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N Bogduk
The posterior elements of the vertebral column are innervated by branches of the dorsal rami of the spinal nerves, while the intervertebral discs and related ligaments are innervated by various branches of the ventral rami and sympathetic nervous system. A knowledge of this nerve supply forms the basis for a systematic classification of the possible sources of primary spinal pain, and the basis for several diagnostic techniques that use needles to provoke and anaesthetize putative sources of pain. In particular, the demonstration of a nerve supply to intervertebral discs vindicates the concept that these structures intrinsically may be sources of pain...
1985: Australian Journal of Physiotherapy
Emerson Krock, Derek H Rosenzweig, Anne-Julie Chabot-Doré, Peter Jarzem, Michael H Weber, Jean A Ouellet, Laura S Stone, Lisbet Haglund
Intervertebral disc degeneration (IVD) can result in chronic low back pain, a common cause of morbidity and disability. Inflammation has been associated with IVD degeneration, however the relationship between inflammatory factors and chronic low back pain remains unclear. Furthermore, increased levels of nerve growth factor (NGF) and brain derived neurotrophic factor (BDNF) are both associated with inflammation and chronic low back pain, but whether degenerating discs release sufficient concentrations of factors that induce nociceptor plasticity remains unclear...
June 2014: Journal of Cellular and Molecular Medicine
Chao Zhang, Yuan Xue, Pei Wang, Zhong Yang, Qin Dai, Hui-Fang Zhou
STUDY DESIGN: Retrospective investigation of surgical treatment of 25 patients with foot drop from single-level disc protrusion in the region of T10 to L1. OBJECTIVE: To describe cases of foot drop from single-level disc protrusion in the region of T10 to L1 and surgical outcomes. SUMMARY OF BACKGROUND DATA: Three cases of foot drop from T12-L1 disc protrusion are reported in the literature. Little is known, however, about foot drop resulting from single-level disc protrusion between T10 and L1 or its surgical outcomes...
December 15, 2013: Spine
D Scott Kreiner, Steven W Hwang, John E Easa, Daniel K Resnick, Jamie L Baisden, Shay Bess, Charles H Cho, Michael J DePalma, Paul Dougherty, Robert Fernand, Gary Ghiselli, Amgad S Hanna, Tim Lamer, Anthony J Lisi, Daniel J Mazanec, Richard J Meagher, Robert C Nucci, Rakesh D Patel, Jonathan N Sembrano, Anil K Sharma, Jeffrey T Summers, Christopher K Taleghani, William L Tontz, John F Toton
BACKGROUND CONTEXT: The objective of the North American Spine Society's (NASS) Evidence-Based Clinical Guideline for the Diagnosis and Treatment of Lumbar Disc Herniation with Radiculopathy is to provide evidence-based recommendations to address key clinical questions surrounding the diagnosis and treatment of lumbar disc herniation with radiculopathy. The guideline is intended to reflect contemporary treatment concepts for symptomatic lumbar disc herniation with radiculopathy as reflected in the highest quality clinical literature available on this subject as of July 2011...
January 2014: Spine Journal: Official Journal of the North American Spine Society
Zong-Bao Yang, Xiang Wu, Yu-Feng Xie, An Gong, Qing Yang, Chen-Guang Wang, Qiong Liu
OBJECTIVE: To observe the effect of electroacupuncture (EA) stimulation of "Huantiao" (GB 30) on the walking ability and touch sensation in rabbits with lumbar intervertebral disc protrusion (LIDP). METHODS: Forty New Zealand rabbits were equally randomized into normal control, model, EA-GB 30 and EA-non-acupoint groups. The LIDP model was established by surgical operation under anesthesia. EA (30 Hz/100 Hz, 2-4 V, 0.5 ms in pulse duration) was applied to bilateral "Huantiao" (GB 30) or non-acupoint...
June 2013: Zhen Ci Yan Jiu, Acupuncture Research
David F Fardon, Alan L Williams, Edward J Dohring, F Reed Murtagh, Stephen L Gabriel Rothman, Gordon K Sze
STUDY DESIGN: This article comprises a review of the literature pertaining to the normal and pathological lumbar disc and the compilation of a standardized nomenclature. OBJECTIVE: To provide a resource that promotes a clear understanding of lumbar disc terminology among clinicians, radiologists, and researchers. SUMMARY OF BACKGROUND DATA: The article "Nomenclature and Classification of Lumbar Disc Pathology. Recommendations of the Combined Task Forces of the North American Spine Society, American Society of Spine Radiology and American Society of Neuroradiology" was published in 2001 in Spine © Lippincott, Williams and Wilkins and formally endorsed by the 3 boards...
November 15, 2014: Spine
P Lama, C L Le Maitre, P Dolan, J F Tarlton, I J Harding, M A Adams
The belief that an intervertebral disc must degenerate before it can herniate has clinical and medicolegal significance, but lacks scientific validity. We hypothesised that tissue changes in herniated discs differ from those in discs that degenerate without herniation. Tissues were obtained at surgery from 21 herniated discs and 11 non-herniated discs of similar degeneration as assessed by the Pfirrmann grade. Thin sections were graded histologically, and certain features were quantified using immunofluorescence combined with confocal microscopy and image analysis...
August 2013: Bone & Joint Journal
Chris T Carter, Lyndon G Amorin-Woods, Arockia Doss
This article describes and discusses the case of an adolescent male with lumbar intervertebral disc injury characterized by chronic low back pain (LBP) and antalgia. A 13-year-old boy presented for care with a complaint of chronic LBP and subsequent loss of quality of life. The patient was examined and diagnosed by means of history, clinical testing and use of imaging. He had showed failure in natural history and conservative management relief in both symptomatic and functional improvement, due to injury to the intervertebral joints of his lower lumbar spine...
2013: Chiropractic & Manual Therapies
Masoud Pouriesa, Rohollah F Fouladi, Sepideh Mesbahi
BACKGROUND CONTEXT: It is suggested that the shape of the vertebral end plates may play a role in the development of abnormalities in the intervertebral disc. On midsagittal magnetic resonance images of the spine in patients with lumbar intervertebral disc herniation, a notable disproportion frequently exists between the end plates of two vertebrae to which the disc is attached. There is apparently no study in the literature examining possible association of this disproportion with development of disc herniation...
April 2013: Spine Journal: Official Journal of the North American Spine Society
Jeffrey A Rihn, Mark Kurd, Alan S Hilibrand, Jon Lurie, Wenyan Zhao, Todd Albert, James Weinstein
BACKGROUND: Questions remain as to the effect that obesity has on patients managed for symptomatic lumbar disc herniation. The purpose of this study was to determine if obesity affects outcomes following the treatment of symptomatic lumbar disc herniation. METHODS: An as-treated analysis was performed on patients enrolled in the Spine Patient Outcomes Research Trial for the treatment of lumbar disc herniation. A comparison was made between patients with a body mass index of <30 kg/m² (nonobese) (n = 854) and those with a body mass index of ≥30 kg/m² (obese) (n = 336)...
January 2, 2013: Journal of Bone and Joint Surgery. American Volume
Shungu Ushewokunze, Naeem Abbas, Ronan Dardis, Ian Killeen
Spontaneous disappearance of a herniated lumbar disc is known to occur. This case study describes a 45-year-old patient whose symptoms of lumbar radiculopathy resolved and follow-up imaging showed complete disappearance of the disc prolapse. This phenomenon strengthens the role of conservative treatment in the management of lumbar disc protrusions.
September 2008: British Journal of General Practice: the Journal of the Royal College of General Practitioners
Frank Heuer, Hendrik Schmidt, Hans-Joachim Wilke
Mechanical failure of the annulus fibrosus is mostly indicated by tears, fissures, protrusions or disc prolapses. Some of these annulus failures can be caused by a high intradiscal pressure. This has an effect on disc bulging. However, it is not fully understood how disc bulging is related to disc loading. Therefore, the aim of this study was to investigate the annular fiber strains and disc bulging under simple and complex spinal loads. A novel laser scanner was used to image surfaces of six L2-3 segments...
2008: Journal of Biomechanics
Kenneth C Thomas, Charles G Fisher, Michael Boyd, Paul Bishop, Peter Wing, Marcel F Dvorak
STUDY DESIGN: Prospective cohort study. OBJECTIVE: To assess health-related quality of life (HRQOL) following either lumbar discectomy or nonoperative care for lumbar disc protrusion causing radiculopathy (LDPR). SUMMARY OF BACKGROUND DATA: Although LDPR is a prevalent disorder, little progress has been made in defining the optimal treatment strategy. METHODS: A total of 497 patients (333 in the lumbar discectomy group and 164 in the nonoperative group) were analyzed...
June 1, 2007: Spine
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