT. This study was conducted to re-examine the diagnostic reliability, effectiveness for surgical decision making and safety of conventional myelography. METHODS: The study was conducted at Tenwek Mission Hospital during June 2009 and March 2010. New patients who presented with features of radiculopathy and/or myelopathy were eligible...
April 27, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28436279/treatment-of-painful-radiculopathies-with-capsaicin-8-cutaneous-patch
#5
R Baron, R D Treede, F Birklein, T Cegla, R Freynhagen, M L Heskamp, K U Kern, C Maier, R Rolke, S Seddigh, C Sommer, S Ständer, C Maihöfner
BACKGROUND AND OBJECTIVE: The treatment of neuropathic pain due to low-back (lumbosacral) radiculopathies, a common source of neuropathic pain, is challenging and often requires a multimodal therapeutic approach. The capsaicin 8% patch is the first topical analgesic licensed for peripheral neuropathic pain. To evaluate this treatment, a subset of patients with painful radiculopathy (lumbar and cervical, including ventral and dorsal rami) enrolled into the multicenter, non-interventional QUEPP study (Qutenza (2) - safety and effectiveness in peripheral neuropathic pain) was analyzed...
May 4, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28429208/ultra-low-dose-periradicular-infiltration-of-the-lumbar-spine-spot-scanning-and-its-potential-for-further-dose-reduction-by-replacing-helical-planning-ct
#6
Fabian Henry Jürgen Elsholtz, Lars-Arne Schaafs, Christoph Erxleben, Bernd Hamm, Stefan Markus Niehues
PURPOSE: Computed tomography (CT)-guided periradicular infiltration has become an accepted procedure for treating radiculopathy-associated low back pain. The purpose of this study is to compare spot scanning and segmental helical planning CT in terms of dose reduction. MATERIALS AND METHODS: Eighty-five patients underwent CT-guided single-site lumbar periradicular therapy. Prior imaging was not available for planning. Sixty-three patients were examined with a new dedicated spot scanning technique (group I), and twenty-two patients underwent conventional segmental planning CT examinations with helical image acquisition serving as controls (group II)...
April 20, 2017: La Radiologia Medica
https://www.readbyqxmd.com/read/28429142/national-clinical-guidelines-for-non-surgical-treatment-of-patients-with-recent-onset-low-back-pain-or-lumbar-radiculopathy
#7
REVIEW
Mette Jensen Stochkendahl, Per Kjaer, Jan Hartvigsen, Alice Kongsted, Jens Aaboe, Margrethe Andersen, Mikkel Ø Andersen, Gilles Fournier, Betina Højgaard, Martin Bach Jensen, Lone Donbæk Jensen, Ture Karbo, Lilli Kirkeskov, Martin Melbye, Lone Morsel-Carlsen, Jan Nordsteen, Thorvaldur Skuli Palsson, Zoreh Rasti, Peter Frost Silbye, Morten Zebitz Steiness, Simon Tarp, Morten Vaagholt
PURPOSE: To summarise recommendations about 20 non-surgical interventions for recent onset (<12 weeks) non-specific low back pain (LBP) and lumbar radiculopathy (LR) based on two guidelines from the Danish Health Authority. METHODS: Two multidisciplinary working groups formulated recommendations based on the GRADE approach. RESULTS: Sixteen recommendations were based on evidence, and four on consensus. Management of LBP and LR should include information about prognosis, warning signs, and advise to remain active...
April 20, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28422833/correction-of-sagittal-imbalance-in-treatment-for-adult-degenerative-scoliosis-with-thoracic-lordosis-and-lumbar-kyphosis-a-case-report
#8
Tao Wang, Hui Wang, Lei Ma, Di Zhang, Wen-Yuan Ding
RATIONALE: Lumbar degenerative scoliosis (LDS) is a common spinal disease for senior citizens. However, LDS accompanied with thoracic lordosis and lumbar kyphosis (LK) is rare in clinic. No reports have reported LDS with thoracic lordosis and LK. PATIENT CONCERNS: A 54-year-old woman just complained about sever back pain without any radiculopathy and neurodeficit of low limb for 2 years, Visual Analogue Scale (VAS) for back pain was 9 points and x-ray showed adult LDS with lordosis angle of 10° from 5th thoracic to 12th thoracic (T5-T12) and LK angle of 20°...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28413533/persistent-l5-lumbosacral-radiculopathy-caused-by-lumbosacral-trunk-schwannoma
#9
Guive Sharifi, Amin Jahanbakhshi
Schwannomais, usually, benign tumor of nerve sheath that occurs evenly along the spinal cord. Intra-pelvic schwannoma is very rare entity that may arise from lumbosacral nerve roots or from sciatic nerve. Radicular pain of the lower limb as a presenting symptom of pelvic schwannoma is extremely rare. In the current report, the patient is presented with a right sided L5 radicular pain typical of lumbar discopathy. Interestingly, a herniated lumbar disc was noted on lumbosacral magnetic resonance imaging (MRI)...
January 2017: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/28375914/low-back-pain
#10
Jinny O Tavee, Kerry H Levin
PURPOSE OF REVIEW: This article provides an overview of evaluating and treating low back pain in the outpatient setting. RECENT FINDINGS: As most cases of acute low back pain have a favorable prognosis, current guidelines on imaging studies recommend conservative treatment for 6 weeks prior to obtaining an MRI if no red flags are present. Of these red flags, a prior history of cancer is the strongest risk factor for a malignant etiology and requires urgent evaluation with MRI...
April 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/28339334/a-movement-system-impairment-approach-to-evaluation-and-treatment-of-a-person-with-lumbar-radiculopathy-a-case-report
#11
Eileen Miller, Shirley A Sahrmann, Dale Avers
BACKGROUND AND PURPOSE: There are several systems of classification and treatment of patients with low back pain (LBP) based on assessment of the effect of lumbar postures and movements on symptoms. The efficacy of one of these systems, The Movement System Impairment (MSI) method, has not yet been demonstrated in the literature. The purpose of this case report is to describe the approach of the MSI method for an individual with lumbar radiculopathy. CASE DESCRIPTION: A 79-year-old woman with a history of chronic LBP was referred to PT with a physician's diagnosis of sciatica...
March 2017: Physiotherapy Theory and Practice
https://www.readbyqxmd.com/read/28338580/textiloma-a-case-of-foreign-body-mimicking-a-spinal-tumor
#12
Ali Meshkini, Firooz Salehpour, Amir Rezakhah, Farhad Mirzaei, Mohammad KazemZadeh, Seyed Ahmad Naseri Alavi
STUDY DESIGN: Case report OBJECTIVE.: To report a case of foreign body mimicking spinal tumor Background: Textiloma, SUMMARY OF BACKGROUND DATA.: Gossypiboma or more broadly Retained Foreign Object (RFO) is a surgical complication resulting from foreign materials such as cotton or gauze pads, surgical sponge, accidentally left inside a patient's body. Such foreign materials cause foreign body reaction in the surrounding tissue. METHODS: A retrospective case report was performed...
March 23, 2017: Spine
https://www.readbyqxmd.com/read/28276661/anterior-lumbar-interbody-fusion-in-left-sided-inferior-vena-cava-and-right-sided-aortic-arch
#13
Kevin Phan, Bernard A M Fang, Monish M Maharaj, Andrew F Lennox, Ralph J Mobbs
Spinal fusion via anterior lumbar interbody fusion (ALIF) can offer symptomatic relief to patients that suffer severe low back pain, radiculopathy, and claudication. However, a detailed working knowledge of the thoracic, abdominal, and lumbar anatomy, particularly of the vasculature, is vital. We report the case of a 68-year-old man who presented with radiculopathy and progressively worsening low back pain despite 9 months of unsuccessful conservative therapy and pain management. Preoperative computed tomography and magnetic resonance imaging revealed a rare anatomical variation, with an anomalous left-sided inferior vena cava and anomalous aorta...
February 2017: Orthopaedic Surgery
https://www.readbyqxmd.com/read/28256498/iliacus-abscess-with-radiculopathy-mimicking-herniated-nucleus-pulposus-additional-diagnostic-value-of-magnetic-resonance-imaging
#14
D H Kim, S H Woo, W J Lee
An iliacus abscess is an extremely rare cause of low back pain. With an iliacus abscess, the classical signs seen with a psoas abscess are frequently absent. Therefore, a timely diagnosis at the initial visit is difficult and inadequate treatment usually results in high mortality. Here, we report the case of 19-year-old man who presented with acute low back pain with radiculopathy and was ultimately diagnosed with an iliacus muscle abscess.
March 2017: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/28250636/health-related-quality-of-life-after-transforaminal-percutaneous-endoscopic-discectomy-an-analysis-according-to-the-level-of-operation
#15
Stylianos Kapetanakis, Georgios Charitoudis, Tryfon Thomaidis, Panagiotis Theodosiadis, Jannis Papathanasiou, Konstantinos Giatroudakis
BACKGROUND: Many patients suffer from radiculopathy and low back pain due to lumbar disc hernia. Transforaminal percutaneous endoscopic discectomy (TPED) is a minimally invasive method that accesses the disc pathology through the intervertebral foramen. Health-related quality of life (HRQoL) has been previously assessed for this method. However, a possible effect of the level of operation on the postoperative progress of HRQoL remains undefined. PURPOSE: The purpose of this study was to evaluate the impact of the level of operation on HRQoL, following TPED...
January 2017: Journal of Craniovertebral Junction and Spine
https://www.readbyqxmd.com/read/28249826/endoscopic-surgical-treatment-of-lumbar-synovial-cyst
#16
Joachim M Oertel, Benedikt W Burkhardt
BACKGROUND: Lumbar synovial cysts (LSC) are an uncommon cause of radiculopathy and back pain. The open surgical treatment is associated with extensive bone resection and muscle trauma. The endoscopic tubular assisted LSC resection has not been described in detail. Here the authors assessed the effectiveness of this technique for LSC resection. METHODS: Eleven patients (4 female and 7 male patients) were operated on via an ipsilateral approach for resection of LSC using an endoscopic tubular retractor system...
February 26, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28243143/positive-medium-term-influence-of-multimodal-pain-management-on-socioeconomic-factors-and-health-care-utilization-in-patients-with-lumbar-radiculopathy-a-prospective-study
#17
Achim Benditz, Martin Loher, Daniel Boluki, Joachim Grifka, Florian Völlner, Tobias Renkawitz, Günther Maderbacher, Jürgen Götz
BACKGROUND: Multimodal pain management (MPM) represents a central approach to avoiding surgery in patients with lumbar radiculopathy. Independent of the type of health system, cost effectiveness and socioeconomic factors are becoming increasingly important. This study investigated the medium-term influence of conservative MPM on health care utilization and socioeconomic factors. METHODS: This study compared subjective, objective, and socioeconomic factors of 60 patients after inpatient MPM because of lumbar radiculopathy, before and 1 year ± 2 weeks after treatment...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28222837/use-of-the-rat-grimace-scale-to-evaluate-neuropathic-pain-in-a-model-of-cervical-radiculopathy
#18
Blythe H Philips, Christine L Weisshaar, Beth A Winkelstein
Although neck and low-back pain are common sources of neuropathic pain with high societal costs, the pathophysiology of neuropathic pain is not well-defined. Traditionally, most rodent pain studies rely on evoked reflex-based testing to measure pain. However, these testing methods do not reveal spontaneous pain, particularly early after injury. The rat grimace scale (RGS) for quantifying spontaneous pain has been validated after visceral, incisional, orthopedic, and inflammatory insults but not neuropathic pain...
February 1, 2017: Comparative Medicine
https://www.readbyqxmd.com/read/28207622/curve-characteristics-and-foraminal-dimensions-in-patients-with-adult-scoliosis-and-radiculopathy
#19
Andrew J Pugely, Zachary Ries, Gnanapradeep Gnanapragasam, Yubo Gao, Rachel Nash, Sergio A Mendoza-Lattes
STUDY DESIGN: Retrospective cohort study. OBJECTIVE: To demonstrate a correlation between radiculopathy symptoms, foraminal morphology, and curve types. SUMMARY OF BACKGROUND DATA: Patients with degenerative scoliosis frequently present with foraminal stenosis and radiculopathy, the origin of which is not well understood. METHODS: A total of 48 patients (384 foraminas) were included: 14 with low back pain (B); 16 with femoral nerve pain (F); and 18 with sciatic nerve pain (S)...
March 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28192790/systemic-pharmacologic-therapies-for-low-back-pain-a-systematic-review-for-an-american-college-of-physicians-clinical-practice-guideline
#20
Roger Chou, Richard Deyo, Janna Friedly, Andrea Skelly, Melissa Weimer, Rochelle Fu, Tracy Dana, Paul Kraegel, Jessica Griffin, Sara Grusing
Background: A 2007 American College of Physicians guideline addressed pharmacologic options for low back pain. New evidence and medications have now become available. Purpose: To review the current evidence on systemic pharmacologic therapies for acute or chronic nonradicular or radicular low back pain. Data Sources: Ovid MEDLINE (January 2008 through November 2016), Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and reference lists...
April 4, 2017: Annals of Internal Medicine
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