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Disc herniation in L5-S1

Evgenii Belykh, Alexander V Krutko, Evgenii S Baykov, Morgan B Giers, Mark C Preul, Vadim A Byvaltsev
BACKGROUND CONTEXT: Recurrence of lumbar disc herniation (rLDH) is one of the unfavorable outcomes after microdiscectomy. Prediction of the patient population with increased risk of rLDH is important because patients may benefit from preventive measures or other surgical options. PURPOSE: The study assessed preoperative factors associated with rLDH after microdiscectomy and created a mathematical model for estimation of chances for rLDH. STUDY DESIGN/SETTING: This is a retrospective case-control study...
October 17, 2016: Spine Journal: Official Journal of the North American Spine Society
Ru-Sen Zhu, Yi-Ming Ren, Jian-Jun Yuan, Zi-Jian Cui, Jun Wan, Bao-You Fan, Wei Lin, Xian-Hu Zhou, Xue-Li Zhang
Lumbar disc herniation (LDH) is a common disease and lumbar discectomy is the most common surgical procedure carried out for patients with low back pain and leg symptoms. Although most researchers are focusing on the surgical techniques during operation, the aim of this study is to evaluate the effect of local intervertebral lavage during microdiscectomy.In this retrospective study, 410 patients were operated on by microdiscectomy for LDH during 2011 to 2014. Retrospectively, 213 of them (group A) accepted local intervertebral irrigation with saline water before wound closure and 197 patients (group B) only had their operative field irrigated with saline water...
October 2016: Medicine (Baltimore)
Edvin Zekaj, Claudia Menghetti, Christian Saleh, Alessandra Isidori, Alberto R Bona, Enrico Aimar, Domenico Servello
BACKGROUND: Intraforaminal disc herniations at the L5-S1 level are extremely surgically challenging lesions. Intracanal approaches frequently require partial or total facetectomy, which may lead to instability. Solely extraforaminal approaches may offer limited visualization of the more medial superiorly exiting and inferiorly exiting nerve roots; this approach is also more complicated at L5-S1 due to the often large L5 transverse process and the iliac wing. METHODS: Nine patients with intraforaminal L5-S1 disc herniations, foraminal stenosis, or synovial cysts underwent contralateral interlaminar approaches for lesion resection...
2016: Surgical Neurology International
Anna Maria Ierardi, Filippo Piacentino, Francesca Giorlando, Alberto Magenta Biasina, Alessandro Bacuzzi, Raffaele Novario, Gianpaolo Carrafiello
OBJECTIVE: To demonstrate the feasibility of percutaneous nucleoplasty procedures at L5/S1 level using cone beam CT (CBCT) and its associated image guidance technology for the treatment of lumbar disc herniation (LDH). MATERIALS AND METHODS: We retrospectively reviewed 25 cases (20 men, 5 women) of LDH at L5/S1 levels. CBCT as guidance imaging was chosen after a first unsuccessful fluoroscopy attempt that was related to complex anatomy (n = 15), rapid pathological changes due to degenerative diseases (n = 7) or both (n = 3)...
October 3, 2016: Skeletal Radiology
Guofang Fang, Jianhe Zhou, Yutan Liu, Hongxun Sang, Xiangyang Xu, Zihai Ding
BACKGROUND: There are many different reasons why patients could be experiencing pain in the gluteal area. Previous studies have shown an association between radicular low back pain (LBP) and gluteal pain (GP). Studies locating the specific level responsible for gluteal pain in lumbar disc hernias have rarely been reported. METHODS: All patients with lumbar disc herniation (LDH) in the Kanghua hospital from 2010 to 2014 were recruited. All patients underwent a lumbar spine MRI to clarify their LDH diagnosis, and patients were allocated to a GP group and a non-GP group...
2016: BMC Musculoskeletal Disorders
Guntram Krzok, Albert Edward Telfeian, Ralf Wagner, Menno Iprenburg
OBJECTIVE: Endoscopic surgery for highly migrated lumbar disc extrusions is a challenge even for spine surgeons who are very familiar with utilizing endoscopic techniques. Because of the anatomic constraints involved in transforaminal access in endoscopic surgery, an incomplete removal of a highly migrated disc extrusion can result in some cases. Here the authors describe a new technique for accessing extruded lumbar discs that have migrated into the canal directly through a transpedicular approach...
August 16, 2016: World Neurosurgery
Babak Pourabbas, Mohammad Ali Effani, Asghar Namdari
Traumatic retrolisthesis is a rare injury and may result in intervertebral disc extrusion and nerve root injury. These injuries are highly unstable and require surgery for decompression and stabilization. Traumatic retrolisthesis of L5 with acute L5/S1 disc extrusion associated with nerve root injury has not been reported previously in English literatures. We herein report a case of traumatic retrolisthesis of L5 and extruded disc. A 22 year-old patient presented with lower extremity weakness due to L5/S1 retrolisthesis and traumatic acute L5/S1 disc extrusion after falling of 8 meters height...
July 2016: Bulletin of Emergency and Trauma
Hong-Fei Nie, Jian-Cheng Zeng, Yue-Ming Song, Guo Chen, Xian-di Wang, Zhu-Hai Li, Hu-Shan Jiang, Qing-Quan Kong
STUDY DESIGN: A prospective, randomized, controlled study of patients with L5-S1 lumbar disc herniations, operated with endoscopic discectomy through an interlaminar or transforaminal approach. OBJECTIVE: To compare the results of percutaneous endoscopic lumbar discectomy in L5-S1 disc herniation through an interlaminar or transforaminal approach. SUMMARY OF BACKGROUND DATA: The transforaminal and interlaminar techniques are both acceptable approaches for L5-S1 disc herniation...
July 22, 2016: Spine
Rasim Skomorac, Jasmin Delić, Hakija Bečulić, Aldin Jusić
Aim To establish presence of segmental instability in patients operated with standard discectomy comparing measurement of translation and rotation on postoperative functional radiographs of lumbosacral spine with reference values,and to explore difference between patients operated on one or two levels. Methods The study included 71 patients, who were operated due to herniated lumbar disc. They were divided into two groups operated on one level (group A) or two adjacent levels (group B). All patients had been imaged in a standing position with functional lateral radiography...
August 1, 2016: Medicinski Glasnik
Tayfun Hakan, Serkan Gürcan
Spontaneous regression of herniated lumbar discs was reported occasionally. The mechanisms proposed for regression of disc herniation are still incomplete. This paper describes and discusses a case of spontaneous regression of herniated lumbar discs with a new disc protrusion in the adjacent level. A 41-year-old man was admitted with radiating pain and numbness in the left lower extremity with a left posterolateral disc extrusion at L5-S1 level. He was admitted to hospital with low back pain due to disc herniation caudally immigrating at L4-5 level three years ago...
2016: Case Reports in Orthopedics
I Arrotegui
INTRODUCTION: We conducted a retrospective study in patients with disc herniation and compared the results obtained in individuals treated with the U device N6 with those acquired in patients treated without any device. The U device is a titanium alloy implant that is placed between the spinous processes. MATERIAL AND METHODS: In a cohort of 50 patients with degenerative lumbar disc, 25 underwent surgical treatment in which the U device was placed and 25 control individuals were treated with discectomy alone...
November 2015: Acta Ortopédica Mexicana
Mohinder Kaushal
BACKGROUND: Avaialable minimal invasive arthro/endoscopic techniques are not compatible with 30 degree arthroscope which orthopedic surgeons uses in knee and shoulder arthroscopy. Minimally invasive "Arthrospine assisted percutaneous technique for lumbar discectomy" is an attempt to allow standard familiar microsurgical discectomy and decompression to be performed using 30° arthroscope used in knee and shoulder arthroscopy with conventional micro discectomy instruments. MATERIALS AND METHODS: 150 patients suffering from lumbar disc herniations were operated between January 2004 and December 2012 by indiginously designed Arthrospine system and were evaluated retrospectively...
May 2016: Indian Journal of Orthopaedics
Yong Ahn, Il-Tae Jang, Woo-Kyung Kim
OBJECTIVES: Transforaminal percutaneous endoscopic lumbar discectomy (PELD) for high-grade migrated disc herniation has been regarded as a challenging task, but because of the remarkable improvement in navigable instruments and advanced epiduroscopic technique, it can be used for the treatment of high- or very high-grade migrated disc herniation. The purpose of this study was to describe in detail the standardized technique of transforaminal PELD for very high-grade migrated disc herniation and demonstrate the clinical results...
August 2016: Clinical Neurology and Neurosurgery
Niladri Kumar Mahato, Daryl Sybert, Tim Law, Brian Clark
PURPOSE: Our objective was to use an open weight-bearing MRI to identify the effects of different loading conditions on the inter-vertebral anatomy of the lumbar spine in a post-discectomy recurrent lumbar disc herniation patient. METHODS: A 43-year-old male with a left-sided L5-S1 post-decompression re-herniation underwent MR imaging in three spine-loading conditions: (1) supine, (2) weight-bearing on standing (WB), and (3) WB with 10 % of body mass axial loading (WB + AL) (5 % through each shoulder)...
May 9, 2016: European Spine Journal
P Stavrinou, R Härtl, B Krischek, C Kabbasch, A Mpotsaris, R Goldbrunner
Purpose. Extraforaminal decompression of the L5 nerve root remains a challenge due to anatomic constraints, severe level-degeneration, and variable anatomy. The purpose of this study is to introduce the use of navigation for transmuscular transtubular decompression at the L5/S1 level and report on radiological features and clinical outcome. Methods. Ten patients who underwent a navigation-assisted extraforaminal decompression of the L5 nerve root were retrospectively analyzed. Results. Six patients had an extraforaminal herniated disc and four had a foraminal stenosis...
2016: BioMed Research International
O B Panta, S Songmen, S Maharjan, K Subedi, M A Ansari, R K Ghimire
BACKGROUND: Morphological changes implicated in low back are complicated by additional age related degenerative changes in spine, which increases with aging. This study aims to compare the morphological MRI findings in young and elderly patients with low back pain and also correlate them with the clinical symptoms. METHODS: The study was a retrospective hospital record based comparative study carried out in a Teaching Hospital. MRI performed for patients with low back pain during May 2012 to October 2012 were reviewed...
September 2015: Journal of Nepal Health Research Council
Serbülent Gökhan Beyaz, Mustafa Erkan İnanmaz, Ezgi Şen Zengin, Ali Metin Ülgen
UNLABELLED: Different minimally invasive procedures are used to treat lumbar disk herniation. It is important to differentiate these techniques due to their specific effects and the disparate technical issues associated with each. This report describes a successful case involving the use of mechanical decompression in conjunction with radiofrequency ablation to treat a patient with pain and neurological deficits due to an extruded disk hernia. CASE REPORT: A 43-year-old male had magnetic resonance imaging (MRI) demonstrating an extruded disk herniation in the left foraminal region, compression at the left spinal nerve root, and obliteration of the left foraminal entrance of the L5-S1 distribution...
June 2016: Pain Practice: the Official Journal of World Institute of Pain
Maiwulanjiang Mamuti, Shunwu Fan, Junhui Liu, Zhi Shan, Chongyan Wang, Shengyun Li, Fengdong Zhao
STUDY DESIGN: A retrospective study. OBJECTIVE: The aim of this study is to evaluate, clinically and radiographically, the efficacy of mini-open retroperitoneal anterior lumbar discectomy followed by anterior lumbar interbody fusion (ALIF) for recurrent lumbar disc herniation following primary posterior instrumentation. SUMMARY OF BACKGROUND DATA: Recurrent disc herniation following previous disc surgery occurs in 5 to 15% of cases. This is often treated by further surgical intervention where posterior approach is generally preferred...
September 15, 2016: Spine
Maryse Fortin, Àron Lazáry, Peter Paul Varga, Iain McCall, Michele C Battié
PURPOSE: To investigate asymmetry in size and composition of the multifidus and erector spinae in patients with posterolateral disc herniation and concordant radicular symptoms, and determine whether symptom duration is associated with degree of asymmetry. METHODS: Thirty-three patients diagnosed with posterolateral disc herniation at L4-L5 verified on imaging and concordant leg pain were included. Multifidus and erector spinae cross-sectional area (CSA), functional cross-sectional area (FCSA, fat-free area), signal intensity and ratio of FCSA to total CSA were measured bilaterally from T 2-weighted axial magnetic resonance imaging (MRI) at L3-L4, L4-L5, L5-S1 and S1 levels...
May 2016: European Spine Journal
Edith Graham, Ahmed Akl, Linda Brubaker, Yasin Dhaher, Colleen Fitzgerald, Elizabeth Rose Mueller
PURPOSE: The aims of the study were to optimize surgical safety and to minimize vertebral disc puncture during sacral needle placement at the time of minimally invasive sacrocolpopexy. Cadaveric studies report that the anterior longitudinal ligament (ALL), which covers the vertebral disc and vertebrae, has a reported thickness of only 1.4 to 2.3 mm at L5-S1. Intervertebral disc puncture can accelerate disc degeneration, disc herniation, and loss of disc height, a risk that may be avoidable...
July 2016: Female Pelvic Medicine & Reconstructive Surgery
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