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Disc herniation in L5-S1

Rafet Ozay, Torel Ogur, Hasan Ali Durmaz, Erhan Turkoglu, Yusuf Sukru Caglar, Zeki Sekerci, Mehmet Sorar, Sahin Hanalioglu
OBJECTIVE: Preserving the ligamentum flavum (LF) during lumbar spine surgery may help limit the extent of postoperative epidural fibrosis (EF), a potential cause of persistent leg pain. We present a retrospective analysis of microdiscectomy with preservation of the LF in order to evaluate the effects of the two LF mobilizing techniques (reflecting inferiorly or medially vs. removing completely) on EF and clinical outcomes. METHODS: Microdiscectomy was performed through a unilateral laminotomy in 93 patients (52 male, 41 female; mean age 46; range 25-65 years) with L3-L4 (n=3), L4-L5 (n=40), and L5-S1 (n=50) lumbar disc herniation...
March 9, 2018: World Neurosurgery
Seung-Kook Kim, Su-Chan Lee, Seung-Woo Park
CONTEXT/OBJECTIVE: Trans-sacral epiduroscopic laser decompression (SELD) is an alternative to microscopic open lumbar discectomy (OLD). SELD and OLD for L5-S1 lumbar disc herniation (LDH) have not been compared. We compared clinical results, including pain control, between SELD and OLD. DESIGN: Retrospective analysis. SETTING: Korean hospital. PARTICIPANTS: Eighty patients treated with SELD (n = 40) or microscopic OLD (n = 40) for L5-S1 LDH...
February 28, 2018: Journal of Spinal Cord Medicine
Julio D Montejo, Joaquin Q Camara-Quintana, Daniel Duran, Jeannine M Rockefeller, Sierra B Conine, Alyssa M Blaise, Kristopher T Kahle, Michael L DiLuna
OBJECTIVE Lumbar disc herniation (LDH) in the pediatric population is rare and exhibits unique characteristics compared with adult LDH. There are limited data regarding the safety and efficacy of minimally invasive surgery (MIS) using tubular retractors in pediatric patients with LDH. Here, the outcomes of MIS tubular microdiscectomy for the treatment of pediatric LDH are evaluated. METHODS Twelve consecutive pediatric patients with LDH were treated with MIS tubular microdiscectomy at the authors' institution between July 2011 and October 2015...
February 23, 2018: Journal of Neurosurgery. Pediatrics
John T Martin, Alexander B Oldweiler, Charles E Spritzer, Brian J Soher, Melissa M Erickson, Adam P Goode, Louis E DeFrate
Low back pain is a significant socioeconomic burden in the United States and lumbar intervertebral disc degeneration is frequently implicated as a cause. The discs play an important mechanical role in the spine, yet the relationship between disc function and back pain is poorly defined. The objective of this work was to develop a technique using magnetic resonance imaging (MRI) and three-dimensional modeling to measure in vivo disc deformations. Using this method, we found that disc geometry was measurable with precision less than the in-plane dimensions of a voxel (≈100 µm, 10% of the MRI pixel size)...
February 9, 2018: Journal of Biomechanics
Wei Li, Yan-Cheng Liu, Chen-Fan Zheng, Jun Miao, Hui Chen, Hai-Ying Quan, Song-Hua Yan, Kuan Zhang
OBJECTIVE: To establish a logistic regression model using surface electromyography (SEMG) parameters for diagnosing the compressed nerve root at L 5 or S 1 level in patients with lumbar disc herniation (LDH). METHODS: This study recruited 24 patients with L 5 nerve root compression and 23 patients with S 1 nerve root compression caused by LDH from May 2014 to May 2016. SEMG signals from the bilateral tibialis anterior and lateral gastrocnemius were measured. The root mean square (RMS), the RMS peak time, the mean power frequency (MPF), and the median frequency (MF) were analyzed...
February 9, 2018: Orthopaedic Surgery
Seung-Kook Kim, Sang-Soo Kang, Young-Ho Hong, Seung-Woo Park, Su-Chan Lee
BACKGROUND: The unilateral biportal endoscopic (UBE) technique is a minimally invasive procedure for spinal surgery, while open microscopic discectomy is the most common surgical treatment for ruptured or herniated discs of the lumbar spine. A new endoscopic technique that uses a UBE approach has been applied to conventional arthroscopic systems for the treatment of spinal disease. In this study, we aimed to compare and evaluate the perioperative parameters and clinical outcomes, including recovery from surgery, pain and life quality modification, patient's satisfaction, and complications, between UBE and open lumbar microdiscectomy (OLM) for single-level discectomy procedures...
January 31, 2018: Journal of Orthopaedic Surgery and Research
Zheng Xu, Yi Liu, Jinchuan Chen
AIM: L5/S1 Adolescent lumbar disc herniation (ALDH) is usually ignored for its low incidence. Recently, percutaneous endoscopic procedures have been widely used. The aim of the study was to investigate the surgical techniques and clinical outcomes of percutaneous endoscopic interlaminar discectomy (PEID) in the treatment of L5/S1 (ALDH). MATERIAL AND METHODS: A retrospective study was performed between May 2012 to September 2014, which included 23 adolescent patients who underwent PEID for L5/S1 lumbar disc herniation...
December 28, 2017: Turkish Neurosurgery
Stylianos Kapetanakis, Constantinos Chaniotakis, Constantinos Kazakos, Jannis V Papathanasiou
Cauda equina syndrome (CES) is a rare neurologic condition that is caused by compression of the cauda equina. Cauda equina consists of spinal nerves L2-L5, S1-S5 and the coccygeal nerve. The compression of these nerve roots can be caused mainly by lumbar disc herniation (45% of all causes). The diagnosis consists of two critical points: a) detailed history and physical examination and b) MRI or CT. The gold standard of the treatment of this syndrome is the surgical approach in combination with the timing of onset of symptoms...
December 20, 2017: Folia Medica
Céline Salaud, Stéphane Ploteau, Olivier Hamel, Olivier Armstrong, Antoine Hamel
PURPOSE: There are only two descriptions of posterior longitudinal ligament (PLL) at the lumbar spine level but its morphologic characteristics are different to cervical and thoracic levels. METHOD: Spine explantation (from Th12 to L5) followed by resection of the neural arch and the dural sheath in 13 fresh cadavers was performed. The PLL was isolated from other epidural structures and its width was measured and compared to the vertebral body width at each vertebral levels...
December 29, 2017: Surgical and Radiologic Anatomy: SRA
Chen Yu, Chang Zhengqi, Yu Xiuchun
BACKGROUND: Lumbar disc herniation complicated with nerve root anomaly presents great challenges to diagnosis and treatment, improper selection of surgical procedures may cause inferior outcomes and neurological injury. CASE DESCRIPTION: A 66-year old male presented with low back pain and radicular symptoms involving bilateral L-5 and S-1 nerve roots. Instead of percutaneous endoscopic lumbar discectomy, aggressive decompression was carried out due to deviation between examination and imaging findings...
December 9, 2017: World Neurosurgery
Seung-Kook Kim, Su-Chan Lee, Seung-Woo Park, Eun-Sang Kim
BACKGROUND: Trans-sacral epiduroscopic lumbar decompression (SELD) is an emerging procedure for the treatment of lumbar disc herniation (LDH), with favorable outcomes having been reported. However, the complications associated with SELD have not been comprehensively evaluated to date. Therefore, the aim of our study was to describe the incidence rate, types, and characteristics of complications following SELD and management outcomes. METHODS: Retrospective analysis of the surgical and clinical outcomes for 127 patients (average age, 42...
December 4, 2017: Journal of Orthopaedic Surgery and Research
Nitin Adsul, Hyeun Sung Kim, Sung Ho Choi, Jee-Soo Jang, Il-Tae Jang, Seong-Hoon Oh
BACKGROUND: Acute bilateral isolated foot drop due to lumbar disk prolapse with canal stenosis is rare with only 3 cases reported in literature. Our patient was managed using the percutaneous full endoscopic technique. This is mainly to highlight the ease of access and patient outcome with preoperative and postoperative images to support our minimally invasive treatment for this rare condition. CASE DESCRIPTION: A 46-year-old male presented with sudden-onset severe back pain with bilateral foot drop...
February 2018: World Neurosurgery
Tian Gao, Qi Lai, Song Zhou, Xuqiang Liu, Yuan Liu, Ping Zhan, Xiaolong Yu, Jun Xiao, Min Dai, Bin Zhang
BACKGROUND: The aim of this study was to investigate the correlation between facet tropism and spinal degenerative diseases, such as degenerative lumbar spondylolisthesis, degenerative lumbar scoliosis, and lumbar disc herniation. METHODS: This study retrospectively analysed clinical data from the Department of Orthopaedics at The First Affiliated Hospital of Nanchang University. Ninety-two patients were diagnosed with lumbar spondylolisthesis, 64 patients with degenerative scoliosis, and 86 patients with lumbar disc herniation between 1 October 2014 and 1 October 2016...
November 22, 2017: BMC Musculoskeletal Disorders
Si-Dong Yang, Feng Zhang, Wen-Yuan Ding
Objectives: In this research we analyzed the results of surgical treatment of cauda equina syndrome (CES) caused by acute lumbar disc herniation. We emphasize the early treatment for good neurological recovery. Methods: A retrospective-prospective, non randomized, clinical study was performed between Jan 2010 and Dec 2014. We retrospectively collected medical records of 18 patients who suffered from CES due to acute lumbar disc herniation and followed up them regularly...
October 13, 2017: Oncotarget
Min Cheol Chang
RATIONALE: Trans-sacral epiduroscopic laser decompression (SELD) is reported to have strong positive short-term effects in controlling lower back pain (LBP) or radicular leg pain following herniated lumbar disc (HLD). However, little is known about the possible complications following SELD. PATIENT CONCERNS: A 36-year-old man received SELD with YAG laser for controlling LBP and radicular pain due to HLD on L5-S1. However, after SELD, voiding and defecation difficulties and sensory deficits on the S3-5 dermatome were presented...
October 2017: Medicine (Baltimore)
Jeannie F Bailey, Stephanie L Miller, Kristine Khieu, Conor W O'Neill, Robert M Healey, Dezba G Coughlin, Jojo V Sayson, Douglas G Chang, Alan R Hargens, Jeffrey C Lotz
Background context Prolonged microgravity exposure is associated with localized low back pain and an elevated risk of post-flight disc herniation. Though the mechanisms by which microgravity impairs the spine are unclear, they should be foundational for developing in-flight countermeasures for maintaining astronaut spine health. Because human spine anatomy has adapted to upright posture on Earth, observations of how spaceflight affects the spine should also provide new and potentially important information on spine biomechanics that benefit the general population...
September 26, 2017: Spine Journal: Official Journal of the North American Spine Society
S Kapetanakis, E Giovannopoulou, G Charitoudis, K Kazakos
BACKGROUND: Lumbar discectomy is among the most frequently performed procedures in spinal surgery. Transforaminal percutaneous endoscopic discectomy (TPED) is a minimally invasive technique that gains ground among surgeons in the recent years. TPED has been studied in terms of effectiveness, however little is known about its overall impact on health-related quality of life (HRQoL) of the patients. OBJECTIVE: To investigate the progress of HRQoL following TPED. PATIENTS AND METHODS: Seventy-six (76) patients were enrolled in the study...
June 10, 2017: Journal of Back and Musculoskeletal Rehabilitation
T Koy, B Ganse, J Zange, J Rittweger, R Pohle-Fröhlich, P Fings-Meuthen, B Johannes, D Felsenberg, P Eysel, P M Bansmann, D L Belavý
OBJECTIVES: Spaceflight back pain and intervertebral disc (IVD) herniations cause problems in astronauts. Purpose of this study was to assess changes in T2-relaxation-time through MRI measurements before and after head-down tilt bed-rest, a spaceflight analog. METHODS: 8 men participated in the bed-rest study. Subjects remained in 6° head down tilt bed-rest in two campaigns of 21 days, and received a nutritional intervention (potassium bicarbonate 90 mmol/d) in a cross-over design...
September 1, 2017: Journal of Musculoskeletal & Neuronal Interactions
M Dobran, D Brancorsini, M Della Costanza, V Liverotti, F Mancini, D Nasi, M Iacoangeli, M Scerrati
BACKGROUND: To limit epidural fibrosis and prevent scar formation/nerve tethering that may contribute to chronic postoperative pain; some surgeons have utilized epidural autologous fat grafts following lumbar microdiscectomy. METHODS: We investigated the correlation between post-microdiscectomy epidural scarring [including select magnetic resonance imaging (MRI) studies] and clinical outcomes in 36 patients operated for symptomatic. MRI documented L4-L5 and L5-S1 disk herniations with (18 patients) and without (18 patient) the application of free fat grafts...
2017: Surgical Neurology International
Jiulong Zhang, Feng Zhang, Fuxia Xiao, Zuogang Xiong, Dong Liu, Ting Hua, Nekitsing Indima, Guangyu Tang
BACKGROUND AND PURPOSE: Nerve root compression by lumbar disc herniation (LDH) induces a series of clinical symptoms, seriously affecting the patient's life and work. The purpose of this study is to investigate microstructural changes and fiber bundle abnormalities of the compressed L5 and S1 nerve roots in young patients with unilateral LDH by using diffusion tensor imaging (DTI). METHODS: Forty young patients with unilateral LDH and 17 healthy volunteers participated in the study, and 33 patients received follow-up DTI examination after one month of conservative treatment...
August 21, 2017: Clinical Neuroradiology
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