Zhen-zhou Li, Shu-xun Hou, Wei-lin Shang, Ke-ran Song, Hong-liang Zhao
OBJECTIVE: To analyze the surgical strategy, safety and clinical outcome of full-endoscopic discectomy through interlaminar approach in the case of L5/S1 intervertebral disc excision. METHODS: From April 2011 to December 2011, 72 cases of intracanalicular non-contained disc herniations at L5/S1 level were treated with full-endoscopic discectomy through interlaminar approach. L5/S1 disc herniation was divided into three types according to position of herniated disc related to S1 nerve root: axilla type, ventral type and shoulder type...
June 2015: Clinical Neurology and Neurosurgery
Scott Holekamp, Vijay Goel, Hiroshi Kuroki, Janet Huntzinger, Nabil Ebraheim
BACKGROUND: In the lumbar spinal column, an annular disruption may be sealed after annulotomy to prevent further prolapse and instability. We investigated the biomechanical effects of various material properties of an injectable sealant. METHODS: We used a 3-dimensional, nonlinear, osteoligamentous, experimentally validated finite-element model of the L3-L5 spine segment to study annulotomies of varying sizes and locations in the L3-L4 annulus followed by replacement with isotropic sealants (plugs) with a Young's modulus of 0...
2007: SAS Journal
Byungho J Kim, Junghoon Ahn, Heecheol Cho, Dongyun Kim, Taeyeong Kim, Bumchul Yoon
BACKGROUND: Lumbar open laser microdiscectomy has been shown to be an effective intervention and safe approach for lumbar disc prolapse. However early post-operative physical disability affecting daily activities have been sporadically reported. OBJECTIVE: To evaluate the feasibility of using early individualised manipulative rehabilitation to improve early post-operative functional disability following lumbar discectomy. METHODS: Randomised controlled pilot trial...
2016: Journal of Back and Musculoskeletal Rehabilitation
Anene Ukaigwe, Akintomi Olugbodi, Richard L Alweis
Compression or irritation of the sciatic nerve and its branches, the common fibular and tibial nerves, causes sciatica which is a common syndrome characterized most often by radiating pain from the lower back down the legs and also manifesting as sensory and motor deficits. Sciatica is a common presentation of lumbosacral disc prolapse and degenerative disease of the lumbar spine in ambulatory settings. Schwannomas rarely cause sciatica; hence, it is seldom considered in evaluation of a patient with radiculopathy...
2015: Journal of Community Hospital Internal Medicine Perspectives
O Linhardt, A Benditz, J Grifka
PURPOSE: The present clinical-radiological study examines retrospectively the relation between lumbar disc prolapse and degenerations like chondrosis and spondylosis. METHOD: Firstly the relation between disc prolapse and chondrosis was examined. 44 patients with disc prolapse and chondrosis in actual MRI scans in the same segment were recruited in our clinic. By regarding older MRI scans, we could find out which finding was first to occur. Concerning the second question, we followed patients with spondylosis to see if they could progress to a disc prolapse...
December 2014: Zeitschrift Für Orthopädie und Unfallchirurgie
Pascal Probst, Sarah-Noemi Knoll, Stefan Breitenstein, Urs Karrer
Vertebral discitis usually arises from haematogenous spread of pathogens to the discs and bones. Vertebral discitis can rarely occur as a complication after laparoscopic operations with fixating sutures on the promontory. We report the case of an 81-year-old woman who underwent a laparoscopic resection rectopexy because of rectal prolapse. Weeks after the operation, the patient developed lower back pain with radiation to both legs not responding to symptomatic therapy. Two months later, a magnetic resonance imaging of the lumbar spine showed vertebral osteomyelitis and discitis...
2014: Journal of Surgical Case Reports
J R Taylor, L T Twomey
Normal notochordal and vascular attrition leaves weak spots in intervertebral discs through which intravertebral prolapse of disc material frequently occurs. Some varieties of prolapse cause somatic spinal pain. Asym-metrical and asynchronous growth of normal vertebral arches rotates thoracic vertebral bodies slightly to the left in infants and to the right in adolescents. Primary vascular asymmetry could cause the observed vertebral asymmetry. Luschka's joints develop in the cervical spine during childhood and give some protection against postero-lateral disc prolapse, but cervical zygapophyseal joints give little protection to the disc in sagittal plane movements...
1985: Australian Journal of Physiotherapy
M A Adams, W C Hutton
Mechanical experiments were performed on cadaveric lumbar intervertebral joints in order to outline the etiology of common back injuries and low back pain. The results suggest that the osteo-ligamentous lumbar spine is most at risk in the lordotic posture and when bending forward. Sustained lordotic posture can produce abnormal loading of the apophyseal joints. Bending forward wedges the lumbar discs, rendering them vulnerable to fatigue injuries if heavy labor is performed in this posture. Excessive flexion at some spinal level will cause posterior ligament damage, and a strong contraction of the back muscles can then cause prolapsed intervertebral disc...
November 1, 1982: Orthopedics
Ashutosh B Sabnis, Ashish D Diwan
Herniation of nucleus pulposus leading to leg pain is the commonest indication for lumbar spine surgery. However, there is no consensus when to stop conservative treatment and when to consider for surgery. A systematic review of literature was done to find a consensus on the issue of when should surgery be performed for herniation of nucleus pulposus in lumbar spine was conducted. Electronic database searches of Medline, Embase and Pubmed Central were performed to find articles relating to optimum time to operate in patients with herniation of nucleus pulposus in lumbar spine, published between January 1975 and 10 December 2012...
March 2014: Indian Journal of Orthopaedics
David Oehme, Peter Ghosh, Susan Shimmon, Jiehua Wu, Courtney McDonald, John M Troupis, Tony Goldschlager, Jeffrey V Rosenfeld, Graham Jenkin
OBJECT: Following microdiscectomy, discs generally fail to undergo spontaneous regeneration and patients may experience chronic low-back pain and recurrent disc prolapse. In published studies, formulations of mesenchymal progenitor cells combined with pentosan polysulfate (MPCs+PPS) have been shown to regenerate disc tissue in animal models, suggesting that this approach may provide a useful adjunct to microdiscectomy. The goal of this preclinical laboratory study was to determine if the transplantation of MPCs+PPS, embedded in a gelatin/fibrin scaffold (SCAF), and transplanted into a defect created by microdiscectomy, could promote disc regeneration...
June 2014: Journal of Neurosurgery. Spine
Jeetendra Bajpai, Sumit Saini, Rakhi Singh
INTRODUCTION: Low backache (LBA) is one of the most common problems and herniated lumbar disc is one of the most commonly diagnosed abnormalities associated with LBA. Disc herniation of the same size may be asymptomatic in one patient and can lead to severe nerve root compromise in another patient. OBJECTIVE: To evaluate correlation between the clinical features of disc collapse and magnetic resonance imaging (MRI) finding to determine the clinical importance of anatomical abnormalities identified by MRI technique...
January 2013: Journal of Craniovertebral Junction and Spine
Rishi M Kanna, Ajoy Prasad Shetty, S Rajasekaran
BACKGROUND CONTEXT: Existing research on lumbar disc degeneration has remained inconclusive regarding its etiology, pathogenesis, symptomatology, prevention, and management. Degenerative disc disease (DDD) and disc prolapse (DP) are common diseases affecting the lumbar discs. Although they manifest clinically differently, existing studies on disc degeneration have included patients with both these features, leading to wide variations in observations. The possible relationship or disaffect between DDD and DP is not fully evaluated...
February 1, 2014: Spine Journal: Official Journal of the North American Spine Society
Miklós F Ivicsics, Nicholas E Bishop, Kay Sellenschloh, Jean-Philippe Berteau, Michael M Morlock, Gerd Huber
BACKGROUND: Lumbar facet joints have been cited as a possible origin of low-back pain. A relationship between disc height decrease and facet joint degeneration has been reported. Facet joint degeneration may also be triggered by nucleotomy, performed on prolapsed discs, which might change the natural load sharing between the anterior and posterior structures of the spine. In this study load bearing of the facet joints was compared between natural and nucleotomised spinal segments. METHODS: Nine porcine lumbar motion segments were tested quasi-statically in ±1...
October 2013: Clinical Biomechanics
S K Jain, I Vijay Sundar, Vinod Sharma, Ravishankar S Goel, Rajesh Gupta
Intradural disc herniation is a rare entity that occurs most commonly in the lumbar spine particularly at L4-L5 region. Most often it is diagnosed intraoperatively in a case of simple intervertebral disc herniation. Contrast enhanced MRI is mandatory for pre operative diagnosis. We describe a case of a 40-year-old female who presented to us with pain lower back, pain in both lower limbs and urinary retention after a fall. She had previously been diagnosed as a case of prolapsed intervertebral disc disease and was being managed conservatively...
2013: Turkish Neurosurgery
G Siracusa, A Sparacino, V L Lentini
OBJECTIVE: Neurogenic bladder refers to morphofunctional alterations of the bladder-sphincter complex secondary to central or peripheral neurological lesions. Discal etiology can be suggested by clinical observation in patients complaining of classical lower back pain, but not excluded even without musculoskeletal pain. This review provides a brief overview of associations between neurogenic bladder and disc disease, analyzing neuroanatomy, pathophysiology, clinical and urodynamic findings...
August 2013: Current Medical Research and Opinion
Melinda Abernethy, Evalynn Vasquez, Kimberly Kenton, Linda Brubaker, Elizabeth Mueller
OBJECTIVES: Sacrocolpopexy presacral sutures are placed at or slightly above the sacral promontory without knowledge of the location of intervertebral discs. We used magnetic resonance imaging to assess the anatomic relationship of the sacral promontory to intervertebral discs. METHODS: We reviewed spinal magnetic resonance images of women imaged at Loyola University Medical Center between January 2010 and February 2012. Sagittal T1 fluid-attenuated inversion recovery sequence images of the lumbosacral spine were used to identify the promontory as the most prominent point where S1 intersected with the superior anatomic structures...
January 2013: Female Pelvic Medicine & Reconstructive Surgery
M Y Farina, H Harunarashid, F Faridzal, T Jegan, S Das
The availability of multiple investigating modalities should be utilized to arrive at the correct diagnosis of the spinal arteriovenous malformation (AVM). We hereby report the case of a 21-year-old, obese female, who presented with paraplegia and impaired bowel control two years after an episode of the fall. The Magnetic Resonance Imaging (MRI) of her spine not only revealed disc prolapse at T11-T12, but also tortuous dilated spinal veins and cord oedema. A diagnosis of a spinal arterio-venous fistula was confirmed after a spinal angiogram...
November 2012: La Clinica Terapeutica
Mashfiqul A Siddiqui, Chusheng Seng, Nidumaran Shanmugam, William Yeo, Karen Zhang, Hwei Chi Chong, John Chen Li Tat, Chang Ming Guo, Seang Beng Tan, Wai Mun Yue
STUDY DESIGN: This is a prospective study. OBJECTIVE: A 2-year outcome of erectile dysfunction (ED) in patients younger than 50 years with fracture-unrelated lumbar spine disease requiring surgical decompression for ED is evaluated. Risk factors for ED were also evaluated. SUMMARY OF BACKGROUND DATA: There is no literature documenting 2-year follow-up of ED status in young patients with atraumatic lumbar spine disease. METHODS: All male patients younger than 50 years who underwent lumbar spine surgery between June 2006 and November 2007 without risk factors for ED were included...
May 1, 2013: Spine
Michael A Adams, Patricia Dolan
We review the evidence that there are two types of disc degeneration. 'Endplate-driven' disc degeneration involves endplate defects and inwards collapse of the annulus, has a high heritability, mostly affects discs in the upper lumbar and thoracic spine, often starts to develop before age 30 years, usually leads to moderate back pain, and is associated with compressive injuries such as a fall on the buttocks. 'Annulus-driven' disc degeneration involves a radial fissure and/or a disc prolapse, has a low heritability, mostly affects discs in the lower lumbar spine, develops progressively after age 30 years, usually leads to severe back pain and sciatica, and is associated with repetitive bending and lifting...
December 2012: Journal of Anatomy
Adam Bastovansky, Kathrin Ziegler, Claudia Stöllberger, Josef Finsterer
BACKGROUND: Peripheral embolism to the lower extremities may mimic disc prolapse with severe consequences. CASE REPORT: A 71-year-old male with a history of chronic alcoholism developed low back pain radiating to both lower extremities in a nonradicular distribution and bilateral dysesthesias of the distal lower legs after lifting a heavy weight. Given that magnetic resonance imaging (MRI) of the lumbar spine showed disc herniation in L3/4 and L4/5, he was scheduled for laminectomy but was unable to undergo surgery due to thrombocytopenia...
2012: Vascular Health and Risk Management
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