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Conservative treatment AND disc herniation

Yong-Peng Lin, Yong-Jin Li, Bo-Lai Chen, Yu-Hai Guo
RATIONALE: Adult spinal epidermoid cyst (SEC) is a rare tumor. Lumbar laminectomy and tumor removal was a routine surgical procedure for adult spinal epidermoid cyst according to the literature, but postoperative lumbar instability and intractable low back pain may occur. In this study, we presented a brief report of an adult lumbar epidermoid cyst and introduced another surgical approach. PATIENT CONCERNS: This 28-year-old woman has been complaining of the severe right buttock pain and right thigh radiating pain for half a year...
January 2018: Medicine (Baltimore)
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
Ding-Jun Hao, Kun Duan, Tuan-Jiang Liu, Ji-Jun Liu, Wen-Tao Wang
This study aimed to develop new grading and classification criteria for lumbar disc herniation (LDH). First, from January 1993 to January 2003, we collected the detailed information of 1127 patients with LDH and, based on that information, developed a new grading classification termed the 6-score-V-type criteria wherein conservative treatment is recommended for patients with type I, II, or IIIA, surgical treatment is recommended for type IIIC, IV, and V, and 3 months of conservative followed by surgery if no improvements are obtained during the conservative treatment period is recommended for type IIIBe...
November 2017: Medicine (Baltimore)
Nico Sollmann, Carmen Morandell, Lucia Albers, Michael Behr, Alexander Preuss, Andreas Dinkel, Bernhard Meyer, Sandro M Krieg
BACKGROUND: Although recent trials provided level I evidence for the most common degenerative lumbar spinal disorders, treatment still varies widely. Thus, the Indications in Spinal Surgery (INDIANA) survey explores whether decision-making is influenced by specialty or personal emotional involvement of the treating specialist. METHOD: Nationwide, neurosurgeons and orthopedic surgeons specialized in spine surgery were asked to answer an Internet-based questionnaire with typical clinical patient cases of lumbar disc herniation (DH), lumbar spinal stenosis (SS), and lumbar degenerative spondylolisthesis (SL)...
January 10, 2018: Acta Neurochirurgica
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
Sara Lener, Christoph Wipplinger, Sebastian Hartmann, Wolfgang N Löscher, Sabrina Neururer, Matthias Wildauer, Claudius Thomé, Anja Tschugg
BACKGROUND: Intervertebral disc degeneration is one of the most common reasons for chronic low back pain and sensomotoric deficits, often treated by lumbar sequestrectomy. Nevertheless, the prognostic factors relevant for time and quality of recovery, of the surgical procedure, relative to conservative treatment, remain controversial and require further investigation. Surface electrical stimulation (SES) may be an influential intervention, already showing positive impact on motor and sensory recovery in different patient groups...
November 25, 2017: Trials
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
Randall J Hlubek, Gregory M Mundis
PURPOSE OF REVIEW: Recurrent lumbar disc herniation (RLDH) is the most common indication for reoperation after a lumbar discectomy. The purpose of this manuscript is to review the incidence, risk factors, and treatment for RLDH. RECENT FINDINGS: Patients who require revision surgery for RLDH improved significantly compared to baseline; however, the magnitude of improvement is less than in primary discectomy patients. Treatment with either repeat discectomy or instrumented fusion has comparable clinical outcomes...
December 2017: Current Reviews in Musculoskeletal Medicine
Saeyoung Kim, Seungwon Jang
Schmörl's node is focal herniation of intervertebral disc through the end plate into the vertebral body. Most of the established Schmörl's nodes are quiescent. However, disc herniation into the vertebral marrow can cause low back pain by irritating a nociceptive system. Schmörl's node induced radicular pain is very rare condition. Some cases of Schmörl's node which generated low back pain or radicular pain were treated by surgical methods. In this article, authors reported a rare case of a patient with radicular pain cause by Schmörl's node located inferior surface of the 5th lumbar spine...
October 4, 2017: Revista Brasileira de Anestesiologia
Sebastian A Ahmadi, Ilja-Paul Burkert, Hans-Jakob Steiger, Sven Oliver Eicker
OBJECTIVE: To present multidimensional long-term results after mono-segmental microdiscectomy for lumbar disc herniation (LDH) in a large adult cohort treated at a tertiary care centre. METHODS: Retrospective study design with Oswestry Disability Index (ODI) questionnaire employed at follow-up. All patients undergoing surgical treatment for single-level LDH between 2003 and 2009 were identified. Electronic patient records and imaging data were analysed. RESULTS: A total of 939 patients underwent single-level lumbar MD at our institution...
October 3, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
David J Kennedy, Patricia Z Zheng, Matthew Smuck, Zachary L McCormick, Lisa Huynh, Byron J Schneider
BACKGROUND CONTEXT: Patients with lumbosacral radiculopathy from an intervertebral disc herniation are frequently treated by transforaminal epidural steroid injections (TFESIs). The long-term outcomes of these patients are poorly described. PURPOSE: We aimed to determine the long-term outcomes for a homogenous group of patients with acute unilateral lumbar radicular pain due to single-level herniated nucleus after lumbar epidural steroid injection at ≥5 years...
January 2018: Spine Journal: Official Journal of the North American Spine Society
Bo Zhang, Haidong Xu, Juntao Wang, Bin Liu, Guodong Sun
Lumbar intervertebral disc herniation (LIDH), as the main contributor to low back pain and sciatica, imposes a heavy burden on both the individual and society. Non-operative treatment or conservative treatment has proven effective in alleviation of the symptoms of LIDH and are considered to be a first-line choice for most cases. Active lifestyle, physical therapy, complementary and alternative medicine therapy or Traditional Chinese medicine (TCM) therapy, and pharmacotherapy are routinely used as effective non-operative treatment for LIDH patients...
2017: Bioscience Trends
Kwang-Sup Song, Jae Hwan Cho, Jae-Young Hong, Jae Hyup Lee, Hyun Kang, Dae-Woong Ham, Hyun-Jun Ryu
Systematic literature review. To review the evidence from high-quality studies regarding the treatment of neuropathic pain originating specifically from spinal disorders. In general, treatment guidelines for neuropathic pain cover all its various causes, including medical disease, peripheral neuropathy, and cancer. However, the natural history of neuropathic pain originating from spinal disorders may differ from that of the pain originating from other causes or lesions. An expert research librarian used terms related to neuropathic pain and spinal disorders, disc herniation, stenosis, and spinal cord injury to search in MEDLINE, Embase, and Cochrane CENTRAL for primary research from January 2000 to October 2015...
August 2017: Asian Spine Journal
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
Francesca Raimondi, Beatriz Moreno-Aguado, Phil Witte, Nadia Shihab
This report describes, for the first time in small animal literature, the spontaneous resorption of herniated Hansen type I intervertebral disc material in the cervical spine of a chondrodystrophic dog over a 4-month period, documented by magnetic resonance imaging. Clinical signs (cervical hyperpathia) responded to conservative treatment during the same period.
August 2017: Canadian Veterinary Journal. la Revue Vétérinaire Canadienne
Sebastien Le Pape, Remi Gauthe, Laure Du Pouget, Olivier Gille, Jean-Marc Vital, Mourad Ould-Slimane
BACKGROUND: The anterior approach to lumbar spine surgery has grown in popularity in the past few years; spinal fusion of the last 2 lumbar levels is often required. Although alternatives to bone grafting are available, including recombinant human bone morphogenetic protein 2 or bone substitutes, only cancellous autologous bone has all the required factors for bone growth. To avoid the use of bone substitutes, remote iliac crest bone harvesting remains the gold standard. However, this technique may lead to some unfavorable outcomes...
October 2017: World Neurosurgery
Amresh S Bhaganagare, S A Nagesh, B G Shrihari, Vikas Naik, M N Nagarjun, Balaji S Pai
BACKGROUND: Cervical radiculopathy is the common clinical entity, often caused by "wear and tear" changes that occur in the spine. In the younger population, cervical radiculopathy is a result of a disc herniation or an acute injury causing foraminal impingement of an exiting nerve, whereas in the older individuals, it is due to foraminal narrowing from osteophyte formation, decreased disc height, and degenerative changes of the uncovertebral joints anteriorly and of the facet joints posteriorly...
April 2017: Journal of Craniovertebral Junction and Spine
Peeyush Kumar Dhagat, Megha Jain, Satyendra Narayan Singh, Sumeet Arora, Kasukarthi Leelakanth
INTRODUCTION: Failed Back Surgery Syndrome (FBSS) is a generalized term used to describe varied spinal symptoms of patients who have had unsuccessful results after spinal surgery. The treatment of FBSS is challenging and varies from conservative management to reoperation. Imaging plays a crucial role in identifying the cause and helps to guide the appropriate therapy. Contrast enhanced Magnetic Resonance Imaging (MRI) with its superior resolution is the imaging modality of choice. AIM: To evaluate the spectrum of imaging findings on postoperative MRI in FBSS...
May 2017: Journal of Clinical and Diagnostic Research: JCDR
Mahmut Uğurlu, Mehmet Atıf Erol Aksekili, Berat Meryem Alkan, Halil Kara, Ceyhun Çağlar
BACKGROUND/AIM: The aim of this study was to assess the efficacy of the Artcure Diffusional Patch, which contains a mixture of 6 herbal oils (oleum thymi, oleum limonis, oleum nigra, oleum rosmarini, oleum chamomilla, oleum lauriexpressum) and has a hypoosmolar lipid structure, in the conservative treatment of lumbar disc herniation patients and to show the advantages and/or possibility of using this as an alternative method to surgery. MATERIALS AND METHODS: Of the 120 patients enrolled, 79 clinically diagnosed patients were included in the study...
June 12, 2017: Turkish Journal of Medical Sciences
A Sharma, K Sargar, A Salter
BACKGROUND AND PURPOSE: Although stress-induced bony changes often resolve with conservative treatment, the long-term effects of such mechanical stresses on intervertebral discs have not been studied. We aimed to assess the differences in the temporal evolution of disc in segments of the lumbar spine with and without signs of increased mechanical stresses. MATERIALS AND METHODS: Using MR imaging performed >6 months apart, 2 radiologists evaluated lumbar intervertebral discs for degenerative changes affecting the annulus fibrosus, the nucleus pulposus, and the endplates in 42 patients (22 male, 20 female; mean age, 16...
June 1, 2017: AJNR. American Journal of Neuroradiology
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