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Sample records for cervical disc herniation

  1. Three-level cervical disc herniation

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    St. Iencean Andrei

    2015-09-01

    Full Text Available Multilevel cervical degenerative disc disease is well known in the cervical spine pathology, with radicular syndromes or cervical myelopathy. One or two level cervical herniated disc is common in adult and multilevel cervical degenerative disc herniation is common in the elderly, with spinal stenosis, and have the same cause: the gradual degeneration of the disc. We report the case of a patient with two level cervical disc herniation (C4 – C5 and C5 – C6 treated by anterior cervical microdiscectomy both levels and fusion at C5 – C6; after five years the patient returned with left C7 radiculopathy and MRI provided the image of a left C6 – C7 disc herniation, he underwent an anterior microsurgical discectomy with rapid relief of symptoms. Three-level cervical herniated disc are rare in adults, and the anterior microdiscectomy with or without fusion solve this pathology.

  2. Percutaneous laser disc decompression for cervical disc herniation

    International Nuclear Information System (INIS)

    Objective: To discuss the clinical application of percutaneous laser disc decompression (PLDD) in the treatment of cervical disc herniation. Methods: The region between anterolateral cervical visceral sheath and carotid sheath was used as puncture access. Under C-arm fluoroscopic monitoring, the puncture needle was inserted to the cervical intervertebral space center, then, the photofiber was implanted in PLDD was performed in 32 patients of cervical disc herniation by using SLT30 semiconductor laser device with the laser output of 500-1 000 J. Results: The effective rate was 87.5%. No infection or serious complications occurred. Conclusion: Percutaneous laser disc decompression is a safe, effective and less invasive treatment for cervical disc herniation. (authors)

  3. MRI findings of traumatic cervical disc herniation

    International Nuclear Information System (INIS)

    In general practice, disc hernia is increasingly being questioned about its relation with traffic injuries. In this study, we examined the image findings of cervical disc herniation for findings indicative of traumatic hernia. In 2008, we examined 35 cases of cervical disc herniation at our hospital by MRI. The patients were divided into two groups; patients with trauma history (19 cases) and those without (16 cases), and their images were compared. Disc herniation in the trauma group showed high intensity at T2, with some of the patients in this group also indicating continuous high intensity of the internal and herniated discs. Traumatic force was found to cause swelling under the laryngeal soft tissue. Cases with further flexion injury showed interspinous ligament hemorrhage. These findings strongly suggest the involvement of injury. But given that some younger patients in the non-trauma group also show high intensity at T2*, attention must be paid not to confuse swelling below the larynx with inflammation of the longus colli muscle. (author)

  4. Acupuncture and Spontaneous Regression of a Radiculopathic Cervical Herniated Disc

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    Kim Sung-Ha

    2012-06-01

    Full Text Available The spontaneous regression of herniated cervical discs is not a well-established phenomenon. However, we encountered a case of a spontaneous regression of a severe radiculopathic herniated cervical disc that was treated with acupuncture, pharmacopuncture, and herb medicine. The symptoms were improved within 12 months of treatment. Magnetic resonance imaging (MRI conducted at that time revealed marked regression of the herniated disc. This case provides an additional example of spontaneous regression of a herniated cervical disc documented by MRI following non-surgical treatment.

  5. Concomitance of fibromyalgia syndrome and cervical disc herniation

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    GÜLER, MUSTAFA; Aydın, Teoman; Akgöl, Erdal; Taşpınar, Özgür

    2015-01-01

    [Purpose] Fibromyalgia syndrome (FMS) and cervical disc herniation (CDH) are a common diseases commonly encountered in physical therapy clinics. There are also patients who have both of these diseases. In this study we aim to investigated whether FMS is a risk factor for cervical disc herniation and the frequency of their coincident occurrence. [Subjects and Methods] Thirty-five patients having a primary FMS diagnosis according to the American Rheumatism Association criteria are taken into co...

  6. Percutaneous treatment of cervical and lumbar herniated disc

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    Kelekis, A., E-mail: akelekis@med.uoa.gr; Filippiadis, D.K., E-mail: dfilippiadis@yahoo.gr

    2015-05-15

    Therapeutic armamentarium for symptomatic intervertebral disc herniation includes conservative therapy, epidural infiltrations (interlaminar or trans-foraminal), percutaneous therapeutic techniques and surgical options. Percutaneous, therapeutic techniques are imaging-guided, minimally invasive treatments for intervertebral disc herniation which can be performed as outpatient procedures. They can be classified in 4 main categories: mechanical, thermal, chemical decompression and biomaterials implantation. Strict sterility measures are a prerequisite and should include extensive local sterility and antibiotic prophylaxis. Indications include the presence of a symptomatic, small to medium sized contained intervertebral disc herniation non-responding to a 4–6 weeks course of conservative therapy. Contraindications include sequestration, infection, segmental instability (spondylolisthesis), uncorrected coagulopathy or a patient unwilling to provide informed consent. Decompression techniques are feasible and reproducible, efficient (75–94% success rate) and safe (>0.5% mean complications rate) therapies for the treatment of symptomatic intervertebral disc herniation. Percutaneous, imaging guided, intervertebral disc therapeutic techniques can be proposed either as an initial treatment or as an attractive alternative prior to surgery for the therapy of symptomatic herniation in both cervical and lumbar spine. This article will describe the mechanism of action for different therapeutic techniques applied to intervertebral discs of cervical and lumbar spine, summarize the data concerning safety and effectiveness of these treatments, and provide a rational approach for the therapy of symptomatic intervertebral disc herniation in cervical and lumbar spine.

  7. Intradural tumor and concomitant disc herniation of cervical spine

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    Mihir R Bapat

    2011-01-01

    Full Text Available We report a rare patient of a simultaneous extradural and intradural compression of the cervical spinal cord due to co-existent intervertebral disc herniation and an intradural schwannoma at the same level. The intradural lesion was missed resulting in recurrence of myelopathy after a surprisingly complete functional recovery following anterior cervical discectomy. Retrospectively, it was noted that the initial cord swelling noticed was tumor being masked by the compression produced by the herniated disc. A contrast magnetic resonance imaging scan is important in differentiating intradural tumors of the spinal cord. A high index of suspicion is often successful in unmasking both the pathologies.

  8. Insertion of PCB to treat traumatic cervical intervertebral disc herniation

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    马远征; 隰建成; 陈兴; 关长勇; 全长彬

    2002-01-01

    Objective: To evaluate the clinical effect of PCB (a new anterior cervical instrumental system combining an intradiscal cage with an integrated plate) in treating traumatic cervical intervertebral disc herniation. Methods: Anterior decompression and PCB internal fixation were used in 22 patients with traumatic cervical intervertebral disc herniation. They were followed up from 3 to 16 months and analyzed by symptom and image data. Among them, 16 patients underwent fixation at one level and 6 patients at two levels. Results: This technique did not cause intraoperative complications. After surgery no screw backout or device failure was found. Based on the JOA grade, 20 patients improved clinically and 2 gently because of serious cervical stenosis. The general excellent rate was 90.9%. Conclusions: PCB internal fixation is stable. Morbidity of donor and acceptor sites is less. No collars are needed after surgery.

  9. Insertion of PCBto treat traumatic cervical intervertebral disc herniation

    Institute of Scientific and Technical Information of China (English)

    马远征; 陈兴; 等

    2002-01-01

    Objective:To evaluate the clinical effect of PCB(a new anterior cervical instrumental system combining an intradiscal cage with an integrated plate)in treating taunatic cervical intervertebral disc herniation.Methods:Anterior decompression and PCB internal fixation were used in 22patients with traumatic cervical intervertebral disc herniation.They were followed up from3to16months and analyzed by symptom and imape data.Among them,16 patients underwent fixation at one level and 6patients at two levels.Results:This technique did not cause intraoperative complications.After surgery on screw backout or device failure was found.Based on the JOAgrade,20 patients improved clinically and 2gently because of serious cervical stenosis.The general excellent rate was90.9%.Conclusions:PCB internal fixation is stable.Morbidity of donor and acceptor sites is less.No collars are needed after surgery.

  10. The value of MRI in the preoperative diagnosis of cervical disc herniation

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    Kuroki, Takefusa; Kumano, Kiyoshi; Hirabayashi, Shigeru; Takahashi, Ryuji; Inasaka, Riki (Kanto Rosai Hospital, Tokyo (Japan))

    1991-12-01

    To determine whether or not magnetic resonance (MR) imaging would become an alternative to conventional myelography in the preoperative diagnosis of cervical disc herniation, MR images of 13 patients were retrospectively reviewed. MR imaging revealed herniated one disc, 2 discs, and 3 discs in 4, 6, and 3 patients, respectively. When herniation confined to one disc was consistent with clinical manifestations, MR imaging alone was capable of determining the disc involved in herniation. MR imaging was, however, of limited value in determining the responsible disc for herniation when there were two or more herniated discs on MR images. (N.K.).

  11. Magnetic resonance imaging for each type of herniated cervical intervertebral disc

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    Kim, Ham Gyum [Ansan 1 College, Ansan (Korea, Republic of)

    2000-04-15

    The classification of herniated intervertebral cervical disc types are clinically important, as treatment methods would be slightly different according to the specific type of the herniated disc. 423 patients who suffered from herniated intervertebral cervical discs were tested with Magnetic Resonance Imaging (MRI), to distinguish the type of the herniated discs. The following are the results: The age of the patients tested ranged from 16 to 75 years old and the mean age of the patients was 41.4 years of age. There were twice as many male patients with a ratio of 288: 135 men to women. 101 patients suffered from single herniated discs while 322 patients suffered from multi-herniated discs. Of single herniated disc injuries. 52 patients had protruded discs (52%) while 25 patients had extruded discs (25%). 21 Patients (21%) had herniated intervertebral discs between C{sub 4} {approx} C{sub 5} and 51 patients (50%) and had the same injury between C{sub 5} and C{sub 6}. Of multi-herniated disc injuries. 140 patients had protruded discs (44%). while 45 patients had extruded discs (14%). 54 patients had both protruded and extruded discs (17%). 36 patients (11%). herniated discs C{sub 3} {approx} C{sub 6}: 69 patients (21%). herniated discs C{sub 3} {approx} C{sub 7}: 47 patients (15%) herniated discs C{sub 4} {approx} C{sub 6} and 67 patients (20%) herniated discs C{sub 5} {approx} C{sub 7}.

  12. Cervical disc herniation manifesting as a Brown-Sequard syndrome

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    Kunio Yokoyama

    2012-01-01

    Full Text Available Brown-Sequard syndrome is commonly seen in the setting of spinal trauma or an extramedullary spinal neoplasm. The clinical picture reflects hemisection of the spinal cord. We report a rare case of Brown-Sequard syndrome caused by a large cervical herniated disc. A 63-year-old man presented with progressive right hemiparesis and disruption of pain and temperature sensation on the left side of the body. Magnetic resonance imaging showed large C3-C4 disc herniation compressing the spinal cord at that level, with severe canal stenosis from C4 through C7. Decompressive cervical laminoplasty was performed. After surgery, complete sensory function was restored and a marked improvement in motor power was obtained.

  13. Acute monoplegia associated with non-traumatic intradural cervical disc herniation:

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    Ahmet Menkü

    2014-03-01

    Full Text Available Intradural disc herniation has been reported as a rare and particular type of intervertebral disc herniation. It occurs mostly in the lumbar spine, and rarely in the cervical or thoracic spine. Non-traumatic cervical intradural disc herniation is rare, with only 17 cases reported in English literature at the cervical region and can manifest itself by severe symptoms such as Brown-Sequard syndrome, transverse myelopathy and radiculopathy. We present a unique case of intradural cervical disc herniation only causing lower extremity monoplegia. To our knowledge, this is the first case described in the literature. The patient underwent microsurgical removal of the herniated disc via an anterior approach followed by interbody fixation using a cervical cage. J Clin Exp Invest 2014; 5 (1: 112-114

  14. Combined Anterior Approach with Transcorporeal Herniotomy for a Huge Migrated Cervical Disc Herniation

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    Choi, Kyung-Chul; Ahn, Yong; Lee, Choon Dae; Lee, Sang-Ho

    2011-01-01

    The report describes the herniation of a huge migrated cervical disc, which was treated by a combined anterior approach. A 50-year-old man presented with radiculopathy and myelopathy. Radiological images revealed the herniation of a huge disc which had migrated superiorly from the C6-7 disc to the C5-6 disc. We tried to combine an anterior cervical discectomy and fusion (ACDF) and transcorporeal herniotomy to avoid corpectomy. Postoperatively, successful clinical and radiological results were...

  15. Computed tomography in the diagnosis of cervical disc herniation with radiculopathy

    International Nuclear Information System (INIS)

    Computed tomography (CT) is an accurate method of diagnosing cervical disc herniation in patients with radiculopathy. We evaluated 7 patients for the treatment of radiculopathy. The CT features of lateral cervical disc herniation include: (1) plain CT reveals a soft tissue mass compatible with laterally herniated disc material within the intervertebral foramen; (2) plain CT shows a soft tissue mass, which implies a fragmented disc, in the lateral recess; (3) CT with the intravenous administration of the contrast medium shows no delineation of the nerve root in the intervertebral foramen; and (4) CT metrizamide myelography demonstrates the filling defect of the root sleeve and hypertrophy of the nerve root. In those seven patients, all CT examinations were interpreted as positive for lateral disc herniation. There was a good correlation between the results of the neurologic examination and the CT findings. We wish to stress the usefulness of CT in the diagnosis of lateral cervical disc herniation. (author)

  16. Cervical Disc Herniation Causing Brown-Séquard's Syndrome: A Case Report and Literature Review

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    Tarush Rustagi

    2011-01-01

    Full Text Available Brown-Séquard's syndrome (BSS is caused by hemisection or hemicompression of the cord leading to ipsilateral motor deficit and contralateral sensory loss. Cervical disc herniation has been reported to be a rare cause of Brown-Séquard's syndrome. We describe a rare case of multilevel cervical disc herniation presenting as BSS. The condition was confirmed by MRI scan. Cervical corpectomy, decompression, and fusion gave a satisfying result. Pertinent literature has been reviewed.

  17. The Management of a Patient with a Cervical Disc Herniation: A Case Report

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    Peter Pidcoe

    2008-01-01

    Full Text Available Purpose: To present the management of a patient with a cervical disc herniation and illustrate the efficacy of cervical traction as a main form of treatment for cervical disc herniation in conjunction with a home exercise program.Background: A 71-year-old white female diagnosed with cervical disc herniation at the levels of C5-6 and C6-7 presented to physical therapy with neck pain radiating into the left upper extremity down to the 5th digit of the left hand.Treatment: The patient reported to outpatient physical therapy for cervical disc herniation and radiculopathy. After initial evaluation she received intermittent cervical traction and was given a home exercise program consisting of cervical lateral flexion stretch, unilateral wall stretch for pectoralis muscles and to continue with her over the door cervical traction.Conclusion: Cervical traction and a good home exercise program have been shown to reduce cervical disc herniation and its subsequent symptoms.

  18. Cervical Disc Herniation as a Cause of Brown-Séquard Syndrome

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    Choi, Kyeong Bo; Lee, Choon Dae; Chung, Dai-Jin; Lee, Sang-Ho

    2009-01-01

    The possible causes of Brown-Séquard Syndrome (BSS) have been frequently observed with spinal trauma and extramedullary spinal tumors, but the cervical disc herniation to cause BSS is rare. The authors present five cases of patients who were diagnosed with BSS resulting from cervical disc herniation, and the results of the literature in view of their distinctive symptoms and clinical outcomes. Postoperatively, the patients showed complete or almost complete recovery from their motor and senso...

  19. Percutaneous endoscopic cervical discectomy for discogenic cervical headache due to soft disc herniation

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    Ahn, Y.; Lee, S.H.; Shin, S.W. [Wooridul Spine Hospital, Department of Neurosurgery, Kangnam-gu (Korea); Chung, S.E.; Park, H.S. [Wooridul Spine Hospital, Department of Radiology, Kangnam-gu (Korea)

    2005-12-01

    A discogenic cervical headache is a subtype of cervicogenic headache (CEH) that arises from a degenerative cervical disc abnormality. The purpose of this study was to evaluate the clinical outcome of percutaneous endoscopic cervical discectomy (PECD) for patients with chronic cervical headache due to soft cervical disc herniation. Seventeen patients underwent PECD for intractable headache. The inclusion criteria were soft disc herniation without segmental instability, proven by both local anesthesia and provocative discography for headache unresponsive to conservative treatment. The mean follow-up period was 37.6 months. Fifteen of the 17 patients (88.2%) showed successful outcomes based on the Macnab criteria. Pain scores on a visual analog scale (VAS) improved from a preoperative mean of 8.35{+-}0.79 to 2.12{+-}1.17, postoperatively (P<0.01). The mean disc height decreased from 6.81{+-}1.08 to 5.98{+-}1.07 mm (P<0.01). There was no newly developed segmental instability or spontaneous fusion on follow-up radiography. In conclusion, PECD appears to be effective for chronic severe discogenic cervical headache under strict inclusion criteria. (orig.)

  20. Percutaneous endoscopic cervical discectomy for discogenic cervical headache due to soft disc herniation

    International Nuclear Information System (INIS)

    A discogenic cervical headache is a subtype of cervicogenic headache (CEH) that arises from a degenerative cervical disc abnormality. The purpose of this study was to evaluate the clinical outcome of percutaneous endoscopic cervical discectomy (PECD) for patients with chronic cervical headache due to soft cervical disc herniation. Seventeen patients underwent PECD for intractable headache. The inclusion criteria were soft disc herniation without segmental instability, proven by both local anesthesia and provocative discography for headache unresponsive to conservative treatment. The mean follow-up period was 37.6 months. Fifteen of the 17 patients (88.2%) showed successful outcomes based on the Macnab criteria. Pain scores on a visual analog scale (VAS) improved from a preoperative mean of 8.35±0.79 to 2.12±1.17, postoperatively (P<0.01). The mean disc height decreased from 6.81±1.08 to 5.98±1.07 mm (P<0.01). There was no newly developed segmental instability or spontaneous fusion on follow-up radiography. In conclusion, PECD appears to be effective for chronic severe discogenic cervical headache under strict inclusion criteria. (orig.)

  1. Disc degeneration of cervical spine on MRI in patients with lumbar disc herniation: comparison study with asymptomatic volunteers

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    Okada, Eijiro; Matsumoto, Morio; Fujiwara, Hirokazu; Toyama, Yoshiaki

    2010-01-01

    An association between progression of cervical disc degeneration and that of lumbar disc degeneration has been considered to exist. To date, however, this association has not yet been adequately studied. Age-related changes in the cervical intervertebral discs were evaluated by magnetic resonance imaging (MRI) in patients with lumbar disc herniation, and compared with the MRI findings of healthy volunteers without lower back pain. The purpose of this study was to clarify whether the prevalenc...

  2. Posterior approach for cervical fracture–dislocations with traumatic disc herniation

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    NAKASHIMA, HIROAKI; Yukawa, Yasutsugu; Ito, Keigo; Machino, Masaaki; El Zahlawy, Hany; Kato, Fumihiko

    2010-01-01

    In the treatment algorithm for cervical spine fracture–dislocations, the recommended approach for treatment if there is a disc fragment in the canal is the anterior approach. The posterior approach is not common because of the disadvantage of potential neurological deterioration during reduction in traumatic cervical herniation patients. However, reports about the frequency of this deterioration and the behavior of disc fragments after reduction are scarce. Forty patients with traumatic disc ...

  3. A Rare Case of Near Complete Regression of a Large Cervical Disc Herniation without Any Intervention Demonstrated on MRI

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    Parag Suresh Mahajan

    2014-01-01

    Full Text Available There are very few reported cases of regression of large cervical disc herniation without any intervention—the so-called spontaneous regression, demonstrated using MRI. We report a rare and interesting case of MRI that demonstrated near complete regression of a large herniated cervical intervertebral disc, without any surgical treatment.

  4. Surgical results of myelopathy secondary to the cervical disc herniation and the availability of CTD

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    Sho, Tomoya; Kataoka, Osamu; Washimi, Masatoshi; Fujita, Masayuki; Bessho, Yasuo (National Kobe Hospital, Hyogo (Japan))

    1990-08-01

    This study evaluated the contribution of computed tomographic discography (CTD) to the surgical indications and selection of surgical techniques in cervical disc herniation. The study population consisted of 73 patients who were diagnosed as having cervical disc herniation by CTD: Of them, hernia mass was confirmed by surgery in 64 patients (a concordance rate of 88% between CTD and surgical findings). In evaluable 40 patients receiving computed tomographic myelography (CTM), the rate of flattened spinal cord on CTM was significantly correlatd with postoperative prognosis. Flattened spinal cord was favorably improved. Higher preoperative flat rate was associated with severer cervical disc herniation. CTD provided the information concerning the positional relation in the posterior longitudinal ligament of hernia mass. Preoperative severity, preoperative rate of flattened spinal cord, and the site of protrusion of hernia mass were independent of surgical outcome. (N.K.).

  5. Surgical results of myelopathy secondary to the cervical disc herniation and the availability of CTD

    International Nuclear Information System (INIS)

    This study evaluated the contribution of computed tomographic discography (CTD) to the surgical indications and selection of surgical techniques in cervical disc herniation. The study population consisted of 73 patients who were diagnosed as having cervical disc herniation by CTD: Of them, hernia mass was confirmed by surgery in 64 patients (a concordance rate of 88% between CTD and surgical findings). In evaluable 40 patients receiving computed tomographic myelography (CTM), the rate of flattened spinal cord on CTM was significantly correlatd with postoperative prognosis. Flattened spinal cord was favorably improved. Higher preoperative flat rate was associated with severer cervical disc herniation. CTD provided the information concerning the positional relation in the posterior longitudinal ligament of hernia mass. Preoperative severity, preoperative rate of flattened spinal cord, and the site of protrusion of hernia mass were independent of surgical outcome. (N.K.)

  6. Percutaneous injection of intradiscal space with O2-O3 mixture to treat cervical disc herniation

    International Nuclear Information System (INIS)

    Objective: To evaluate the security and therapeutic effect for the treatment of cervical disc herniation with O2-O3 mixture. Methods: Thirty-two patients with cervical herniated discs verified by MRI were selected in study, and all patients presented the symptoms of upper limb, cervical and shoulder areas pain. The procedure was guided by DSA and their puncture route was defined as the right common cervical artery and trachea clearance. 1.5-3.0 ml O2-O3 mixture gas at (30-50) μg/ml was injected into every herniated disc space and 3-5 ml mixture gas was injected in paraspinal space. Results: Thirty-two patients were followed up from 3 to 32 months after treatment. The therapeutic effect showed that 17 cases (53.1%) had excellent recovery, 8 cases (25.0%) had significant relief of symptoms, and 7 cases (21.9%) got failure in treatment. No serious complication occurred. Conclusion: The therapeutic method developed by using O2-O3 mixture injection in cervical intradiscal space was a safe and effective method for the treatment of the cervical disc herniation. (authors)

  7. RESULTS OF SURGICAL TREATMENT IN CERVICAL HERNIATED DISC ANALYSIS OF 275 CASES

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    L. Eva

    2010-02-01

    Full Text Available Background: Problems of surgical treatment of cervical disc hernia are still far from being resolved. It shows variety of surgical procedures it. The operations for cervical level with radiculopatie were quite limited. Limits method were dictated by the absence of accurate diagnosis, microsurgical methods, extensions, sometimes unjustified, conservative treatment. Material and method Complex issue of cervical spine degenerative pathologies, particularly cervical disc hernia with radicular syndrome was studied on a group of 275 patients. Results: From the 275 patients with herniated disc cervical admitted in the study, 182 (66.18% of cases had surgical intervention to a single level disc, 72 patients (26.18% of cases in two levels, 20 patients (7.27% cases at three levels and one case (0.36% at four levels.

  8. Herniated Lumbar Disc

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    Herniated Lumbar Disc What is a herniated disc? Nonsurgical treatment Medication and pain management Surgery What can I expect after ... at and just below the waist. A herniated lumbar disc can press on the nerves in the spine ...

  9. Cervical disc herniation presenting with neck pain and contralateral symptoms: a case report

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    Yeung Jacky T

    2012-06-01

    Full Text Available Abstract Introduction Cervical disc herniation often results in neck and arm pain in patients as a result of direct impingement of nerve roots and associated inflammatory processes. The clinical presentation usually corresponds with the side of herniation and ipsilateral symptoms predominate the clinical picture. Case presentation A 35-year-old Caucasian man presented to our facility with neck pain and left-sided upper and lower extremity pain. A magnetic resonance imaging scan revealed a right paramedian herniated disc at the C5 to C6 level. All other cervical levels were normal without central canal stenosis or neural foraminal stenosis. Results from magnetic reasonance imaging scans of the brain and lumbar spine were negative. An anterior cervical discectomy was performed at the C5 to C6 level, and an inter-body graft and plate were placed. Our patient had complete resolution of his neck and left arm pain. Conclusions Anterior discectomy and fusion of the cervical spine resulted in complete resolution of our patient’s neck and left arm symptoms and improvement of his contralateral left leg pain. Cervical disc herniation may present with contralateral symptoms that are different from the current perception of this disease.

  10. Cervical spine disc herniation at C2-C3 level: Study of a Clinical Observation and Literature Review

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    Oka Dominique N'Dri

    2015-12-01

    Full Text Available Cervical C2-C3 herniated disc is rare. It is characterized by its clinical polymorphism. Several surgical approaches have been described for the discectomy of a herniated disc. This work aims at discussing through personal observations and literature review clinical semiology and surgical treatment.

  11. Safe physiotherapy interventions in large cervical disc herniations.

    LENUS (Irish Health Repository)

    Keramat, Keramat Ullah

    2012-01-01

    A 34-year-old woman was seen in a physiotherapy department with signs and symptoms of cervical radiculopathy. Loss of cervical lordosis and a large paracentral to intraforaminal disc prolapse (8 mm) at C5-C6 level was reported on MRI. She was taking diclofenac sodium, tramadol HCl, diazepam and pregabalin for the preceding 2 months and no significant improvement, except temporary relief, was reported. She was referred to physiotherapy while awaiting a surgical opinion from a neurosurgeon. In physiotherapy she was treated with mobilisation of the upper thoracic spine from C7 to T6 level. A cervical extension exercise was performed with prior voluntary extension of the thoracic spine and elevated shoulders. She was advised to continue the same at home. General posture advice was given. Signs and symptoms resolved within the following four sessions of treatment over 3 weeks. Surgical intervention was subsequently deemed unnecessary.

  12. Outcomes of conservative treatment for cervical myelopathy caused by soft disc herniation

    International Nuclear Information System (INIS)

    The purposes of this study are to delineate the clinical course and MRI findings of patients with disc hernias which regressed spontaneously and to determine who is eligible for conservative treatment. Twenty-three patients with mild cervical myelopathy (initial Japanese Orthopedic Association (JOA) scores >10) caused by soft disc herniation were treated conservatively for more than two years (13 males, 10 females, mean age 50, mean follow-up 3.6 years). The investigated items included JOA scores and MRI findings (morphology of disc herniation). Morphology of disc herniation was classified into focal type (herniated mass persisting at the intervertebral level) and diffuse type (herniated mass migrating rostrally or caudally) in the sagittal plane and median type or paramedian type in the axial plane. The mean JOA scores were 13.4±1.5 before treatment, and 16.0±1.0 at follow-up. Regression of herniation was observed in 14 patients (Group A), while no regression was seen in 9 patients (Group B). The JOA scores were 13.7±1.5 (Group A) and 14.0±1.6 (Group B) before treatment, and 16.3±1.6 and 15.7±1.2 at follow-up, respectively. On sagittal MR images, diffuse-type herniation was observed in 9 patients (64%) and focal-type in 5 (36%) in Group A, and 3 (33%) and 6 (67%) in Group B, respectively. On axial images, median-type herniation was observed in 10 patients (71%), and paramedian-type in 4 (29%) in Group A, and 6 (67%) and 3 (33%) in Group B, respectively. Spontaneous soft disc regression in patients with cervical myelopathy was observed in more than half of those treated conservatively for longer than 2 years. Conservative treatment can be recommended for patients with mild cervical myelopathy, especially when caused by median-and/or diffuse-type disc hernia, although close observation is mandatory. (author)

  13. The NEtherlands Cervical Kinematics (NECK) Trial. Cost-effectiveness of anterior cervical discectomy with or without interbody fusion and arthroplasty in the treatment of cervical disc herniation; A double-blind randomised multicenter study

    NARCIS (Netherlands)

    M.P. Arts (Mark); R. Brand (René); B.W. Koes (Bart); W.C. Peul (Wilco); M.E. van den Akker (Elske)

    2010-01-01

    textabstractBackground. Patients with cervical radicular syndrome due to disc herniation refractory to conservative treatment are offered surgical treatment. Anterior cervical discectomy is the standard procedure, often in combination with interbody fusion. Accelerated adjacent disc degeneration is

  14. Single level cervical disc herniation: A questionnaire based study on current surgical practices

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    Abrishamkar Saeid

    2009-01-01

    Full Text Available Background: Operative procedures like simple discectomy, with or without fusion and with or without instrumentation, for single level cervical disc herniation causing neck pain or neurological compromise have been described and are largely successful. However, there is a debate on definitive criteria to perform fusion (with or without instrumentation for single level cervical disc herniation. Hence, we conducted a questionnaire based study to elicit the opinions of practicing neurosurgeons. Materials and Methods: About 148 neurosurgeons with atleast 12 years of operative experience on single level cervical disc herniation, utilizing the anterior approach, were enrolled in our study. All participating neurosurgeons were asked to complete a practice based questionnaire. The responses of 120 neurosurgeons were analysed. Results: The mean age of enrolled surgeons was 51 yrs (range 45-73 with mean surgical experience of 16.9 yrs (range 12-40 yrs on single level cervical disc herniation. Out of 120 surgeons 10(8% had 15-25 years experience and always preferred fusion with or without instrumentation and six (five per cent with 17-27 yrs experience had never used fusion techniques. However, 104 (87% surgeons with 12-40 yrs experience had their own criteria based on their experiences for performing fusion with graft and instrumentation (FGI, while. 85 (75% preferred auto graft with cage. Conclusions: Most of surgeons performed FGI before the age of 40, but for others, patient criteria such as job (heavier job, physical examination (especially myelopathy and imaging findings (mild degenerative changes on X-ray and signal change in the spinal cord on MRI were considered significant for performing FGI.

  15. Spontaneous Cervical Intradural Disc Herniation Associated with Ossification of Posterior Longitudinal Ligament

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    Dachuan Wang

    2014-01-01

    Full Text Available Intradural herniation of a cervical disc is rare; less than 35 cases have been reported to date. A 52-year-old man with preexisting ossification of posterior longitudinal ligament developed severe neck pain with Lt hemiparesis while asleep. Neurological exam was consistent with Brown-Séquard syndrome. Magnetic resonance images showed a C5-6 herniated disc that was adjacent to the ossified ligament and indenting the cord. The mass was surrounded by cerebrospinal fluid signal intensity margin, and caudally the ventral dura line appears divided into two, consistent with the “Y-sign” described by Sasaji et al. Cord edema were noted. Because of preexisting canal stenosis and spinal cord at risk, a laminoplasty was performed, followed by an anterior C6 corpectomy. Spot-weld type adhesions of the posterior longitudinal ligament to the dura was noted, along with a longitudinal tear in the dura. An intradural extra-arachnoid fragment of herniated disc was removed. Clinical exam at 6 months after surgery revealed normal muscle strength but persistent mild paresthesias. It is difficult to make a definite diagnosis of intradural herniation preoperatively; however, the clinical findings and radiographic signs mentioned above are suggestive and should alert the surgeon to look for an intradural fragment.

  16. Cervical disc herniation. Follow-up studies on morphological changes seen by MRI

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    Nagata, Kensei; Ohashi, Teruaki; Ishibashi, Kazumasa; Abe, Jun; Morita, Masakazu; Hirohashi, Akiyuki; Satou, Kimiaki; Ishida, Hyota; Inoue, Akio [Kurume Univ., Fukuoka (Japan). School of Medicine

    1996-03-01

    In recent years, many authors have reported that an extruded lumbar intervertebral disc was absorbed through phagocytosis and dehydration. However, absorption of an extruded cervical intervertebral disc has rarely been reported. We have investigated the follow-up MRI of all 24 patients with cervical disc herniation seen between 1991 and 1995. Of these, 8 patients with radiculopathy and 7 with myelopathy had been treated nonoperatively, and a further 9 patients with severe myelopathy had undergone expansive laminoplasty. In follow-up MRI, a reduction in the size of the extruded disc was seen in 5 of the 15 nonoperative patients and in 8 of the 9 operative patients. The 9 operative patients showed a mean recovery rate of 68.4{+-}15.2% (range from 44 to 90%) according to their JOA score. In the nonoperative group, recovery of symptoms was seen in all 5 patients with reduction, and in only 4 of 10 patients with nonreduction. The initial MRI of the 5 patients with reduction was taken between 2 and 7 weeks (mean 4 weeks) after onset, and between 1 month and 14 years (mean 13 months, not including the one at 14 years) after onset in the 10 patients with nonreduction. The initial MRI of the 9 operative patients was taken between 1 month and 6 years (mean 14 months after onset). The pathomechanism for disc reduction was concluded to have been the same as for lumbar disc herniation in the nonoperative patients. However, the pathomechanism in the operative patients was inconclusive and was likely to be different from that in the nonoperative patients. (author).

  17. Cervical disc herniation. Follow-up studies on morphological changes seen by MRI

    International Nuclear Information System (INIS)

    In recent years, many authors have reported that an extruded lumbar intervertebral disc was absorbed through phagocytosis and dehydration. However, absorption of an extruded cervical intervertebral disc has rarely been reported. We have investigated the follow-up MRI of all 24 patients with cervical disc herniation seen between 1991 and 1995. Of these, 8 patients with radiculopathy and 7 with myelopathy had been treated nonoperatively, and a further 9 patients with severe myelopathy had undergone expansive laminoplasty. In follow-up MRI, a reduction in the size of the extruded disc was seen in 5 of the 15 nonoperative patients and in 8 of the 9 operative patients. The 9 operative patients showed a mean recovery rate of 68.4±15.2% (range from 44 to 90%) according to their JOA score. In the nonoperative group, recovery of symptoms was seen in all 5 patients with reduction, and in only 4 of 10 patients with nonreduction. The initial MRI of the 5 patients with reduction was taken between 2 and 7 weeks (mean 4 weeks) after onset, and between 1 month and 14 years (mean 13 months, not including the one at 14 years) after onset in the 10 patients with nonreduction. The initial MRI of the 9 operative patients was taken between 1 month and 6 years (mean 14 months after onset). The pathomechanism for disc reduction was concluded to have been the same as for lumbar disc herniation in the nonoperative patients. However, the pathomechanism in the operative patients was inconclusive and was likely to be different from that in the nonoperative patients. (author)

  18. Herniated lumbar disc

    OpenAIRE

    Jordon, Jo; Konstantinou, Kika; O'Dowd, John

    2011-01-01

    Herniated lumbar disc is a displacement of disc material (nucleus pulposus or annulus fibrosis) beyond the intervertebral disc space. The highest prevalence is among people aged 30 to 50 years, with a male to female ratio of 2:1.

  19. Ozone Therapy and Its Effect on Cervical - Lumbar Disc Herniation

    OpenAIRE

    Korkut, Yasemin; Ayada, Ceylan; Toru, Ümran

    2015-01-01

    Ozone consists of three oxygen atoms and is a colorless gas that is heavier than air with a pungent smell. Medical ozone is administered to the patient always in the form of a mixture of pure oxygen and pure ozone and in a certain concentration. The ozone gas, which can be used in many types of diseases, is preferred as its side effects are at minimal rate. There are different forms of medical ozone application. Cervical and lumbar pains are located in the first row of the reasons for applyin...

  20. Brachioradial pruritus in a patient with cervical disc herniation and Parsonage-Turner syndrome*

    Science.gov (United States)

    Carvalho, Sandrina; Sanches, Madalena; Alves, Rosário; Selores, Manuela

    2015-01-01

    Brachioradial pruritus is a chronic sensory neuropathy of unknown etiology which affects the skin of the shoulders, arms and forearms on the insertion of the brachioradialis muscle. We describe the case of a 60-yearold woman recently diagnosed with multiple myeloma who refers paresis, severe pruritus and itching lesions on the right arm with 6 months of evolution. Investigation led to a diagnosis of Brachioradial pruritus consequent to the presence of cervical disc herniation and Parsonage-Turner syndrome. The patient started gabapentin 900mg/day with good control of itching. Corticosteroids and antihistamines are often ineffective in the treatment of BP. Gabapentin has been used with encouraging results. All patients with Brachioradial pruritus should be evaluated for cervical spine injuries. PMID:26131874

  1. LUMBAR DISC HERNIATION

    OpenAIRE

    Vialle, Luis Roberto; Vialle, Emiliano Neves; Suárez Henao, Juan Esteban; Giraldo, Gustavo

    2015-01-01

    Lumbar disc herniation is the most common diagnosis among the degenerative abnormalities of the lumbar spine (affecting 2 to 3% of the population), and is the principal cause of spinal surgery among the adult population. The typical clinical picture includes initial lumbalgia, followed by progressive sciatica. The natural history of disc herniation is one of rapid resolution of the symptoms (four to six weeks). The initial treatment should be conservative, managed through medication and physi...

  2. RESULTS OF SURGICAL TREATMENT IN CERVICAL HERNIATED DISC ANALYSIS OF 275 CASES

    OpenAIRE

    L. Eva

    2010-01-01

    Background: Problems of surgical treatment of cervical disc hernia are still far from being resolved. It shows variety of surgical procedures it. The operations for cervical level with radiculopatie were quite limited. Limits method were dictated by the absence of accurate diagnosis, microsurgical methods, extensions, sometimes unjustified, conservative treatment. Material and method Complex issue of cervical spine degenerative pathologies, particularly cervical disc hernia with radicular syn...

  3. Cervical myelopathy due to single level disc herniation presenting as intramedullary mass lesion: What to do first?

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    Murat Sakir Eksi

    2015-01-01

    Full Text Available Cervical myelopathy (CM is mostly a degenerative process ending in myelopathic and/or radiculopathic syndromes. On T2-weighted magnetic resonance imaging (MRI, CM appears as a hyperintense area near the spondylotic spine. This high intensity signal depends on the impact of outer forces and their duration. It also determines the prognosis of the surgical candidate. A 40-year-old male patient admitted to our clinic with right upper extremity weakness and hypoesthesia that had started 2 months earlier. On neurological examination there was 2/5 motor weakness of right biceps brachii, and hypoesthesia over right C6 dermatome. Right upper extremity deep tendon reflexes were hypoactive, but lower ones were hyperactive. After clinical and radiological work-up, preliminary diagnosis was directed to a spinal intramedullary tumor. Total resection of the herniated cervical disc fragment and the mass lesion was managed. Pathology of the mass lesion was compatible with subacute infarct tissue and inflammatory response. Final diagnosis was CM under effect of cervical disc herniation. Contrast-enhanced spinal cord myelopathic lesions are very rare and resemble much more tumors and inflammatory processes. However, the principal treatment approach totally differs depending on pathology. When there are both a disc herniation and a high clinical suspicion; biopsy should be delayed. The most probable solution will be surgery for the disc disease with thorough preoperative scanning of vascular malformations; clinical and radiological close follow-up after surgery. Biopsy or surgical resection can be performed if patient deteriorates despite the primary surgery.

  4. Surgical treatment of cervical disc herniation%颈椎间盘突出症的手术治疗

    Institute of Scientific and Technical Information of China (English)

    吴洁石; 包聚良; 徐瑞生; 陆华; 王刊石; 王雪松; 薛骏

    2012-01-01

    目的 探讨颈椎间盘突出症的临床病理特点、临床分型及手术要点.方法 回顾性分析1999年1月至2010年10月接受手术治疗的颈椎间盘突出症患者的临床资料.结果 颈椎间盘突出症128例,均经手术治疗.其中脊髓型96例,神经根型22例,混合型10例.脊髓型和混合型颈椎间盘突出症使用JOA评分,由术前(12.30±1.05)分至术后(16.70±1.11)分.神经根型颈椎间盘突出症使用VSA评分:由术前(8.10±1.37)分至术后(0.30±0.19)分.结论 认识其游离压迫物和硬膜囊、后纵韧带、神经结构之间的相互关系,正确选择手术方案和手术细节可以确保手术安全性和有效率.%Objective To study the pathology,clinical classification and surgical treatment of cervical disc herniation.Methods The clinical data of patients of cervical disc herniation from January 1999 to October 2010 were collected.Results All the 128 cases of cervical disc herniation were surgically treated.Among the 128 cases,96 cases with myelopathy,22 cases with radiculopathy and 10 cases with both.JOA and VSA scores were used to evaluate the surgical effectiveness respectively for myelopathy and radiculopathy.JOA score was improved from 12.30 ± 1.05 before to 16.70 ± 1.11after operation.VSA score was improved from 8.10 ± 1.37 before to 0.30 ±0.19 after operation.Conclusions The high safety and effectiveness of surgery for cervical disc herniation could be achieved both by the awareness of the pathological characteristics of how the sequestrated disc materical relates to the nerve structure in the canal and by paying attention to specific operation details.

  5. Radicular interdural lumbar disc herniation

    OpenAIRE

    Akhaddar, Ali; Boulahroud, Omar; Elasri, Abad; Elmostarchid, Brahim; Boucetta, Mohammed

    2009-01-01

    Intraradicular lumbar disc herniation is a rare complication of disc disease that is generally diagnosed only during surgery. The mechanism for herniated disc penetration into the intradural space is not known with certainty, but adhesion between the radicular dura and the posterior longitudinal ligament was suggested as the most important condition. The authors report the first case of an intraradicular lumbar disc herniation without subdural penetration; the disc hernia was lodged between t...

  6. Acute spontaneous cervical disc herniation causing rapidly progressive myelopathy in a patient with comorbid ossified posterior longitudinal ligament: Case report and literature review

    Directory of Open Access Journals (Sweden)

    Harrison J Westwick

    2014-01-01

    Full Text Available Background: Ossification of the posterior longitudinal ligament (OPLL and cervical disc herniation are commonly encountered neurosurgical conditions. Here we present an unusual case of nontraumatic rapidly progressive myelopathy due to cervical disc herniation with comorbid OPLL and conduct a literature review focusing on the frequency and management of disc herniations with OPLL. Case Description: A 52-year-old healthy female presented with a 72-h history of rapid progression of dense quadriparesis with sensory deficits, with a precedent 4-week history of nontraumatic midline neck pain. Clinical examination revealed profound motor deficits below the C5 myotome. Spinal neuroimaging revealed OPLL (computed tomography [CT] and a cervical disc herniation spanning from C4/5 to C5/6 with significant retrovertebral disease (magnetic resonance imaging [MRI]. Operative management involved an anterior cervical corpectomy and instrumented fusion, with removal of both the sequestered disc material and the locally compressive OPLL. The patient recovered full motor function and independent ambulation with no residual signs or symptoms of myelopathy at the time of discharge. Conclusion: This unique case of a spontaneous cervical disc herniation in the context of OPLL causing rapidly progressive myelopathy illustrates the complementarity of CT and MRI in diagnosing the underlying cause of a rapidly progressive neurologic deficit in the absence of antecedent trauma. Though the optimal surgical management of such pathology remains uncertain; in this case, the anterior approach was motivated by the significant retrovertebral ventrally compressive sequestrum, and provided for excellent neurologic outcome. This article also reviews the occurrence/management of such acute cervical discs with OPLL.

  7. Imaging of Herniated Discs of the Cervical Spine: Inter-Modality Differences between 64-Slice Multidetector CT and 1.5-T MRI

    Energy Technology Data Exchange (ETDEWEB)

    Yi, Ji Sook; Cha, Jang Gyu [Dept. of Radiology, Soonchunhyang University Bucheon Hospital, Bucheon (Korea, Republic of); Han, Jong Kyu [Dept. of Radiology, Soonchunhyang University Cheonan Hospital, Cheonan (Korea, Republic of); Kim, Hyun Joo [Dept. of Radiology, Soonchunhyang University Seoul Hospital, Seoul (Korea, Republic of)

    2015-08-15

    To assess inter-modality variability when evaluating cervical intervertebral disc herniation using 64-slice multidetector-row computed tomography (MDCT) and magnetic resonance imaging (MRI). Three musculoskeletal radiologists independently reviewed cervical spine 1.5-T MRI and 64-slice MDCT data on C2-3 though C6-7 of 51 patients in the context of intervertebral disc herniation. Interobserver and inter-modality agreements were expressed as unweighted kappa values. Weighted kappa statistics were used to assess the extents of agreement in terms of the number of involved segments (NIS) in disc herniation and epicenter measurements collected using MDCT and MRI. The interobserver agreement rates upon evaluation of disc morphology by the three radiologists were in fair to moderate agreement (k = 0.39-0.53 for MDCT images; k = 0.45-0.56 for MRIs). When the disc morphology was categorized into two and four grades, the inter-modality agreement rates were moderate (k-value, 0.59) and substantial (k-value, 0.66), respectively. The inter-modality agreements for evaluations of the NIS (k-value, 0.78) and the epicenter (k-value, 0.79) were substantial. Also, the interobserver agreements for the NIS (CT; k-value, 0.85 and MRI; k-value, 0.88) and epicenter (CT; k-value, 0.74 and MRI; k-value, 0.70) evaluations by two readers were substantial. MDCT tended to underestimate the extent of herniated disc lesions compared with MRI. Multidetector-row computed tomography and MRI showed a moderate-to-substantial degree of inter-modality agreement for the assessment of herniated cervical discs. MDCT images have a tendency to underestimate the anterior/posterior extent of the herniated disc compared with MRI.

  8. Imaging of Herniated Discs of the Cervical Spine: Inter-Modality Differences between 64-Slice Multidetector CT and 1.5-T MRI

    International Nuclear Information System (INIS)

    To assess inter-modality variability when evaluating cervical intervertebral disc herniation using 64-slice multidetector-row computed tomography (MDCT) and magnetic resonance imaging (MRI). Three musculoskeletal radiologists independently reviewed cervical spine 1.5-T MRI and 64-slice MDCT data on C2-3 though C6-7 of 51 patients in the context of intervertebral disc herniation. Interobserver and inter-modality agreements were expressed as unweighted kappa values. Weighted kappa statistics were used to assess the extents of agreement in terms of the number of involved segments (NIS) in disc herniation and epicenter measurements collected using MDCT and MRI. The interobserver agreement rates upon evaluation of disc morphology by the three radiologists were in fair to moderate agreement (k = 0.39-0.53 for MDCT images; k = 0.45-0.56 for MRIs). When the disc morphology was categorized into two and four grades, the inter-modality agreement rates were moderate (k-value, 0.59) and substantial (k-value, 0.66), respectively. The inter-modality agreements for evaluations of the NIS (k-value, 0.78) and the epicenter (k-value, 0.79) were substantial. Also, the interobserver agreements for the NIS (CT; k-value, 0.85 and MRI; k-value, 0.88) and epicenter (CT; k-value, 0.74 and MRI; k-value, 0.70) evaluations by two readers were substantial. MDCT tended to underestimate the extent of herniated disc lesions compared with MRI. Multidetector-row computed tomography and MRI showed a moderate-to-substantial degree of inter-modality agreement for the assessment of herniated cervical discs. MDCT images have a tendency to underestimate the anterior/posterior extent of the herniated disc compared with MRI

  9. Pseudoenhancement of intervertebral disc herniation

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    Araki, Y.; Ootani, M.; Furukawa, T.; Tsukaguchi, I. (Dept. of Radiology, Osaka Rosai Hospital (Japan)); Mitomo, M. (Dept. of Radiology, Osaka Univ. Medical School (Japan))

    1992-08-01

    Two patients with intervertebral disc herniation appeared to demonstrate abnormally diffuse and intense enhancement of the disc after intravenous administration of gadolinium-DTPA for MRI. Surgery disclosed a dilated epidural venous plexus in one and vascular granulation tissue in the other, associated with the herniated disc material. The mechanism of this 'pseudoenhancement' of the disc appears to be a partial volume effect of disc material and the adjacent veins or granulation tissue. Pseudoenhancement of a herniated disc should be included in the differential diagnosis of a diffusely enhancing epidural mass. (orig.).

  10. Chemonucleolysis of lumbar disc herniation

    International Nuclear Information System (INIS)

    Chemonucleolysis is an advantageous alternative to surgical treatment of lumbar disc herniation. To achieve the best results the indications must be strictly observed and the procedure itself must be technically perfect. In these circumstances a rapid, non-invasive and less expensive treatment of lumbar disc herniation is possible. (orig.)

  11. Fractalkine receptor chemokine (CX3CR1 influences on cervical and lumbar disc herniation

    Directory of Open Access Journals (Sweden)

    In-Soo Oh

    2015-01-01

    of CX3CL1 and CX3CR1 in the disc degeneration and to compare between cervical and lumbar HNP. Materials and Methods: The mRNA concentrations of CX3CL1/CX3CR1 chemokine were analyzed in the surgically obtained disc specimens from C-HNP (n = 13 and L-HNP (n = 13 by real-time polymerase chain reaction (PCR. The localization of CX3CL1/CX3CR1 chemokine in the disc of C-HNP and L-HNP patients was determined using immunohistochemical study. Blood samples from patients with C-HNP and L-HNP patients were stained for CX3CR1 with flow cytometric analysis. Results: The CX3CL1 positive cell ratio in the discs was observed in both groups by immunohistochemical study. CX3CR1 was strongly expressed on endothelial cells in C-spine disc, but sparely expressed in L-spine disc. There was greater CX3CR1 mRNA expression in C-HNP patients than in L-HNP patients as quantified by reversal transcription-PCR (P = 0.010. CX3CR1 positive cell frequencies and CX3CR1 expression levels were increased in CD4 (+ T-cells and natural killer (NK cells from patients with C-HNP (P = 0.210 and P = 0.040. Conclusions: This study identified that increases in CX3CL1 and CX3CR1-expressing cells are significantly related to pathomechanism of HNP for the first time. Especially, CD4 (+ T-cells and NK cells expressing CX3CR1 may play an important role in developing C-HNP.

  12. Spontaneous Regression of Lumbar Disc Herniation: Report of Two Cases

    OpenAIRE

    Mehmet ŞENOĞLU; Kasım Zafer YÜKSEL; Mürvet YÜKSEL

    2006-01-01

    Spontaneous disc regression is described in lumbar, thoracic, cervical regions and also in various clinical situations. Although, spontaneous regression of lumbar disc herniation is a well defined clinical situation, the exact mechanism has not been adequately clarified yet. Currently , there are some suggested hypotheses. In this study, two cases with the complaint of lumbar radiculopathy and spontaneous regression of the disc herniation during their follow-up period, relevant with their cli...

  13. Cervical disc hernia operations through posterior laminoforaminotomy

    OpenAIRE

    Coskun Yolas; Nuriye Guzin Ozdemir; Hilmi Onder Okay; Ayhan Kanat; Mehmet Senol; Ibrahim Burak Atci; Hakan Yilmaz; Mustafa Kemal Coban; Mehmet Onur Yuksel; Umit Kahraman

    2016-01-01

    Objective: The most common used technique for posterolateral cervical disc herniations is anterior approach. However, posterior cervical laminotoforaminomy can provide excellent results in appropriately selected patients with foraminal stenosis in either soft disc prolapse or cervical spondylosis. The purpose of this study was to present the clinical outcomes following posterior laminoforaminotomy in patients with radiculopathy. Materials and Methods: We retrospectively evaluated 35 patients ...

  14. 颈椎间盘突出症合并腰椎间盘突出症的非手术治疗效果分析%Effect of non-operative treatments on herniation of cervical disc complicated by prolapse of lumbar intervertebral disc

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    @@ Background: There are many reports about the operative or non- operative treatments of herniation of cervical disc or prolapse of lumbar intervertebral disc, but few about the non- operative treatments curative effect and attentive affairs of their combination. Objective: To study the non- operative treatments' curative effect of herniation of cervical disc combined with prolapse of lumbar intervertebral disc. Design: To make retrospective survey and study of non- operative treatments' curative effect of herniation of cervical disc combined with prolapse of lumbar intervertebral disc. Unit: First Affiliated Hospital of Anhui Medical University. Subject: From February 1990 to February 1998, 55 patients were with the complication, occupied 15. 41% of the simple cervical disc, and 9. 34% of the simple lumbar intervertebral disc.

  15. ACDR 和 ACDF 治疗单节段颈椎间盘突出症的对比分析%Comparative analysis of ACDR and ACDF in the treatment of single segmental cervical intervertebral disc herniation

    Institute of Scientific and Technical Information of China (English)

    黄长安; 李军; 袁文旗; 周立

    2015-01-01

    目的:对比分析颈椎前路椎间盘切除植骨融合术( ACDF)和颈椎人工椎间盘置换术( ACDR)%Objective To compare the effect of anterior cervical discectomy and interbody fusion(ACDF) and artificial cervical disc replacement(ACDR) in the treatment of single segmental cervical disc herniation.Methods A total of 81 patients with single segmental cervical disc herniation were collected in our hospital from January 2010 to June 2014, in which 40 patients received ACDF surgery(fusion group) and other 41 patients underwent ACDR sur-gery(permutation group).The changes of activity were compared between the two groups before and the last follow-up after the surgery.Results There were significant differences in the changes of activity between the two groups at the last time of follow-up after the surgery(P <0.01).For each group, the activity improved at the end of the follow-up compared with that before the surgery(P <0.01).Conclusion Both ACDR and ACDF are effective in the treatment of single segmental cervical disc herniation, which improves the activity of cervical disc herniation.ACDR also makes the surgery adjacent segments of the compensatory activity increased, and therefore may prevent adjacent segment de-generation.

  16. Spontaneous Regression of a Cervical Disk Herniation

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    Emre Delen

    2014-03-01

    Full Text Available A 54 years old female patient was admitted to our outpatient clinic with a two months history of muscle spasms of her neck and pain radiating to the left upper extremity. Magnetic resonance imaging had shown a large left-sided paracentral disk herniation at the C6-C7 disk space (Figure 1. Neurological examination showed no obvious neurological deficit. She received conservative treatment including bed rest, rehabilitation, and analgesic drugs. After 13 months, requested by the patient, a second magnetic resonance imaging study showed resolution of the disc herniation.(Figure 2 Although the literature contains several reports about spontaneous regression of herniated lumbar disc without surgical intervention, that of phenomenon reported for herniated cervical level is rare, and such reports are few[1]. In conclusion, herniated intervertebral disc have the potential to spontaneously regress independently from the spine level. With further studies, determining the predictive signs for prognostic evaluation for spontaneous regression which would yield to conservative treatment would be beneficial.

  17. Unusual disc herniation in a dog: a case history report

    International Nuclear Information System (INIS)

    Unusual disc herniation was identified in a dog. Disc herniation was considered unusual because of its displacement into the vertebral endplate of the adjoining vertebra. Unusual disc herniation in this dog was compared with Schmorl's node in humans

  18. Cervical disc hernia operations through posterior laminoforaminotomy

    Directory of Open Access Journals (Sweden)

    Coskun Yolas

    2016-01-01

    Full Text Available Objective: The most common used technique for posterolateral cervical disc herniations is anterior approach. However, posterior cervical laminotoforaminomy can provide excellent results in appropriately selected patients with foraminal stenosis in either soft disc prolapse or cervical spondylosis. The purpose of this study was to present the clinical outcomes following posterior laminoforaminotomy in patients with radiculopathy. Materials and Methods: We retrospectively evaluated 35 patients diagnosed with posterolateral cervical disc herniation and cervical spondylosis with foraminal stenosis causing radiculopathy operated by the posterior cervical keyhole laminoforaminotomy between the years 2010 and 2015. Results: The file records and the radiographic images of the 35 patients were assessed retrospectively. The mean age was 46.4 years (range: 34-66 years. Of the patients, 19 were males and 16 were females. In all of the patients, the neurologic deficit observed was radiculopathy. The posterolaterally localized disc herniations and the osteophytic structures were on the left side in 18 cases and on the right in 17 cases. In 10 of the patients, the disc level was at C5-6, in 18 at C6-7, in 2 at C3-4, in 2 at C4-5, in 1 at C7-T1, in 1 patient at both C5-6 and C6-7, and in 1 at both C4-5 and C5-6. In 14 of these 35 patients, both osteophytic structures and protruded disc herniation were present. Intervertebral foramen stenosis was present in all of the patients with osteophytes. Postoperatively, in 31 patients the complaints were relieved completely and four patients had complaints of neck pain and paresthesia radiating to the arm (the success of operation was 88.5%. On control examinations, there was no finding of instability or cervical kyphosis. Conclusion: Posterior cervical laminoforaminotomy is an alternative appropriate choice in both cervical soft disc herniations and cervical stenosis.

  19. Cervical disc hernia operations through posterior laminoforaminotomy

    Science.gov (United States)

    Yolas, Coskun; Ozdemir, Nuriye Guzin; Okay, Hilmi Onder; Kanat, Ayhan; Senol, Mehmet; Atci, Ibrahim Burak; Yilmaz, Hakan; Coban, Mustafa Kemal; Yuksel, Mehmet Onur; Kahraman, Umit

    2016-01-01

    Objective: The most common used technique for posterolateral cervical disc herniations is anterior approach. However, posterior cervical laminotoforaminomy can provide excellent results in appropriately selected patients with foraminal stenosis in either soft disc prolapse or cervical spondylosis. The purpose of this study was to present the clinical outcomes following posterior laminoforaminotomy in patients with radiculopathy. Materials and Methods: We retrospectively evaluated 35 patients diagnosed with posterolateral cervical disc herniation and cervical spondylosis with foraminal stenosis causing radiculopathy operated by the posterior cervical keyhole laminoforaminotomy between the years 2010 and 2015. Results: The file records and the radiographic images of the 35 patients were assessed retrospectively. The mean age was 46.4 years (range: 34-66 years). Of the patients, 19 were males and 16 were females. In all of the patients, the neurologic deficit observed was radiculopathy. The posterolaterally localized disc herniations and the osteophytic structures were on the left side in 18 cases and on the right in 17 cases. In 10 of the patients, the disc level was at C5-6, in 18 at C6-7, in 2 at C3-4, in 2 at C4-5, in 1 at C7-T1, in 1 patient at both C5-6 and C6-7, and in 1 at both C4-5 and C5-6. In 14 of these 35 patients, both osteophytic structures and protruded disc herniation were present. Intervertebral foramen stenosis was present in all of the patients with osteophytes. Postoperatively, in 31 patients the complaints were relieved completely and four patients had complaints of neck pain and paresthesia radiating to the arm (the success of operation was 88.5%). On control examinations, there was no finding of instability or cervical kyphosis. Conclusion: Posterior cervical laminoforaminotomy is an alternative appropriate choice in both cervical soft disc herniations and cervical stenosis.

  20. Herniated Cervical Disc

    Science.gov (United States)

    ... doctor, with the help of a nurse or physical therapist, may also begin education and training on specific ... performed at home or you may visit a physical therapist for a more specific program to meet your ...

  1. Lumbar Epidural Varix Mimicking Disc Herniation.

    Science.gov (United States)

    Bursalı, Adem; Akyoldas, Goktug; Guvenal, Ahmet Burak; Yaman, Onur

    2016-07-01

    Lumbar radiculopathy is generally caused by such well-recognized entity as lumbar disc herniation in neurosurgical practice; however rare pathologies such as thrombosed epidural varix may mimic them by causing radicular symptoms. In this case report, we present a 26-year-old man with the complaint of back and right leg pain who was operated for right L4-5 disc herniation. The lesion interpreted as an extruded disc herniation preoperatively was found to be a thrombosed epidural varix compressing the nerve root preoperatively. The nerve root was decompressed by shrinking the lesion with bipolar thermocoagulation and excision. The patient's complaints disappeared in the postoperative period. Thrombosed lumbar epidural varices may mimic lumbar disc herniations both radiologically and clinically. Therefore, must be kept in mind in the differential diagnosis of lumbar disc herniations. Microsurgical techniques are mandatory for the treatment of these pathologies and decompression with thermocoagulation and excision is an efficient method. PMID:27446525

  2. Lumbar Epidural Varix Mimicking Disc Herniation

    Science.gov (United States)

    Bursalı, Adem; Guvenal, Ahmet Burak; Yaman, Onur

    2016-01-01

    Lumbar radiculopathy is generally caused by such well-recognized entity as lumbar disc herniation in neurosurgical practice; however rare pathologies such as thrombosed epidural varix may mimic them by causing radicular symptoms. In this case report, we present a 26-year-old man with the complaint of back and right leg pain who was operated for right L4–5 disc herniation. The lesion interpreted as an extruded disc herniation preoperatively was found to be a thrombosed epidural varix compressing the nerve root preoperatively. The nerve root was decompressed by shrinking the lesion with bipolar thermocoagulation and excision. The patient's complaints disappeared in the postoperative period. Thrombosed lumbar epidural varices may mimic lumbar disc herniations both radiologically and clinically. Therefore, must be kept in mind in the differential diagnosis of lumbar disc herniations. Microsurgical techniques are mandatory for the treatment of these pathologies and decompression with thermocoagulation and excision is an efficient method. PMID:27446525

  3. Management of cervical disc herniation with nonfusion surgical technique%非融合手术治疗颈椎间盘突出症

    Institute of Scientific and Technical Information of China (English)

    任先军; 王卫东; 初同伟; 王建; 李长青; 蒋涛; 郝勇; 张年春

    2008-01-01

    Objective To evaluate the clinical restdts of Bryan cervical disc prosthesis in treatment of cervical disc herniation. Methods There were 34 patients with cervical disc herniation.There were 13 females and 21 males at age range of 31-57 years(mean43 years).The herniated disc was located at C3-4 in 2 patients,at C4-5 in 4,at C5-6 in 22,at C6-7 in 1,at C4-5,5-6 in 2,C3.4.5-6 in 2 and C5-6,6-7 in 1.There were 14 patients with myelopathy and 20 with radiculopathy.A total of 39 sets of Bryan cervical disc prosthesis were implanted,with single level disc replaced in 29 patients and bi-level in 5.The Bryan cervical disc prosthesis contained a proprietary,low-friction,wear-resistant,unique polyurethane nucleus and a titanium plate(shells)that included convex porous ingrowth surfaces,to allow bony fixation to the adjacent vertebral endplates.The level of stableness and mobility at the implanting location were observed on dynamic radiograph postoperatively.The nerve function was evaluated by CSM40 score. Results The average follow-up was 14 months(3-42 months),which showed significant improvement in neurological symptoms in.all patients.Radicular pain for patients suffering from raduculopathy was relieved completely.The average CSM40 score was improved by 8.5 points.with efficiency rate of 100%.There was no prosthesis displacement or loosening in all patients,with mean range of motion(ROM)for 9.3 degrees at implant level on the flexion-extension radiographs. ConclusionImplantation of cervical disc prosthesis Can attain deftnite stabilization and satisfactory mobility,significantly improve neurological symptom and hence provides a new effective treatment for cervical disc herniation.%目的 探讨Bryan人工颈椎间盘假体置换治疗颈椎间盘突出症的临床效果.方法 本组34例颈椎间盘突出症患者,其中男21例,女13例;年龄31~57岁,平均43岁.突出部位:C3~4 2例,C4~5 4例,C5~6 22例,C6~7 1例,C4~5,5~6 2例,C3~4,5~6 2例,C5~6,6

  4. [Lumbar disc herniation and andrological diseases].

    Science.gov (United States)

    Jin, Bao-fang

    2015-10-01

    Lumbar disc herniation is a common male disease. In the past, More academic attention was directed to its relationship with lumbago and leg pain than to its association with andrological diseases. Studies show that central lumber intervertebral disc herniation may cause cauda equina injury and result in premature ejaculation, erectile dysfunction, chronic pelvic pain syndrome, priapism, and emission. This article presents an overview on the correlation between central lumbar intervertebral disc herniation and andrological diseases, focusing on the aspects of etiology, pathology, and clinical progress, hoping to invite more attention from andrological and osteological clinicians. PMID:26665671

  5. Transradicular lumbar disc herniation: An extreme variant of intraradicular disc herniation

    OpenAIRE

    Kasliwal, Manish K.; Shimer, Adam L

    2015-01-01

    Intradural or intraradicular lumbar disc herniation (IDH) is a relatively rare condition often diagnosed intraoperatively. We encountered an extreme variant of IDH - a transradicular herniation as the disc material extruded through the lumbar nerve root through a split essentially transecting the nerve root. While failure to recognize intradural and intraradicular disc herniation can lead to failed back surgery, the variant described in the present case could lead to iatrogenic injury and com...

  6. 椎体入路经皮内镜髓核摘除术治疗颈椎间盘突出症%Percutaneous endoscopic cervical discectomy via anterior transcorporeal approach for cervical disc herniation

    Institute of Scientific and Technical Information of China (English)

    楚磊; 刘超; 陈亮; 柯珍勇; 陈富; 邓忠良

    2016-01-01

    Objective To evaluate the feasiblility and efifcacy of percutaneous endoscopic cervical discectomy via anterior transcorporeal approach for cervical disc herniation.Methods From September 2013 to July 2014, 9 patients suffering cervical disc herniation received anterior transcorporeal approach for cervical disc herniation in the second Afifliated Hospital of Chongqing Medical University including 4 males, 5 females, with the average age of ( 44.5 ± 12.4 ) years ( range 24 - 68 years ). Levels of herniation: C3-4: 1, C4-5: 3, C5-6: 4, C6-7: 1. Percutaneous endoscopic cervical discectomy via anterior transcorporeal approach for cervical disc herniation: Guide wire was inserted between carotid sheath and tracheal esophageal sheath to the vertebra, then working trocar was applied. Burrs was used to make osseous channel in order to achieve access to the target. Herniated fragments and osteophyte were removed, and spinal cord and nerve roots were decompressed through the osseous channel. Operation time, amount of removed disc fragments and operation-related complications were observed and recorded. Clinical results were evaluated with VAS of shoulders and arms at one day before surgery, and postoperatively 1 day, 1 week, 1 month, 3 months 6 months. The follow-up included AP, lateral and dynamic X-ray of cervical spine, cervical CT and MRI.Results The surgeries were successfully performed for all the 9 patients, with an average operation time of ( 81.5 ± 23.4 ) min and an average amount of herniated disc fragments of ( 0.5 ± 0.2 ) g. One patient developed postoperative headache. One patient reported transient postoperative quadriplegia. Vertebral collapse were observed in 2 patients. The VAS was ( 75 ± 10 ) points before surgery, and respectively ( 32 ± 4 ) points, ( 22 ± 3 ) points, ( 19 ± 2 ) points, ( 16 ± 2 ) points and ( 8 ± 2 ) points at postoperatively 1 day, 1 week, 1 month, 3 months and 6 months. The VAS scores in follow-up were different from the one at

  7. Transradicular lumbar disc herniation: An extreme variant of intraradicular disc herniation

    Directory of Open Access Journals (Sweden)

    Manish K Kasliwal

    2015-01-01

    Full Text Available Intradural or intraradicular lumbar disc herniation (IDH is a relatively rare condition often diagnosed intraoperatively. We encountered an extreme variant of IDH - a transradicular herniation as the disc material extruded through the lumbar nerve root through a split essentially transecting the nerve root. While failure to recognize intradural and intraradicular disc herniation can lead to failed back surgery, the variant described in the present case could lead to iatrogenic injury and complication if not recognized. A unique case of transradicular lumbar disc herniation in a 25-year-old patient is presented with the depiction of intraoperative images supplementing the text.

  8. Computed tomography in the diagnosis of the lumbar disc herniation

    Energy Technology Data Exchange (ETDEWEB)

    Iwakura, Yuichiro (Yatsushiro General Hospital, Kumamoto (Japan)); Hayashi, Yasuo; Suzuki, Mutsuaki; Uemura, Mitsuharu; Fukuda, Kazuyuki; Koito, Hirofumi

    1984-06-01

    In this study, effectiveness of computed tomography (CT) in diagnosing lumbar disc herniation was evaluated. Twenty CT examinations which were interpreted as positive for a herniated disc, and were comfirmed by myelography, were reviewed. In 19 patients, CT demonstrated posterior protrusion of the disc but in one normal disc. Three typical cases were described. This study suggests that CT accurately demonstrates lumbar disc herniation.

  9. CT findings of calcified herniated lumbar disc

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Hyo Kun; Lee, Jun Hyung [Chang Dong Armed Forces Evacuation Hospital, Seoul (Korea, Republic of)

    1987-12-15

    Computed tomography (CT) of 10 calcified herniated lumber discs among 46 operated cases were analysed at the aspects of incidence, location, shape, etc. The results are as follows: 1. The incidence of calcification is 22% (10/46). 2. Among 10 cases, 3 cases are at the level of L4-5 disc space and 7 cases are at the level of L5-S1 disc space. 3. Central herniation (8 cases) are more common than posterolateral herniation (2 cases). 4. Linear or band-like calcifications in the periphery of herniated disc (annulus fibrosus type) are 6 cases and dense patchy calcification in the central portion of herniated disc (nucleus pulposus type) are 4 cases. 5. Two cases (50%) of 4 cases with nucleus pulposus type calcification were found to be ruptured at operation, but none of 6 annulus fibrous calcification types showed rupture. 6. Because more wide operation field and invasive exploration were required in calcified cases than non-calcified cases, it is suggested to evaluate the presence, location, and type of calcification in herniated disc in detail.

  10. 突出的颈椎间盘组织炎症反应机制研究%Study on inflammatory mechanism of herniated cervical intervertebral discs from patients with cervical spondylotic myelopathy

    Institute of Scientific and Technical Information of China (English)

    彭宝淦; 王占朝; 唐家广; 侯树勋; 吴仕良

    2003-01-01

    Aim To study the inflammatory mechanism of herniatedcervical intervertebral discs from patients with cervical spondyloticmyelopathy, and the roles of the inflammation in the cervical disc degenera-tion and cervical spondylosis. Methods 35 herniated cervical discs wereobtained fron 31 patients with cervical spondylotic myeloyathy during theanterior cervical surgery. 7 normal, nondegenerated cervical discs(controlgroup) were obtained from three fresh cadavers. All discs were divided intotwo samples, one of which was used as histological examination, and theother was used to detect contents of IL-1α. IL-6 and TNF-α biochemi-cally. Results In 35 herniated cervical discs, 18(51% ) were shownabundant inflammatory cell infiltrates in margin of herniated discs; 17(49%) no inflammatory cell infiltrates; normal discs also no any inflam-matory cell infiltrates. Biochemical assay indicated IL-1 α, IL-6 and TNF-αin cervical spondylotic myelopathy was (10.4 ± 1.9), (7.7 ± 2. 1 ) and(7.5 ± 1.7) pg/g respectively and those in noninflammatory infiltrates groupwas (10.2 ± 1.6), (6.7 ± 2.6) and (7.0 ± 1.8) pg/g respectively and thosein the control group was (2.0±0.9), (1.2±1.0) and (1.3±0.8)pg/g.The contents of cytokine IL-1α, IL-6 and TNF-α were obviously higher thanthat of normal discs( P =0. 000 1, t = 11. 359 1, 7. 951 0, 9. 372 8), andthere were no differences in the contents of cytokines between discs withinflammatory cell infiltrates and discs with no inflammatory cell infiltrates(P> 0.05, t=0.6120, 2.6204, 1.7394).Conelusion Herniatedcervical disc from the cervical spondylotic myelopathy was inflammatory, andinflammation may play an important role in cervical disc degeneration and inpathogenesis of cervical spondylosis.%目的研究颈椎病发生中突出颈椎间盘组织的炎症反应机制及其在颈椎间盘退行性变和颈椎病发病中的作用.方法临床收集了31例脊髓型颈椎病患者的35个突出的颈椎间盘标本和3

  11. CLINICAL STUDY OF PERCUTANEOUS CERVICAL DISCECTOMY WITH OZONE INJECTION IN TREATING CERVICAL DISC HERNIATION%经皮旋切术配合臭氧注射治疗颈椎间盘突出症的临床研究

    Institute of Scientific and Technical Information of China (English)

    张强; 刘萍; 张敏

    2013-01-01

    Objective:To evaluate the effect of percutaneous cervical discectomy with ozone injection in treating cervical disc herniation.Methods:Eighty-six patients were randomly divided into 2 groups with different treatment methods:40 patients were treated by percutaneous cervical discectomy with ozone injection (group A),46 patients were treated by percutaneous cervical discectomy only (group B).The visual analogue scale (VAS) and clinical efficacy for patients in the two groups were analyzed.Results:In both groups,the VAS scores were significantly decreased after treatment (P < 0.05),while the VAS score for group A was superior to group B.For clinical efficacy,the effective rate for group A (90.0%,36/40) was superior to group B (69.6%,32/46) (P < 0.05).Conclusion:Percutaneous cervical discectomy with ozone injection was superior to single percutaneous cervical discectomy in decreasing VAS scores and the clinical efficacy for patients with cervical disc herniation.%目的:评价经皮旋切术配合臭氧注射治疗颈椎间盘突出症患者的疗效.方法:将86例颈椎间盘突出症患者随机分为2组,即使用经皮穿刺旋切术配合臭氧注射治疗(A组)40例及单纯旋切术(B组)46例.分析两组患者的视觉模拟评分(visual analogue scale,VAS)及临床疗效.结果:两组治疗后VAS评分均显著降低(P<0.05),A组优于B组(P<0.05).临床疗效方面,A组有效率90.0%(36/40),优于B组69.6%(32/46)(P<0.05).结论:经皮旋切术配合臭氧注射治疗颈椎间盘突出症在降低患者的VAS评分及临床疗效方面优于单纯旋切术.

  12. Percutaneous minimally invasive techniques in the treatment of cervical disc herniation%经皮微创技术治疗颈椎间盘突出症

    Institute of Scientific and Technical Information of China (English)

    杨波; 谢景开; 尹飚; 宋磊; 方世兵; 万盛钰; 李健

    2011-01-01

    目的 比较经皮颈椎间盘切除术(percutaneous cervical discectomy,PCD)、经皮颈椎间盘髓核成形术(percutaneous cervical disc nucleoplasty,PCN)与联合使用两种微创技术(percutaneous cervical discectomy and nucleoplasty,PCDN)治疗颈椎间盘突出症的临床疗效及其对颈椎稳定性的影响.方法 回顾性分析2003年2月至2011年4月收治的退变性颈椎间盘突出症患者171例.年龄21~74岁,平均47.8岁.171例患者分为三组:PCD组97例,男53例,女44例;PCN组50例,男29例,女21例;PCDN组24例,男15例,女9例.比较三组的临床效果及颈椎稳定性.结果 所有病例中位随访4.1年:PCD组4.2年,PCN组2.6年,PCDN组3.3年.三组手术均获成功.三组手术临床效果(JOA评分),经手术前后配对t检验示差异均有统计学意义(PCD:t=21.85,P<0.05;PCN:t=14.50,P<0.05;PCDN:t=8.56,P<0.05),即三组均有效;三组间手术临床效果(JOA评分治疗改善率)经单因素方差分析,差异无统计学意义(F=2.19,P=0.12).按照Odom标准评定优良率:PCD组为81.35%,PCN组为82.44%,PCDN组为83.19%.三组手术后均无颈椎不稳病例发生,手术前后颈椎稳定性比较,差异均无统计学意义(P>0.05).结论 应用PCD、PCN以及联合使用这两种微创技术的PCDN治疗颈椎间盘突出症的临床疗效优良,对颈椎稳定性影响小,不会造成颈椎失稳的发生.%Objective To compare the therapeutic effects of percutaneous cervical discectomy (PCD group),percutaneous cervical disc nucleoplasty(PCN) and the association of them (PCDN) for the treatment of cervical intervertebral disk displacement and instability of cervical vertebral column.Methods From February 2003 to April 2011,171 consecutive patients with cervical disc herniation have presented at the authors' hospital and were retrospectively studied.The average age of patients was 47.8 years (ranged,21-74).Ninety-seven cases were treated with PCD,50 cases with PCN,and the other 24 cases with PCDN

  13. Artificial cervical disc replacement and anterior cervical decompression and fusion for the treatment of single segmental cervical disc herniation:a 3-year follow-up%颈椎人工间盘置换与前路减压融合修复单节段颈椎间盘突出症:3年随访

    Institute of Scientific and Technical Information of China (English)

    程俊杰; 眭江涛; 马原; 田慧中

    2015-01-01

    背景:前路减压融合是修复颈椎退行性椎间盘突出症的良好选择,但有报道显示融合可使颈椎邻近阶段的运动受到影响。人工椎间盘置换不仅能发挥缓解颈椎病神经症状和体征的作用,还能保持颈椎的稳定和节段活动,减少邻近节段继发性退变。而目前两种方法应用于颈椎退行性椎间盘突出症仍存在争议。  目的:探讨颈椎人工间盘置换与前路减压融合修复单节段颈椎间盘突出症的近期效果。  方法:纳入因颈椎间盘突出导致单节段神经根型或脊髓型颈椎病而需手术治疗并且获得了3个月以上随访的48例患者进行回顾性分析。根据修复方案分为两组,置换组21例采用Prestige LP人工颈椎间盘置换,融合组27例采用强生椎间融合器或异体腓骨环行椎间盘融合。患者治疗后1周及3,6,12,24,36个月医院门诊随访,记录随访过程中并发症发生情况。采用颈部和上肢疼痛目测类比评分评估患者的疼痛情况,治疗效果评价采用日本骨科学会(JOA)评分法,治疗后临床症状改善和日常功能状态采用颈椎功能障碍指数评价。结果与结论:末次随访融合组融合率为93%(25/27)。组内比较,治疗后1周及末次随访时,颈部及上肢目测类比评分、颈椎功能障碍指数均低于治疗前,JOA评分高于治疗前(P0.05)。置换组治疗后颈椎活动度及手术节段活动度明显高于融合组,差异有显著性意义(P 0.05)。提示颈椎人工间盘置换与前路减压融合修复单节段颈椎间盘突出症在患者症状缓解方面效果相同。人工椎间盘置换相对于融合技术具有保持颈椎稳定和置换节段活动度的优势。%BACKGROUND:Anterior cervical discectomy and fusion surgery is a good choice for repair of degenerative cervical disc herniation, but it is reported that fusion can affect the exercise of cervical neighboring

  14. Pure traumatic upper cervical disc herniation causing spinal cord injury: a case report and review of literature

    OpenAIRE

    Sharifi, Guive; Mosavi, Seyed Ali; Shafieezad, Misagh; Asgari Nosari, Massoud

    2012-01-01

    Abstract: One third of all spinal injuries involve cervical vertebrae, and the impact of injury to the cervical spinal cord is profound and requires systemic treatment. The role and timing of surgical decompression after an acute spinal cord injury (SCI) remains one of the most controversial topics pertaining to spinal surgery. Lack of controlled, prospective, multicenter clinical studies has contributed to confusion in optimal treatment methods for patients with injuries of the cervical spin...

  15. Diagnostics and therapy of spinal disc herniation

    International Nuclear Information System (INIS)

    Degenerative processes in a movement segment of the vertebral column, which can potentially give rise to herniation of elements of the nucleus pulposus, are complex and of variable clinical and radiological dimensions; however the mere assumption that degenerative changes precede disc herniation remains a matter of debate. By definition, spinal disc herniation (SDH) refers to components of the gelatinous nucleus pulposus protruding beyond the dorsal level of the vertebral body margin through tears in the annulus fibrosus. Clinical presentation may include pain, paresis and sensory disturbances. Magnetic resonance imaging (MRI) is considered the gold standard in the diagnosis of SDH. In the majority of patients a conservative approach with physical therapy exercises and adequate analgesic and antiphlogistic medical treatment results in a substantial improvement of symptoms. (orig.)

  16. Treatment of Cervical Intervertebral Disc Herniation by Radio Frequency Target Combined with Collagenase%射频靶点结合胶原酶治疗颈椎间盘突出症研究

    Institute of Scientific and Technical Information of China (English)

    肖林; 王娴默; 黄亮; 徐澄; 张忠贵; 陈爱萍

    2013-01-01

    Objective To observe the treatment effect of radio frequency target combined with collagenase in treatment of cervical intervertebral disc herniation. Methods From March 2011 to September 2011, 40 patients with cervical intervertebral disc herniation were divided into 2 groups: Group A and Group B. Patients in Group A were given radio frequency target radiofrequency for treatment of the cervical intervertebral disc herniation and patients in Group B of 20 were given radio frequency target combined with collagenase for treatment of cervical intervertebral disc herniation. Results 40 patients were followed up for 6 months. At the 1st week and 6 months after surgery, the VAS score difference between before and after surgery in patients were compared between two groups by t test. There was no statistically significant difference at the 1st week after surgery between two groups (P>0.05), while 6 months after surgery, there was statistically significant difference between two groups (P<0.05) .Conclusion Radio frequency target combined with collagenase for treatment of cervical intervertebral disc herniation can alleviate the pain symptoms of patients,and the short-term and long-term curative effect is very good. The long-term curative effect has statistically significant difference with pure target radiofrequency ablation treatment. Radio frequency target combined with collagenase for treatment of cervical intervertebral disc herniation has good safety, few side effects, low risks and good short-term and long-term curative effect, so it deserves to be generalized.%目的观察颈椎间盘靶点射频消融术结合胶原酶治疗的疗效.方法将2011年3~9月收治的40例颈椎间盘突出患者分2组,A组20例使用颈椎间盘靶点射频消融治疗,B组20例行颈椎间盘靶点射频消融术结合胶原酶治疗颈椎间盘突出症.结果40例患者术后1周,6个月后使用VAS评分对比术前VAS评分差值行t检验.术后1周2组对比差

  17. Traumatic Intradural Lumbar Disc Herniation without Bone Injury

    OpenAIRE

    Lee, Hyun-Woo; Kwon, Young-Min

    2013-01-01

    Intradural lumbar disc herniation is a rare disease. According to the reports of intradural lumbar disc herniations, most cases have developed as a chronic degenerative disc diseases. Traumatic intradural lumbar disc herniations are even rarer. A 52-year-old man visited our emergency center with numbness in his left calf and ankle after falling accident. Initial impression by radiologic findings was a spinal subdural hematoma at the L1 level. A follow up image two weeks later, however, did no...

  18. The anterior operation for cervical ossification of posterior longitudinal ligament combined with adjacent disc herniation%前路手术治疗合并邻近椎间盘突出的颈椎后纵韧带骨化症

    Institute of Scientific and Technical Information of China (English)

    任斌; 蔡林; 陈志龙; 王建平; 胡超; 张桃根

    2012-01-01

    Objective To investigate the efficacy and the selection of surgery time of anterior operation for cervical ossification of posterior longitudinal ligament combined with cervical disc herniation. Methods Totally 24 cases of cervical ossification of posterior longitudinal ligament combined with cervical disc herniation underwent anterior operation in our department from January 2005 to January 2011. There were 21 males and 3 females. The mean age was 52 years old (range; 40-68 years). Preoperatively, 2-3 ossified segments of the posterior longitudinal ligament combined with contiguous cervical herniated disc compressing the spinal cord were revealed through cervical X-ray film, CT and MRI examinations. All patients were treated with the anterior cervical subtotal corpectomy combined with the discectomy of contiguous cervical herniated disc by the cage fusion surgery of internal fixation for reconstruction. The preoperative and postoperative Japanese Orthopaedic Association (JOA) scores were analyzed and compared, and the improvement rate was also calculated. Results All patients were followed up for an average period of 22 months (range; 8-36 months). The mean JOA score of neurological function was preoperatively 7.5 points (range; 4-13 points). The mean JOA score was postoperatively 13.6 points (range; 10-16 points). The mean improvement rate of neurological function was 65.6% (range; 32%-81%). The efficacy of 7 cases was excellent, 12 cases good, 5 cases fair and none bad. The excellence rate was 79.1%. Conclusions Cervical ossification of posterior longitudinal ligament often combines with contiguous cervical herniated disc resulting in spinal cord injury. To avoid the sharp deterioration of spinal cord function, early surgical intervention should be taken. The anterior cervical subtotal corpectomy combined with the discectomy of contiguous cervical herniated disc by the cage fusion surgery of internal fixation for reconstruction in the treatment of cervical

  19. Adolescent lumbar disc herniation: a case report

    OpenAIRE

    King, Laurie; Mior, Silvano A.; Devonshire-Zielonka, Kim

    1996-01-01

    Lumbar spine disc herniations in children are a relatively rare condition reported to occur in less than 3% of those presenting with low back pain. Unlike the adult, the etiology and clinical picture often provides few clues to making the diagnosis. Although conservative management is the treatment of choice, surgical intervention may be required in some cases. The role of spinal manipulation in these cases may be of limited value. A case report is presented that illustrates the difficulty in...

  20. Acupuncture Treatment for Lumbar Disc Herniation

    OpenAIRE

    Karovski, Martin; Zhu, Jihe; Arsovska, Blagica; Kozovska, Kristina

    2016-01-01

    BACKGROUND: Herniated disc is a disease that comes with aging, which always comes to prolapse and irritation of the surrounding nerves and the conventional medicine offer non-painful and invasive treatments such as epidural injection, lumbar microscopic discectomy open or laparoscopic surgery of the spine. Acupuncture for centuries is been used as a successful treatment for many diseases and the development of the medicine and better knowledge of the pathological conditions of the organism, n...

  1. Computed tomography in lumbar herniated disc

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Chul Soon; Chang, Kee Hyun; Han, Man Chung [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1984-09-15

    197 spine CTs were performed from 29th , March 1982 to 7th March, 1984. Among them, 39 patients preoperatively diagnosed as herniated nucleus pulposus or bulging disc with CT and myelography were operated. 43 disc spaces of disc disease are analysed in true positive and false negative cases. Finally the accuracy, sensitivity and specificity of spine CT and myelography are calculated. The results are as follows: 1. The CT findings of disc diseases are in order of frequency, asymmetrical obliteration of epidural fat (82%) , ventral indentation or compression on dural sac (72%), focal protrusion of disc (64%), root changes - obliteration, displacement, compression, non-filling of metrizamide - (54%), diffuse disc bulging (36%), disc at body level (31%), disc calcifications (26%), disc vacuum (10%) and other associated findings - spinal stenosis, foraminal stenosis, ligament flavum thickening, facet joint hypertrophy (26%). 2. Sensitivities of spine CT and myelography are 95% and 94%, specificities are 67%, 50% and overall accuracies 93%, 87%, respectively. 3. Therefore, it is recommended that the spine CT be used as a primary diagnostic method and the myelography as a secondary complementary study when the CT gives no conclusive findings.

  2. MC+PEEK融合器在颈椎间盘突出症手术中的临床应用%Clinical application of MC+PEEK cage in cervical disc herniation

    Institute of Scientific and Technical Information of China (English)

    江兵; 刘立明; 曹燕庆; 潘宏; 金卫国; 章小军; 陶岳峰; 刘镇

    2012-01-01

    Objective To evaluate the clinical results of surgical treatment for cervical disc herniation with stand-alone MC+ PEEK cage without anterior cervical plating. Methods All of 44 patients with cervical disc herniation were reconstructed after discectomy with the cage filled with autogenous cancellous illic-bone graft. Recovery of nerve function was observed by JOA score and every patient was followed up by X-ray. Results All patients were followed up for an average time of 26 months (from 6 to 40 months). The average time of bone graft fusion was 4.5 months. No dislocation or dislodging of the cage was seen by X-ray every 3 days and 3,6,12,18,24,36 months, and the heights of intervertebral spaces were restored. The complications of internal fixation were not found. The average JOA was 10.20 before operation and 16.30 after operation. Conclusion Using this new cage, cervical disc herniation can be safely treated without the need of anterior cervical plating, and the surgery is minimally invasive and can exclude complications of internal fixation.%目的 评价一种单独使用无前方钢板的MC+PEEK融合器在颈椎间盘突出症前路手术中应用的临床效果.方法 对颈椎间盘突出症44例采用椎间盘摘除,应用该融合器内植自体髂骨行椎间融合术,以术后X线片和JOA评分评价疗效.结果 本组获随访6~40个月,平均26个月,植骨融合时间平均4.5个月,术后3d和3、6、12、18、24、36个月复查X线片未见融合器松动和移位,病变椎间隙高度恢复正常,未出现相关内固定并发症,JOA评分由术前平均10.20分恢复到术后平均16.30分.结论 采用此融合器无需使用前方钢板,手术创伤小,避免了内固定相关并发症的发生,是治疗颈椎间盘突出症的一种理想方法.

  3. Clinical and Radiological Findings of Nerve Root Herniation after Discectomy of Lumbar Disc Herniation

    OpenAIRE

    Bae, Jun Seok; Pee, Yong Hun; Jang, Jee-Soo; Lee, Sang-Ho

    2012-01-01

    The authors report 2 cases of nerve root herniation after discectomy of a large lumbar disc herniation caused by an unrecognized dural tear. Patients complained of the abrupt onset of radiating pain after lumbar discectomy. Magnetic resonance imaging showed cerebrospinal fluid signal in the disc space and nerve root displacement into the disc space. Symptoms improved after the herniated nerve root was repositioned. Clinical symptoms and suggestive radiologic image findings are important for e...

  4. Spontaneous Regression of Herniated Lumbar Disc with New Disc Protrusion in the Adjacent Level

    OpenAIRE

    Hakan, Tayfun; Gürcan, Serkan

    2016-01-01

    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 ...

  5. Intradural herniation of a thoracic disc presenting as left radicular pain and left drop foot

    Directory of Open Access Journals (Sweden)

    Takuji Matsumoto

    2015-09-01

    Full Text Available Intradural disc herniation is a rare pathological entity. Normally, it is associated with severe neurological deficits, including compression syndrome of the spinal cord or cauda equina. Intradural disc herniations comprise 0.26% to 030% of all herniated discs. Overall, 5% are found in the thoracic region, 3% in the cervical region, and 92% in the lumbar region. Although intradural disc herniation may be suspected preoperatively because of myelography, computed tomography, and magnetic resonance imaging results, establishing the diagnosis before surgery is difficult. We report a patient with thoracic intradural disc herniation at T11-12 who presented with left radicular pain and left drop foot. Preoperative magnetic resonance imaging, computed tomography, and myelography failed to demonstrate an intradural lesion. The patient underwent T11-L1 dorsal hemilaminectomy with lateral extension to the left side. The herniation was identified only intraoperatively during inspection of the thecal sac. The disc was removed surgically, and the operation was performed safely under intraoperative spinal cord monitoring. The patient had a good neurological recovery. She remains pain-free 2 years after the surgery.

  6. Spontaneous regression of lumbar herniated disc Case presentation

    Directory of Open Access Journals (Sweden)

    Chiriac A.

    2015-12-01

    Full Text Available Intervertebral disc herniation is a common disease that usually requires surgical intervention. However, in some cases, neurological symptoms may improve with conservative treatment. In this article, we present a case with spontaneous regression of extruded lumbar herniated disc correlated with clinical improvement and documented with follow up MRI studies.

  7. Chemonucleolysis of lumbar disc herniation. [Localization of lesion by CT

    Energy Technology Data Exchange (ETDEWEB)

    Braun, J.P.; Tournade, A.

    1989-04-01

    Chemonucleolysis is an advantageous alternative to surgical treatment of lumbar disc herniation. To achieve the best results the indications must be strictly observed and the procedure itself must be technically perfect. In these circumstances a rapid, non-invasive and less expensive treatment of lumbar disc herniation is possible.

  8. Percutaneous treatment of lumbar disc herniation

    Energy Technology Data Exchange (ETDEWEB)

    Leonardi, M.; Resta, F.; Bettinelli, A. [Ospedale Maggiore di Milano (Italy); Lavaroni, A.; Fabris, G. [Ospedale Civile di Udine (Italy); Abelli, F. [Fondazione Clinica del Lavorno, Pavia (Italy)

    1994-12-31

    918 patients were subjected to percutaneous treatment of lumbar herniated disc. 733 of these were treated through enzymatic nucleolysis with chymopapain, for a total 883 levels. Chemonucleolysis was carried out on 733 patients (79.8%). Automated discectomy has been carried out in 185 cases (20.1%). Chemonucleolysis has led to the resolution of the symptoms in a high percentage of cases (82.2%). Nucleotomy has proved to be an effective method in 74.6% of cases. (author). 7 refs, 6 figs, 1 tab.

  9. Clinical study of CT discography for the lumbar disc herniation

    Energy Technology Data Exchange (ETDEWEB)

    Sakamoto, Tadashi (Yamaguchi Univ., Ube (Japan). School of Medicine)

    1990-08-01

    The purpose of this clinical study was to introduce technique for correct positioning of the needle into the center of the disc for discography by means of CT analysis and also to clarify usefulness of CT discography for diagnosis of the lumbar disc herniation. We have taken CT analysis in order to determine correct place and the angle of inserting the needle. This measurement provides easy needle insertion. Unless the needle tip places center of disc, discogram false positive or negative will occur as a result. The materials of this study are 222 discs of 105 cases with the lumbar disc herniation. Comparative study of the findings among myelography, discography and CT discography was investigated. The results indicated that CT discography demonstrates the most clear findings and is useful in the diagnosis of lumbar disc herniation, especially in obtaining detailed observation of herniated discs. (author).

  10. Magnetic Resonance Imaging in the Diagnostics of Spinal Disc Herniations

    OpenAIRE

    Katsiaryna, A.; Dmitry, A.

    2015-01-01

    BACKGROUND Currently the preoperative detection of degenerative disc diseases does not always correlate with neurological symptoms and present status of a patient. This paper outlines the possibilities of using magnetic resonance imaging in evaluation of thethe grade of severity of intervertebral disc herniations. METHODS A total 20 patients of the disc herniations with age group between 20 to 81 y were diagnosed and studied on «Avanta» highfield Magnetic Resonance Imaging machine by «Siemens...

  11. Endoscopic anterior decompression in cervical disc disease

    Directory of Open Access Journals (Sweden)

    Yad Ram Yadav

    2014-01-01

    Full Text Available Background: Although microscopic anterior cervical discectomy with or without fusion are common surgical procedures for treatment of cervical herniated discs, loss of disc height, pseudarthrosis, and adjacent disc degeneration are some of the problems associated with it. This study is aimed to evaluate results of endoscopic microforaminotomy in cervical disc diseases. Materials and Methods: A prospective study of 50 patients of mono segmental soft or hard disc causing myeloradiculopathy was undertaken. A visual analogue scale (VAS for neck and arm pain and functional outcomes using the Nurick grading system were assessed. There were 28, 12, 8, and 2 patients at C5-6, C6-7, C4-5, and C3-4 levels disc diseases, respectively. Patients with two or more level disc, instabilities, disc extending more than half vertebral body height, and previous operation at the same segment were excluded. Results: Age ranged from 21 to 67 years. Average postoperative reduction in disc height, operating time, and blood loss was 1.1 mm, 110 minutes, and 30 ml, respectively. Average pre-operative VAS score for arm pain and Nurick grading was 7.6 and 2.7, which improved to 1.9 and 0.82, respectively. All patients improved; 1, 2, 3 grade improvement was seen in 10, 27, and 10 patients, respectively. There was no significant complication or any mortality. Conclusion: Although longer follow up of large number of patients is required, endoscopic microforaminotomy is a safe and an effective alternative to microscopic anterior discectomy with or without fusion.

  12. Spontaneous Regression of Herniated Lumbar Disc with New Disc Protrusion in the Adjacent Level.

    Science.gov (United States)

    Hakan, Tayfun; Gürcan, Serkan

    2016-01-01

    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. He refused the surgical intervention that was offered and was treated conservatively at that time. He had no neurological deficit and a history of spontaneous regression of the extruded lumbar disc; so, a conservative therapy, including bed rest, physical therapy, nonsteroidal anti-inflammatory drugs, and analgesics, was advised. In conclusion, herniated lumbar disc fragments may regress spontaneously. Reports are prone to advise conservative treatment for extruded or sequestrated lumbar disc herniations. However, these patients should be followed up closely; new herniation at adjacent/different level may occur. Furthermore, it is important to know which herniated disk should be removed and which should be treated conservatively, because disc herniation may cause serious complications as muscle weakness and cauda equine syndrome. PMID:27429818

  13. Spontaneous Regression of Herniated Lumbar Disc with New Disc Protrusion in the Adjacent Level

    Directory of Open Access Journals (Sweden)

    Tayfun Hakan

    2016-01-01

    Full Text Available 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. He refused the surgical intervention that was offered and was treated conservatively at that time. He had no neurological deficit and a history of spontaneous regression of the extruded lumbar disc; so, a conservative therapy, including bed rest, physical therapy, nonsteroidal anti-inflammatory drugs, and analgesics, was advised. In conclusion, herniated lumbar disc fragments may regress spontaneously. Reports are prone to advise conservative treatment for extruded or sequestrated lumbar disc herniations. However, these patients should be followed up closely; new herniation at adjacent/different level may occur. Furthermore, it is important to know which herniated disk should be removed and which should be treated conservatively, because disc herniation may cause serious complications as muscle weakness and cauda equine syndrome.

  14. Microendoscopic discectomy for treatment of lumbar disc herniation

    Institute of Scientific and Technical Information of China (English)

    ARJUN Sinkemani; WU Xiao-tao

    2015-01-01

    A lumbar microendoscopic discectomy ( MED ) is a minimally invasive surgical technique performed through a tubular device which is designed for the pain relieve caused by herniated discs pressing the nerve roots . In 1997, a new minimally invasive surgical approach for the management of symptomatic lumbar disc herniation , MED was introduced .This technique uses a tubular retractor system and a microendoscope for visualization rather than the operating microscope .However , recent literature suggests that MED is an effective microendoscopic system which has a fine long-term outcome in treating lumbar disc herniation .This article describes the operative tech-niques and outcomes reported in the literature for MED .

  15. Acupuncture with Throat Fascia Dilatation Treatment for Cervical Intervertebral Disc Herniation:Clinical Observation of 30 Cases%针刺配合颈前筋膜扩张术治疗颈椎间盘突出症30例

    Institute of Scientific and Technical Information of China (English)

    孙飞; 赵树华

    2013-01-01

    Objective: To observe the curative effect of throat fascia dilatation treatment on cervical intervertebral disc herniation. Methods;90 patients with cervical intervertebral disc hemiation were randomly divided into neck expanding group (30 cases), acupuncture group (30 cases) , acupuncture plus neck expanding group (30 cases) , use the throat fascia dilatation, conventional acupuncture therapy, conventional acupuncture plus throat fascia dilatation, to observe the analgesic effect to time, curative effect to maintain time, brachial plexus pull test, comprehensive evaluation of curative effect. Results: Analgesic effect of the acupuncture plus neck expanding group needed less time to exert function compared with other two groups, curative effect held longer time than other two groups, analgesic effect, comprehensive evaluation of curative effect were better than the other two groups, and there was a significant difference( P < 0.01). Conclusion: Curative effect of acupuncture with throat fascia dilatation treatment on cervical intervertebral disc herniation is better than the simple acupuncture and throat fascia dilatation treatment.%目的:观察针刺配合颈前筋膜扩张术治疗颈椎间盘突出症的临床疗效.方法:将90例颈椎间盘突出症患者随机分为颈扩组(30例)、针刺组(30例)、联合组(30例),分别采用颈前筋膜扩张术、常规针刺治疗、常规针刺加颈前筋膜扩张术,观察各疗法的镇痛起效时间、疗效维持时间、臂丛牵拉试验,评价综合疗效.结果:联合组镇痛起效时间短于其他两组,疗效维持时间长于其他两组,镇痛效果、综合疗效评价均优于其他两组,差异均有显著统计学意义(P<0.01).结论:针刺配合颈前筋膜扩张术治疗颈椎间盘突出症临床疗效优于单纯针刺及颈前筋膜扩张术治疗.

  16. Comparison between Two Minimally Invasive Approaches for Contained Cervical Disc Herniation%2种微创方法治疗包容型颈椎间盘突出症的比较

    Institute of Scientific and Technical Information of China (English)

    莫世奋; 李健; 曾勉东; 黄海; 吕玉明; 杨波

    2012-01-01

    Objective To compare the efficacy of percutaneous cervical discectomy (PCD) and percutaneous coblation nucleoplasty (PCNP) for contained cervical disc herniation, and their complications and influence on the stability of the cervical vertebrae. Methods From January 2006 to June 2010, 94 patients with contained cervical herniation were admitted to our hospital, of whom 53 patients received PCD, the other 41 underwent PCNP. The efficacy, complications, and postoperative stability of the cervical vertebrae of the two procedures were compared. Results The mean follow-up time of the PCD group was 13 months (ranged from 5 to 21 months) and that of the PCNP group was 11 months (ranged from 7 to 15 months). The excellent and good rate at one week, six months and one year postoperation were 83.0% and 80.5% (x2 =0.010, P =0.944) , 81. 1% and 78.0% (x2 = 0. 136, P =0.712) , and 78.4% and 74. 4% (x2 = 0. 205, P=0.651) respectively in the PCD and PCNP groups, by modified MacNab criterion. During the follow-up, 3 patients (5. 7% ) in the PCD group and 2 patients (4. 9% ) in the PCNP group were converted to anterior cervical discectomy and fusion ( ACDF) because of recurrent disc herniation. No patients had discitis or abscess formation after the surgery. The preoperative, and 1-week, half-year, and 1-year postoperative intervertebral height (IVH) were (7.14±0.84) mm, (7.12±0.93) mm, (7.09±0.78) mm, and (7.11±0.82) mm in the PCD group, respectively, which were not significantly different from those of the PCNP group [ (7.32 ±0.95) mm, (7.23 ±0.87) mm, (7.21 ±0.81) mm, and (7.22 ± 0.91) mm, P>0.05]. No signs suggested unstable cervical vertebrae after the surgery. Conclusions Both PCD and PCNP can relieve the symptoms of contained cervical disc herniation quickly with a low rate of compilation and little change of IVH postoperation, without influencing cervical stability. They are safe and effective approaches for percutaneous disc decompression.%目的 比较经皮

  17. Clinical observation experience of radio frequency target ozone ablation treatment on cervical disc herniation%射频靶点臭氧消融术治疗颈椎间盘突出症临床观察体会

    Institute of Scientific and Technical Information of China (English)

    李靖; 吴成富; 余四海

    2014-01-01

    目的:探讨颈椎间盘突出症采取射频热凝靶点消融术联合臭氧进行治疗的细节及临床疗效。方法:2007年5月-2013年5月收治颈椎间盘突出症患者210例,回顾性分析经射频热凝靶点消融术复合臭氧的临床情况。患者在C臂机引导下,经颈前行颈椎间隙穿刺至靶点,感觉运动测试后,采用神经射频仪对靶点加热热凝,在70℃、80℃、86℃、90℃连续治疗4个周期,每周期60 s,最高温度点300 s。每个椎间盘给予45~50μg/mL 臭氧3 mL,对疗效、并发症进行观察分析。结果:本组经1年随访,优180例,良13例,可13例,差4例,优良率91.9%,术后吞咽疼痛30例,血肿2例,无脊髓损伤及椎间隙感染等并发症。结论:C臂引导下经颈前路穿刺射频热凝靶点热凝联合臭氧注射治疗颈椎间盘突出症是有效、安全的微创治疗,具有操作简单、效果好、并发症少等优点。%Objective:To explore the details and clinical curative effect of radio frequency thermosetting target ablation combined with ozone in the treatment of cervical disc herniation.Methods:210 patients with cervical disc herniation were selected from May 2007 to May 2013.The clinical circumstance of radio frequency thermosetting target ablation combined with ozone was retrospectively analyzed.Patients were guided under the C arm machine with cervical vertebra puncture to target through anterior portion,after sensorimotor tests,using nerve radiofrequency device on targets heating thermal coagulation,continuous treatment for 4 cycles at 70 ℃,80 ℃,86 ℃,90 ℃,60 s per cycle,and the highest temperature point was 300 s.Each disc was given 45 to 50 μg/mL ozone 3 mL.The effects and complications were observed and analyzed.Results:The group after 1 year of follow-up,180 cases were excellent;13 cases were good;13 cases were ok;4 cases were poor;the excellent and good rate was 91.9%.30 cases were swallowing pain

  18. Sacral perineural cyst accompanying disc herniation.

    Science.gov (United States)

    Ju, Chang Il; Shin, Ho; Kim, Seok Won; Kim, Hyeun Sung

    2009-03-01

    Although most of sacral perineural cysts are asymptomatic, some may produce symptoms. Specific radicular pain may be due to distortion, compression, or stretching of nerve root by a space occupying cyst. We report a rare case of S1 radiculopathy caused by sacral perineural cyst accompanying disc herniation. The patient underwent a microscopic discectomy at L5-S1 level. However, the patient's symptoms did not improved. The hypesthesia persisted, as did the right leg pain. Cyst-subarachnoid shunt was set to decompress nerve root and to equalize the cerebrospinal fluid pressure between the cephalad thecal sac and cyst. Immediately after surgery, the patient had no leg pain. After 6 months, the patient still remained free of leg pain. PMID:19352483

  19. A radiological study on lumbar disc herniation in Korean

    International Nuclear Information System (INIS)

    Among the patients operated because of lumbar disc herniation from January 1973 to May 1979 at Korea University Hospital, 154 cases were analyzed radiologically and the following conclusions were obtained. 1. The ratio of male to female was 1.96 : 1. 2. The incidences of single and multiple involvement were 74.7% and 25.3%. 3. Most frequent level of lumbar disc herniation was L4-5 interspace. 4. The incidences of left, central and bilateral defects were 45.45%, 33.76%, 12.33% and 8.44% respectively. 5. The incidences of spina bifida and transitional vertebra were 24.04% and 9.09% respectively. 6. The overall mean of the lumbosacral angle was 33.97 .deg. 7. The overall mean depth of the lumbar lordosis was 8.48 mm. 8. The ratio of the height of L4-5 interspace to the shorter anteroposterior diameter of L-5 body was obtained by authors' idea. The mean ratios of male and female patients of L4-5 disc herniation which had no evidence of the narrowing of L4-5 interspace on simple radiologic finding were 0.3042 and 0.3064 respectively. So the ratio had a little value in the diagnosis of L4-5 disc herniation on simple radiologic study. 9. Myelography had high diagnostic accuracy, and the majority of the pseudonegative finding on lumbar disc herniation myelographically was seen at L4-5 disc herniation.

  20. 儿童颈椎间盘钙化伴髓核疝(附八例报告)%Calcification of Intervertebral Discs in Cervical Spine With Herniation of Nucleus Pulposus in Children

    Institute of Scientific and Technical Information of China (English)

    王舒; 吴秀芬; 朱葆伦; 周坤祥

    1991-01-01

    儿童椎间盘钙化是一种具有较明确的临床症状及X线表现的综合征.病程经过良好,钙化可自然吸收.钙化可见于脊柱任何水平,但好发于颈部.作者报道8例儿童颈椎间盘钙化,6例伴有髓核前疝.结合文献报道,对本病的症状、X线表现等进行讨论.%Eight cases with calcification of intervertebral discs in cervical spine are reported.Among them,six had anterior herniation of the nucleus pulposus.Symptoms disappeared within one to four weeks after cervical traction.The calcification was gradually absorbed,but the adjacent vertebral alterations were still in existence on X-ray film one year later.The etiology,clinical.manifestations and X-ray findings are briefly discussed.

  1. Artificial Cervical Disc Replacement Improves Mobility

    Medline Plus

    Full Text Available ... a total disc replacement arthroplasty on a young patient who has a herniated disc in her neck. ... way in, it’s, you know, I find that patients have very little pain after surgery. And just ...

  2. Surface image of herniated disc on three-dimensional CT

    International Nuclear Information System (INIS)

    To evaluate surface configuration of herniated disc on three-dimensional CT. Three dimensional surface images reconstructed from CT scans(1 mm thick) of 24 surgically confirmed herniated discs in 23 patients were reviewed. Disc surface was classified into peripheral and central zones in contact with consecutive peripheral ring and central endplate. Surface irregularity was categorized into two types(local and general). The incidence, size, and extent of local irregularity were observed. General irregularity incidence and severity ranges in 4 grades, and peripheral width were evaluated. The findings were correlated with discography. Local irregularity compatible with anulus tear in discography was shown in all. It was large(13/24) and mainly peripheral tract extending to disc margin in protrusion(3/5) and sequestration(5/7), and cleft encompassing central zone to disc margin in extrusion(9/12). General irregularity was predominantly grade 3(15/22) and was shown in all except in 2 protrusions. Peripheral width was 0.56 of central radius. Extrusion in herniated disc shows characteristic cleft encompassing central zone to disc margin whereas sequestration or protrusion displays tract extending from peripheral zone to disc margin. Thus, three dimensional surface imaging may aid the diagnosis, follow-up, prediction, and treatment of herniated disc

  3. Surface image of herniated disc on three-dimensional CT

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Kyung Il; Jeon, Chang Hoon; Kim, Sun Yong; Kim, Ok Hwa; Suh, Jung Ho [Ajou Univ. College of Medicine, Suwon(Korea, Republic of)

    1996-03-01

    To evaluate surface configuration of herniated disc on three-dimensional CT. Three dimensional surface images reconstructed from CT scans(1 mm thick) of 24 surgically confirmed herniated discs in 23 patients were reviewed. Disc surface was classified into peripheral and central zones in contact with consecutive peripheral ring and central endplate. Surface irregularity was categorized into two types(local and general). The incidence, size, and extent of local irregularity were observed. General irregularity incidence and severity ranges in 4 grades, and peripheral width were evaluated. The findings were correlated with discography. Local irregularity compatible with anulus tear in discography was shown in all. It was large(13/24) and mainly peripheral tract extending to disc margin in protrusion(3/5) and sequestration(5/7), and cleft encompassing central zone to disc margin in extrusion(9/12). General irregularity was predominantly grade 3(15/22) and was shown in all except in 2 protrusions. Peripheral width was 0.56 of central radius. Extrusion in herniated disc shows characteristic cleft encompassing central zone to disc margin whereas sequestration or protrusion displays tract extending from peripheral zone to disc margin. Thus, three dimensional surface imaging may aid the diagnosis, follow-up, prediction, and treatment of herniated disc.

  4. Clinical report in treating cervical disc herniation by nucleoplasty of percutaneous radiofrequency abrasion%多靶点射频消融术治疗颈椎间盘突出症临床疗效分析

    Institute of Scientific and Technical Information of China (English)

    卫秀洋; 陈勇忠; 周清碧; 王金星; 陈庆泉

    2013-01-01

    目的 探讨射频消融髓核成形术治疗颈椎间盘突出症的临床疗效.方法 回顾2009 年10月~2010年10月福州总医院476医院应用经皮穿刺多靶点射频消融髓核成形术治疗颈椎间盘突出症168 例.按Macnab 疗效评定标准和视觉模拟评分法(VAS),对比患者手术前后及随访时进行疗效评定.结果 按Macnab 疗效评分标准,术后即刻优76例,良64例,可22例,差6例,优良率为83.33%.本组术前VAS评分为(6.76±0.52)分,术后即刻为(2.15±0.58)分,术后3个月为(2.68±0.56)分,术后1年为(2.95±0.63)分,术后即刻、术后3个月、术后1年评分与术前比较差异有高度统计学意义(P < 0.01).结论 射频消融髓核成形术治疗颈椎病具有操作简单、安全微创、并发症少、起效快及近、中期疗效满意等特点,是治疗轻度颈椎间盘突出症较好的方法.%Objective To observe therapeutic effect of radiofrequency ablation nucleoplasty on cervical disc herniation. Methods From October 2009 to October 2010, 168 patient with cervical disc herniation were analyzed NO.476 Hospital of PLA, who were treated by percutaneous multi-target radiofrequency ablation nucleoplasty treatment. Therapeutic effects were evaluated before and after surgery, 3 month and 12 month by using the average scores of VAS and Mac-nab evaluation standard. Results All cases were followed-up from immediate postoperative to 12 months after operation. According to Macnab efficacy score, the immediate postoperative period were excellent in 76 cases, good in 64 cases, maybe 22 cases and poor in 6 cases, the total good rate of 83.33%. The preoperative VAS score was (6.76±0.52) scores, immediately after was (2.15 ±0.58) scores, 3 months after surgery was (2.68 ±0.56) scores, after an annual was (2.95±0.63) scores. There were significant difference between preoperative surgery and intraoperative immediately after surgery, 3 months after surgery, 1 year after surgery (P < 0

  5. Cervical Disc Disease: Biomechanical Aspects

    OpenAIRE

    Kolstad, Frode

    2011-01-01

    Degenerative disc disease in the cervical spine may cause significant pain and disability. Patients present themselves with neck pain, radiculopathy, and/or myelopathy. When the symptoms do not improve with conservative treatment, surgical treatment is considered. The goal of surgical treatment is to decompress nervous structures and to restore the normal anatomical conditions of disc height, alignment, and stability.The present thesis concerns four studies involving the treatment of cervical...

  6. The Specific Sagittal Magnetic Resonance Imaging of Intradural Extra-Arachnoid Lumbar Disc Herniation

    OpenAIRE

    Tatsuro Sasaji; Kiyoshi Horaguchi; Noboru Yamada; Kazuo Iwai

    2012-01-01

    Intradural extra-arachnoid lumbar disc herniation is a rare disease. Few MRI findings have been reported. We experienced an intradural extra-arachnoid lumbar disc herniation. We reviewed the preoperative MRI findings. Lumbar spine T2-weighted sagittal MRI showed that one line of the ventral dura was divided into two by a disc herniation. We speculated that the two lines comprised the dura and arachnoid and that a disc herniation existed between them. We believe that division of the ventral du...

  7. Spinal Nerve Root Swelling Mimicking Intervertebral Disc Herniation in Magnetic Resonance Imaging -A Case Report-

    OpenAIRE

    Kim, Yu Yil; Lee, Jun Hak; Kwon, Young Eun; Gim, Tae Jun

    2010-01-01

    A herniated intervertebral disc is the most common type of soft tissue mass lesion within the lumbar spinal canal. Magnetic resonance imaging (MRI) is a useful tool for the assessment of patients with lower back pain and radiating pain, especially intervertebral disc herniation. MRI findings of intervertebral disc herniation are typical. However, from time to time, despite an apparently classic history and typical MRI findings suggestive of disc herniation, surgical exploration fails to revea...

  8. Is that lumbar disc symptomatic? Herniated lumbar disc associated with contralateral radiculopathy

    Science.gov (United States)

    Abdul Jalil, Muhammad Fahmi; Lam, Miu Fei; Wang, Yi Yuen

    2014-01-01

    Herniated lumbar disc may be asymptomatic or associated with lower limb radiculopathy. Most spinal surgeons would offer surgery following a period of conservative measures if the radiological and clinical findings correlate. However, the existing dictum that lumbar radiculopathy should correlate with ipsilateral lumbar disc herniation may not be accurate as it can rarely present with contralateral sciatica. Literature regarding this phenomenon is scarce. Therefore, we report a patient with herniated lumbar disc presenting with predominantly contralateral motor weakness radiculopathy, which resolved after discectomy. PMID:24811105

  9. Treatment of lumbar disc herniation: Evidence-based practice

    Directory of Open Access Journals (Sweden)

    Andrew J Schoenfeld

    2010-07-01

    Full Text Available Andrew J Schoenfeld1, Bradley K Weiner21Department of Orthopedic Surgery, William Beaumont Army Medical Center, Texas Tech University Health Sciences Center, El Paso, TX, USA; 2Weill Cornell Medical College and The Methodist Hospital, Houston, TX, USAClinical question: What is the best treatment for lumbar disc herniations? Results: For patients failing six weeks of conservative care, the current literature supports surgical intervention or prolonged conservative management as appropriate treatment options for lumbar radiculopathy in the setting of disc herniation. Surgical intervention may result in more rapid relief of symptoms and restoration of function.Implementation: While surgery appears to provide more rapid relief, many patients will gradually get better with continued nonoperative management; thus, patient education and active participation in decision-making is vital.Keywords: lumbar disc, herniation, back pain, spine

  10. Posterior transdural discectomy : a new approach for the removal of a central thoracic disc herniation

    NARCIS (Netherlands)

    Coppes, Maarten H; Bakker, Nicolaas A; Metzemaekers, Jan D M; Groen, Rob J M

    2012-01-01

    BACKGROUND: The optimal surgical approach for thoracic disc herniation remains a matter of debate, especially for central disc herniation. In this paper, we present a new technique to remove central thoracic disc herniation, the posterior transdural approach, and report a series of 13 cases operated

  11. A radiological study on lumbar disc herniation in Korean

    Energy Technology Data Exchange (ETDEWEB)

    Seol, Hae Young; Park, In Sik; Suh, Won Hyuk; Lee, Min Jae [Korea University College of Medicine, Seoul (Korea, Republic of)

    1979-12-15

    Among the patients operated because of lumbar disc herniation from January 1973 to May 1979 at Korea University Hospital, 154 cases were analyzed radiologically and the following conclusions were obtained. 1. The ratio of male to female was 1.96 : 1. 2. The incidences of single and multiple involvement were 74.7% and 25.3%. 3. Most frequent level of lumbar disc herniation was L4-5 interspace. 4. The incidences of left, central and bilateral defects were 45.45%, 33.76%, 12.33% and 8.44% respectively. 5. The incidences of spina bifida and transitional vertebra were 24.04% and 9.09% respectively. 6. The overall mean of the lumbosacral angle was 33.97 .deg. 7. The overall mean depth of the lumbar lordosis was 8.48 mm. 8. The ratio of the height of L4-5 interspace to the shorter anteroposterior diameter of L-5 body was obtained by authors' idea. The mean ratios of male and female patients of L4-5 disc herniation which had no evidence of the narrowing of L4-5 interspace on simple radiologic finding were 0.3042 and 0.3064 respectively. So the ratio had a little value in the diagnosis of L4-5 disc herniation on simple radiologic study. 9. Myelography had high diagnostic accuracy, and the majority of the pseudonegative finding on lumbar disc herniation myelographically was seen at L4-5 disc herniation.

  12. [Relationship between lumbosacral multifidus muscle and lumbar disc herniation].

    Science.gov (United States)

    Chen, Wei-ye; Wang, Kuan; Yuan, Wei-an; Zhan, Hong-sheng

    2016-06-01

    As a common disease in clinical, the treatment of lumbar disc herniation (LDH) focused on local intervertebral disc, such as surgery and other interventional therapy treatment, but postoperative complications and recurrence rate has been a difficult problem in the field of profession. With the development of spine biomechanics and anatomy, researches on lumbar herniation also increased. Researchers discovered that the incidence and prognosis of LDH were inseparable with local muscle and soft tissue. As the deep paraspinal muscles, multifidus muscle plays an important role to make lumbar stability. Its abnormal function could reduce the stable of lumbar spine, and the chronic lumbar disease could also lead to multifidus muscle atrophy. PMID:27534095

  13. Reoperations Following Cervical Disc Replacement

    OpenAIRE

    Skovrlj, Branko; Lee, Dong-Ho; Caridi, John Michael; Cho, Samuel Kang-Wook

    2015-01-01

    Cervical disc replacement (CDR) has emerged as an alternative surgical option to cervical arthrodesis. With increasing numbers of patients and longer follow-ups, complications related to the device and/or aging spine are growing, leaving us with a new challenge in the management and surgical revision of CDR. The purpose of this study is to review the current literature regarding reoperations following CDR and to discuss about the approaches and solutions for the current and future potential c...

  14. Herniated intervertebral disc associated with a lumbar spine dislocation as a cause of Cauda Equina syndrome: a case report

    OpenAIRE

    Kreichati, Gaby E.; Kassab, Farid N.; Kharrat, Khalil E.

    2006-01-01

    To report a case of Cauda Equina syndrome with the completion of the paralysis after the reduction of a L4L5 dislocation due to a herniated disc. Although several articles have described a post-traumatic disc herniation in the cervical spinal canal, this is not well known in the lumbar region. A 30-year-old man was admitted to the emergency room with blunt trauma to the chest and abdomen with multiple contusions plus a dislocation of L4-L5 with an incomplete neurological injury. After an emer...

  15. Is that lumbar disc symptomatic? Herniated lumbar disc associated with contralateral radiculopathy

    OpenAIRE

    Abdul Jalil, Muhammad Fahmi; Lam, Miu Fei; Wang, Yi Yuen

    2014-01-01

    Herniated lumbar disc may be asymptomatic or associated with lower limb radiculopathy. Most spinal surgeons would offer surgery following a period of conservative measures if the radiological and clinical findings correlate. However, the existing dictum that lumbar radiculopathy should correlate with ipsilateral lumbar disc herniation may not be accurate as it can rarely present with contralateral sciatica. Literature regarding this phenomenon is scarce. Therefore, we report a patient with he...

  16. Treatment of lumbar disc herniation by percutaneous laser disc decompression (PLDD) and modified PLDD

    Science.gov (United States)

    Chi, Xiao fei; Li, Hong zhi; Wu, Ru zhou; Sui, Yun xian

    2005-07-01

    Objective: To study the micro-invasive operative method and to compare the effect of treatment of PLDD and modified PLDD for Lumbar Disc Herniation. Method: Vaporized part of the nucleus pulposus in single or multiple point after acupuncture into lumbar disc, to reach the purpose of the decompression of the lumbar disc. Result: Among the 19 cases of the regular PLDD group, the excellent and good rate was 63.2%, and among the 40 cases of the modified PLDD group, the excellent and good rate was 82.5%. Conclusion: The modified PLDD has good effect on the treatment for lumbar disc herniation.

  17. Artificial Cervical Disc Replacement Improves Mobility

    Medline Plus

    Full Text Available ... the way to do this in the near future of the state of the art. What are ... the-art of treating disc herniations in the future. Thank you. Thank you for watching this “OR ...

  18. Gd-DTPA-enhanced MR in thoracic disc herniations

    Energy Technology Data Exchange (ETDEWEB)

    Parizel, P.M.; Rodesch, G.; Baleriaux, D.; Segebarth, C.; Zegers de Beyl, D.; Haens, J. d' ; Noterman, J.

    1989-03-01

    The Gd-DTPA-enhanced magnetic resonance findings in two patients with herniated thoracic intervertebral discs are reported. The first patient was a 56-year-old woman with a small subligamentous T6-7 disc herniation, slightly lateralized to the right. The second patient was a 51-year-old man with a central and right posterolateral disc herniation, including a large calcified fragment, at the T8-9 level. The nonenhanced MR examination revealed the presence of an extradural mass lesion in both patients, impinging upon the dural sac and compressing and displacing the spinal cord posteriorly. The lesion was slightly hypointense on both T1- and T2-weighted spin echo sequences. Following intravenous injection of Gd-DTPA in a dosage of 0.1 mmol/kg body weight, enhancement of the posterior longitudinal ligament was noted and triangular areas of contrast uptake were seen to occur in the epidural space above and below the herniated disc. At surgery, they were found to correspond to dilated and congested epidural veins.

  19. Síndrome de Brown-Séquard por hérnia discal cervical a duplo nível: caso clínico e revisão da literatura Síndrome de Brown-Séquard por hernia discal cervical en nivel doble: caso clínico y revisión de la literatura Brown-Séquard syndrome by double level cervical disc herniation: case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Jorge Miguel Silva Ribeiro Olliveira Alves

    2012-09-01

    paciente con síndrome de Brown-Séquard por hernia de disco cervical.This article presents a case in which Brown-Séquard syndrome resulted from a double level cervical disc herniation. A 40-year-old man without previous history of cervical pathology, presented with insidious right arm and leg paresis associated with associated with decreased pain and thermal sensitivity in the left hemibody after diving which caused indirect trauma of the cervical spine. Magnetic resonance imaging of the cervical spine showed double level disc herniation in C4-C5 and C5-6 with compression of the right half of spinal cord and hyperintensity in T2-weighted images. After a complete decompression of neural structures, a double level interbody fusion was performed. There was partial recovery of neurological status after a long period of physical therapy. Early surgical intervention and prompt rehabilitation are paramount to achieve neurological recovery in patients with Brown-Séquard syndrome resulting from a cervical disc herniation.

  20. CT discography for cervical soft disc hernia

    International Nuclear Information System (INIS)

    In this study the effectiveness of computed tomographic discography (CTD) in diagnosing cervical soft disc hernia was evaluated. Twenty-five interververtebral discs of 15 cases with cervical soft disc hernia were examined with a discography and then a CT scan. Results of the CT scan were as follows: three discs were protruded, 12 discs were prolapsed, 6 discs were extruded, and 4 discs were sequestrated. The findings were helpful in determining the location of soft disc hernians between the median and posterolateral discs. They were also valuable in classifying types of hernians and surgical aproaches. (author)

  1. Diagnosis of cervical disc disease

    International Nuclear Information System (INIS)

    High resolution CT easily localized lesions including soft tissues of the bone such as disc protrusion and thickening of the yellow ligament. In all cases, myelography demonstrated compression of the nerve roots of the spinal cord which corresponded to CT findings at the level where plain CT revealed a lesion. However, CT metrizamide myelography demonstrated the lesion more clearly than did conventional myelography. CT metrizamide myelography also outlined compression of the nerve roots satisfactorily and demonstrated compressed findings of the spinal cord in the dynamic study. Thus, high resolution CT was useful for screening of cervical disc disease, and CT metrizamide myelography, for identification of lesions of the nerve roots. (Chiba, N.)

  2. ASSOCIATION OF SPINOPELVIC PARAMETERS WITH THE LOCATION OF LUMBAR DISC HERNIATION

    Directory of Open Access Journals (Sweden)

    Jefferson Coelho de Léo

    2015-09-01

    Full Text Available Objective:To associate spinopelvic parameters, pelvic incidence, sacral slope, pelvic tilt and lumbar lordosis with the axial location of lumbar disc herniation.Methods:Retrospective study, which evaluated imaging and medical records of 61 patients with lumbar disc herniation, who underwent surgery with decompression and instrumented lumbar fusion in only one level. Pelvic incidence, sacral slope, pelvic tilt and lumbar lordosis with simple lumbopelvic lateral radiographs, which included the lumbar spine, the sacrum and the proximal femur. The affected segment was identified as the level and location of lumbar disc herniation in the axial plane with MRI scans.Results:Of 61 patients, 29 (47.5% had low lumbar lordosis; in this group 24 (82.8% had central disc herniation, 4 (13.8% had lateral recess disc herniation and 1 (3.4% had extraforaminal disc herniation (p<0.05. Of the 61 patients, 18 (29.5% had low sacral slope; of this group 15 (83.3% had central disc herniation and 3 (16.7% had disc herniation in lateral recess (p<0.05.Conclusions:There is a trend towards greater load distribution in the anterior region of the spine when the spine has hypolordotic curve. This study found an association between low lordosis and central disc herniation, as well as low sacral slope and central disc herniation.

  3. Enhanced MRI in lumbar disc herniation. Study on the types of herniation and histological findings

    Energy Technology Data Exchange (ETDEWEB)

    Koh, Sadao; Okamura, Yuji; Honda, Eiichiro; Takazawa, Shunji [Misato Junshin Hospital, Saitama (Japan); Ohno, Ryuichi; Yasuma, Tsuguo

    1999-06-01

    In the cases which had surgery after enhanced MRI, prolapsed form of hernia and the usefulness of enhanced MRI were examined. The patients were 13 males (14 intervertebral discs) and 5 females (6 intervertebral discs) with lumber disc herniation. The lumber disc herniation was classified into 3 types reference to Macnab's classification; SE (protrusion and subligamentous extrusion), TE (transligamentous extrusion) and SEQ (sequestration). Prolapsed forms were identified in 20 intervertebral discs. Enhanced MRI showed positive in 9 intervertebral discs (SE 1, TE 4 and SEQ 4) and showed negative in 11 discs (SE 10 and TE 1). As for the period from development to enhanced MRI, the significant difference wasn't recognized between positive group and negative group. The diagnostic rate of enhanced MRI was 88.9% (8/9) in sensitivity, 90.9% (10/11) in specificity and 90.0% (18/20) in accuracy. In enhanced MRI, engorged epidural venous plexus was also imaged, and minute change as only annular tear couldn't be detected. Looking from 2 directions crossing at right angles, the effect of contrast enhancement should be judged. (K.H.)

  4. Enhanced MRI in lumbar disc herniation. Study on the types of herniation and histological findings

    International Nuclear Information System (INIS)

    In the cases which had surgery after enhanced MRI, prolapsed form of hernia and the usefulness of enhanced MRI were examined. The patients were 13 males (14 intervertebral discs) and 5 females (6 intervertebral discs) with lumber disc herniation. The lumber disc herniation was classified into 3 types reference to Macnab's classification; SE (protrusion and subligamentous extrusion), TE (transligamentous extrusion) and SEQ (sequestration). Prolapsed forms were identified in 20 intervertebral discs. Enhanced MRI showed positive in 9 intervertebral discs (SE 1, TE 4 and SEQ 4) and showed negative in 11 discs (SE 10 and TE 1). As for the period from development to enhanced MRI, the significant difference wasn't recognized between positive group and negative group. The diagnostic rate of enhanced MRI was 88.9% (8/9) in sensitivity, 90.9% (10/11) in specificity and 90.0% (18/20) in accuracy. In enhanced MRI, engorged epidural venous plexus was also imaged, and minute change as only annular tear couldn't be detected. Looking from 2 directions crossing at right angles, the effect of contrast enhancement should be judged. (K.H.)

  5. MRI findings in posterior disc prolapse associated with cervical fracture dislocation

    Energy Technology Data Exchange (ETDEWEB)

    Maeda, Go; Shiba, Keiichiro; Ueta, Takayoshi; Shirasawa, Kenzo; Ohta, Hideki; Mori, Eiji; Rikimaru, Shunichi; Hida, Shinichi; Tokunaga, Masami (Spinal Injuries Center, Fukuoka (Japan))

    1994-03-01

    Although disc injury is common in cervical spinal fractures the mechanism of disc herniation in cervical fracture dislocations is not known. This study evaluated the pathogenesis of disc hernia in cervical fracture dislocations. Twenty-two patients who underwent anterior and posterior spinal fixation were studied. Findings of preoperative magnetic resonance imaging (MRI) were compared with surgical findings. During surgery, cervical disk hernia were found in six patients (27 %), and the MRI finding of these patients were evaluated in detail. We concluded that the characteristic MRI findings of cervical disc hernia are as follows: (1) discontinuity of injured disc, (2) anterior indentation of spinal cord at the site of dislocated vertebral body, and (3) signal irregularity at the site of interspace between dislocated vertebral body and spinal cord. (author).

  6. MRI findings in posterior disc prolapse associated with cervical fracture dislocation

    International Nuclear Information System (INIS)

    Although disc injury is common in cervical spinal fractures the mechanism of disc herniation in cervical fracture dislocations is not known. This study evaluated the pathogenesis of disc hernia in cervical fracture dislocations. Twenty-two patients who underwent anterior and posterior spinal fixation were studied. Findings of preoperative magnetic resonance imaging (MRI) were compared with surgical findings. During surgery, cervical disk hernia were found in six patients (27 %), and the MRI finding of these patients were evaluated in detail. We concluded that the characteristic MRI findings of cervical disc hernia are as follows: 1) discontinuity of injured disc, 2) anterior indentation of spinal cord at the site of dislocated vertebral body, and 3) signal irregularity at the site of interspace between dislocated vertebral body and spinal cord. (author)

  7. Diagnostic Characteristics of Neuroradiological Tests in Lumbar Disc Herniation

    Directory of Open Access Journals (Sweden)

    Harun Brkic

    2011-07-01

    Full Text Available Background: Many apparent advantages of the magnetic resonance imaging (MRI in establishing diagnosis of lumbar disc herniation are counter parted by its relatively high cost and sparse availability in developing countries. Thus, a significant portion of patients are still subjected to lumbar disc surgery based solely on computed tomography (CT findings. Aim: The aim of this study was to compare diagnostic characteristics of afore mentioned radiological tests (CT and MRI and to investigate if the choice of diagnostic test influences outcome of discectomy. Methods: Basic demographic, clinical and radiological variables were evaluated in a group of 70 patients operated on for disc herniation of whom 30 were operated based on MRI findings and the remainder were operated based on CT scan alone. Outcome was assessed using Visual Analogue Scale (VAS and Roland-Morris (RM scale 6 months postoperatively and correlated to the type of neuroradiological examination. Basic diagnostic characteristic of the two diagnostic modalities (MR and CT were compared. Results: The type of radiological investigation was shown to be statistically poor predictor of outcome after microdiscectomy. Even though MR scan was more sensitive in detecting disc extrusion than CT (sensitivity of 100% versus 65%, respectively, the presence of preoperative MR scan did not influence the outcome. Conclusion: We conclude that although the presence of preoperative MR scan does not influence outcome, higher sensitivity and specificity in detecting disc extrusions and superior ability to detect nerve root compression warrant an introduction of MR scan prior to any disc surgery.

  8. 'Hard discs' associated with lumbar disc herniation: CT analysis

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Il Kwon; Bang, Dae Hong; Yim, Jung Ik; Lee, Jae Mun; Bahk, Yong Whee [Catholic University Medical College, Seoul (Korea, Republic of)

    1989-02-15

    Thirty cases showing hard discs were collected from 206 consecutive cases of posterior disk herniation during the past one and a half years period. According to the shape of hard disk and the presence of marginal bone defect (MBD) of vertebral end plate, 30 cases could be categorized into 4 distinct groups. They were small hard disc with focal MBD (group 1), large hard disc with broad based MBD (group 2), hard disc separated from vertebral body without MBD (group 3) and hard disc fused with vertebral body without MBD (group 4). There were 14 patients in group 1. In all but one case, the hard disc and MBDs were located at the paramedial aspect of the posterior margin of the end plate. Ten (76.9%) of these had Schmorl's nodes and these were considered to represented an avulsion from the weakened bone margin as the disk herniated acutely. The posterior longitudinal ligament seemed to have prevented detachment of the bony fragment. Group 2 included 2 patients and CT findings as well as plain X-ray features were identical to a limbus vertebra. This was considered to represent passive displacement of bony fragment by the intravertebral herniation of the disk. Nine patients belonged to group 3 and represent dystrophic calcifications of herniated disk. Group 4 included 5 patients and was disclosed as a simple osteophyte. From our study, it was concluded; (1) that the hard disc seen in lumbar CT scan was probably the results of the detachment of a bone fragment from the vertebral end plate which has an underlying weak area due to the herniated disc as well as a calcification or osteophyte formation and (2) specific terms (avulsed fragment, limbus vertebra, calcification or spur formation) is more preferable to use than hard disc which is inaccurate.

  9. Changes in disc herniation after CT-guided Percutaneous Laser Disc Decompression (PLDD): MR findings

    Science.gov (United States)

    Brat, Hugues G.; Bouziane, Tarik; Lambert, Jean; Divano, Luisa

    2004-09-01

    The aim of Percutaneous Laser Disc Decompression (PLDD) is to vaporize a small portion of the nucleus pulposus. Clinical efficacy of this technique is largely proven. However, time-evolution of intervertebral disc and its hernia after PLDD is not known. This study analyses changes in disc herniation and its native intervertebral disc at a mean follow-up of 7.5 months after PLDD in asymptomatic patients. Main observations at MRI are appearance of a high signal on T2WI in the hernia in 59%, shrinking of the hernia in 66% and overall stability of disc height.

  10. CT-guided steroid injection into disc herniation: a causative therapy for lower back pain due to disc herniation

    International Nuclear Information System (INIS)

    Purpose: to evaluate the therapeutic benefit of CT-guided steroid injection into disc herniations. Materials and methods: in 64 patients, 2.5 mg Dexamethasone was injected into a symptomatic disc herniation under CT-guidance. Conservative treatment 3 to 12 months before injection was unsuccessful. Classified as ''complete relief'', ''strong relief'', ''mild relief'' and ''no relief'' of pain, the change of discomfort and pain was registered at 14 days, 3 months and 6 months after injection while the conservative regimen continued. Results: at 14 days after injection, 36 patients (56%) showed complete relief, 5 strong relief (8%), 12 mild relief (19%) and 11 no relief (17%). At 6 months after injection, 25 patients showed complete relief (39%), 16 strong relief (25%), and 23 no relief (36%). One complicating spondylodiscitis was observed. Conclusion: CT-guided steroid injection into symptomatic disc herniation represents a therapeutic alternative with good therapeutic results. It can be recommended as an alterative to other minimal invasive therapeutic regimens. The disc material acts as reservoir for the drug with good long term depot effect. (orig.)

  11. Artificial Cervical Disc Replacement Improves Mobility

    Science.gov (United States)

    Artificial Cervical Disc Replacement Improves Mobility February 18, 2009 From PinnacleHealth, Harrisburg, PA Welcome to this “OR ... this new technology with the use of an artificial disc has some significant benefits over the previous ...

  12. Automatic diagnosis of lumbar disc herniation with shape and appearance features from MRI

    Science.gov (United States)

    Alomari, Raja'S.; Corso, Jason J.; Chaudhary, Vipin; Dhillon, Gurmeet

    2010-03-01

    Intervertebral disc herniation is a major reason for lower back pain (LBP), which is the second most common neurological ailment in the United States. Automation of herniated disc diagnosis reduces the large burden on radiologists who have to diagnose hundreds of cases each day using clinical MRI. We present a method for automatic diagnosis of lumbar disc herniation using appearance and shape features. We jointly use the intensity signal for modeling the appearance of herniated disc and the active shape model for modeling the shape of herniated disc. We utilize a Gibbs distribution for classification of discs using appearance and shape features. We use 33 clinical MRI cases of the lumbar area for training and testing both appearance and shape models. We achieve over 91% accuracy in detection of herniation in a cross-validation experiment with specificity of 91% and sensitivity of 94%.

  13. The Specific Sagittal Magnetic Resonance Imaging of Intradural Extra-Arachnoid Lumbar Disc Herniation

    Directory of Open Access Journals (Sweden)

    Tatsuro Sasaji

    2012-01-01

    Full Text Available Intradural extra-arachnoid lumbar disc herniation is a rare disease. Few MRI findings have been reported. We experienced an intradural extra-arachnoid lumbar disc herniation. We reviewed the preoperative MRI findings. Lumbar spine T2-weighted sagittal MRI showed that one line of the ventral dura was divided into two by a disc herniation. We speculated that the two lines comprised the dura and arachnoid and that a disc herniation existed between them. We believe that division of the ventral dural line on T2-weighted sagittal images is a characteristic finding of intradural extra-arachnoid lumbar disc herniation. The division of ventral dural line seemed to be a “Y,” and, thus, we called it the “Y sign.” The “Y sign” may be useful for diagnosing intradural extra-arachnoid lumbar disc herniation.

  14. Treatment of lumbar disc herniation: Evidence-based practice

    OpenAIRE

    Weiner, Bradley

    2010-01-01

    Andrew J Schoenfeld1, Bradley K Weiner21Department of Orthopedic Surgery, William Beaumont Army Medical Center, Texas Tech University Health Sciences Center, El Paso, TX, USA; 2Weill Cornell Medical College and The Methodist Hospital, Houston, TX, USAClinical question: What is the best treatment for lumbar disc herniations? Results: For patients failing six weeks of conservative care, the current literature supports surgical intervention or prolonged conservative management as appropriate tre...

  15. CT scan of the spine for herniated discs

    Energy Technology Data Exchange (ETDEWEB)

    Gulati, A.N.; Weinstein, R.; Studdard, E.

    1981-10-01

    The high resolution conversion kit introduced for the EMI CT 5005 scanner has twice the spatial resolution of the usual scan mode and has proven to be quite useful in evaluation of the spinal canal. The present study was performed to determine the capability of the high resolution system to diagnose herniated lumbar disc without intrathecal contrast. HNP was diagnosed in 83% of the cases which had a positive myelogram, 70% of which had operation and all were proven positive.

  16. Artificial Cervical Disc Replacement Improves Mobility

    Medline Plus

    Full Text Available ... so much different than the fusion. The ProDisc C total disc replacement from Synthes Spine is an ... intervertebral disc in the cervical spine. The ProDisc C is indicated for patients suffering from intractable symptomatic ...

  17. The therapeutic effect of percutaneous transforaminal endoscopic discectomy through interlaminar approach for treating lumbar disc herniation

    OpenAIRE

    Wan-ru DUAN; Hu, Yue; Teng-fei QI; Qi, Meng; Feng-zeng JIAN; CHEN Zan

    2016-01-01

    Objective To evaluate the therapeutic efficacy of percutaneous transforaminal endoscopic discectomy (PTED) through interlaminar approach in the treatment of lumbar disc herniation (LDH).  Methods From October 2013 to January 2015, 54 LDH patients underwent PTED by using transforaminal endoscopic spine system (TESSYS) in our hospitial. CT or MRI indicated L4-5 disc herniation in 13 patients and L5-S1 disc herniation in other 41 patients. Visual Analogue Scale (VAS) and Oswestry Disabil...

  18. Redundant Nerve Roots of Cauda Equina Mimicking Intradural Disc Herniation: A Case Report

    OpenAIRE

    Yang, Sang Mi; Park, Hyung Ki; Cho, Sung Jin; Chang, Jae Chil

    2013-01-01

    Redundant Nerve Roots (RNRs) is an uncommon clinical condition characterized by a tortuous, serpentine, large and elongated nerve root of the cauda equina. To our knowledge, most cases of RNRs are associated with lumbar stenosis, and RNRs associated with lumbar disc herniation has not been reported until now. Here we present a rare case of unusual RNRs associated with lumbar disc herniation mimicking intradural disc herniation.

  19. Spontaneous Remission of a Big Subligamentous Extruded Disc Herniation: Case Report and Review of the Literature

    OpenAIRE

    Çitişli, Veli; İbrahimoğlu, Muhammet

    2015-01-01

    Spontaneous Regression of a Big Subligamentous Extruded Disc Herniation: Case Report And Review of The Literature The most efficient method for the treatment of lumbar disc herniation is still controversial. The most important aspect is the application of the suitable conservative or surgical treatment to the right patient at the right time. In lumbar disc herniation patients, one must not precipitate except for cases that require surgical indications as in cauda equina syndrome, evolutive mo...

  20. 臭氧联合靶点射频治疗颈椎间盘突出症手术护理模式及康复指导%Ozone combined target radiofrequency treatment of cervical intervertebral disc herniation surgery and rehabilitation nursing mode guidance

    Institute of Scientific and Technical Information of China (English)

    许玉红

    2015-01-01

    目的:探讨CT引导下臭氧联合靶点射频热凝治疗颈椎间盘突出症手术护理及康复指导模式。方法:对30例CT引导下臭氧联合靶点射频热凝治疗颈椎间盘突出症患者采用术前、术中、术后分阶段护理,并给以康复指导。结果:所有病例无任何手术相关并发症,临床康复满意。结论:手术分阶段护理和康复指导适用于臭氧联合靶点射频治疗颈椎间盘突出症手术。%Objective To explore the cT guided by ozone combined target radiofrequency thermal coagulation treatment of cervical intervertebral disc herniation surgery nursing and rehabilitation instruction mode.Methods Of 30 cases were treated by preoperative, intraoperative and postoperative nursing in stages, and rehabilitation guidance.Results All cases without any complications related to the operation and clinical recovery satisfaction.Conclusions Surgical nursing and rehabilitation instruction in stages is suitable for the joint of ozone target radiofrequency treatment of cervical intervertebral disc herniation surgery.

  1. Preliminary clinical outcomes of traumatic cervical herniation by artificial cervical disc replacement%人工椎间盘置换治疗外伤性颈椎椎间盘突出症的初期临床疗效

    Institute of Scientific and Technical Information of China (English)

    欧云生; 刘显宏; 权正学; 唐可; 罗小辑; 蒋电明; 安洪

    2011-01-01

    Objective To observe the preliminary outcomes of traumatic cervical hemiation treated by artificial cervical disc replacement (ACDR). Methods Clinical data of 8 patients with traumatic cervical hemiation undergoing ACDR from April 2007 to February 2011 were studied retrospectively. All the patients were assessed by clinical observation and radiological studies preoperatively, in 3 and 6 months postoperatively, and at the end of follow-up. Clinical outcome was evaluated using Japanese Orthopaedic Association (JOA) score, neck disabiliy index (NDI) criteria, and visual analog scale (VAS). Functional spinal unit range of motion (ROM) was also measured in the reontgenographs at anteroposterior and lateral, bending and extending positions. Results All cases were followed up for 6-36 months (mean 15 months). The JOA, NDI, VAS ( neck pain and arm pain) and cervical unit ROM were all significantly improved after operation ( P <0.05). No neurological or vascular complication was found in these 8 cases. The disc height and stability of cervical vertebra were maintained in the reontgenographs taken at the final follow-up. One case was found having artificial cervical prosthesis antedisplacement 1 mm 42 d after operation, and the distance of antedisplacement was not increased at the final follow-up. There was no subsidence, loosening, excursion, or heterotopic ossification in the other 7 patients. Conclusion As long as indication is correctly chosen, satisfactory outcomes will be achieved for traumatic cervical hemiation by ACDR.%目的 观察人工颈椎椎间盘置换术(artificial cervical disc replacement,ACDR)治疗外伤性颈椎椎间盘突出症的初期临床疗效.方法 对8例行ACDR的外伤性颈椎椎间盘突出症患者的临床资料进行随访分析.临床疗效评价包括术前、术后3个月、术后6个月及末次随访时的日本骨科学会(Japanese Orthopaedic Association,JOA)评分、颈椎功能障碍指数( neck disabiliy index,NDI)评分

  2. Percutaneous thoracic intervertebral disc nucleoplasty: technical notes from 3 patients with painful thoracic disc herniations

    NARCIS (Netherlands)

    Chua Hai Liang, N.; Gultuna, I.; Riezebos, P.; Beems, T.; Vissers, K.C.P.

    2011-01-01

    Symptomatic thoracic disc herniation is an uncommon condition and early surgical approaches were associated with significant morbidity and even mortality. We are the first to describe the technique of percutaneous thoracic nucleoplasty in three patients with severe radicular pain due to thoracic dis

  3. Fusion around cervical disc prosthesis: case report.

    NARCIS (Netherlands)

    Bartels, R.H.M.A.; Donk, R.

    2005-01-01

    OBJECTIVE AND IMPORTANCE: Cervical arthroplasty is a relatively new method to maintain motion after cervical anterior discectomy. Two cases are presented in which bony fusion occurred around a cervical disc prosthesis. CLINICAL PRESENTATION: A 30-year-old man and a 49-year-old woman underwent a righ

  4. MR imaging of herniated lumbar disc : morphologic change between supine and flexed-prone position

    Energy Technology Data Exchange (ETDEWEB)

    Seong, Jin Yong; Lee, Seung Ro; Moon, Won Jin; Park, Dong Woo; Hahm, Chang Kok [Hanyang Univ., Seoul (Korea, Republic of); Kim, Sung Tae [Sungnam Inha Hospital, Sungnam (Korea, Republic of)

    1997-12-01

    The purpose of this study is to determine morphologic change in a herniated lumbar disc, as seen on MR imaging according to position change (supine and flexed-prone positions). A hundred and twenty-two patients with herniated lumbar discs, as seen on supine MR imaging, underwent repeat MR imaging in the flexed-prone position; 100 patients, who showed more than 2 deg of flexion angle difference, were included in this study. Sixty-two were men and thirty-eight were women, and their ages ranged from 13 to 59 (mean, 30) years. Disc degeneration was graded as 1,2 or 3, depending on the area of decreased signal intensity seen on a T2-weighted MR image. Difference in the angle of flexion is defined as the angle difference of lumbar curvature, calculated by the Begg-falconer method in supine and flexed-prone positions. Morphologic changes in herniated discs in difference positions were analysed on the basis of shape change of anterior epidural spaces, thecal sacs and posterior margins of herniated discs, and classified as either A (not changed) or B (changed). Group B was subtyped as type I (decreased herniation without change of shape), type II (decreased herniation with change of shape) or type III (increased disc herniation). We statistically analysed correlations between a patient`s age, morphologic change in a herniated disc in different positions, and degree of degeneration in such a disc, as well as the correlation between morphologic change in a herniated disc in different positions and the degree of the flexion angle. In the flexed-prone position, which is similar to that used during surgery, MRI can reveal various morphologic changes in a herniated lumbar disc, mainly decreased herniation, and is helpful in making decisions related to surgery. (author). 12 refs., 2 tabs., 4 figs.

  5. Posteriorly migrated thoracic disc herniation: a case report

    Directory of Open Access Journals (Sweden)

    Miyakoshi Naohisa

    2013-02-01

    Full Text Available Abstract Introduction Posterior epidural migration of thoracic disc herniation is extremely rare but may occur in the same manner as in the lumbar spine. Case presentation A 53-year-old Japanese man experienced sudden onset of incomplete paraplegia after lifting a heavy object. Magnetic resonance imaging revealed a posterior epidural mass compressing the spinal cord at the T9-T10 level. The patient underwent emergency surgery consisting of laminectomy at T9-T10 with right medial facetectomy, removal of the mass lesion, and posterior instrumented fusion. Histological examination of the mass lesion yielded findings consistent with sequestered disc material. His symptoms resolved, and he was able to resume walking without a cane 4 weeks after surgery. Conclusions Pre-operative diagnosis of posterior epidural migration of herniated thoracic disc based on magnetic resonance imaging alone may be overlooked, given the rarity of this pathology. However, this entity should be considered among the differential diagnoses for an enhancing posterior thoracic extradural mass.

  6. Target radiofrequency combined with collagenase chemonucleolysis in the treatment of lumbar intervertebral disc herniation

    OpenAIRE

    Zhang, Daying; Yong ZHANG; Wang, Zhijian; Zhang, Xuexue; Sheng, Mulan

    2015-01-01

    Both target radiofrequency thermocoagulation and collagenase chemonucleolysis are effective micro-invasive therapy means for lumbar intervertebral disc herniation. In order to analyze the clinical effects of target radiofrequency thermocoagulation combined with collagenase chemonucleolysis on lumbar intervertebral disc herniation, the contents of hydroxyproline and glycosaminoglycan were measured and the histological changes of nucleus pulposus was detected in the vitro experiments. Radiofreq...

  7. Artificial Cervical Disc Replacement Improves Mobility

    Medline Plus

    Full Text Available ... younger patients, the patients in their 30s and 40s with disc herniations, than an older patient, let’s ... go to the recovery room, spend maybe an hour, hour and 15 minutes in recovery room and ...

  8. The Course of Pain Intensity in Patients Undergoing Herniated Disc Surgery: A 5-Year Longitudinal Observational Study.

    Directory of Open Access Journals (Sweden)

    Marie Dorow

    Full Text Available The aims of this study are to answer the following questions (1 How does the pain intensity of lumbar and cervical disc surgery patients change within a postoperative time frame of 5 years? (2 Which sociodemographic, medical, work-related, and psychological factors are associated with postoperative pain in lumbar and cervical disc surgery patients?The baseline survey (T0; n = 534 was conducted 3.6 days (SD 2.48 post-surgery in the form of face-to-face interviews. The follow-up interviews were conducted 3 months (T1; n = 486 patients, 9 months (T2; n = 457, 15 months (T3; n = 438, and 5 years (T4; n = 404 post-surgery. Pain intensity was measured on a numeric rating-scale (NRS 0-100. Estimated changes to and influences on postoperative pain by random effects were accounted by regression models.Average pain decreased continuously over time in patients with lumbar herniated disc (Wald Chi² = 25.97, p<0.001. In patients with cervical herniated disc a reduction of pain was observed, albeit not significant (Chi² = 7.02, p = 0.135. Two predictors were associated with postoperative pain in lumbar and cervical disc surgery patients: the subjective prognosis of gainful employment (p<0.001 and depression (p<0.001.In the majority of disc surgery patients, a long-term reduction of pain was observed. Cervical surgery patients seemed to benefit less from surgery than the lumbar surgery patients. A negative subjective prognosis of gainful employment and stronger depressive symptoms were associated with postoperative pain. The findings may promote multimodal rehabilitation concepts including psychological and work-related support.

  9. Bryan total disc arthroplasty: a replacement disc for cervical disc disease

    OpenAIRE

    Wenger, Markus

    2010-01-01

    Markus Wenger1, Thomas-Marc Markwalder21Neurosurgery, Klinik Beau-Site and Salem-Spital, Berne, Switzerland; 2Attending Neurosurgeon FMH, Private Practice Spine Surgery, Berne-Muri, SwitzerlandAbstract: Total disc arthroplasty is a new option in the treatment of cervical degenerative disc disease. Several types of cervical disc prostheses currently challenge the gold-standard discectomy and fusion procedures. This review describes the Bryan Cervical Disc System and presents the Bryan prosthes...

  10. Thoracic disc herniations: evolution in the approach and indications

    International Nuclear Information System (INIS)

    Between 1960 and 1 June 1985, 21 patients were operated for thoracic disc herniations. The advent of new operative techniques (with transverso-arthropediculectomy) has brought about new indications in the management of such disorders. These new indications are important because such protrusions may be abruptly complicate by compression of blood vessels, which may produce abrupt and irreversible neurological deficit. The progress in the radiological examinations allows a more precise study of the topography and density of the hernia. Furthermore, the use of a surgical microscope and microsurgical techniques allows a surgical treatment without preoperative medullary angiography. (Author)

  11. Imbalanced protein expression patterns of anabolic, catabolic, anti-catabolic and inflammatory cytokines in degenerative cervical disc cells: new indications for gene therapeutic treatments of cervical disc diseases.

    Directory of Open Access Journals (Sweden)

    Demissew S Mern

    Full Text Available Degenerative disc disease (DDD of the cervical spine is common after middle age and can cause loss of disc height with painful nerve impingement, bone and joint inflammation. Despite the clinical importance of these problems, in current publications the pathology of cervical disc degeneration has been studied merely from a morphologic view point using magnetic resonance imaging (MRI, without addressing the issue of biological treatment approaches. So far a wide range of endogenously expressed bioactive factors in degenerative cervical disc cells has not yet been investigated, despite its importance for gene therapeutic approaches. Although degenerative lumbar disc cells have been targeted by different biological treatment approaches, the quantities of disc cells and the concentrations of gene therapeutic factors used in animal models differ extremely. These indicate lack of experimentally acquired data regarding disc cell proliferation and levels of target proteins. Therefore, we analysed proliferation and endogenous expression levels of anabolic, catabolic, ant-catabolic, inflammatory cytokines and matrix proteins of degenerative cervical disc cells in three-dimensional cultures. Preoperative MRI grading of cervical discs was used, then grade III and IV nucleus pulposus (NP tissues were isolated from 15 patients, operated due to cervical disc herniation. NP cells were cultured for four weeks with low-glucose in collagen I scaffold. Their proliferation rates were analysed using 3-(4, 5-dimethylthiazolyl-2-2,5-diphenyltetrazolium bromide. Their protein expression levels of 28 therapeutic targets were analysed using enzyme-linked immunosorbent assay. During progressive grades of degeneration NP cell proliferation rates were similar. Significantly decreased aggrecan and collagen II expressions (P<0.0001 were accompanied by accumulations of selective catabolic and inflammatory cytokines (disintegrin and metalloproteinase with thrombospondin motifs 4

  12. Observation on effect of percutaneous puncture nucleus pulposus forceps holder decompression combined ozone under DSA guide treatment of cervical disc herniation%DSA引导下经皮穿刺髓核钳夹减压术联合臭氧治疗颈椎间盘突出症的疗效观察

    Institute of Scientific and Technical Information of China (English)

    吴越宏; 符彦基; 庞亮明; 钟海英; 郭绍彬

    2016-01-01

    目的:观察颈椎间盘突出症于DSA引导下经皮穿刺髓核钳夹减压术联合臭氧治疗后的疗效。方法选取我院2012年5月~2015年6月间186例颈椎间盘突出症患者,所有患者均于DSA引导下经皮穿刺髓核钳夹减压术联合臭氧治疗,观察其治疗效果。结果186例患者治愈146例(78.5%),好转37例(19.8%),疗效不佳3例(1.6%),总有效率为98.4%。与治疗前比较,治疗后24 h、1周、l个月、3个月、6个月视觉模拟评分(VAS)降低,差异有统计学意义(P<0.05)。结论 DSA引导下经皮穿刺髓核钳夹联合臭气治疗颈椎间突出症创伤小、有效、安全,值得临床推广。%Objective To observe the effect of percutaneous puncture nucleus pulposus forceps holder decompression combined ozone under DSA guide in the treatment of cervical disc herniation.Methods To select 186 patients with cervical disc herniation in our hospital from May 2012 to June 2015, to treat with percutaneous puncture nucleus pulposus forceps holder decompression combined ozone under DSA guide in all patients, to observe the treatment effect.ResultsOf the 186 patients, the total effective rate was 98.4%, with cured 146 cases(78.5%), improvement 37 cases(19.8%), and poor therapeutic effect 3 cases(1.6%). The visual analogue score(VAS) after 24h, 1 week, 1 month, 3 months, 6 months treatment had reduced compared with which before treatment, the differences was statically significant(P<0.05).Conclusion Percutaneous puncture nucleus pulposus forceps holder decompression combined ozone under DSA guide in the treatment of cervical disc herniation has less trauma, is effective and safe, is worthy of clinical popularization.

  13. 胶原酶溶解术与射频热凝术治疗颈椎间盘突出症的对照研究%Comparison of the effects of collagenase chemonucleolysis and radiofrequency thermocoagula-tion in the treatment of cervical intervertebral disc herniation

    Institute of Scientific and Technical Information of China (English)

    齐亮; 胡熙苒; 郭建; 黄桂明; 陈平国

    2014-01-01

    目的:比较胶原酶化学溶解术与射频热凝术治疗颈椎间盘突出症的临床疗效。方法158例颈椎间盘突出症患者分为2组,采用射频热凝术治疗72例;采用胶原酶化学溶解术治疗86例。于术后1周、1个月、3个月、6个月随访,根据MacNab疗效评定标准和VAS评分法,对治疗后优良率、总有效率和疼痛程度进行比较。结果胶原酶优良率及有效率明显高于射频组(P<0.05);VAS评分后,术后1周,射频组优于胶原酶组(P<0.01)。但6个月后胶原酶组优于射频组(P<0.05)。结论射频热凝术和胶原酶溶解术均为治疗颈椎间盘突出症的有效疗法。%Objective To compare and evaluate the effect of collagenase chemonucleolysis (CNL)and radiofrequency thermocoagulation in the treatment of cervical intervertebral disc hernia-tion. Methods 158 patients with cervical intervertebral disc herniation were divided into two groups based on the treatment they received.72 patients in A group were treated by radiofrequency thermocoagulation,and 86 patients in B group were treated by CNL. The total effective rate and pain degree were assessed according to MacNab criteria and VAS scoring after follow-up for one week, one month, three months and six months. Results The assessment of MacNab showed the effect of group B was better than group A after surgery (P<0.05). One week after treatment,the as-sessment of VAS showed that the effect of group A was better than group B after surgery (P<0.01), but 6 months after treatment, the effect of group B was better than group A (P<0.05). Conclusion The radiofrequency thermocoagulation and CNL are both effective in the treatment of cervical inter-vertebral disc herniation.

  14. Clinical effect of radiofrequency catheter ablation combined with ozone injection in the treatment of lumbar disc herniation of cervical spine%射频消融加臭氧注射微创技术治疗腰椎间盘突出症的临床效果观察

    Institute of Scientific and Technical Information of China (English)

    杨劲松; 刘衡; 佟言

    2015-01-01

    Objective: To observe the clinical effect of radiofrequency ablation combined with ozone injection in the treat-ment of cervical intervertebral disc herniation.Methods: selected in our hospital in 2013 from August in August were 60 cases of cervical lumbar disc herniation patients, through the double chromosphere randomly divided into observation group (n = 30) and control group (n = 30), the clinical therapeutic effect of two groups of patients were compared and analyzed.Results: after treatment, the VAS score of the observation group was lower than that of the control group, the effective rate was 90%, higher than that of the control group 70% (P<0.05).Conclusion: in the treatment of cervical inter-vertebral disc herniation, the minimally invasive technique of radiofrequency ablation combined with improve the quality of life of patients. It is worthy of clinical application.%目的:观察分析腰椎间盘突出症患者采用射频消融加臭氧注射微创技术治疗的临床效果。方法:选取我院2013年8月-2014年8月收治的60例腰椎间盘突出症患者,通过双色球随机分组法分为观察组(n=30)及对照组(n=30),对照组患者采用常规治疗,观察组患者采用射频消融加臭氧注射微创技术治疗,对两组患者临床治疗效果进行比较和分析。结果:治疗后观察组患者VAS评分较对照组更低,治疗有效率90.00%,高于对照组70.00%(P<0.05)。结论:在腰椎间盘突出症治疗中,射频消融加臭氧注射微创技术可明显缓解腰椎间盘突出症状,减轻患者身心疼痛,提高临床治疗效果,进而改善患者生活质量,值得临床推广应用。

  15. Effect of Age and Lordotic Angle on the Level of Lumbar Disc Herniation

    Directory of Open Access Journals (Sweden)

    Ghassan S. Skaf

    2011-01-01

    Full Text Available It has been previously suggested in the literature that with aging, degenerative changes as well as disc herniation start at the lower lumbar segments, with higher disc involvement observed in an ascending fashion in older age groups. We conducted a study to investigate this correlation between age and level of disc herniation, and to associate it with the magnitude of the Lumbar Lordotic Angle (LLA, as measured by Cobb’s method. We followed retrospectively lumbosacral spine MRI’s of 1419 patients with symptomatic disc herniation. Pearson’s correlation was used in order to investigate the relationship between LLA, age, and level of disc herniation. Student’s -test was applied to assess gender differences. Young patients were found to have higher LLA (=0.44, <0.0001 and lower levels of disc herniation (=0.302, <0.0001, whereas older patients had higher level herniation in lower LLA group (mean LLA 28.6° and 25.4° and lower level herniation in high LLA group (mean LLA 33.2°. We concluded that Lumbar lordotic Cobb’s angle and age can be predictors of the level of lumbar disc herniation. This did not differ among men and women (=0.341, <0.0001.

  16. CT findings of lumbar intervertebral disc: II. Disc herniation (HNP)

    International Nuclear Information System (INIS)

    In lumbar region the epidural fat pad is relatively abundant so that CT can provides sufficient information in diagnosis of lumbar HNP. Many authors have reported on the CT findings of HNP such as focal nodular protrusion of the posterior disc margin, obliteration of epidural fat pad, impingement of dural sac and nerve root, swelling of nerve root, soft tissue density in the spinal canal and calcification of disc. However there was so previous report describing incidence and reliability of the findings. It is the purpose of the present study to survey the frequency, reliability, and limitation of these CT findings. The clinical material was consisted of 30 operatively proven cases of HNP of the lumbar spine. Each lumbar CT scan was reviewed retrospectively and the findings were analysed by two radiologists independently. There were 20 males and 10 females and the mean age was 36.7 years. Involvement of L4-S5 level was 2.3 times more frequent than that of L5-S1 level. Of 30 cases, 22 were unilateral posterolateral types and 8 cases central or unilateral far lateral types. CT findings observed were nodular protrusion of the posterior margin of the disc, obliteration of epidural fat pad, impingement of dural sac or nerve root, soft tissue density in the spinal canal and calcification in the posterior portion of the protruded disc, in order of decreasing frequency. The conclusions are follows: 1. Nodular protrusion of the posterior disc margin accompanied by obliteration of epidural fat pad was observed in every case. The former findings was designated as direct sign and the latter indirect. 2. Obliteration of the epidural fat appears to be significant in lateral recesses especially when it occurs unilaterally. This was not true, however, in the centrally located fat pad. 3. Impingement of the dural sac and nerve root were observed in 90% and 67%, respectively, and were very helpful in establishing HNP diagnosis when the direct and indirect signs were equivocal

  17. Episodic cauda equina compression from an intradural lumbar herniated disc: a case of ‘floppy disc’

    OpenAIRE

    Nagaria, J; Chan, CC; Kamel, MH; McEvoy, L; Bolger, C.

    2011-01-01

    Intradural disc herniation (IDDH) is a rare complication of intervertebral disc disease and comprises 0.26-0.30% of all herniated discs, with 92% of them located in the lumbar region (1). We present a case of IDDH that presented with intermittent symptoms and signs of cauda equina compression. We were unable to find in the literature, any previously described cases of intermittent cauda equina compression from a herniated intradural disc fragment leading to a “floppy disc syndrome”.

  18. History of lumbar disc herniation with Gd-DPTA enhanced MRI

    Energy Technology Data Exchange (ETDEWEB)

    Iwahara, Toshihito; Satou, Toshikazu [Wakkanai Municipal Hospital, Hokkaido (Japan)

    1995-09-01

    The pathological changes of primary lumbar disc herniation was monitored on T1-weighted and Gd-weighted MR imagings. The subjects were 11 patients whose symptoms improved solely by conservative therapy. Herniated area on T1-weighted images (whole herniated area), enhanced herniated area on Gd-MRI (enhanced area), and non-enhanced herniated area on Gd-MRI (non-enhanced area) were calculated, and each proportion to the vertebral canal was assessed. Changes in herniated area was correlated with changes of enhanced area. Gd-MRI was found to be useful in predicting the prognosis of primary herniation, as well as in differentiating recurrent herniation and cicatricial tissues. (S.Y.).

  19. Paraplegia by Acute Cervical Disc Protrusion after Lumbar Spine Surgery.

    Directory of Open Access Journals (Sweden)

    Sheng-Huan Chen

    2005-04-01

    Full Text Available Non-traumatic paraplegia caused by herniation of the cervical intervertebral disc is anuncommon postoperative complication. A patient with claudication and radiculopathy wasscheduled for lumbar laminectomy due to spinal stenosis. Postoperatively, numbness belowT6 was found in his both legs of the patient. MRI showed a protruded intervertebral discbetween C6 and C7. Despite urgent disectomy, the patient's lower extremities remained paralyzedwithout significant improvement for 3 months. Loss of muscle support during generalanesthesia, excessive neck extension during endotracheal intubation and positioning, as wellas bucking and agitation are believed as triggering factors for the protrusion of the cervicaldisc. We suggest that a complete history taking and physical examination be accomplishedin patients scheduled for lumbar spine surgery in order to exclude coexisting cervical spinedisorders. In addition, skillful endotracheal intubation and careful neck positioning aremandatory for patients receiving surgery in the prone position.

  20. Study of Frequency of Low Back Pain and Lumbar Disc Herniation in Patients of Hamadan MRI Center in 2002

    Directory of Open Access Journals (Sweden)

    M. Jabbari

    2004-07-01

    Full Text Available Low back pain is one of the prevalent diseases of the world. In this research, with helping of MRI the incidence of disc herniation in patients of low back pain in our living area was studied. Survey of the specifications of disc herniation was carried out and data was compared with some performed studies in other parts of the world. In this study, for 600 patients referred to HAMEDAN MRI CENTER, who had complaint of low back pain, MRI study was performed. Then, MRI Images of the patients who had disc hernition, studied for number, form, severity and anatomic position of the herniated disc and family history of low back pain. 83.7% of the studied cases was pathologic and 16.3% was normal. Among the pathologic cases, 70.12% had disc herniation. The most common age group in both sex for disc herniotion was 30-50 years. Disc herniation in men was more common than women. The most common anatomic position of the herniated disc was L4- L5 disc, mostly was one herniated disc and centrolateral form. There was not any meaningful relation between family history of the low back pain and lumbar disc herniation. This study showed that lumbar disc herniation is one of the common causes of the low back pain in our living area and MRI is the choice imaging modality for diagnosis and survey of low back pain and disc herniation.

  1. Activ C cervical disc replacement for myelopathy

    Directory of Open Access Journals (Sweden)

    L McGonagle

    2011-01-01

    Full Text Available Background: Cervical disc replacement is becoming an increasingly popular treatment option for cervical myelopathy. It retains motion at the affected segment, unlike anterior cervical discectomy and fusion. The aim of this study is to assess the outcomes of a series of patients who underwent Activ C disc replacement for cervical myelopathy. Materials and Methods: A series of patients at the above Trust with clinical and radiological evidence of cervical myelopathy who were suitable for cervical disc replacement from 2007 to 2009 were included. Implants were inserted by one of two consultant surgeons {IMS, MO′M}. Patients were assessed preoperatively and at six, 12 and 24 months, postoperatively, with a visual analogue score (VAS for neck and arm pain severity and frequency, the Neck Disability Index questionnaire (NDI and the Centre for Epidemiologic Studies Depression questionnaire (CES-D. Results: Ten patients underwent surgery between May 2007 and July 2009, 6 women, and 4 men. Average age was 54 years (40-64. Disc levels replaced were: four at C4-5; eight at C5-6; seven at C6-7. Three patients had one disc replaced, five patients had two discs replaced, and two patients had three discs replaced. The VAS for neck pain improved from 5.9 pre-operatively to 1.4-24 months postoperatively and the VAS arm pain improved from 5.4 to 2.6. The NDI improved from 51% preoperatively to 26.8% at 24 months postoperatively. The CES-D showed a slight increase from 19.5 preoperatively to 21.7 at 24 months, postoperatively. Conclusion: Cervical decompression and disc replacement improves pain and function in patients with cervical myelopathy. This benefit is maintained at 24 months post op, with no cases requiring revision.

  2. Clinical study on the treatment of cervical disc herniation through the method of traction combined with muscle meridian manipulation%牵引配合经筋推拿治疗颈椎间盘突出症的临床研究

    Institute of Scientific and Technical Information of China (English)

    龚星军; 马文央; 王倩芬

    2011-01-01

    Objective: To observe the clinical curative effect of traction combined with muscle meridian manipulation on cervical disc herniation(CDH). Methods: 196 CDH patients met the criteria were randomly divided into 2 groups,98 cases in each group. Patients in treatment group were administrated with traction combined with muscle meridian manipulation, while the others in control group were administrated with traction combined with the specific electromagnetic wave. The curative effects of the patients were compared between the 2 groups after 2 course of treatment. Results: The curative effect of treatment group was better than that of control group and there was statistical difference between the two groups( Z = 5. 1.50, P = 0. 000). Conclusion :The method of traction combined with muscle meridian manipulation has definite curative effect on cervical disc herniation,it is worth popularizing in clinic.%目的:观察牵引配合经筋推拿治疗颈椎间盘突出症的临床疗效.方法:将符合标准的196例颈椎间盘突出症患者随机分为2组,每组98例.治疗组采用牵引配合经筋推拿治疗,对照组采用牵引结合特定电磁波治疗.治疗2个疗程后对比2组患者的疗效.结果:治疗组疗效优于对照组,差异有统计学意义(Z=5.150,P=0.000).结论:牵引配合经筋推拿治疗颈椎间盘突出症疗效确切,值得临床推广应用.

  3. CT-discography; diagnostic accuracy in lumbar disc herniation and significance of induced pain during procedure

    Energy Technology Data Exchange (ETDEWEB)

    Jin, En Hao [Yan Bian Medical College, Beijing (China); Chung, Tae Sub; Jeong, Mi Gyoung; Kim, Young Soo; Roh, Sung Woo [Yonsei Univ. College of Medicine, Seoul (Korea, Republic of)

    1996-01-01

    To evaluate the usefulness and the accuracy of CT-discography in lumbar disc disease by analyzing the findings of CT-discogram and types of evoked pain during the procedure. CT-discograms were retrospectively evaluated in 47 intervertebral discs of 20 patients with multilevel involvement of lumbar disc diseases. In 28 herniated discs confirmed at surgery, the findings of CT-discogram (28 disc levels/20 patients), MRI(23/16) and CT(21/15) were comparatively analysed. The type of pain after infusion of contrast media during CT-discography was compared with that prior to the procedure. The accuracy for determining types of the herniated lumbar disc when compared with post-operative results was 96.4%(27 discs/28 discs) in the CT-discogram, 82.6%(19 discs/23 discs) in MRI and 71.4%(15 discs/21 discs) in the CT scan. Pains encountered during discography were radiating pain in 12 discs and back pain in 24 discs. CT-discography was especially helpful in 10 patients with multilevel involvement of the lumbar disc diseases to evaluate the exact location of diseased disc(s) that provoked the pain. CT-discography is a highly accurate method in diagnosis of the herniated lumbar intervertebral discs and is very useful in determining the precise location related to the development of pain in such cases.

  4. Suspected herniated lumbar disc - computed tomography in differential diagnosis of non-disc-related sciatica

    Energy Technology Data Exchange (ETDEWEB)

    Weiss, T.; Koehler, D.; Treisch, J.; Claussen, C.; Felix, R.

    1984-07-01

    The most common reason a patient is referred for spinal CT examination is to exclude a ruptured intervertebral disc. Besides nerve root entrapment due to herniated disc, a number of unusual or unexpected conditions have been encountered in the course of CT lumbar spine studies. These include spondylolisthesis, spinal dysraphism, Paget's disease, and inflammatory, neoplastic, or metastatic lesions. The application of spinal (small-circle) target imaging includes the risk of overlooking soft tissue lesions that extend beyond the reconstruction circle. Therefore, complete (large-circle) circumferential abdominal scanning is recommended in case of a suspected extraspinal cause of sciatica.

  5. Artificial Cervical Disc Replacement Improves Mobility

    Medline Plus

    Full Text Available Artificial Cervical Disc Replacement Improves Mobility February 18, 2009 From PinnacleHealth, Harrisburg, PA Welcome to this “OR ... this new technology with the use of an artificial disc has some significant benefits over the previous ...

  6. The Clinical Analysis on 32 Cases of Herniated Lumbar Disc Patients according to Lumbar CT scan

    Directory of Open Access Journals (Sweden)

    Jeong-ho Kim

    2010-06-01

    Full Text Available Objective : This study is to evaluate the effectiveness of the oriental medicine treatment on lumbar disc herniation. Subjects and Methods : The clinical analysis was done on 32 cases of patients with lumbar disc herniation diagnosed by lumbar CT scan. Patients who admitted in Cheongju Oriental Medicine Hospital from April 2007 to April 2008 were analyzed according to the distribution of sex, age, the period of disease, condition on admission, the symptom on admission, Admission day, the treatment efficacy at discharge day. Results : 1. The forties was the most, the acutest phase the most, the day of 8-14 days the most. 2. Multiple bulging disc in 37.5% of CT scan was the most common, followed by a single HNP was 28.1%. 3. Almost 81% patients showed effective efficacy under VAS 3 at discharge day. 4. Single bulging and herniated disc were more short admission days than multiple bulging and herniated disc.

  7. Cervical lung lobe herniation in dogs identified by fluoroscopy.

    Science.gov (United States)

    Nafe, Laura A; Robertson, Ian D; Hawkins, Eleanor C

    2013-10-01

    This study aimed to determine the frequency of cervical lung lobe herniation (CLLH) in dogs evaluated fluoroscopically and to identify associated characteristics. Reports of diagnostic procedures and patient summaries from 2008 to 2010 were reviewed retrospectively. Signalment, body weight, duration of cough, presence of heart murmur and airway collapse, and radiographic findings were compared between dogs with and without CLLH. Of the 121 dogs that were examined, CLLH occurred in 85 (70%). The extra-thoracic trachea kinked during herniation in 33 (39%) dogs with CLLH. Collapse of the intra-thoracic trachea (assessed fluoroscopically or bronchoscopically) and collapse of major bronchi (assessed fluoroscopically) were strongly associated with CLLH. Although redundant dorsal tracheal membrane on radiographs was associated with CLLH, extra-thoracic tracheal collapse, assessed fluoroscopically or bronchoscopically, was not. No other associations were found. Cervical lung lobe herniation was present in most dogs evaluated during cough and was associated with intra-thoracic large airway collapse, but not duration of cough. PMID:24155415

  8. Nursing care for patients receiving percutaneous lumbar discectomy and intradiscal electrothermal treatment for lumbar disc herniation

    International Nuclear Information System (INIS)

    Objective: To summarize the nursing experience in caring patients with lumbar intervertebral disc herniation who received percutaneous lumbar discectomy (PLD) together with intradiscal electrothermal treatment (IDET) under DSA guidance. Methods: The perioperative nursing care measures carried out in 126 patients with lumbar intervertebral disc herniation who underwent PLD and IDET were retrospectively analyzed. Results: Successful treatment of PLD and IDET was accomplished in 112 cases. Under comprehensive and scientific nursing care and observation, no serious complications occurred. Conclusion: Scientific and proper nursing care is a strong guarantee for a successful surgery and a better recovery in treating lumbar intervertebral disc herniation with PLD and IDET under DSA guidance. (authors)

  9. Anterior or posterior approach of thoracic disc herniation? A comparative cohort of mini-transthoracic versus transpedicular discectomies

    NARCIS (Netherlands)

    Arts, M.P.; Bartels, R.H.M.A.

    2014-01-01

    BACKGROUND CONTEXT: The optimal surgical treatment of thoracic disc herniations remains controversial and depends on the consistency of the herniation and its location related to the spinal cord. PURPOSE: To compare the outcomes of patients with symptomatic thoracic disc herniations treated with ant

  10. Spontaneous regression of herniated lumbar discs: Report of one illustrative case and review of the literature.

    Science.gov (United States)

    Yang, Xiaohui; Zhang, Qin; Hao, Xiaoning; Guo, Xinghua; Wang, Liping

    2016-04-01

    Lumbar disc herniation (LDH) is a common disease that induces back pain and radicular pain. The most efficient method for the treatment of lumbar disc herniation is still controversial. Spontaneous regression of LDH has been recognized with the advancement of radiological diagnostic tools and can explain the reason of spontaneous relief of symptoms without treatment. The proposed hypotheses are; dehydration, retraction of the disc to the hernia in the annulus fibrosis, enzymatic catabolism and phagocytosis. In this study, the case of a patient with huge lumbar disc hernia regressing by itself has been presented and the potential mechanisms of disc regression have been discussed. PMID:26907997

  11. CT of lumbar disc herniation: correlation with surgical findings

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Suk Yl; Lee, Dong Jin; Sung, Kyu Bo; Woo, Won Hyung [Korea General Hospital, Seoul (Korea, Republic of)

    1986-10-15

    CT from forty nine patients with 53 surgical disc explorations were reviewed and correlated with surgical findings. The results were as follows: 1. Frequent locations of HNP were in L4-5 (65%) and L5-S1 (31%). The most common type of HNP was paramidine type (71%). 2. Focal protrusion of the posterior margin of disc and obliteration of epidural fat pad were observed in all of cases (100%) and other common findings were indentation of epidural sac in 46 cases (96%) and compression of nerve root sleeve in 33 cases (69%). 3. Cephalad and caudad extension of protruded soft tissue density in the spinal canal was observed in 15 cases (31%) with variable degree. And more than 6mm extension were provided to be extruded disc in 9 cases. 4. Vacuum phenomenon was demonstrated in 5 cases (10%) and was accompanied with bulging annulus. 5. Forty eight herniated nucleus (HNP) were confirmed surgically in 44 patients. Misinterpretations were made in 4 instances (4 patients); 1 because of lumbar scoliosis, 1 because of spondylolisthesis, and the other 2 because of calcified posterior longitudinal ligament and bulging annulus. One case of true negative examination was central and foraminal stenosis in spinal CT. Thus, sensitivity, specificity and overall accuracy of lumbar spine CT in HNP were 92%, 100% and 92%, respectively.

  12. EVALUATION OF 754 SURGICALLY TREATED LUMBAR DISC HERNIATION

    Directory of Open Access Journals (Sweden)

    S.A MIRHOSEINI

    2003-09-01

    Full Text Available This article reports the outcome of a series of patients who received surgical treatment for lumbar disc herniation during a 5 year period in Kashani hospital. Three operative procedures were used for discectomy: unilateral interlaminar bilateral interlaminar and bilateral laminectomy. An objective method of assessing outcome that would not depend on the procedures, the prolo functional-economic outcome rating scale used to evaluate patients. Most patients had good outcome. The patient with non-industrial injuries had better had good outcome. The patient with non-industrial injuries had better outcome. The prolo scale appears to be a useful tool for comparing different procedures more objectively and for comparing the outcome across series.

  13. [Cauda equina syndrome due to giant disc herniation].

    Science.gov (United States)

    Barriga, A; Villas, C

    2002-01-01

    In cases of acute or progressive development in a few hours of bilateral sciatica, severe foot and occasional quadriceps weakness and/or retention or incontinence of urine with perineal hypalgesia or anesthesia, acute compression of the cauda equina should be suspected, which is usually due to a lumbar disc herniation. Cauda equina syndrome requires emergency spinal surgery. To identify and confirm this syndrome by MR, Ismanoatory. Early surgical decompression must be achieved. Decompression within 24-48 hours significantly improves the neurological and urological outcome. We present the case of a patient who had previously been treated for low back pain who developed a cauda equina syndrome a few days later. PMID:12685115

  14. Concomitance of cervical intramedullary traumatic neuroma and cervical cord herniation in a tetraplegic woman.

    Science.gov (United States)

    Su, Hui-Yi; Wu, Yung-Tsan; Liu, Ming-Ying; Lin, Yu-Chun; Chu, Heng-Yi; Chang, Shin-Tsu

    2013-01-01

    We present the first case of concomitant intramedullary traumatic neuroma and spinal cord herniation. A 57-year-old woman injured her cervical spine with subluxation and cord compression at the C5-C6 level. After the operation, the patient received intensive rehabilitation for one year with well response. Unfortunately, she experienced weakness and progressive numbness extending to all the limbs later. Cervical magnetic resonance imaging revealed spinal cord herniation at the C5-C6 level and pathology proved intramedullary traumatic neuroma. After the second operation, the paresthesia over the trunk and limbs persisted, and the patient was nearly totally assisted in her activities of daily living. The intramedullary traumatic neuroma and spinal cord herniation are rare causes in patients with spinal cord dysfunction. The case presented here indicates the possibility of the coexisting conditions leading to progressive neurologic deficits in patients with old spinal cord injury. PMID:23887176

  15. Analysis of crucial molecules involved in herniated discs and degenerative disc disease

    Directory of Open Access Journals (Sweden)

    Zhigang Qu

    2013-01-01

    Full Text Available OBJECTIVES: Herniated discs and degenerative disc disease are major health problems worldwide. However, their pathogenesis remains obscure. This study aimed to explore the molecular mechanisms of these ailments and to identify underlying therapeutic targets. MATERIAL AND METHODS: Using the GSE23130 microarray datasets downloaded from the Gene Expression Omnibus database, differentially co-expressed genes and links were identified using the differentially co-expressed gene and link method with a false discovery rate ,0.25 as a significant threshold. Subsequently, the underlying molecular mechanisms of the differential co-expression of these genes were investigated using Kyoto Encyclopedia of Genes and Genomes pathway enrichment analysis. In addition, the transcriptional regulatory relationship was also investigated. RESULTS: Through the analysis of the gene expression profiles of different specimens from patients with these diseases, 539 differentially co-expressed genes were identified for these ailments. The ten most significant signaling pathways involving the differentially co-expressed genes were identified by enrichment analysis. Among these pathways, apoptosis and extracellular matrix-receptor interaction pathways have been reported to be related to these diseases. A total of 62 pairs of regulatory relationships between transcription factors and their target genes were identified as critical for the pathogenesis of these diseases. CONCLUSION: The results of our study will help to identify the mechanisms responsible for herniated discs and degenerative disc disease and provides a theoretical basis for further therapeutic study.

  16. A study of transforaminal epidural steroid injections in patients with lumber disc herniation

    Directory of Open Access Journals (Sweden)

    Vipul L. Kuvad

    2015-12-01

    Conclusion: Transforaminal epidural steroid is a safe, simple, least morbid and cost effective approach for the patients with lumbar disc herniation with radiculopathy. [Int J Res Med Sci 2015; 3(12.000: 3853-3857

  17. Imaging features of traumatic dislocation of the lumbosacral joint associated with disc herniation

    Energy Technology Data Exchange (ETDEWEB)

    Tohme-Noun, C.; Krainik, A.; Menu, Y. [Department of Radiology, Hopital Beaujon, AP HP, Universite Paris 7, Faculte de Medecine Bichat-Beaujon, Paris (France); Rillardon, L.; Guigui, P. [Department of Orthopedic Surgery, Hopital Beaujon, AP HP, Universite Paris 7, Faculte de Medecine Bichat-Beaujon, Paris (France); Feydy, A. [Department of Radiology, Hopital Beaujon, AP HP, Universite Paris 7, Faculte de Medecine Bichat-Beaujon, Paris (France); Department of Radiology, Hopital Beaujon, 100 avenue du General Leclerc, 92118, Clichy (France)

    2003-06-01

    Bilateral facet dislocation of the lumbosacral joint is an uncommon injury. We report on the imaging findings in a patient who had an acute disc herniation associated with a bilateral traumatic lumbosacral dislocation. (orig.)

  18. Lumbar disc herniation treated with qi pathway intervention and spinal adjustment:a randomized controlled trial

    Institute of Scientific and Technical Information of China (English)

    杨军雄

    2013-01-01

    Objective To compare the efficacy difference in the treatment of lumbar disc herniation(LDH)between the comprehensive therapy of Qi pathway intervention and the spinal adjustment and the conventional therapy of acupuncture and Tuina and explore the analgesic mechanism

  19. Imaging features of traumatic dislocation of the lumbosacral joint associated with disc herniation

    International Nuclear Information System (INIS)

    Bilateral facet dislocation of the lumbosacral joint is an uncommon injury. We report on the imaging findings in a patient who had an acute disc herniation associated with a bilateral traumatic lumbosacral dislocation. (orig.)

  20. Genotypic and antimicrobial characterisation of Propionibacterium acnes isolates from surgically excised lumbar disc herniations

    DEFF Research Database (Denmark)

    Rollason, Jess; McDowell, Andrew; Albert, Hanne B;

    2013-01-01

    The anaerobic skin commensal Propionibacterium acnes is an underestimated cause of human infections and clinical conditions. Previous studies have suggested a role for the bacterium in lumbar disc herniation and infection. To further investigate this, five biopsy samples were surgically excised...... from each of 64 patients with lumbar disc herniation. P. acnes and other bacteria were detected by anaerobic culture, followed by biochemical and PCR-based identification. In total, 24/64 (38%) patients had evidence of P. acnes in their excised herniated disc tissue. Using recA and mAb typing methods...... isolate collection (63%) suggests that the role of P. acnes in lumbar disc herniation should not be readily dismissed....

  1. Percutaneous treatment of lumbar disc herniation by oxygen-ozone injection -clinical study with indication

    International Nuclear Information System (INIS)

    Objective: To study the clinical effect and the range of indications of oxygen-ozone treatment for lumber disc herniation. Methods: 6-15 ml of oxygen-ozone (35-45 μg/ml) were injected percutaneously into lumbar disc. In case of multiple disc herniations, the procedure could be taken with two discs for once. Results: 323 patients with 433 discs were treated by oxygen-ozone injection procedure. Total effective rate was 77.7%. Conclusions: The treatment of lumber disc herniation by oxygen-ozone injection is simple, safe and effective with mild trauma. Oxygen-ozone not only can oxidize the proteoglycan in the nucleus leading to the contraction of nucleus, but also provide anti-inflammation effect with pain relief and without complication yet. (authors)

  2. A reappraisal of the diagnosis in cervical disc disease: The posterior longitudinal ligament perforated or not

    International Nuclear Information System (INIS)

    Herniated nuclear material of the cervical disc often perforates the posterior longitudinal ligament. Of 22 patients who were operated on by an anterior approach, 10 were of this type (the subligamentous type of cervical disc protrusion), while in the remaining 12 patients and 15 discs the protruded disc caused no tear in the ligament (the epiligamentous type). Myelography and CT myelography of these patients were reviewed. On CT myelography a localized and sharply demarcated excavation of the metrizamide ring was commonly found in the subligamentous type. Myelographic lateral view in this group shows a moderate or large indentation of the metrizamide column, since the herniated nucleus pulposus sometimes migrates caudally or cephalically. A small myelographic deformity coupled with diffuse excavation of the metrizamide ring on a CT myelogram leads us to the diagnosis of the epiligamentous type of cervical disc protrusion. In such cases, excision of the ligament is unnecessary during exploration of the discs, except when there is marked depression in the posterior longitudinal ligament. Presurgical recognition of both anatomical processes must be stressed for anterior discectomy. (orig.)

  3. Reappraisal of the diagnosis in cervical disc disease: The posterior longitudinal ligament perforated or not

    Energy Technology Data Exchange (ETDEWEB)

    Isu, Toyohiko; Iwasaki, Yoshinobu; Abe, Hiroshi; Tashiro, Kunio; Miyasaka, Kazuo; Ito, Terufumi

    1986-05-01

    Herniated nuclear material of the cervical disc often perforates the posterior longitudinal ligament. Of 22 patients who were operated on by an anterior approach, 10 were of this type (the subligamentous type of cervical disc protrusion), while in the remaining 12 patients and 15 discs the protruded disc caused no tear in the ligament (the epiligamentous type). Myelography and CT myelography of these patients were reviewed. On CT myelography a localized and sharply demarcated excavation of the metrizamide ring was commonly found in the subligamentous type. Myelographic lateral view in this group shows a moderate or large indentation of the metrizamide column, since the herniated nucleus pulposus sometimes migrates caudally or cephalically. A small myelographic deformity coupled with diffuse excavation of the metrizamide ring on a CT myelogram leads us to the diagnosis of the epiligamentous type of cervical disc protrusion. In such cases, excision of the ligament is unnecessary during exploration of the discs, except when there is marked depression in the posterior longitudinal ligament. Presurgical recognition of both anatomical processes must be stressed for anterior discectomy.

  4. Free sequestered disc herniation at the S2 level misdiagnosed as neuroma

    Energy Technology Data Exchange (ETDEWEB)

    Witzmann, A.; Fischer, J. (Wagner-Jauregg-Krankenhaus des Landes Oberoesterreich, Linz (Austria). Neurochirurgische Abt.); Hammer, B. (Wagner-Jauregg-Krankenhaus des Landes Oberoesterreich, Linz (Austria). Roentgeninstitut)

    1991-02-01

    The case of a 38 year-old-man with a mass at the S2 level similar to a benign nerve root tumor (neuroma) is reported. The CT scan examination revealed the mass close underneath but not in connection with a disc herniation at the L5/S1 level. During operation the mass was not encountered as tumor but as free sequestered disc herniation, which was confirmed by histological examination. The reasons for considering the mass a tumor are discussed. (orig.).

  5. CT of adult lumbar disc herniations mimicking posterior apophyseal ring fractures

    Energy Technology Data Exchange (ETDEWEB)

    Gomori, J.M. (Hadassah Univ. Hospital, Jerusalem (Israel). Dept. of Radiology); Floman, Y.; Liebergall, M. (Hadassah Univ. Hospital, Jerusalem (Israel). Dept. of Orthopedics)

    1991-10-01

    This report concerns 35 adult patients with lumbar or sciatic pain and axial CT findings reportedly associated with posterior apophyseal ring fractures. Review of the CT images suggested two pathophysiologic categories. (1) Posterior Schmorl - A posterior intravertebral disc herniation with posterior displacement of a fractured or remodelled vertebral margin. (2) Calcified subligamentous - Reactive annular and or posterior longitudinal ligament calcification at the periphery of a herniated disc with or without remodelling and anterior displacement of the posterior vertebral margin. (orig.).

  6. ASSOCIATION OF SPINOPELVIC PARAMETERS WITH THE LOCATION OF LUMBAR DISC HERNIATION

    OpenAIRE

    Jefferson Coelho de Léo; Álvaro Coelho de Léo; Igor Machado Cardoso; Charbel Jacob Júnior; José Lucas Batista Júnior

    2015-01-01

    Objective:To associate spinopelvic parameters, pelvic incidence, sacral slope, pelvic tilt and lumbar lordosis with the axial location of lumbar disc herniation.Methods:Retrospective study, which evaluated imaging and medical records of 61 patients with lumbar disc herniation, who underwent surgery with decompression and instrumented lumbar fusion in only one level. Pelvic incidence, sacral slope, pelvic tilt and lumbar lordosis with simple lumbopelvic lateral radiographs, which included the ...

  7. Co-occurrence of lumbar spondylolysis and lumbar disc herniation with lumbosacral nerve root anomaly

    OpenAIRE

    Tevfik Yilmaz; Yahya Turan; Ismail Gulsen; Sedat Dalbayrak

    2014-01-01

    Lumbosacral nerve root anomalies are the leading cause of lumbar surgery failures. Although co-occurrence of lumbar spondylolysis and disc herniation is common, it is very rare to observe that a nerve root anomaly accompanies these lesions. A 49-year-old male patient presented with sudden-onset right leg pain. Examinations revealed L5/S1 lumbar spondylolysis and disc herniation. At preoperative period, he was also diagnosed with lumbosacral root anomaly. Following discectomy and root decompre...

  8. Unusual chest wall pain caused by thoracic disc herniation in a professional baseball pitcher.

    Science.gov (United States)

    Kato, Kinshi; Yabuki, Shoji; Otani, Koji; Nikaido, Takuya; Otoshi, Ken-Ichi; Watanabe, Kazuyuki; Kikuchi, Shin-Ichi; Konno, Shin-Ichi

    2016-06-01

    Symptomatic thoracic disc herniation is clinically rare. There are few cases of disc herniation of the thoracic spine in top athletes described in the literature. We herein present a rare case of chest wall pain due to thoracic disc herniation in a professional baseball pitcher. A 30-year-old, left-handed pitcher complained of left-sided chest wall pain in the region of his lower ribs during a game. Neurological examination revealed hypoesthesia of the left side of the chest at the level of the lower thoracic spine. Magnetic resonance imaging (MRI) of the thoracic spine showed a left-sided paramedian disc herniation at the T9-T10 level. The player was initially prescribed rest, administration of pregabalin (150 mg twice a day), and subsequent physical rehabilitation. He was able to resume full training and pitching without medication 6 months after the onset. A follow-up MRI of the thoracic spine showed a reduction in the size of the herniated disc compared to the initial findings. Though relatively rare, thoracic disc herniation should be considered in cases of chest wall pain in athletes. PMID:26983590

  9. Diagnosis of disc herniation based on classifiers and features generated from spine MR images

    Science.gov (United States)

    Koh, Jaehan; Chaudhary, Vipin; Dhillon, Gurmeet

    2010-03-01

    In recent years the demand for an automated method for diagnosis of disc abnormalities has grown as more patients suffer from lumbar disorders and radiologists have to treat more patients reliably in a limited amount of time. In this paper, we propose and compare several classifiers that diagnose disc herniation, one of the common problems of the lumbar spine, based on lumbar MR images. Experimental results on a limited data set of 68 clinical cases with 340 lumbar discs show that our classifiers can diagnose disc herniation with 97% accuracy.

  10. Conservative treatment of lumbar disc herniation. Epidural steroid injection and MRI findings

    Energy Technology Data Exchange (ETDEWEB)

    Ohmura, Munehisa; Sakanaka, Hideki; Wada, Eiji; Inaoka, Masahiro; Yonenobe, Sakuo [Kansai Rosai Hospital, Amagasaki, Hyogo (Japan)

    1996-01-01

    A study was made on the efficacy of the epidural injection of steroids in 65 patients of lumbar disc herniation. It was recognized that epidural steroids were effective in 49 cases (75 percent) and the effect was closely correlated with the prognosis of lumbar disc herniation. On follow-up MRI studies, a definite decrease in the size of the herniated nucleus pulposus was observed in six patients of the sequestration type: disappearance in five. No definite change was observed except for one patient in the protrusion type. (author).

  11. THE CLINICAL EFFICACY OF INTRADISCAL OZONE INJECTION COMBINED WITH RADIOFREQUENCY THERMOCOAGULATION TECHNOLOGY IN THE TREATMENT OF CERVICAL DISC HERNIATION%CT引导下臭氧联合经皮射频热凝注射治疗颈椎间盘突出症

    Institute of Scientific and Technical Information of China (English)

    周伶; 李荣春

    2012-01-01

    目的:观察经皮穿刺盘内臭氧髓核化学溶解联合射频热凝治疗颈椎间盘突出症的临床效果.方法:颈椎间盘突出症患者528例,分为臭氧组264例,臭氧+射频组264例.均在CT引导下经颈前血管鞘和气管鞘之间穿刺入椎间盘髓核或突出物靶点.臭氧组每个盘内注射浓度为50 μg/ml的臭氧4ml.臭氧+射频组盘内注射浓度为50 μg/ml的臭氧后再行髓核或/和突出物射频热凝,设定最高温度为90℃,时间为4个周期.观察治疗后各个时期的疼痛视觉模拟评分(visual analoguescale,VAS)以及临床效果.记录治疗过程中及治疗后的并发症.结果:治疗后不同时期(24小时、1周、1个月、3个月及6个月)疼痛VAS评分与术前相比显著改善.且臭氧+射频组在治疗后3个月及6个月的VAS评分较臭氧组明显降低.治疗后6个月,臭氧组优良率为80.3%,臭氧+射频组优良率为86.5%.无一例发生严重并发症.结论:CT引导下经皮穿刺臭氧髓核化学溶解联合射频热凝是治疗颈椎间盘突出症有效的方法之一.%Objective: To observe the clinical efficacy of intradiscal ozone (O3) injection combined with radiofrequency (RF) thermocoagulation for the treatment of cervical disc hemiation. Methods: 528 patients with cervical disc herniation were randomly and evenly divided into two groups: O3 group (264 cases) and O3+RF group (264 cases). Under CT guiding, the needles were inserted into the nucleus pulposus and/or targets of cervical intervetebral disc through the path between anterior jugular tracheal sheath and vagina vasorum. In the O3 group, each disc was injected with ozone 50μg/ml (4 ml). In the O3+RF group, after injection of ozone 50μg/ml (4 ml), RF thermocoagulation was performed within nucleus pulposus and/or targets with the highest temperature of 90°C for 4 cycles. The VAS scores and complications were recorded at 24 h, 1 w, 1 month, 3 months and 6 months after treatment. Results: Compared with

  12. Technique and results of the spinal computed tomography in the diagnosis of cervical disc disease

    International Nuclear Information System (INIS)

    We give a description of a technique of the patient's positioning with traction of the arms during the cervical spinal computed tomography which allows to draw the shoulders downwards by about one to three cervical segments. By this method the quality of the images can be improved in 96% in the cervical segment 6/7 and in 81% in the cervical/thoracal segment 7/1 to such a degree that a reliable judgement of the soft parts in the spinal canal becomes possible. The diagnostic reliability of the computed tomography of the cervical disc herniation is thus improved so that the necessity of a myelography is decreasing. The results of 396 cervical spinal computed tomographies are presented. (orig.)

  13. MR findings of degenerative changes of nucleus pulposus in lumbar spine: sequential changes after disc herniation

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Sang Joon [Choong-Ang Gil Hospital, Seoul (Korea, Republic of); Cha, Yoo Mi; Hwang, Hee Young [College of Medicine, Dankook University, Chenoan (Korea, Republic of)

    1994-04-15

    To evaluate the relationship between MR changes of the nucleus pulposus and the time interval after traumatic disc herniation. T2-weighted MR images of 132 patients with back pain and/or sciatica were reviewed. The changes of signal intensity, central cleft and height of the nucleus pulposus were used as criteria of disc degeneration and they were graded as normal, mild, moderate and severe degree of degeneration. Putting these criteria together we provided integrated grade of degeneration of the nucleus pulposus(grade 0-3). To get the preliminary data for normal and age-related disc degeneration, we measured the disc height by age groups and disc levels and analyzed the relationship between the age of the patients and the signal intensity, cleft and height in normal disc levels of the 132 patients. In 68 patients of 88 levels disc herniation, we analyzed the relationship between symptom duration and the degree of degeneration. Among these 68 patients we selected 14 patients(16 levels) who were under 30 years of age and had history of recent trauma to minimize data distortion from age related degeneration and ambiguity of initiation point of degeneration. In this group we analyzed the relationship between the time period after traumatic disc herniation and the degree of degeneration. The age of the patient had close relationship with the grade of signal intensity, central cleft, and disc height and grade of degeneration of the nucleus pulposus in normal discs. In 88 levels of herniated discs, the duration of symptom and degree of degeneration showed moderate correlation. In 14 patients of disc herniation who were under 30 years old and had trauma history in recent 2 years, grade 1 disc degeneration occurred in average 3.7 months after trauma. Although it was difficult to proceed statistical analysis in the last group because of small patients number, the degree of degeneration of nucleus pulposus had close relationship with the duration after traumas or duration of

  14. Material Science in Cervical Total Disc Replacement

    OpenAIRE

    Pham, Martin H.; Mehta, Vivek A.; Alexander Tuchman; Hsieh, Patrick C.

    2015-01-01

    Current cervical total disc replacement (TDR) designs incorporate a variety of different biomaterials including polyethylene, stainless steel, titanium (Ti), and cobalt-chrome (CoCr). These materials are most important in their utilization as bearing surfaces which allow for articular motion at the disc space. Long-term biological effects of implanted materials include wear debris, host inflammatory immune reactions, and osteolysis resulting in implant failure. We review here the most common ...

  15. Clinical outcomes after posterior dynamic transpedicular stabilization with limited lumbar discectomy: Carragee classification system for lumbar disc herniations

    OpenAIRE

    Kaner, Tuncay; Sasani, Mehdi; Oktenoglu, Tunc; Cosar, Murat; Ozer, Ali Fahir

    2010-01-01

    Background The observed rate of recurrent disc herniation after limited posterior lumbar discectomy is highest in patients with posterior wide annular defects, according to the Carragee classification of type II (fragment-defect) disc hernia. Although the recurrent herniation rate is lower in both type III (fragment-contained) and type IV (no fragment-contained) patients, recurrent persistent sciatica is observed in both groups. A higher rate of recurrent disc herniation and sciatica was obse...

  16. MR imaging of cervical disc disease

    International Nuclear Information System (INIS)

    Since magnetic resonance imaging (MRI) technology has been greatly improved, MRI for cervical disc disease has become widely used in many facilities. Among non-invasive procedures, MRI is regarded as one of the most useful ones. Conventional myelography, CT myelography, and MRI were performed on 10 patients with cervical disc disease. The authors discussed the correlation between conventional myelography, CT myelography, and MRI as regards their ability to determine the localization and the laterality of disc protrusion and osteophyte. In our MRI study, we use both short-echo (SE) images and GRASS images. The parameters of our GRASS included 5 mm-thick sections. TR=200, TE=20, and flip angles of 10deg. This pulse sequence generates images with high signal cerebrospinal fluid (CSF), resulting in a high-contrast CSF-spinal cord, osteophyte, and disc protrusion. As yet, although it easily shows the localization and laterality of the disc and/or osteophyte, image quality of the GRASS is not yet sufficient to allow us to evaluate detailed deformity of the spinal cord and nerve root. The authors stress the usefulness of this GRASS image for the evaluation of suspected cervical disc disease. (author)

  17. Hérnia discal lombar Lumbar disc herniation

    Directory of Open Access Journals (Sweden)

    Luis Roberto Vialle

    2010-01-01

    Full Text Available A hérnia discal lombar é o diagnóstico mais comum dentre as alterações degenerativas da coluna lombar (acomete 2 a 3% da população e a principal causa de cirurgia de coluna na população adulta. O quadro clínico típico inclui lombalgia inicial, seguida de lombociatalgia e, finalmente, de dor ciática pura. A história natural da hérnia de disco é de resolução rápida dos sintomas (quatro a seis semanas. O tratamento inicial deve ser conservador, com manejo medicamentoso e fisioterápico, podendo ser acompanhado ou não por bloqueios percutâneos radiculares. O tratamento cirúrgico está indicado na falha do controle da dor, déficit motor maior que grau 3, dor radicular associada à estenose óssea foraminal ou síndrome de cauda equina, sendo esta última uma emergência médica. Uma técnica cirúrgica refinada, com remoção do fragmento extruso, e preservação do ligamento amarelo, resolve a sintomatologia da ciática e reduz a possibilidade de recidiva em longo prazo.Lumbar disc herniation is the most common diagnosis amongst the degenerative conditions of the lumbar spine (affecting around 2 to 3% of the population, and is the principal cause of spine surgery in the adult population. The typical clinical picture includes initial lumbalgia, followed by progressive sciatica. The natural history of disc herniation is one of rapid resolution of the symptoms (from 4-6 weeks. Early treatment should be conservative, with pain management and physiotherapy, sometimes associated with selective nerve root block. Surgery should be considered if pain management is unsuccessful, if there is a motor deficit (strength grade 3 or less, where there is radicular pain associated with foraminal stenosis, or in the presence of cauda equina syndrome, the latter representing a medical emergency. A refined surgical technique, with removal of the extruded fragment and preservation of the ligamentum flavum, resolves the sciatic symptoms and reduces

  18. Treatment of Recurrent Disc Herniation: A Systematic Review.

    Science.gov (United States)

    Drazin, Doniel; Ugiliweneza, Beatrice; Al-Khouja, Lutfi; Yang, Dongyan; Johnson, Patrick; Kim, Terrence; Boakye, Maxwell

    2016-01-01

    Intervertebral disc herniation is one of the most common causes of back and extremity pain. The most commonly used surgical treatment is lumbar discectomy. About 0.5-25% go on to develop recurrent disc herniation (rDH) after a successful first discectomy. Currently, there aren't any guidelines to assist surgeons in determining which approach is most appropriate to treat rDH. A recent survey showed significant heterogeneity among surgeons regarding treatment options for rDH. It remains unclear which methods lead to better outcomes, as there are no comparative studies with a sufficient level of evidence. In this study, we aimed to perform a systematic review to compare treatment options for rDH and determine if one intervention provides better outcomes than the other; more specifically, whether outcome differences exist between discectomy alone and discectomy with fusion. We applied the PICOS (participants, intervention, comparison, outcome, study design) format to develop this systematic review through PubMed. Twenty-seven papers from 1978-2014 met our inclusion criteria and were included in the analysis. Nine papers reported outcomes after discectomy and seven of them showed good or excellent outcomes (70.60%-89%). Ten papers reported on minimally invasive discectomy. The percent change in visual analog scale (VAS) ranged from -50.77% to -86.57%, indicating an overall pain reduction. Four studies out of the ten reported good or excellent outcomes (81% to 90.2%). Three studies looked at posterolateral fusion. Three studies analyzed posterior lumbar interbody fusion. For one study, we found the VAS percentage change to be -46.02%. All reported good to excellent outcomes. Six studies evaluated the transforaminal lumbar interbody fusion. All reported improvement in pain. Four used VAS, and we found the percent change to be -54% to -86.5%. The other two used the Japanese Orthopedic Association (JOA) score, and we found the percent change to be 68.3% to 93.3%. We did

  19. Reoperations after first lumbar disc herniation surgery; a special interest on residives during a 5-year follow-up

    OpenAIRE

    Kautiainen Hannu; Neva Marko H; Kiviranta Ilkka; Häkkinen Arja; Ylinen Jari

    2007-01-01

    Abstract Background The overall rate of operations after recurrent lumbar disc herniation has been shown to be 3–11%. However, little is known about the rate of residives. Thus the aim of this study was to explore the cumulative rates of re-operations and especially residive disc herniations at the same side and level as the primary disc herniation after first lumbar disc herniation surgery and the factors that influence the risk of re-operations over a five year follow-up study. Methods 166 ...

  20. THE EFFICACY OF PLASMA-MEDIATED COBLATION COMBINED WITH OZONE INJECTION ON CONTAINED CERVICAL DISC HERNIATION AIMING BY C-ARM MACHINE%C型臂引导下等离子髓核低温消融术联合臭氧治疗包容型颈椎间盘突出症的对比观察

    Institute of Scientific and Technical Information of China (English)

    王君; 杨艳梅; 韩悦; 杨连海; 夏庆来; 郑宝森

    2012-01-01

    目的:观察在C型臂引导下采用等离子髓核低温消融术联合髓核内臭氧注射治疗包容型颈椎间盘突出症的临床疗效.方法:回顾性分析60例包容型颈椎间盘突出症,30例患者采用等离子髓核低温消融术治疗(A组),同期30例患者采用等离子髓核低温消融术+髓核内臭氧注射(B组).采用视觉模拟疼痛评分(visual analogue scale,VAS)作为疼痛水平评价指标,改良Macnab标准评估治疗效果.观察两组患者术后1周、2周、1个月、2个月的临床疗效.结果:A组治疗后的优良率为80% (24/30例),B组治疗后的优良率为96.6% (29/30例).B组术后2个月优良率高于A组(P<0.05).结论:等离子髓核低温消融术联合髓核内臭氧注射治疗包容型颈椎间盘突出症的疗效优于单独应用等离子髓核低温消融术.%Objective: To observe the efficacy of plasma-mediated coblation combined with ozone injection therapy on contained cervical disc herniation aiming by C-arm machine. Methods: Respectively analysis was used to analyse sixty patients who were diognosised as contained cervical disc herniation by MRI. These patients were into A, B groups in which thirty patients were enrolled respectively. The technique of plasma-mediated coblation alone were used in A group (n = 30). Plasmamediated coblation combined with ozone injection therapy were used in B group (n = 30). Visual analogue scale (VAS) was used to evaluate the degree of pain and improved Macnab criteria were used to evaluate the clinical efficacy which were observed during the time point one week, two weeks, one month, two months after surgery. Result: The efficacy rate of B group two month after surgery is 96.6%, which was significantly higher than the A group which was 80% (P < 0.05). Conclusion: The efficacy of technique of plasma-mediated coblation combined with ozone injection on cervical disc herniation have advantage than the technique of plasma-mediated coblation therapy alone.

  1. 臭氧联合射频热凝术治疗颈椎间盘突出症的临床疗效%Clinical effect of ozone combined with radiofrequency thermocoagulation for the treatment of cervical interver-tebral disc herniation

    Institute of Scientific and Technical Information of China (English)

    张昊; 周建华; 菅新民; 胡亚威; 张弦; 陈少初; 卢学有

    2015-01-01

    Objective To analyze the treatment effects of cervical disc herniation treated by ozone combined with radiofrequency ther-mocoagulation. Methods Ninety cases of cervical intervertebral disc herniation were collected from our hospital in July 2009 to December 2013,who were treated by ozone combined with radiofrequency thermocoagulation. The patients were followed up for at least 3~6 months and the improvement rate was calculated according to the Macnab improved standard. Results All the patients were followed up for at least 3~6 months,according to the Macnab standard improved,50 cases were excellent,good in 25 cases,in 10 cases and poor in 5 cases,the improve-ment rate was 94. 4%. Conclusion The treatment of cervical disc herniation by ozone combined with radiofrequency thermocoagulation is one of the interventional therapy methods,which is minimally invasive and relatively safe. The treatment method has the following advantages, such as,satisfactory effect,accurate operation safety,less complications and without destroying the stability of the spinal structure.%目的:臭氧联合射频热凝术治疗颈椎间盘突出症的疗效分析。方法我院自2009年7月至2013年12月收治90例颈椎间盘突出症患者,在局麻下后路经皮穿刺臭氧联合射频热凝术治疗颈椎间盘突出症,男46例,女44例;20例C3~C4,30例C4~C5,30例C5~C6,10例C6~C7。术后随访至少3~6个月,根据改良的Macnab评定标准,判定患者症状改善率。结果所有患者均得到随访,随访至少3个月以上,根据改良的Macnab评定标准,优50例,良25例,可10例,差5例,改善率94.4%。结论臭氧联合射频热凝术治疗颈椎间盘突出症,具有疗效满意、操作精准安全、并发症少、不破坏脊柱结构的稳定性等优势,是相对安全的微创介入治疗之一。

  2. The Research of Artificial Cervical Disc Replacement

    Institute of Scientific and Technical Information of China (English)

    Zhao Zhua; Qiang Shenb

    2008-01-01

    Cervical arthroplasty after anterior decompression with insertion of a prosthetic total disc replacement has been suggested as an alternate to anterior cervical fusion. It develops quickly during recent years. Currently there are several cervical arthroplasty devices. Each device varies in terms of materials, range of motion and constraint. Early studies suggest that in the short term, the complication rate and efficacy is no worse than fusion surgery. Long-term results have not yet been reported. This review examines the current prostheses as well as discussing issues regarding indications and technique. It is hoped that an improvement of cervical arthroplasty occurs in terms of materials and design as spinal surgeons enter a new dines of the management of cervical spine disease.

  3. Clinical evaluation of CT discography in the diagnosis of lumbar disc herniation

    International Nuclear Information System (INIS)

    The CT discographic findings of 56 discs in 43 patients with low-back and/or leg pain were evaluated mainly from the clinical standpoint including pain provocation during the injection of the contrast material, correlation between the type of the herniation and symptoms and clinical course after the examination. The clinical value of CT discography is controversial, but it is well recognized that CT discography is the diagnostic method of choice for equivocal situations as patients showing negative myelography and significant symptoms and for the preoperative evaluation of patient thought to have the extreme lateral disc herniation. Exact provoked pain response was noted in 72 % of 43 pathologic discs and almost all discs especially in patients showing positive SLR test at less than 70 deg. So this pain response seems to provide additional information indicating the true pathologic disc level. Sciatic pain in the legs was much more frequently seen in the paramedian or lateral type herniation, but there was no relation between low-back pain and central type herniation. Majority of either type of disc herniation showed both low-back and leg pains. This suggests that clinical symptoms are based on not only disc herniation but also disc degeneration itself. We injected steroid (4 mg of Decadron) and local anesthetic (1 ml of 1 % Carbocain) into the disc after the examination for the purpose of improving the clinical symptoms as the first attempt. Definite improvement of various degree was noted in 56 % of total 43 cases after the procedure and CT discography was thought to be a valuable method of diagnosis in proper indications despite risky needle puncture. (author)

  4. Predictors of vocational prognosis after herniated lumbar disc

    DEFF Research Database (Denmark)

    Jensen, Lone Donbæk; Frost, Poul; Schiøttz-Christensen, Berit;

    2011-01-01

    Study Design. A register study with 2 years of follow up. Objective. To identify predictors of an unfavorable vocational prognosis after hospital contact for herniated lumbar disc (HLD). Summary of Background Data. There is sparse information about vocational prognosis among HLD patients diagnosed...... at hospital. Methods. We followed all in- and outpatients diagnosed with HLD at a Danish University Hospital 2001 to 2005 eligible for the labor market in the Danish National Register on Public Transfer Payments (n = 2039). Clinical data were obtained from the Danish National Patient Register. The outcome...... were lumbar fusion alone HR 1.4 (CI = 1.1–1.8) and in combination with discectomy HR 1.6 (CI = 1.2–2.2) as compared with nonsurgical treatment, ethnicity other than Danish HR 1.55 (CI = 1.2–1.8), and female gender HR 1.2 (CI = 1.1–1.4). Discectomy, age, and year of inclusion were not associated...

  5. Value of spinal computed tomography in diagnosis of herniated lumbar discs

    Energy Technology Data Exchange (ETDEWEB)

    Sachsenheimer, W.; Hamer, J. (Heidelberg Univ. (Germany, F.R.). Abt. fuer Neurochirurgie); Mueller, H.A. (Deutsches Krebsforschungszentrum, Heidelberg (Germany, F.R.). Abt. fuer spez. onkologische Diagnostik)

    1982-01-01

    In this study the diagnostic value and topographical accuracy of spinal computed tomography (CT) in the preoperative diagnosis of lumbar disc herniations were tested in 36 patients with surgically proven herniated discs. All patients also underwent metrizamide myelography. CT findings and myelograms were compared and correlated with the surgical observations. Especially in demonstrating exact diagnosis (lateral or more medial protrusion), and in showing the extent of upward and downward displacement of free disc material, CT provides valuable preoperative information. As a non-invasive diagnostic procedure, spinal CT scan may replace lumbar myelography in many patients with radicular lumbar pain.

  6. Material Science in Cervical Total Disc Replacement.

    Science.gov (United States)

    Pham, Martin H; Mehta, Vivek A; Tuchman, Alexander; Hsieh, Patrick C

    2015-01-01

    Current cervical total disc replacement (TDR) designs incorporate a variety of different biomaterials including polyethylene, stainless steel, titanium (Ti), and cobalt-chrome (CoCr). These materials are most important in their utilization as bearing surfaces which allow for articular motion at the disc space. Long-term biological effects of implanted materials include wear debris, host inflammatory immune reactions, and osteolysis resulting in implant failure. We review here the most common materials used in cervical TDR prosthetic devices, examine their bearing surfaces, describe the construction of the seven current cervical TDR devices that are approved for use in the United States, and discuss known adverse biological effects associated with long-term implantation of these materials. It is important to appreciate and understand the variety of biomaterials available in the design and construction of these prosthetics and the considerations which guide their implementation. PMID:26523281

  7. Material Science in Cervical Total Disc Replacement

    Directory of Open Access Journals (Sweden)

    Martin H. Pham

    2015-01-01

    Full Text Available Current cervical total disc replacement (TDR designs incorporate a variety of different biomaterials including polyethylene, stainless steel, titanium (Ti, and cobalt-chrome (CoCr. These materials are most important in their utilization as bearing surfaces which allow for articular motion at the disc space. Long-term biological effects of implanted materials include wear debris, host inflammatory immune reactions, and osteolysis resulting in implant failure. We review here the most common materials used in cervical TDR prosthetic devices, examine their bearing surfaces, describe the construction of the seven current cervical TDR devices that are approved for use in the United States, and discuss known adverse biological effects associated with long-term implantation of these materials. It is important to appreciate and understand the variety of biomaterials available in the design and construction of these prosthetics and the considerations which guide their implementation.

  8. Gd-enhanced MR imaging of the herniated lumbar disc: patterns of enhancement

    Energy Technology Data Exchange (ETDEWEB)

    Kwag, Hyon Joo; Choi, Hye Young; Kim, Hyae Young; Kim, Yoo Kyung; Kim, Ah Young; Chung, Eun Chul [College of Medicine, Ewah Womans University, Seoul (Korea, Republic of)

    1995-07-15

    The purpose of this study is to describe the patterns of enhancement of the herniated lumbar disc with Gd-DTPA enhanced MR imaging. Out of 65 patients, 103 lumbar discs diagnosed to be herniated by MR image were retrospectively analyzed. The MR imaging was performed with 1.5 T MR unit, using T1-and T2-weighted sagittal and axial spin echo techniques. Contrast-enhanced T1 weighted sagittal and axial images were performed after intravenous injection of Gadopentetate-dimeglumine(Magnevist, Shering) (0.1 mmol/kg). Contrast enhancement was seen in 66 cases(64%). Thirteen cases of bulging disc were not enhanced. Twenty-eight cases of protruded disc showed intraannular enchantment in 23 cases, peripheral linear and irregular enhancement in each of one case, and nonenhancement in three cases. Fifty-seven cases of extruded disc showed irregular enhancement in 14 cases, peripheral linear enhancement in 12 cases, peripheral ring enhancement in five cases and intraannular enhancement in five cases. All five cases of sequestered disc showed peripheral ring enhancement. Protruded discs show intraannular enhancement frequently and sequestered discs usually show peripheral ring enhancement. Enhanced MR imaging may be helpful to evaluate the type of herniated lumbar disc and relationship among disc material, nerve root and thecal sac.

  9. Minimally invasive strategies and options for far-lateral Iumbar disc herniation

    Institute of Scientific and Technical Information of China (English)

    ZHOU Yue; ZHANG Chao; WANG Jian; CHU Tong-wei; LI Chang-qing; ZHANG Zheng-feng; ZHENG wen-jie

    2008-01-01

    Objective: To investigate the surgical procedlures,options and surgical indications for far-lateral lumbar disc herniation between three different minimally invasive procedures.Methods: From January 2000 to October 2006, 52 patients with far-lateral lumbar disc herniation (29 males and 23 females, with the average age of 41.5 years) were treated with minimally invasive procedures. All the patients were assessed by X-ray and CT. Some were given additional myeography, discography, Computerized tomography myelography (CTM) and MRI examination. Yeung Endoscopy Spine System (YESS), METRx and X-tube procedures were performed in 25, 13 and 14 cases, respectively. All patients were followed up for a mean period of 13.5 months. Clinical outcomes were assessed by visual analog score (VAS) and Nakai criteria. Results: The results indicated that the three procedures could significantly improve the radiating leg symptoms (PO.05). The YESS procedure had several advantages including shortest operation time, simplest anesthesia and least trauma as compared with the other two procedures, especially for simple type I far-lateral lumbar disc herniation. METRx procedure was specially suitable for simple type II. And the procedure of posterior endoscopic facetectomy, posterior lumbar interbody fusion and unilateral pedicle screw instrumentation with X-tube was designed for far-lateral disc herniation combined with degenerative lumbar instability. Conclusion: Minimally invasive strategies and options should be determined by different types of far-lateral lumbar disc herniation.

  10. Genetic mapping of a susceptibility locus for disc herniation and spastic paraplegia on 6q23.3-q24.1

    OpenAIRE

    Zortea, M.; Vettori, A; Trevisan, C; Bellini, S.; Vazza, G.; Armani, M; Simonati, A; Mostacciuolo, M

    2002-01-01

    It has been suggested that a genetic factor(s) or a familial predisposition may contribute to the clinical manifestations of disc herniation; moreover, no genetic linkage between spinal disc herniation and spastic paraplegia has ever been described.

  11. Comparison of preoperative neuroradiographic findings and surgical findings in lumbar disc herniation

    Energy Technology Data Exchange (ETDEWEB)

    Takahara, Kazuhiro; Sera, Keisuke; Nakamura, Masakazu; Uchida, Takeshi [Nagasaki Mitsubishi Hospital (Japan); Ito, Nobuyuki

    1997-09-01

    Surgical findings in lumbar disc hernia were compared to pre-operative MRI, CTM and myelogram findings. Ninety-one cases were studied using Love`s method. The accuracy of hernia diagnosis in MRI was 59.3%, 41.2% in CTM, and 35.2% in myelogram. At the L5/S1 disc level, the accuracy of hernia diagnosis by CTM and myelogram was decreased. MRI was useful for the diagnosis and cure of lumbar disc herniation. (author)

  12. Comparison of preoperative neuroradiographic findings and surgical findings in lumbar disc herniation

    International Nuclear Information System (INIS)

    Surgical findings in lumbar disc hernia were compared to pre-operative MRI, CTM and myelogram findings. Ninety-one cases were studied using Love's method. The accuracy of hernia diagnosis in MRI was 59.3%, 41.2% in CTM, and 35.2% in myelogram. At the L5/S1 disc level, the accuracy of hernia diagnosis by CTM and myelogram was decreased. MRI was useful for the diagnosis and cure of lumbar disc herniation. (author)

  13. Topical vancomycine and bacterial culture from intervertebral herniated disc prevent postoperative osteodiscitis

    Directory of Open Access Journals (Sweden)

    Adam1 Danil

    2014-12-01

    Full Text Available Osteodiscitis represents a serious complication of lumbar disc herniation operations. The treatment of osteodiscitis is controversial and expensive to society. It extends over a period of several months from diagnosis. Reducing postoperative osteodiscitis by using simple measures may limit patient's suffering and reduce costs. The purpose of this study is to evaluate the early diagnosis of bacterial infections of the intervertebral disc by isolating germs located in the herniated disc fragment and topical Vancomycine powder application, along with the conventional anti-infective therapy. Medical files of patients who were operated on for lumbar disc herniations during 01.01.2013 - 30.06.2014 were reviewed. The diagnosis of lumbar disc herniation was established based on the clinical evaluation, confirmed by MRI results. The surgical intervention was performed by mini-open approach: fenestration and foraminotomy completed with removal of the herniated disc fragment and disc remnants from the intervertebral space. A group of 162 patients (group A received conventional therapy for prevention of post-operative infections with 2 doses of cephalosporin. In the second group of 137 patients (group B, after the removal of the herniated disc fragments, 1g of Vancomycine powder was topically applied and the disc fragments were bacteriologically analyzed. They received the conventional treatment of preventing post-operative infections with cephalosprin - 2 doses. The two groups of patients were similar in terms of demographic characteristics: age, sex, operative level. Out of the 162 patients of group A, one patient developed postoperative osteodiscitis and was treated for 3 months with antibiotics. Regarding patients in group B, in four cases Staphylococcus was isolated from the disc fragments. Postoperative treatment for these patients with prolonged antibiotic therapy over the standard period avoided the developement of the clinical picture of

  14. Lumbar multifidus muscle changes in unilateral lumbar disc herniation using magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Altinkaya, Naime [Baskent University Medical School, Department of Radiology, Adana (Turkey); Cekinmez, Melih [Baskent University Medical School Adana, Department of Neurosurgery, Adana (Turkey)

    2016-01-15

    To assess multifidus muscle asymmetry using the cross-sectional area (CSA) and perpendicular distance of the multifidus muscle to the lamina (MLD) measurements in patients with nerve compression due to lumbosacral disc hernia. In total, 122 patients who underwent microdiscectomy for unilateral radiculopathy caused by disc herniation, diagnosed by magnetic resonance imaging (MRI), were evaluated retrospectively. Posterolateral or foraminal disc herniation at only one disc level, the L3-4, L4-L5, or L5-S1 region, was confirmed using MRI. Subjects were divided by symptom duration: 1-30 days, (group A), 31-90 days (group B), and > 90 days (group C). There were 48 cases in group A, 26 in group B, and 48 in group C. In groups A, B, and C, the median MLD differed significantly between the diseased and normal sides (P < 0.05). The MLD increased on the diseased side with symptom duration by lumbar disc herniation. The diseased side MLD was 5.1, 6.7, and 7.6 mm in groups A, B, and C, respectively (P < 0.05). The cut-off values for the MLD measurements were 5.3 mm (sensitivity = 62.3 %, specificity = 55.5 %; P < 0.05). In groups A, B, and C, the median CSA of the multifidus muscle was not significantly different between the diseased and the normal side (P > 0.05). The MLD measurement correlated significantly with multifidus asymmetry in patients with lumbar disc herniation. (orig.)

  15. Lumbar multifidus muscle changes in unilateral lumbar disc herniation using magnetic resonance imaging

    International Nuclear Information System (INIS)

    To assess multifidus muscle asymmetry using the cross-sectional area (CSA) and perpendicular distance of the multifidus muscle to the lamina (MLD) measurements in patients with nerve compression due to lumbosacral disc hernia. In total, 122 patients who underwent microdiscectomy for unilateral radiculopathy caused by disc herniation, diagnosed by magnetic resonance imaging (MRI), were evaluated retrospectively. Posterolateral or foraminal disc herniation at only one disc level, the L3-4, L4-L5, or L5-S1 region, was confirmed using MRI. Subjects were divided by symptom duration: 1-30 days, (group A), 31-90 days (group B), and > 90 days (group C). There were 48 cases in group A, 26 in group B, and 48 in group C. In groups A, B, and C, the median MLD differed significantly between the diseased and normal sides (P < 0.05). The MLD increased on the diseased side with symptom duration by lumbar disc herniation. The diseased side MLD was 5.1, 6.7, and 7.6 mm in groups A, B, and C, respectively (P < 0.05). The cut-off values for the MLD measurements were 5.3 mm (sensitivity = 62.3 %, specificity = 55.5 %; P < 0.05). In groups A, B, and C, the median CSA of the multifidus muscle was not significantly different between the diseased and the normal side (P > 0.05). The MLD measurement correlated significantly with multifidus asymmetry in patients with lumbar disc herniation. (orig.)

  16. The value of ultrasonic evaluation for diagnosis of lumbar disc herniation

    International Nuclear Information System (INIS)

    The aim of the investigation was to evaluate the diagnostic effectiveness of sonography in the evaluation of the lower lumbar intervertebral disc herniations. Prospective ultrasonographic examinations by transabdominal approach were performed on 65 consecutive patients (32 males and 33 females) with clinically suspected lumbar disc herniation, and the findings were compared with MR findings. The transabdominal representation of lumbar disc herniations was successful in 64 cases at L3-4 level,59 cases at L4-5 level and 55 cases at L5-S1 level. The sonographic examination wa inconclusive in the some patients because of degenerative disc with vacuum phenomenon, osteophytosis and diminution of the intervertebal disc space. Both sensitivity and specificity of sonography were 100% at L3-4 level. At the same time, the sensitivity and specificity of sonography were 60% and 97% at L4-5 level and 36% and 100% at L5-S1 level. Although ultrasound is not currently used as a screening modality because of the low sensitivity, ultrasound shows a high specificity with non-invasiveness but without radiation hazard. Therefore, ultrasound can be used as an aid for diagnosing lumbar disc herniation, especially in young men without spondylosis.

  17. The value of ultrasonic evaluation for diagnosis of lumbar disc herniation

    Energy Technology Data Exchange (ETDEWEB)

    Oh, Jae Cheon [Sarang Hospitl, Seoul (Korea, Republic of); Rhim, Hyun Chul; Jeong, Woo Koeng; Lee, Seung Ro [Hanyang University College of Medicine, Seoul (Korea, Republic of)

    2001-12-15

    The aim of the investigation was to evaluate the diagnostic effectiveness of sonography in the evaluation of the lower lumbar intervertebral disc herniations. Prospective ultrasonographic examinations by transabdominal approach were performed on 65 consecutive patients (32 males and 33 females) with clinically suspected lumbar disc herniation, and the findings were compared with MR findings. The transabdominal representation of lumbar disc herniations was successful in 64 cases at L3-4 level,59 cases at L4-5 level and 55 cases at L5-S1 level. The sonographic examination wa inconclusive in the some patients because of degenerative disc with vacuum phenomenon, osteophytosis and diminution of the intervertebal disc space. Both sensitivity and specificity of sonography were 100% at L3-4 level. At the same time, the sensitivity and specificity of sonography were 60% and 97% at L4-5 level and 36% and 100% at L5-S1 level. Although ultrasound is not currently used as a screening modality because of the low sensitivity, ultrasound shows a high specificity with non-invasiveness but without radiation hazard. Therefore, ultrasound can be used as an aid for diagnosing lumbar disc herniation, especially in young men without spondylosis.

  18. Co-occurrence of lumbar spondylolysis and lumbar disc herniation with lumbosacral nerve root anomaly

    Directory of Open Access Journals (Sweden)

    Tevfik Yilmaz

    2014-01-01

    Full Text Available Lumbosacral nerve root anomalies are the leading cause of lumbar surgery failures. Although co-occurrence of lumbar spondylolysis and disc herniation is common, it is very rare to observe that a nerve root anomaly accompanies these lesions. A 49-year-old male patient presented with sudden-onset right leg pain. Examinations revealed L5/S1 lumbar spondylolysis and disc herniation. At preoperative period, he was also diagnosed with lumbosacral root anomaly. Following discectomy and root decompression, stabilization was performed. The complaints of the patient diagnosed with lumbosacral root anomaly at intraoperative period were improved at postoperative period. It should be remembered that in patients with lumbar disc herniation and spondylolysis, lumbar root anomalies may coexist when clinical and neurological picture is severe. Preoperative and perioperative assessments should be made meticulously to prevent neurological injury.

  19. Lumbar disc herniation associated with scoliosis in a 15-year-old girl: case report

    Directory of Open Access Journals (Sweden)

    Pinto Fernando Campos Gomes

    2002-01-01

    Full Text Available Intervertebral disc herniation is a rare condition in childhood and adolescence, although some cases have already been reported in the literature. We present the case of a 15 year-old-girl with low back pain and scoliosis. She had no previous history of trauma or collagen diseases. MRI showed L4-L5 and L5-S1 disc herniations and no further bone and structural changes. After two level discectomy, pain ceased and scoliosis improved, without further treatment. Based on her evolution and on what has already been reported in literature, we consider that scoliosis associated with disc herniation in young patients is most likely to be only an anthalgic position, not indicative of further structural changes.

  20. Prognostic factors for return to work after low-back disc herniation surgery.

    Science.gov (United States)

    Seyedmehdi, Mohammad; Attarchi, Mirsaeed; Ghaffari, Mostafa; Mohammadi, Saber; Darnahal, Maryam; Sadeghi, Zargham

    2015-03-01

    Return to work (RTW) is an important outcome following disc herniation surgery. The present study aimed at determining factors that may affect early RTW after disc herniation surgery. Data were collected from 603 patients who underwent disc herniation surgery in an educational hospital via phone interviews during a 4-year period (2005-2009). Delayed RTW and failed RTW were associated with female gender, lower educational levels, longer hospitalization periods, greater BMI, biological age exceeding 40 years, employment in manual labor, lack of encouragement by the physician to RTW, being in pain at the time of the phone interview, having negative expectations about the outcome of surgery preoperatively, and low job satisfaction (P work. PMID:23293315

  1. Natural history of lumbar disc herniation. MRI findings of improved case treated non-operatively

    International Nuclear Information System (INIS)

    This study was to determine whether magnetic resonance imaging (MRI) can predict the changes in morphology of herniation. MRI examinations were done in 42 patients with symptomatic lumbar disc herniation, who were managed conservatively. Of these patients, 15 underwent Gd-DTPA-enhanced MRI. Morphology of herniation was classified as protrusion (n=15) and prolapse (n=27). The patients in the group of protrusion were significantly younger than those in the group of prolapse. Symptoms tended to improve earlier in the group of prolapse. Reduction of herniation was observed in one in the group of protrusion and 21 in the group of prolapse. Herniation was shown as hyperintensity on T2-weighted images in 16 patients and as isointensity in 26 patients. Enhancement of the nerve root, which was observed on the first contrast-enhanced MRI, disappeared in 8 patients whose symptoms improved. Herniation was reduced more readily in the group of prolapse than in the group of protrusion, revealing the potential of MRI to predict morphological changes of herniation. Furthermore, Gd-DTPA-enhanced MRI was useful in determining the prognosis of herniation. (N.K.)

  2. CT- and fluoroscopy-guided percutaneous discectomy for lumbar radiculopathy related to disc herniation: a comparative prospective study comparing lateral to medial herniated discs

    Energy Technology Data Exchange (ETDEWEB)

    Amoretti, Nicolas; Huwart, Laurent; Marcy, Pierre-Yves [Centre Hospital-Universitaire de Nice, Department of Radiology, Hopital archet 2, Nice (France); Foti, Pauline [Centre Hospital-Universitaire de Nice, Department of Medical Statistics, Hopital archet 2, Nice (France); Hauger, Olivier [Centre Hospitalo-Universitaire de Bordeaux, Department of Radiology, Hopital Pellegrin, Bordeaux (France); Boileau, Pascal [Centre Hospital-Universitaire de Nice, Department of Orthopedic Surgery, Hopital archet 2, Nice (France)

    2013-01-15

    To evaluate and compare two groups of patients with sciatica due to intervertebral disc herniation with no neurologic deficit. The groups consisted of patients with intervertebral disc herniation in a medial location (group 1) and those in a lateral location (group 2). A total of 200 patients were included in the study and were followed for a minimum of 6 months. In our series, we treated 80 postero-lateral herniated discs (40% of cases), 46 postero-medial herniated discs (23%), and 74 foraminal herniated discs (37%). Level L3-L4 was treated in 30 cases (15%), L4-L5 in 98 cases (49%), and L5-S1 in 72 cases (36%). The procedure was performed under dual guidance: fluoroscopic and CT. A helical probe was activated. It penetrates the herniated disc and causes the pulpous material to be mechanically evacuated through the probe. All 200 patients were followed for a minimum of 6 months. In group 1, the patients had a mean pain score of 7.9 {+-} 2.5 VAS units (range 6-10 units) prior to intervention. This was reduced to 3.2 {+-} 2.1 VAS units (range 0-10 units) at 48 h follow-up and increased to 3.9 {+-} 1.2 VAS units (range 0-10 VAS units) at 1 month follow-up and further reduced to 2.7 {+-} 1.2 units (range 0-10 VAS units) at 6 month follow-up. In group 2, the patients had a mean pain score of 8.2 {+-} 3.2 VAS units (range 6-10 units) prior to intervention. This was reduced to 2.8 {+-} 1.5 VAS units (range 0-10 units) at 48 h follow-up and decreased to 1.5 {+-} 0.9 VAS units (range 0-10 units) at 1 month and further reduced to 1.1 {+-} 0.5 VAS units (range 0-10 units) at 6 months. Our study showed that results were more satisfactory for the hernia located laterally (postero-lateral, foraminal, and extra-foraminal) as compared to the hernia located posteromedially. (orig.)

  3. CT- and fluoroscopy-guided percutaneous discectomy for lumbar radiculopathy related to disc herniation: a comparative prospective study comparing lateral to medial herniated discs

    International Nuclear Information System (INIS)

    To evaluate and compare two groups of patients with sciatica due to intervertebral disc herniation with no neurologic deficit. The groups consisted of patients with intervertebral disc herniation in a medial location (group 1) and those in a lateral location (group 2). A total of 200 patients were included in the study and were followed for a minimum of 6 months. In our series, we treated 80 postero-lateral herniated discs (40% of cases), 46 postero-medial herniated discs (23%), and 74 foraminal herniated discs (37%). Level L3-L4 was treated in 30 cases (15%), L4-L5 in 98 cases (49%), and L5-S1 in 72 cases (36%). The procedure was performed under dual guidance: fluoroscopic and CT. A helical probe was activated. It penetrates the herniated disc and causes the pulpous material to be mechanically evacuated through the probe. All 200 patients were followed for a minimum of 6 months. In group 1, the patients had a mean pain score of 7.9 ± 2.5 VAS units (range 6-10 units) prior to intervention. This was reduced to 3.2 ± 2.1 VAS units (range 0-10 units) at 48 h follow-up and increased to 3.9 ± 1.2 VAS units (range 0-10 VAS units) at 1 month follow-up and further reduced to 2.7 ± 1.2 units (range 0-10 VAS units) at 6 month follow-up. In group 2, the patients had a mean pain score of 8.2 ± 3.2 VAS units (range 6-10 units) prior to intervention. This was reduced to 2.8 ± 1.5 VAS units (range 0-10 units) at 48 h follow-up and decreased to 1.5 ± 0.9 VAS units (range 0-10 units) at 1 month and further reduced to 1.1 ± 0.5 VAS units (range 0-10 units) at 6 months. Our study showed that results were more satisfactory for the hernia located laterally (postero-lateral, foraminal, and extra-foraminal) as compared to the hernia located posteromedially. (orig.)

  4. Comparative study of supine and prone flexed posture CT/MRI examination for lumber disc herniation

    International Nuclear Information System (INIS)

    Objective: To evaluate the clinical value of prone flexed posture lumber CT/MRI examination for. lumber disc herniation. Methods: Supine posture CT/MRI (SPCT/MRI) and prone flexed posture CT/MRI (PFPCT/MRI) examinations were performed on 1200 patients with lumber disc herniation. The imaging findings on SPCT/MRI and PFPCT/MRI of each case were compared. According to the CT/ MRI diagnostic criteria for encapsulated lumber disc herniation (HLDH), adhered lumber disc herniation (ALDH) and ruptured lumber disc herniation (RLDH), the 1200 cases were divided into three groups. On the basis of PFPCT/MRI findings, 868 cases were selected for percutaneous lumbar diskectomy (PLD) with half to twelve years follow up. Treatment effects of PLD on HLDH, ALDH and RLDH were analyzed with χ2 test. Results: Among 249 ALDH cases diagnosed by SPCT/MRI 35 were identified as HLDH by PFPCT/ MRI. Among 163 RLDH cases diagnosed by SPCT/MRI, 9 HLDH and 17 ALDH were identified by PFPCT/ MRI. In 868 cases treated with PLD, the effective rate of HLDH (n=832), ALDH (n=25), RLDH (n= 11) were 825/832 (99.2%), 13/25, and 1/11 respectively. The effective rate of HLDH is significantly different from that of ALDH and RLDH (χ22=369.69, P<0.01). Conclusion: PFPCT/MRI may change the grouping result of lumber disc herniation made by SPCT/MRI and can be used to objectively select patients for PLD. (authors)

  5. Spinal manipulation results in immediate H-reflex changes in patients with unilateral disc herniation

    OpenAIRE

    Floman, Y.; Liram, N.; Gilai, A. N.

    1997-01-01

    The aim of this clinical investigation was to determine whether the abnormal H-reflex complex present in patients with S 1 nerve root compression due to lumbosacral disc herniation is improved by single-session lumbar manipulation. Twenty-four patients with unilateral disc herniation at the L5-S1 level underwent spinal H-reflex electro-physiological evaluation. This was carried out before and after single-session lumbar manipulation in the side-lying position. Eligibility criteria for inclusi...

  6. Lumbar disc herniation in three patients with cystic fibrosis: a case series

    OpenAIRE

    Gruebl Armin; Spaeth Manfred; Steinborn Marc; Wurmser Harald; Vogl-Voswinckel Anna E; Denne Christian; Burdach Stefan

    2011-01-01

    Abstract Introduction To date, lumbar disc herniation has not been reported in the context of cystic fibrosis even though back pain and musculoskeletal problems are very common in patients with cystic fibrosis. Case presentation We report on three patients with cystic fibrosis who experienced lumbar disc herniation in the course of their disease at ages 19 to 21 years (a 22-year-old Caucasian man, a 23-year-old Caucasian man, and a 21-year-old Caucasian woman). Our third patient eventually di...

  7. Magnetic resonance imaging of lumbar disc herniation with special reference to the myelographic and anatomical correlation

    Energy Technology Data Exchange (ETDEWEB)

    Iwamura, Yuichi; Imamura, Kiyohiko; Uematsu, Hirokazu; Sakai, Naotaka; Yamashita, Hajime; Takemura, Kenji (Yokosuka Kyosai Hospital, Kanagawa (Japan))

    1992-08-01

    T1-weighted magnetic resonance (MR) images of 49 lumbar vertebrae from 44 patients were restrospectively reviewed, focusing on herniated material, low signal intensity zone and extradural fatty tissue in the posterior edge of intervertebral disc. Morphological MR appearance was correlated with myelograms and surgical findings to determine which morphology can be detected by MR imaging alone. The MR features of the posterior edge of intervertebral disc were morphologically divided into three main types: (I) massive, swollen herniation and clear low signal intensity zone, but little or no disruption of the extradual fatty tissue; (II) posterior protrusion of the segmental herniation, partial unclearness or lack of low signal intensity zone, and disrupted extradual fatty tissue; and (III) massive herniation, lack of low signal intensity zone, and widespread disruption of the extradual fatty tissue. Types I, II and, III were seen in 18, 19, and 12 vertebrae, respectively. Herniation was clearly visualized on T1-weighted images in 73% for Type II and 83% for Type III, compared to 28% for Type I. Herniated material was seen as isointensity in 18 vertebrae in Type II and as hyperintensity in 7 vertebrae in Type III. Fifteen vertebrae (79%) in Type II and 9 vertebrae (75%) in Type III were diagnosed by MR imaging alone, which is contrast with Type I in which 11 vertebrae required myelography for diagnosis. In evaluable 25 vertebrae, common surgical findings were bulging in Type I, prolaps in Type II, and extrusion or sequestration in Type III. (N.K.).

  8. Characteristics and Neurological Manifestations of Patients with Operated Lumbar Disc Herniation

    Directory of Open Access Journals (Sweden)

    Amir Mohammad Bazzazi

    2014-01-01

    Full Text Available Background and aim: Lumbar disk herniation is one of the most common causes of surgery in the spine with a variety of signs and symptoms. Sensory and motor deficits, as well as reflex and autonomic abnormalities may be seen. This study aimed to investigate characteristics and neurological manifestations in a series of operated cases with lumbar disc herniation. Methods: In a retrospective setting, profiles of 163 operated cases with lumbar disc herniation were reviewed. Demographics as well as preoperational sign and symptoms were extracted and evaluated. Results: There were 86 females and 77 males with a mean age of 44.85±0.91 (range: 23-78 years in the studied population. The most common involved levels were L4-L5 and L5-S1, respectively. Low back pain, radicular pain, and positive Lasegue test were documented in 98.2%, 96.9% and 77.3% of the patients, respectively. Sensory, motor and reflexive abnormalities were documented in 66.3%, 51.5% and 19.6% of the cases, respectively. Sphincter and sexual dysfunction was presented in 4.9% and 1.2%, respectively. Conclusion: Clinical and neurological signs of operated patients with lumbar disc herniation in the studied center are not far different from available reports in this regard. Keywords: Lumbar disk herniation; Signs and symptoms; Surgery 

  9. The Course of Pain Intensity in Patients Undergoing Herniated Disc Surgery: A 5-Year Longitudinal Observational Study

    Science.gov (United States)

    Dorow, Marie; Löbner, Margrit; Stein, Janine; Pabst, Alexander; Konnopka, Alexander; Meisel, Hans J.; Günther, Lutz; Meixensberger, Jürgen; Stengler, Katarina; König, Hans-Helmut; Riedel-Heller, Steffi G.

    2016-01-01

    Objectives The aims of this study are to answer the following questions (1) How does the pain intensity of lumbar and cervical disc surgery patients change within a postoperative time frame of 5 years? (2) Which sociodemographic, medical, work-related, and psychological factors are associated with postoperative pain in lumbar and cervical disc surgery patients? Methods The baseline survey (T0; n = 534) was conducted 3.6 days (SD 2.48) post-surgery in the form of face-to-face interviews. The follow-up interviews were conducted 3 months (T1; n = 486 patients), 9 months (T2; n = 457), 15 months (T3; n = 438), and 5 years (T4; n = 404) post-surgery. Pain intensity was measured on a numeric rating-scale (NRS 0–100). Estimated changes to and influences on postoperative pain by random effects were accounted by regression models. Results Average pain decreased continuously over time in patients with lumbar herniated disc (Wald Chi² = 25.97, pdepression (pdepressive symptoms were associated with postoperative pain. The findings may promote multimodal rehabilitation concepts including psychological and work-related support. PMID:27243810

  10. Ordinary Disc Herniation Changing into Posterior Epidural Migration of Lumbar Disc Fragments Confirmed by Magnetic Resonance Imaging: A Case Report of a Successful Endoscopic Treatment

    OpenAIRE

    Tarukado, Kiyoshi; Tono, Osamu; Doi, Toshio

    2014-01-01

    The posterior epidural migration of lumbar disc fragments is an extremely rare event with an unknown pathogenesis. To the best of our knowledge, there are no previously reported cases of a change of ordinary disc herniation into the posterior epidural migration of lumbar disc fragments as confirmed by magnetic resonance imaging (MRI). A 26-year-old male presented to our department complaining of left buttock and lateral leg pain. An ordinary herniation was shown in the first MRI. The patient'...

  11. Comparative Effectivenesses of Pulsed Radiofrequency and Transforaminal Steroid Injection for Radicular Pain due to Disc Herniation: a Prospective Randomized Trial.

    Science.gov (United States)

    Lee, Dong Gyu; Ahn, Sang-Ho; Lee, Jungwon

    2016-08-01

    Transforaminal Epidural steroid injections (TFESI) have been widely adopted to alleviate and control radicular pain in accord with current guidelines. However, sometimes repeated steroid injections have adverse effects, and thus, this prospective randomized trial was undertaken to compare the effectivenesses of pulsed radiofrequency (PRF) administered to a targeted dorsal root ganglion (DRG) and TFESI for the treatment of radicular pain due to disc herniation. Subjects were recruited when first proved unsuccessful (defined as a score of > 4 on a visual analogue scale (VAS; 0-10 mm) and of > 30% according to the Oswestry Disability Index (ODI) or the Neck Disability Index (NDI)). Forty-four patients that met the inclusion criteria were enrolled. The 38 subjects were randomly assigned to receive either PRF (PRF group; n = 19) or additional TFESI (TFESI group; n = 19) and were then followed for 2, 4, 8, and 12 weeks. To evaluate pain intensity were assessed by VAS. ODI and NDI were applied to evaluate functional disability. Mean VAS scores for cervical and lumbar radicular pain were significantly lower 12 weeks after treatment in both study groups. NDI and ODI scores also declined after treatment. However, no statistically significant difference was observed between the PRF and TFESI groups in terms of VAS, ODI, or NDI scores at any time during follow-up. PRF administered to a DRG might be as effective as TFESI in terms of attenuating radicular pain caused by disc herniation, and its use would avoid the adverse effects of steroid. PMID:27478346

  12. OZONE NUCLEOLYSIS IN LUMBAR INTERVERTEBRAL DISC HERNIATION: NON - RANDOMIZED PROSPECTIVE ANALYSIS

    Directory of Open Access Journals (Sweden)

    Vivekananda S

    2015-05-01

    Full Text Available STUDY DESI GN: Non - randomized, prospective analysis of 68 patients of lumbar disc herniation treated with ozone nucleolysis. OBJECTIVE: To assess the patients with lumbar disc herniation treated with intradiscal ozone, pre and post ozone nucleolysis, for pain using Visual Analog Scale (VAS functional & disability score using Japanese Orthopedic Association (JOA Clinical Symptom Score. SUMMARY OF BACKGROUN D DATA: Ozone therapy for disc herniation is becoming popu lar because of its minimal invasive, lesser recurrences and remarkably fewer side effects. Successful outcomes of ozone therapy have been reported from various European & Indian centers. METHODS: A series of 68 patients were treated with ozone therapy for lumbar disc herniation from January 2009 to January 2012. The procedure is done under C - arm guidance under local anesthesia by “Single sitting double injection technique”. All patients were assessed using VAS for radiation pain & back pain, Clinical Symptom Score of the Japanese Orthopaedic Association (JOA for a Patient with Lumbar Disc Herniation, pre op and post op, on day one, after a week, two weeks, first month, third months, sixth month one year second year. Were classified them as Good, Moder ate & Poor outcome. RESULTS: Out of 68 patients 89.7% (61/68 patients had good outcome, 7.35% (5/68 patients had moderate outcome, 2.95% (2/68 had poor outcome. Intra - op in 1 patient where ozone spread in Para spinal muscles but had no postoperative pro blem.4 patients had mild nausea, 2 had mild headache & No infection. CONCLUSIONS: Ozone nucleolysis is a new, minimally invasive procedure done under local anesthesia & has shown effective results in the treatment of contained intervertebral disc herniatio n with no side effects.

  13. Comparison of Myelography and computed tomography in establishing lumbar disc herniation

    Energy Technology Data Exchange (ETDEWEB)

    Fagerlund, M.K.J.; Thelander, U.E.

    The results of lumbar myelography and computed tomography (CT) were compared in 51 consecutive patients with clinically suggested lumbar disc herniation. A total of 100 intervertebral levels were examined. At 62 levels, either L4/L5 or L5/S1, myelography was normal. CT showed no pathologic changes at 55 levels. The results concurred between myelography and CT in 89% of the patients with normal findings. Four cases of disc herniation and one bulging disc, which had been missed at myelography because of a large epidural space at L5/S1, were picked up by CT. Two of these were verified by surgery and two were treated conservatively. There was one possible false negative case with CT as well. Abnormalities were shown at 38 intervertebral levels, 22 in the bulging and 16 in the herniated disc group. The pathologic changes concurred in 84% between the two investigations. For intervertebral disc herniation the true negative rate was, for myelography 88% and for CT 97%. The treatment strategy could have been based on CT alone at 37 out of 38 levels (97%), and on myelography alone at 34 out of 38 levels (89%). Furthermore, at CT the imaging of soft tissues and intervertebral joints was superior to that at myelography. It is concluded that CT should be the primary examination method of imaging for lumbar disc herniation. Myelography is, however, to be preferred where the level of the lesion is clinically unclear or when the entire lumbar region and thoraco-lumbar junction are to be examined. (orig.).

  14. Outcome of nucleoplasty in patients with radicular pain due to lumbar intervertebral disc herniation

    OpenAIRE

    Ogbonnaya, Sunny; Kaliaperumal, Chandrasekaran; Qassim, Abdulla; O’Sullivan, Michael

    2013-01-01

    Background: Nucleoplasty (percutaneous lumbar disc decompression) is a minimally invasive procedure that utilizes radiofrequency energy as a treatment for symptomatic lumbar disc herniation, against open microdiscectomy, which would be the mainstay treatment modality. The literature reports a favorable outcome in up to 77% of patients at 6 months. Aim: To evaluate the effectiveness of nucleoplasty in the management of discogenic radicular pain. Materials and Methods: The medical notes of 33 p...

  15. Availability of Gd-DTPA enhanced MRI for lumbar disc herniation; Mechanism enhancing scar tissue around herniated disc and its meaning

    Energy Technology Data Exchange (ETDEWEB)

    Morita, Chisato; Yoshizawa, Hidezo; Nakai, Sadaaki; Kobayashi, Shigeru; Morita, Tomofumi; Kojima, Motohiro (Fujita Health Univ., Toyoake, Aichi (Japan))

    1994-05-01

    Extradural scar tissue arising between the herniated disk in the lumbar spine and its surrounding tissue was examined in 44 patients with lumbar disc herniation, using Gd-DTPA enhanced magnetic resonance imaging (MRI). Findings of enhanced MRI were divided into three types: that is, type 1 in which the surrounding of the herniated disk was not enhanced; type 2 in which it was partially enhanced; type 3 in which it was entirely enhanced. Of these 44 patients, 15 (34.1%) had type I, 22 (50.0%) had type 2 and 7 (15.9%) had type 3. Extradural scar tissue was seen as high signal intensity on T1-weighted images in 66%, revealing the extent of nerve root compression. Furthermore, 18 of the 44 patients underwent surgery and surgical findings were compared with types of MRI findings. According to MRI findings, these 18 patients consisted of 2 with type 1, 11 with type 2, and 5 with type 3. The two type 1 patients had subligamentous type; 9 type 2 patients had subligamentous type and the other 2 had transligamentous type; and the 5 type 3 patients had all sequestration type. Extradural scar tissue was microscopically shown to be composed of collagenic fibers containing many vessels and to be leakily neovascular structure associated with gap junction and fenestra. Enhanced MRI was capable of delineating the proliferation of extradural scar tissue surrounding the herniated disk easily, thus allowing the determination of pathological changes arising between the herniated disc and nerve root. (N.K.).

  16. [Acupuncture combined with traction therapy for lumbar disc herniation: a systematic review].

    Science.gov (United States)

    Li, Xiu-zhen; Chen, Hai-yong; Zheng, Xiao; Liu, Nong-yu

    2014-09-01

    To evaluate the efficacy and safety of acupuncture combined with traction therapy for lumbar disc herniation, providing the basis for future research strategies. Randomized control trials. (RCT) of acupuncture combined with traction therapy for lumber disc herniation at home and abroad from 2000 to 2013 were searched, analysis and evaluation of literature and strength of evidence were based on the principles and methods of Evidence-based Medicine. The total effective rate and curative rate were considered as primary outcome measures; pain improvement, quality of life, relapse rate and adverse effects were considered as secondary outcome measures. Seventeen RCTs were identified, Meta-analysis showed that (1) total effective rate and curative rate: acupuncture combined with traction therapy was better than single therapy (acupuncture or traction); (2) pain improvement: acupuncture combined with traction therapy was better than traction therapy; (3) relapse rate: current evidence could not support the conclusion that acupuncture combined with traction therapy was better than traction therapy. Acupuncture combined with traction therapy for lumbar disc herniation was effective. However, the included studies were with high risk of bias, important outcome measures such as quality of life, relapse rate and adverse effects were not found in most of the studies. Current evidence has not yet been able to fully reflect acupuncture combined with traction therapy for lumbar disc herniation is better than single therapy, so more RCTs of higher quality are needed to further confirm its efficacy and safety. PMID:25509761

  17. Percutaneous bipolar radiofrequency thermocoagulation for the treatment of lumbar disc herniation.

    Science.gov (United States)

    Zeng, Zhenhua; Yan, Min; Dai, Yi; Qiu, Weidong; Deng, Shuo; Gu, Xinzhu

    2016-08-01

    Lumbar disc herniation is usually managed with conservative treatment or surgery. However, conservative therapy seldom yields good results, and surgery is associated with multiple complications. This study aimed to assess bipolar radiofrequency thermocoagulation for the treatment of lumbar disc herniation. A total of 168 patients with lumbar disc herniation suitable for radiofrequency thermocoagulation were enrolled and randomized to monopolar radiofrequency thermocoagulation (control group, n=84) or bipolar radiofrequency thermocoagulation (experimental group, n=84) treatment groups. Ablation sites were targeted under CT scan guidance, and consecutive radiofrequency therapy was used. One and two probes were used for monopolar and bipolar thermocoagulation, respectively. Thermocoagulation was achieved at 50°C, 60°C, and 70°C for 60s each, 80°C for 90s, and 92°C for 100s. Symptoms and complications were evaluated using the modified Macnab criteria and Visual Analog Scale at 7, 30, and 180days postoperatively. At 180days, a significantly higher efficacy rate was obtained in the experimental group compared with control patients (91.6% versus 79.7%, Plumbar disc herniation treatment, and should be further explored for broad clinical application. PMID:27234606

  18. Inflammatory Serum Protein Profiling of Patients with Lumbar Radicular Pain One Year after Disc Herniation

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    Aurora Moen

    2016-01-01

    Full Text Available Earlier studies suggest that lumbar radicular pain following disc herniation may be associated with a local or systemic inflammatory process. In the present study, we investigated the serum inflammatory protein profile of such patients. All 45 patients were recruited from Oslo University Hospital, Ullevål, Norway, during the period 2007–2009. The new multiplex proximity extension assay (PEA technology was used to analyze the levels of 92 proteins. Interestingly, the present data showed that patients with radicular pain 12 months after disc herniation may be different from other patients with regard to many measurable serum cytokines. Given a false discovery rate (FDR of 0.10 and 0.05, we identified 41 and 13 proteins, respectively, which were significantly upregulated in the patients with severe pain one year after disc herniation. On the top of the list ranked by estimated increase we found C-X-C motif chemokine 5 (CXCM5; 217% increase, epidermal growth factor (EGF; 142% increase, and monocyte chemotactic protein 4 (MCP-4; 70% increase. Moreover, a clear overall difference in the serum cytokine profile between the chronic and the recovered patients was demonstrated. Thus, the present results may be important for future protein serum profiling of lumbar radicular pain patients with regard to prognosis and choice of treatment. We conclude that serum proteins may be measurable molecular markers of persistent pain after disc herniation.

  19. Physical examination for lumbar radiculopathy due to disc herniation in patients with low-back pain.

    NARCIS (Netherlands)

    Windt, D.A.W.M. van der; Simons, E.; Riphagen, I.I.; Ammendolia, C.; Verhangen, A.P.; Laslett, M.; Devillé, W.; Deyo, R.A.; Bouter, L.M.; Vet, H.C.W. de; Aertgeerts, B.

    2010-01-01

    Background: Low-back pain with leg pain (sciatica) may be caused by a herniated intervertebral disc exerting pressure on the nerve root. Most patients will respond to conservative treatment, but in carefully selected patients, surgical discectomy may provide faster relief of symptoms. Primary care c

  20. Physical examination for lumbar radiculopathy due to disc herniation in patients with low-back pain

    NARCIS (Netherlands)

    D.A.W.M. van der Windt; E. Simons; I.I. Riphagen; C. Ammendolia; A.P. Verhagen; M. Laslett; W. Devillé; R.A. Deyo; L.M. Bouter; H.C.W. de Vet; B. Aertgeerts

    2010-01-01

    Background Low-back pain with leg pain (sciatica) may be caused by a herniated intervertebral disc exerting pressure on the nerve root. Most patients will respond to conservative treatment, but in carefully selected patients, surgical discectomy may provide faster relief of symptoms. Primary care cl

  1. Inflammatory Serum Protein Profiling of Patients with Lumbar Radicular Pain One Year after Disc Herniation.

    Science.gov (United States)

    Moen, Aurora; Lind, Anne-Li; Thulin, Måns; Kamali-Moghaddam, Masood; Røe, Cecilie; Gjerstad, Johannes; Gordh, Torsten

    2016-01-01

    Earlier studies suggest that lumbar radicular pain following disc herniation may be associated with a local or systemic inflammatory process. In the present study, we investigated the serum inflammatory protein profile of such patients. All 45 patients were recruited from Oslo University Hospital, Ullevål, Norway, during the period 2007-2009. The new multiplex proximity extension assay (PEA) technology was used to analyze the levels of 92 proteins. Interestingly, the present data showed that patients with radicular pain 12 months after disc herniation may be different from other patients with regard to many measurable serum cytokines. Given a false discovery rate (FDR) of 0.10 and 0.05, we identified 41 and 13 proteins, respectively, which were significantly upregulated in the patients with severe pain one year after disc herniation. On the top of the list ranked by estimated increase we found C-X-C motif chemokine 5 (CXCM5; 217% increase), epidermal growth factor (EGF; 142% increase), and monocyte chemotactic protein 4 (MCP-4; 70% increase). Moreover, a clear overall difference in the serum cytokine profile between the chronic and the recovered patients was demonstrated. Thus, the present results may be important for future protein serum profiling of lumbar radicular pain patients with regard to prognosis and choice of treatment. We conclude that serum proteins may be measurable molecular markers of persistent pain after disc herniation. PMID:27293953

  2. Is the surgical outcome for lumbar disc herniation related to the duration of symptoms?

    DEFF Research Database (Denmark)

    Støttrup, Christian; Ernst, Carsten; Clemmensen, Dorte;

    Background: Lumbar disc herniation (LDH) is associated with great morbidity and significant socio-economic impact in many parts of the world. Studies have shown that most LDH can be treated effectively with conservative management and the passage of time. However for the group of patients where...

  3. The Relationship Between Morphology of Lumbar Disc Herniation and MRI Changes in Adjacent Vertebral Bodies

    Directory of Open Access Journals (Sweden)

    Hamed Reyhani Kermani

    2013-12-01

    Full Text Available   Background: Intervertebral disc herniation has two common types, extrusion and protrusion, which may affect the adjacent vertebrae.In addition, it is associated with significant signal changes in T1 MRI (short TR/TE and T2 MRI (long TR/TE.   Methods: The present study is a cross-sectional analytic one, in which sampling was performed retrospectively. Cases were randomly selected from the patients undergoing discectomy in our department in a one-year period. Before surgery, MRI images, T1-weighted and T2-weighted sagittal cuts were interpreted by an expert radiologist. Signal intensity of the upper and the lower adjacent vertebra and the operated herniated disc were compared with the normal discs, both in T1-weighted and T2-weighted. Changes in signal intensity were recorded in qualitative variables. Statistical analysis was then performed between two groups. Results: In the present study, we have evaluated 170 patients undergoing lumbar disc herniation surgery, which included 97 protruded and 86 extruded discs. The patients’ age ranged from 21 to 78 years old, with an average of 43.03 ±11.4 years. Evaluating the type of discopathy with the presence of signal changes (hypo or hyper signal changes demonstrated more signal changes in upper adjacent vertebrae in T2-weighted MRI (45.3%. However, patients with protruded discs showed less changes (30.9%. It showed that the difference was statistically significant (P

  4. The Relationship Between Morphology of Lumbar Disc Herniation and MRI Changes in Adjacent Vertebral Bodies

    Directory of Open Access Journals (Sweden)

    Hamed Reyhani Kermani

    2013-12-01

    Full Text Available Background: Intervertebral disc herniation has two common types, extrusion and protrusion, which may affect the adjacent vertebrae.In addition, it is associated with significant signal changes in T1 MRI (short TR/TE and T2 MRI (long TR/TE.   Methods: The present study is a cross-sectional analytic one, in which sampling was performed retrospectively. Cases were randomly selected from the patients undergoing discectomy in our department in a one-year period. Before surgery, MRI images, T1-weighted and T2-weighted sagittal cuts were interpreted by an expert radiologist. Signal intensity of the upper and the lower adjacent vertebra and the operated herniated disc were compared with the normal discs, both in T1-weighted and T2-weighted. Changes in signal intensity were recorded in qualitative variables. Statistical analysis was then performed between two groups. Results: In the present study, we have evaluated 170 patients undergoing lumbar disc herniation surgery, which included 97 protruded and 86 extruded discs. The patients’ age ranged from 21 to 78 years old, with an average of 43.03 ±11.4 years. Evaluating the type of discopathy with the presence of signal changes (hypo or hyper signal changes demonstrated more signal changes in upper adjacent vertebrae in T2-weighted MRI (45.3%. However, patients with protruded discs showed less changes (30.9%. It showed that the difference was statistically significant (P

  5. The Use of A Hollow Polymethylmethacrylate Cervical Spacer with Plating in the Treatment of Single Level Cervical Disc Disease

    Directory of Open Access Journals (Sweden)

    Jyi-Feng Chen

    2009-08-01

    Full Text Available Background: At present, the use of a cervical cage and plating has become an acceptedand widely practiced surgical intervention for the treatment of cervicalspondylosis and disc herniation. Polymethylmethacrylate (PMMA bonecement has been used in cervical disc disease as a spacer, with good longterm outcomes, but the method does not result in solid bone fusion in allcases.Methods: A prospective study was performed with 92 consecutive patients who underwent single-level anterior cervical discectomy and fusion (ACDF with ahollow PMMA spacer, cancellous allograft and titanium cervical plate stabilization between January 2002 and December 2003. Patients were followedfor a minimum of 2 years.Results: The surgical procedures used were technically successful for all patients, andthere were no major complications related to anesthesia or the overall surgical procedure. The fusion rate was 89.8% at the 12-month follow-up, and100% at the 24-month follow-up. The mean intervertebral disc height was6.5 1.5 mm and regained height was 3.4 1.3 mm at the 24-month follow-up. The mean segmental lordotic angle was 3.7 2.0° with an increaseof 6.1 2.3° at the 24-month follow-up. There was no hollow PMMA spacer dislodgment or failure. However, 5 (5.4% patients had screw looseningand 3 (3.3% patients underwent a secondary operation for removal of theplate and screws.Conclusions: The procedure for a single-level ACDF with a hollow PMMA spacer, cancellous allograft and titanium cervical plate stabilization is safe and effective.There were no complications related to the hollow PMMA spacer. This procedure has a high fusion rate, and can restore disc height and maintain normal cervical lordosis. This method achieves results similar to those of othermethods.

  6. Comparative study of myelography with postmyelographic CT in cervical spondylosis and herniated disk

    Energy Technology Data Exchange (ETDEWEB)

    Jung, Kyoon Soon; Park, Yong Tae; Choi, Woo Suk; Lee, Sun Wha; Lim, Jae Hoon [Kyung Hee University College of Medicine, Seoul (Korea, Republic of)

    1988-10-15

    Eight patients, who had symptoms and signs of cervical spondylosis and/or disk were studied with myelography (using Omnipaque) followed by postmyelographic computed tomography to evaluate the relative efficacy of these two methods in the determination of cervical herniation and spondylosis. Thirty nine levels in 26 patients were confirmed by surgery. Of these, 20 levels proved to have operative evidence of herniated disk. Postmyelographic CT adds useful information to the myelographic findings. Cord and root compression are better evaluated and osteopathy can be differentiated from disk herniation. In osteopathy, myelography was as diagnostic as postmyelographic CT. But, disk herniation was identified in 70% (14/20 levels) with postmyelographic CT and only in 15% (3/20 levels) with myelography.

  7. Reoperations after first lumbar disc herniation surgery; a special interest on residives during a 5-year follow-up

    Directory of Open Access Journals (Sweden)

    Kautiainen Hannu

    2007-01-01

    Full Text Available Abstract Background The overall rate of operations after recurrent lumbar disc herniation has been shown to be 3–11%. However, little is known about the rate of residives. Thus the aim of this study was to explore the cumulative rates of re-operations and especially residive disc herniations at the same side and level as the primary disc herniation after first lumbar disc herniation surgery and the factors that influence the risk of re-operations over a five year follow-up study. Methods 166 virgin lumbar disc herniation patients (mean age 42 years, 57% males were studied. Data on patients' initial disc operations and type and timing of re-operations during the follow-up were collected from patient files. Back and leg pain on visual analog scale and employment status were collected by questionnaires. Results The cumulative rate of re-operations for lumbar disc herniation was 10.2% (95% Cl 6.0 to 15.1. The rate of residives at initial site was 7.4% (95% Cl 3.7 to 11.3 and rate of lumbar disc herniations at other sites was 3.1% (95% Cl 0.6 to 6.2. The occurrence of residive lumbar disc herniations was evenly distributed across the 5 years. Neither age, gender, preoperative symptoms, physical activity nor employment had effect on the probability of re-operation. Conclusion Seven percent of the lumbar disc patients had a residive lumbar disc operation within five years of their first operation. No specific factors influencing the risk for re-operation were found.

  8. The value of MRI and CT in the pre-operative diagnosis of lumbar disc herniation

    Energy Technology Data Exchange (ETDEWEB)

    Hirabayashi, Shigeru; Kumano, Kiyoshi; Takahashi, Soichiro; Ishii, Jun (Kanto Rosai Hospital, Kawasaki, Kanagawa (Japan))

    1991-05-01

    A prospective analysis of computed tomography (CT) and magnetic resonance imaging (MRI) scans in 51 patients with lumbar disc herniation was made to determine the height of hernia for operation and, if impossible, the indications of myelography. Among the 51 patients, 40 (78%) received surgery based on these imaging modalities (Group A); and the remaining 11 (22%) underwent myelography for the confirmation of the height of hernia or detailed examination (Group B). Satisfactory or excellent surgical outcome was achieved in 95% in Group A and in 91% in Group B. Twenty seven patients had multiple disc herniation on CT and MRI; in 17 patients surgery was performed for one disc hernia that was radiologically found to compress the spinal nerve root; and in the other 10 hernia-related disc was not determined by either radiological or neurological manifestations. Satisfactory or excellent surgical outcome could, however, be achieved in 26 patients (96%). Myelography should be indicated when there is no neurological radicular sign in the lower extremities, and when there is no radiological evidence of the compressed spinal nerve root in spite of the presence of multiple disc herniation. The height of hernia may be determined when compression of the spinal nerve root is visualized on CT or MRI. (N.K.).

  9. The value of MRI and CT in the pre-operative diagnosis of lumbar disc herniation

    International Nuclear Information System (INIS)

    A prospective analysis of computed tomography (CT) and magnetic resonance imaging (MRI) scans in 51 patients with lumbar disc herniation was made to determine the height of hernia for operation and, if impossible, the indications of myelography. Among the 51 patients, 40 (78%) received surgery based on these imaging modalities (Group A); and the remaining 11 (22%) underwent myelography for the confirmation of the height of hernia or detailed examination (Group B). Satisfactory or excellent surgical outcome was achieved in 95% in Group A and in 91% in Group B. Twenty seven patients had multiple disc herniation on CT and MRI; in 17 patients surgery was performed for one disc hernia that was radiologically found to compress the spinal nerve root; and in the other 10 hernia-related disc was not determined by either radiological or neurological manifestations. Satisfactory or excellent surgical outcome could, however, be achieved in 26 patients (96%). Myelography should be indicated when there is no neurological radicular sign in the lower extremities, and when there is no radiological evidence of the compressed spinal nerve root in spite of the presence of multiple disc herniation. The height of hernia may be determined when compression of the spinal nerve root is visualized on CT or MRI. (N.K.)

  10. Conus medullaris syndrome due to an intradural disc herniation: A case report

    Directory of Open Access Journals (Sweden)

    Chaudhary Kshitij

    2008-01-01

    Full Text Available A 70-year-old male patient developed acute paraplegia due to conus medullaris compression secondary to extrusion of D12-L1 disc. After negative epidural examination intraoperatively, a durotomy was performed and an intradural disc fragment was excised. Patient did not regain ambulatory status at two-year follow-up. Intraoperative finding of negative extradural compression, tense swollen dura and CSF leak from ventral dura should alert the surgeon for the possibility of intradural disc herniation. A routine preoperative MRI is misleading and a high index of suspicion helps to avoid a missed diagnosis.

  11. Anterior herniation of lumbar disc induces persistent visceral pain:discogenic visceral pain

    Institute of Scientific and Technical Information of China (English)

    TANG Yuan-zhang; Moore-Langston Shannon; LAI Guang-hui; LI Xuan-ying; LI Na; NI Jia-xiang

    2013-01-01

    Background Visceral pain is a common cause for seeking medical attention.Afferent fibers innervating viscera project to the central nervous system via sympathetic nerves.The lumbar sympathetic nerve trunk lies in front of the lumbar spine.Thus,it is possible for patients to suffer visceral pain originating from sympathetic nerve irritation induced by anterior herniation of the lumbar disc.This study aimed to evaluate lumbar discogenic visceral pain and its treatment.Methods Twelve consecutive patients with a median age of 56.4 years were enrolled for investigation between June 2012 and December 2012.These patients suffered from long-term abdominal pain unresponsive to current treatment options.Apart from obvious anterior herniation of the lumbar discs and high signal intensity anterior to the herniated disc on magnetic resonance imaging,no significant pathology was noted on gastroscopy,vascular ultrasound,or abdominal computed tomography (CT).To prove that their visceral pain originated from the anteriorly protruding disc,we evaluated whether pain was relieved by sympathetic block at the level of the anteriorly protruding disc.If the block was effective,CT-guided continuous lumbar sympathetic nerve block was finally performed.Results All patients were positive for pain relief by sympathetic block.Furthermore,the average Visual Analog Scale of visceral pain significantly improved after treatment in all patients (P <0.05).Up to 11/12 patients had satisfactory pain relief at 1 week after discharge,8/12 at 4 weeks,7/12 at 8 weeks,6/12 at 12 weeks,and 5/12 at 24 weeks.Conclusions It is important to consider the possibility of discogenic visceral pain secondary to anterior herniation of the lumbar disc when forming a differential diagnosis for seemingly idiopathic abdominal pain.Continuous lumbar sympathetic nerve block is an effective and safe therapy for patients with discogenic visceral pain.

  12. 低温等离子消融术联合臭氧注射术在颈椎间盘突出症治疗中的应用%Application of coblation combined with ozone injection in treatment of cervical intervertebral disc herniation

    Institute of Scientific and Technical Information of China (English)

    何明伟; 赵治涛; 葛维鹏; 郭向飞; 霍岩松; 王成彬; 刘亚光; 吴宪洪; 马骏

    2015-01-01

    Objective To investigate the clinical effect of coblation combined with ozone injection in treatment of cervical intervertebral disc herniation.Methods Totally 40 cases of cervical disc herniation patients in Beijing Anzhen Hospital,Capital Medical University From January 2013 to January 2014 were enrolled and randomly divided into combined treatment group (20 cases) which received coblation combined with ozone injection and control group (20 cases) which received pure ozone injection.The treatment effect was evaluated,and the visual analogue scale (VAS) before treatment,1 and 7 days after treatment,1 month and 3 months after diacharge were compared between the two groups.Results The excellent rate in combined treatment group after treatment was 95.0% (19/20),higher than that in control group [70.0% (14/20)].The VAS scores before treatment,1 and 7 days after treatment,1 month and 3 months after discharge was (7.0 ± 1.2),(4.2 ± 1.5),(1.5 ± 0.9),(0.6 ± 0.7),(0.8 ± 0.6) scores in combined treatment group,respectively; it was (7.2 ± 1.5),(4.0 ± 0.8),(5.0 ± 1.2),(5.4 ± 1.2),(5.6 ± 1.0)scores in control group,respectively.Compared with that before treatment,the VAS was significantly decreased 7 days after treatment,1 and 3 months after discharge in combined treatment group; it also decreased 1 day after treatment in control group (P < 0.05).Compared with that in control group,the VAS of combined treatment group was statistically lower 1 and 3 months after discharge (P < 0.05).Conclusions Coblation combined with ozone injection in treatment of cervical intervertebral disc herniation may play a complementary role,the curative effect is obviously superior to the single ozone injection.%目的 探讨低温等离子消融术联合臭氧注射术对颈椎间盘突出症的临床疗效.方法 选取2013年1月至2014年1月于首都医科大学附属北京安贞医院疼痛科住院的颈椎间盘突出症患者40例,完全随机分为2组,各20例.联合治

  13. CLINICAL EVALUATION OF DSA-GUIDING COMBINED USE OF OXYGEN-OZONE THERAPY WITH PERCUTANEOUS INTRADISCAL RADIOFREQUENCY THERMOCOAGULATION FOR THE TREATMENT OF CERVICAL DISC HERNIATIONS%DSA引导臭氧联合射频热凝术治疗颈椎间盘突出症的临床评价

    Institute of Scientific and Technical Information of China (English)

    孙琳; 杨晓秋; 周泽军; 刘茂林; 邓琼; 陈世玉

    2013-01-01

    目的:评价数字减影血管造影(digital subtraction angiography,DSA)引导经皮穿刺椎间盘臭氧联合射频热凝术治疗颈椎间盘突出症的临床疗效与安全性.方法:回顾性分析49例颈椎间盘突出症患者,分为两组:DSA引导经皮椎间盘臭氧联合射频热凝术组(O组,n=30),在DSA引导下行经皮椎间盘射频热凝术,5 min后经射频针于椎间盘内注射臭氧(浓度:40 ug/ml)5~8 ml; DSA引导经皮椎间盘射频热凝术组(P组,n=19),仅行颈椎间盘射频热凝术.根据疼痛视觉模拟评分量表(visual analogue scale,VAS)、改良MacNab评价法及患者满意度指标,在术后2周、1个月、3个月评估临床疗效,观察患者不良反应.结果:两组患者术后VAS评分与基线值相比均显著下降(P< 0.05),O组患者VAS评分较P组在2周、1个月、3个月显著降低(P<0.05);O组优良率在2周,1个月,3个月显著高于P组(P<0.05);O组患者满意度较P组显著提高(P<0.05).两组患者均无严重不良反应发生.结论:DSA引导经皮椎间盘臭氧联合射频热凝术治疗颈椎间盘突出症能更有效地降低患者疼痛评分,改善患者颈肩功能;患者满意度高于单纯经皮椎间盘射频热凝术.DSA引导下两种治疗方法的安全性均较高.%Objective: To evaluate the efficacy and security of DSA-guiding combined use of oxygen-ozone therapy with percutaneous intradiscal radiofrequency thermocoagulation (PIRFT) for the treatment of cervical disc herniations. Methods: To analyze retrospectively the clinical material about 49 cases of patients with cervical disc herniations into two groups. P group (n = 19) received DSA-guiding PIRFT; 0 group (n = 30) received a combination of oxygen-ozone therapy after PIRFT. Primary outcome measures included visual analogue scale (VAS) for pain and the modified MacNab evaluation method, complication and patient's satisfaction. Clinical assessment of these outcome measures was performed at 2 weeks, 1

  14. Effectiveness of percutaneous laser disc decompression versus conventional open discectomy in the treatment of lumbar disc herniation; Design of a prospective randomized controlled trial

    NARCIS (Netherlands)

    P.A. Brouwer (Patrick); W.C. Peul (Wilco); R. Brand (René); M.P. Arts (Mark); B.W. Koes (Bart); A.A. van den Berg (Annette); M.A. van Buchem (Mark)

    2009-01-01

    textabstractBackground. The usual surgical treatment of refractory sciatica caused by lumbar disc herniation, is open discectomy. Minimally invasive procedures, including percutaneous therapies under local anesthesia, are increasingly gaining attention. One of these treatments is Percutaneous Laser

  15. Spontaneous Regression of Intervertebral Disc Herniation – Case Reports

    OpenAIRE

    Rapan, Saša; Gulan, Gordan; Lovrić, Ivan; Jovanović, Savo

    2011-01-01

    Lumbar disc hernia (LDH) is a common cause of low back pain and radicular leg pain. It is well known that the majority of LDH patients recover spontaneously. Since the advent of MRI, a spontaneous regression of fragment size of disc hernia occurs, as well as mitigation of subjective difficulties and neurological disorders. Therefore, surgical treatment is not always method of choice in this disease. Two cases of conservatively treated large disc extrusion which result in significant ...

  16. Body mass index and its association with lumbar disc herniation and sciatica: a large-scale, population-based study

    OpenAIRE

    Samartzis, D; Karppinen, JI; Luk, KDK; Cheung, KMC

    2014-01-01

    INTRODUCTION: This large-scale study addressed the association of body mass index (BMI), especially overweight / obesity with lumbar disc herniation, its global lumbar involvement and implications with sciatica that little of which is ...

  17. Calcified cervical intervertebral disc in children: radiological findings

    International Nuclear Information System (INIS)

    Nucleus pulposus calcification in children (CCIDC) is relatively rare but well known clinical syndrome, usually localized at the level of cervical spine. More than hundred and fifty cases have been reported in the literature with an increasing number of new reports in the last decade. The disease entity has been attributed to trauma, inflammation , or increased hydrostatic pressure with the disc, but the exact etiology still remains uncertain. The prognosis of disc calcification in children is good. As a rule pain resolves and there is a spontaneous resorption. Although the benign nature of the disease has been emphasized by many authors, herniation of the calcified nucleus pulposus through ruptured annulus fibrosus may occasionally occur. This rare but potentially serious complication with radiological signs of extradural space occupying lesion rises the question of eventual operative therapy. In several cases which have been reported in literature remission of symptoms occurred with conservative treatment. Radiological investigations are important for the diagnosis, evaluation of extent and follow-up of the disease. Radiography, computed tomography (CT) and magnetic resonance imaging (MRI) may be used. The first radiologic examination is standard radiography of the cervical spine. An addition of oblique views suggested before introduction of CT for better presentation of eventual protrusion (extrusion) of calcified discs material into the region of the intervertebral foramen (nerve root comprehension). Since frequently multilevel disc calcifications have been reported some authors suggest standard radiography of the whole spine. Radiography clearly demonstrates nucleus pulposus calcifications, which are round, oval flattened or fragmented. Radiographic appearances are to some extent reminiscent of discographic findings in normal or degenerated disc. Affected disc spaces may be slightly expanded indicating possibility of increased intradiscal pressure. Some of the

  18. Anterior Cervical Surgery Cervical Disc Experience%颈椎前路手术治疗颈椎间盘突出症体会

    Institute of Scientific and Technical Information of China (English)

    吴向东; 刘绍武; 唐佩福

    2012-01-01

    Objective:Observation of the anterior cervical surgical treatment of cervical disc herniation .Methods:52cases of cervical disc herniation, anterior cervical decompression, bone graft and application of cervical locking anterior plate internal fixation. Results:46 cases after 2~ 18months, anaverage of 8.2 months of follow-up of all cases of graft to achieve bone fusion, the integration time of 12 ~ 16 weeks, with an average of 12.6 weeks, 100% of the fusion rate; MRI examination of spinal cord deformation. The compression performance of spinal cord function tests, with the exception of three cases of unsatisfactory outside. The results were satisfactory in all cases bone graft. Conclusion:Indications to choose the right anterior cervical decompression surgery bone graft and plate system is simple and can provide a fixed segmental stability, conducive to the recovery of neurological function, applicable to the treatment of cervical disc herniation, cervical trauma. Anterior cervical surgery for two cervical disc, three vertebrae. Power and restricted anterior cervical fixation materials was no significant differencein clinical therapy.%目的:观察颈椎前路手术治疗颈椎间盘突出症的疗效.方法:对52例颈椎间盘突出症,行颈椎前路减压、植骨并应用锁定型颈椎前路钢板内固定.结果:46例经过2~18个月、平均8.2月的随访,所有病例植骨均达到骨性融合,融合时间12~16周,平均12.6周,融合率100%;MRI检查无脊髓变形、受压表现,脊髓功能检查,除3例不理想外.所有病例植骨疗效满意.结论:适应症选择正确,颈椎前路手术减压植骨、钢板系统操作简单,可提供有效的固定节段稳定性,利于神经功能恢复,适用于颈椎间盘突出症、颈椎外伤的治疗.颈椎前路手术适用于2个颈椎间盘,3个椎体.动力性和限制性颈椎前路内固定材料在临床治疗疗效上无明显差别.

  19. Surgical treatment of thoracic disc herniations using a modified transfacet approach

    Directory of Open Access Journals (Sweden)

    Xizhong Yang

    2014-01-01

    Full Text Available Background: Ideal surgical treatment for thoracic disc herniation (TDH is controversial due to variations in patient presentation, pathology, and possible surgical approach. Althougth discectomy may lead to improvements in neurologic function, it can be complicated by approach related morbidity. Various posterior surgical approaches have been developed to treate TDH, but the gold standard remains transthoracic decompression. Certain patients have comorbidities and herniation that are not optimally treated with an anterior approach. A transfacet pedicle approach was first described in 1995, but outcomes and complications have not been well described. The aim of this work was to evaluate the clinical effect and complications in a consecutive series of patients with symptomatic thoracic disc herniations undergoing thoracic discectomy using a modified transfacet approach. Materials and Methods: 33 patients with thoracic disc herniation were included in this study. Duration of the disease was from 12 days to 36 months, with less than 1 month in 13 patients. Of these, 15 patients were diagnosed with simple thoracic disc herniation, 6 were associated with ossified posterior longitudinal ligament, and 12 with ossified or hypertrophied yellow ligament. A total of 45 discs were involved. All the herniated discs and the ossified posterior longitudinal ligaments were excised using a modified transfacet approach. Laminectomy and replantation were performed for patients with ossified or hypertrophied yellow ligament. The screw-rod system was used on both sides in 14 patients and on one side in l9 patients. Results: 29 patients were followed up for an average of 37 months (range 12-63 months and 4 patients were lost to followup. Evaluation was based on Epstein and Schwall criteria.5 15 were classified as excellent and 10 as good, accounting for 86.21% (25/29; 2 patients were classified as improved and 2 as poor. All the patients recovered neurologically after

  20. Value of magnetic resonance myelography in the diagnosis of disc herniation and spinal stenosis

    International Nuclear Information System (INIS)

    Magnetic resonance imaging provides a good-quality image over the entire length of the spine and can assess the morphology of the discs and cord. It is the imaging modality of choice in the investigation of spinal diseases. Magnetic resonance myelography (MRM) is non-invasive, has comparable sensitivity to conventional myelography in visualizing lumbar nerve roots and allows overall assessment of the spinal canal even in the presence of cerebrospinal fluid block. Seventy-two patients with pre-surgical diagnosis of disc herniation were prospectively investigated prior to surgery to determine the value of MRM in the diagnosis of disc herniation and spinal stenosis. The difference between the sensitivity and accuracy of MRI (89.0-95.6%, 89.1-95.7%) and MRM (82.4-89.0%, 82.6-89.1%) was not significant for both observers. There was no significant improvement with the addition of MRM to MRI (91.2-97.8%, 91.3-97.8%). Although MRM did not significantly improve the diagnostic accuracy of MRI, it allowed a better overall view of the dural sac and root sleeves, therefore making it easier to diagnose spinal stenosis and disc herniation in a minority of cases. Copyright (2000) Blackwell Science Pty Ltd

  1. Comparison of discectomy versus sequestrectomy in lumbar disc herniation: a meta-analysis of comparative studies.

    Directory of Open Access Journals (Sweden)

    Jisheng Ran

    Full Text Available Lumbar disc removal is currently the standard treatment for lumbar disc herniation. No consensus has been achieved whether aggressive disc resection with curettage (discectomy versus conservative removal of the offending disc fragment alone (sequestrectomy provides better outcomes. This study aims to compare the reherniation rate and clinical outcomes between discectomy and sequestrectomy by literature review and a meta-analysis.A systematic search of PubMed, Medline, Embase and the Cochrane Library was performed up to June 1, 2014. Outcomes of interest assessing the two techniques included demographic and clinical baseline characteristics, perioperative variables, complications, recurrent herniation rate and post-operative functional outcomes.Twelve eligible trials evaluating discectomy vs sequestrectomy were identified including one randomized controlled study, five prospective and six retrospective comparative studies. By contrast to discectomy, sequestrectomy was associated with significantly less operative time (p<0.001, lower visual analogue scale (VAS for low back pain (p<0.05, less post-operative analgesic usage (p<0.05 and better patients' satisfaction (p<0.05. Recurrent herniation rate, reoperation rate, intraoperative blood loss, hospitalization duration and VAS for sciatica were without significant difference.According to our pooled data, sequestrectomy entails equivalent reherniation rate and complications compared with discectomy but maintains a lower incidence of recurrent low back pain and higher satisfactory rate. High-quality prospective randomized controlled trials are needed to firmly assess these two procedures.

  2. Clinical study of lateral lumber disc herniation (intra- and extra-foraminal LDH)

    International Nuclear Information System (INIS)

    We report on 10 cases with lateral lumber disc herniation who were surgically treated. Of these, 9 were male and 1 female ranging in age from 19-73 years (mean; 48.7 years). The level of herniation was L3/4 in 2, L4/5 in 5, L5/S1 in 3 cases. All patients complained of severe pain in lower extremities. Axial, sagittal, coronal views of MRI and selective root block were useful for accurate diagnosis of lateral herniation. Facetectomy with posterolateral fusion in 7 cases, osteoplastic hemilaminectomy in 2 cases, and lateral fenestration in 1 case were performed. Excellent and good results were achieved in all cases. (author)

  3. Clinical study of lateral lumber disc herniation (intra- and extra-foraminal LDH)

    Energy Technology Data Exchange (ETDEWEB)

    Ikuta, Kou; Oga, Masayoshi; Tamaru, Takuya; Arima, Junichi; Esaki, Yukio; Yoshikane, Kouichi; Imamura, Toshihiro; Tomishige, Mamoru [Hiroshima Red Cross Hospital and Atomic-Bomb Survivors Hospital (Japan)

    1996-09-01

    We report on 10 cases with lateral lumber disc herniation who were surgically treated. Of these, 9 were male and 1 female ranging in age from 19-73 years (mean; 48.7 years). The level of herniation was L3/4 in 2, L4/5 in 5, L5/S1 in 3 cases. All patients complained of severe pain in lower extremities. Axial, sagittal, coronal views of MRI and selective root block were useful for accurate diagnosis of lateral herniation. Facetectomy with posterolateral fusion in 7 cases, osteoplastic hemilaminectomy in 2 cases, and lateral fenestration in 1 case were performed. Excellent and good results were achieved in all cases. (author)

  4. Introducing a New Risk Factor for Lumbar Disc Herniation in Females : Vertical Angle of the Sacral Curvature

    OpenAIRE

    Kanat, Ayhan; Yazar, Ugur; Kazdal, Hizir; Sonmez, Osman Fikret

    2012-01-01

    Objective To characterize the importance of the vertical angle of the sacral curvature (VASC) in lumbar disc herniations. Methods Morphological data derived from lumbar sagittal MRI imaging. The statistical significance of the findings are discussed. The angles of 60 female patients with lumbar disc herniations (LDH) were compared with the 34 female patients without LDH. Results 128 of the 185 patients met our inclusion criteria. The vertical angle of sacral curvature is statistically signifi...

  5. Value of CT in the evaluation of nerve root compression in the lumbar herniated disc disease: comparative study with myelography

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Kun Il; Ku, Yong Woon; Sol, Chang Hyo; Kim, Byung Su [Pusan National University College of Medicine, Busan (Korea, Republic of)

    1988-04-15

    High resolution computed tomography is the most accurate diagnostic tool to define a lumbar herniated disc disease, because it provides a complete in vivo analysis of bony framework of lumbar spine as well as the supporting soft tissue structures and neural elements. The purpose of this study is to estimate the valve of CT in athe evaluation of nerve root compression caused by herniated disc disease. We analyzed 52 roots of 26 patients of single level herniated disc disease with definite evidence of bilateral or unilateral neurologic deficit who had both CT and myelography at Pusan National University Hospital from May 1983 to March, 1987. The results were as follows: 1. Sensitivity and specificity of CT is 77% and 81%, respectively in the diagnosis of nerve root compression caused by lumbar herniated disc disease. 2. Sensitivity and specificity of myelography is 77% and 81% respectively, in the diagnosis of nerve root compression caused by lumbar herniated disc disease. 3. The results of this study indicate that high resolution CT was equivalent to myelography in the diagnosis of nerve root compression caused by lumar herniated disc disease.

  6. A paired study of bone mineral density between the patients of type 2 diabetes mellitus and herniation of intervertebral disc

    International Nuclear Information System (INIS)

    Objective: To observe the changes of bone mineral density (BMD)'s changing in different parts of body and the relation with diagnosis of osteoporosis in patients with type 2 diabetes mellitus or herniation of intervertebral disc. Methods: There are 41 patients in each group of DM or herniation of intervertebral disc, who were paired by the factors of sex, age etc. BMD of whole body, arms, legs and lumbar spines were measured by dual energy X-ray absorptiometry (DEXA). Results: The whole body BMD in group of DM was significantly higher than in group of herniation of intervertebral disc (P<0.01). BMD of arms and legs in DM patients (esp. legs) was more significantly decreased than in group of herniation of intervertebral disc (P<0.05). Lumbar BMD in group of DM was higher than in group of herniation of intervertebral disc (P<0.01). Conclusion: It may be a characteristic of the osteoporosis in DM that BMD reduced mainly in extremity. Contrast to osteoporosis by herniation of intervertebral disc, it maybe mainly caused by central bone. It shows that it is necessary to make different rules for different diseases on diagnosis of osteoporosis

  7. Combination use of ozone and collagenase for the treatment of prolapsed lumbar intervertebral disc herniation

    International Nuclear Information System (INIS)

    Objective: To assess the therapeutic effect of combination use of ozone and collagenase for the treatment of prolapsed lumbar intervertebral disc herniation. Methods: Combination use of ozone intra-disc ablation and collagenase extra-disc dissolution was employed to treat acute lumbar intervertebral disc protrusion. A total of 41 patients (50 diseased intervertebral discs) were enrolled in this study. The clinical results were analyzed and the therapeutic efficacy was evaluated. Results: Combination use of ozone ablation together with collagenase dissolution was carried out in 41 patients. According to Macnab criterion, the therapeutic efficacy was evaluated. The excellent effectiveness was achieved in 85.3% of patients. Follow-up CT scanning and MRI were performed 12 months after the treatment. Both preoperative and postoperative AB value and R value were determined and compared with each other. The postoperative AB value and R value were 36% and 43% of the preoperative ones, respectively. The reduction was very obvious. Conclusion: The combination use of ozone and collagenase has reliable effectiveness in the treatment of prolapsed lumbar intervertebral disc herniation. Collagenase has proteolytic effect on the fiber ring, while ozone possesses oxidation effect on the nucleus pulposus. A combination use of the two has definite curative effect. (authors)

  8. Herniated disk

    Science.gov (United States)

    ... the disk. This may place pressure on nearby nerves or the spinal cord. ... Lumbar radiculopathy; Cervical radiculopathy; Herniated intervertebral disk; Prolapsed intervertebral disk; Slipped disk; Ruptured disk; Herniated nucleus pulposus

  9. A history of lumbar disc herniation from Hippocrates to the 1990s.

    Science.gov (United States)

    Truumees, Eeric

    2015-06-01

    In ancient times, a supernatural understanding of the syndrome of lumbar radiculopathy often involved demonic forces vexing the individual with often crippling pain. The ancient Greeks and Egyptians began to take a more naturalistic view and, critically, suspected a relationship between lumbar spinal pathology and leg symptoms. Relatively little then changed for those with sciatica until the classic works by Cotugno and Kocher arrived in the late 18th century. Early lumbar canal explorations were performed in the late 1800s and early 1900s by MacEwen, Horsley, Krause, Taylor, Dandy, and Cushing, among others. In these cases, when compressive pathologies were found and removed, the lesions typically were (mis-)identified as enchondromas or osteochondritis dissecans. To better understand the history, learn more about the first treatments of lumbar disc herniation, and evaluate the impact of the early influences on modern spine practice, searches of PubMed and Embase were performed using the search terms discectomy, medical history, lumbar spine surgery, herniated disc, herniated nucleus pulposus, sciatica, and lumbar radiculopathy. Additional sources were identified from the reference lists of the reviewed papers. Many older and ancient sources including De Ischiade Nervosa are available in English translations and were used. When full texts were not available, English abstracts were used. The first true, intentional discectomy surgery was performed by Mixter and Barr in 1932. Early on, a transdural approach was favored. In 1938, Love described the intralaminar, extradural approach. His technique, although modified with improved lighting, magnification, and retractors, remains a staple approach to disc herniations today. Other modalities such as chymopapain have been investigated. Some remain a part of the therapeutic armamentarium, whereas others have disappeared. By the 1970s, CT scanning after myelography markedly improved the clinical evaluation of patients with

  10. Utility of Discography as a Preoperative Diagnostic Tool for Intradural Lumbar Disc Herniation.

    Science.gov (United States)

    Matsumoto, Tomiya; Toyoda, Hiromitsu; Terai, Hidetomi; Dohzono, Sho; Hori, Yusuke; Nakamura, Hiroaki

    2016-08-01

    Preoperative definitive diagnosis of intradural lumbar disc herniation (ILDH) is difficult despite the availability of various neuroradiological investigative tools. We present a case of ILDH diagnosed preoperatively by discography and computed tomography-discography (disco-CT).The patient was a 63-year-old man with acute excruciating right leg pain. Discography and disco-CT demonstrated leakage of the contrast medium into the intradural space. Based on these findings, a right L5 nerve root disturbance caused by ILDH was diagnosed. A right L5 hemi-laminectomy and a dorsal durotomy were performed. The herniated disc was carefully dissected and then completely removed. Three months after surgery, the patient had fully recovered. This report highlights the importance of making a definitive diagnosis of ILDH preoperatively for better surgical planning and improved clinical outcomes. Furthermore, discography and disco-CT are both useful preoperative diagnostic tools for the diagnosis of ILDH. PMID:27559461

  11. Adjacent Lumbar Disc Herniation after Lumbar Short Spinal Fusion

    Directory of Open Access Journals (Sweden)

    Koshi Ninomiya

    2014-01-01

    Full Text Available A 70-year-old outpatient presented with a chief complaint of sudden left leg motor weakness and sensory disturbance. He had undergone L4/5 posterior interbody fusion with L3–5 posterior fusions for spondylolisthesis 3 years prior, and the screws were removed 1 year later. He has been followed up for 3 years, and there had been no adjacent segment problems before this presentation. Lumbar magnetic resonance imaging (MRI showed a large L2/3 disc hernia descending to the L3/4 level. Compared to the initial MRI, this hernia occurred in an “intact” disc among multilevel severely degenerated discs. Right leg paresis and bladder dysfunction appeared a few days after admission. Microscopic lumbar disc herniotomy was performed. The right leg motor weakness improved just after the operation, but the moderate left leg motor weakness and difficulty in urination persisted.

  12. Frisbee - the first artificial cervical disc of 3RD generation

    OpenAIRE

    Karin Büttner-Janz; Bernhard Meyer; Rafael Donatus Sambale; Hans-Joachim Wilke; Nelli Rüdiger; Eiko Büttner

    2014-01-01

    OBJECTIVE: The current cervical disc arthroplasty is limited by postoperative facet joint arthritis, heterotopic ossification and segmental kyphosis. The total Frisbee disc, which has an upper convex/concave non-spherical surface and a lower flat sliding surface, is a new approach for improved outcomes. Prior to clinical application, safety and suitability tests are required. METHODS: The Frisbee is the first 3rd generation disc according to a new classification of total disc because it can...

  13. Discussion on Non-surgery and Physical Therapy of Patients with Cervical Disc Herniation%论颈椎间盘突出症患者的非手术及理疗

    Institute of Scientific and Technical Information of China (English)

    谢昆岭

    2011-01-01

    本文主要探讨了椎间盘病学特征、病理特征、临床分型、临床症状与表现、非手术及治疗以及康复治疗的一些实际问题.%In this article, some practical problems of intervertebral disc, such as epidemiology characteristics, pathological features, clinical classification, clinical symptoms and performance, non-operative treatment and rehabilitation therapy were discussed.

  14. Radiofrequency-Induced Intradiscal Nucleoplasty Chronic Low Back Pain Secondary To Lumbar Disc Herniation

    OpenAIRE

    Lee, DW; Loh, ESY; Kueh, CC; Poi, JH; Francis, T.; Koh, KC; Wazir, NN; Singh, H

    2013-01-01

    Abstract We set out to assess the efficacy of radiofrequency-induced intradiscal nucleoplasty in reducing pain in symptomatic patients with MRI-defined lumbar disc herniation and their satisfaction with the procedure. We compared the patients’ pain intensity and severity of disability scores before and after undergoing the procedure in a retrospective questionnaire. These patients reported statistically significant reduction of pain intensity and disability level after the procedure. We concl...

  15. Intradural lumbar disc herniation with intradural gas: report of three cases

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Seung Eun; Lee, Sang Ho; Jo, Byung June [Wooridul Spine Hospital, Seoul (Korea, Republic of); Kim, Tae Hong [Inje University College of Medicine, Seoul (Korea, Republic of)

    2005-12-15

    This paper reports on three cases of an intradural lumbar disc herniation (IDLDH) that were diagnosed by a radiological examination. In all cases, an intradural vacuum (IDV) was detected on the CT scans, and the IDLDH showed iso- or lower signal intensity on the T2-weighted images. Enhanced MRI of one case revealed a small amount of air, but this was without enhancement. All the cases showed definite IDV on the CT scans, and this was an important clue for diagnosing IDLDH.

  16. Surgery for lumbar disc herniation: Analysis of 500 consecutive patients treated in an interdisciplinary spine centre.

    Science.gov (United States)

    Schmid, S L; Wechsler, C; Farshad, M; Antoniadis, A; Ulrich, N H; Min, K; Woernle, C M

    2016-05-01

    Surgical removal of a symptomatic herniated lumbar disc is performed either with or without the support of a microscope. Up to the time of writing, the literature has reported similar clinical outcomes for the two procedures. Five hundred consecutive patients, operated upon for primary single-level lumbar disc herniation in our University Spine Center between 2003-2011, with (n=275), or without (n=225), the aid of a microscope were included. Data were retrospectively analyzed, comparing the primary endpoint of clinical outcome and the secondary endpoints of complications, surgical time and length of hospitalization. Clinical outcomes and reoperation rates were comparable in both groups. Surgical time was significantly shorter with a mean time of 47minutes without use of the microscope compared to the mean time of 87minutes (p<0.001) with the use of the microscope. Mean length of hospitalization was shorter in those operated with the microscope (5.3days) compared to those without (6.1days, p=0.004). There was no difference in rates of complications. Microdiscectomy versus open sequestrectomy and discectomy for surgical treatment of lumbar disc herniation is associated with similar clinical outcomes and reoperation rates. Open sequestrectomy is associated with shorter operation times. Microdiscectomy is associated with shorter hospitalization stays. PMID:26778355

  17. Impact of Obesity and Underweight on Surgical Outcome of Lumbar Disc Herniation

    Directory of Open Access Journals (Sweden)

    Farzad Omidi-Kashani

    2014-01-01

    Full Text Available Background. The relationship between underweight and lumbar spine surgery is still unknown. Aim. To evaluate the effect of underweight versus obesity based on surgical outcome of lumbar disc herniation. Material and Method. In this retrospective study, we evaluated 206 patients (112 male and 94 female with a mean age of 37.5±3.1 years old (ranged 20–72 who have been surgically treated due to the refractory simple primary L4-L5 disc herniation. We followed them up for a mean period of 42.4±7.2 months (ranged 24–57. We used Body Mass Index (BMI, Oswestry Disability Index (ODI, and Visual Analogue Scale (VAS for categorization, disability, and pain assessment, respectively. We used Wilcoxon and Mann-Whitney U tests for statistics. Results. Surgical discectomy in all weight groups was associated with significant improvement in pain and disability, but intergroup comparison showed these improvements in both underweight and obese groups and they were significantly lower than in normal weight group. Excellent and good satisfaction rate was also somewhat lower in both these ends of weight spectrum, but statistically insignificant. Conclusion. Both obesity and underweight may have adverse prognostic influences on the surgical outcome of lumbar disc herniation, although their impact on subjective satisfaction rate seems to be insignificant.

  18. Minimally invasive discectomy versus microdiscectomy/ discectomy for symptomatic lumbar disc herniation

    OpenAIRE

    Rahimi-Movaghar, Vafa; Rasouli, Mohammad; Shokraneh, Farhad; Moradi-lakeh, Maziyar; Vakaro, Alex; Sadeghi-Naini, Mohsen

    2012-01-01

    Abstract: Background: Lumbar discectomy is a surgery to remove all or part of a disc cushion that helps protect the spinal column. These cushions, called disks, separate the spinal vertebrae/bones. When one of the disks herniates (moves out of place) in patients with protruded disc, the soft gel inside pushes through the wall of the disk. The disk may then place pressure on the spinal cord and nerves that are coming out of the spinal column. The lumbar discectomy procedure remained basically ...

  19. The therapeutic effect of percutaneous transforaminal endoscopic discectomy through interlaminar approach for treating lumbar disc herniation

    Directory of Open Access Journals (Sweden)

    Wan-ru DUAN

    2016-04-01

    Full Text Available Objective To evaluate the therapeutic efficacy of percutaneous transforaminal endoscopic discectomy (PTED through interlaminar approach in the treatment of lumbar disc herniation (LDH.  Methods From October 2013 to January 2015, 54 LDH patients underwent PTED by using transforaminal endoscopic spine system (TESSYS in our hospitial. CT or MRI indicated L4-5 disc herniation in 13 patients and L5-S1 disc herniation in other 41 patients. Visual Analogue Scale (VAS and Oswestry Disability Index (ODI were used to evaluate the degree of pain in the low back and leg before operation, one day, 3 months and one year after operation. MRI was performed after operation to assess if the nucleus pulposus was removed completely and whether there was a relapse.  Results The success rate of operations was 96.30% (52/54. Two patients suffered from rupture of spinal dura mater during the surgery, and underwent fenestration laminectomy in turn. The average operation time was 58.35 min and median hospital stay was 3 d. At discharge, pain was disappeared in 52 patients and relieved in 2 patients, however, 5 patients presented worsened numbness of lateral lower leg. Compared with preoperation, VAS and ODI scores decreased significantly one day, 3 months and one year after operation (P = 0.000, for all. Lumbar MRI one day after operation revealed nucleus pulposus had been completely removed and the compression of nerve root had been relieved in all cases. There was no relapse in MRI findings 3 months and one year after operation. No surgical complication, such as infection, was found. One patient with L5-S1 disc herniation presented postoperative numbness of S1 nerve root region caused by heavy stretching of nerve root during the operation, and was improved one month later.  Conclusions Percutaneous transforaminal endoscopic discectomy through interlaminar approach in the treatment of lumbar disc herniation is effective and safe. DOI: 10.3969/j.issn.1672-6731.2016.04.006

  20. Treatment of herniated lumbar disc by percutaneous laser disc decompression combined with synchronous suction technique through syringe

    Institute of Scientific and Technical Information of China (English)

    Dhir B. Gurung; Gaojian Tao; Hongyi Lin; Yanning Qian; Jian Lin

    2007-01-01

    Objective: To compare the outcomes of percutaneous laser disc decompression (PLDD) and PLDD with synchronous suction through syringe in the patients with herniated lumbar disc (HLD). Methods: Forty-two patients with HLD on MRI and those who did not respond to conservative treatment for 6 weeks were randomly divided into group A and group B. In group A, the patients were treated with PLDD and those in group B with PLDD and synchronous suction through syringe. GaAIAS diode laser at 810 nm was used for the ablation in both groups. The treatment effect was evaluated by modified MacNab's criteria on the 7th, 30th and 90th day. Results: Evaluated by modified MacNab's criteria, the percentages of the excellent and good cases in total patients treated for group B and A were 80.95% and 57.14% on the 7th follow-up day, 85.71% and 66.67% on the 30th follow-up day, and 95.24% and 71.43% on the 90th follow-up day, respectively. Conclusion: Synchronous suction technique through syringe during PLDD improves the overall outcome in the treatment of herniated lumbar disc.

  1. Follow-up Study on the Motion Range after Treatment of Degenerative Disc Disease with the Bryan Cervical Disc Prosthesis

    Institute of Scientific and Technical Information of China (English)

    YANG Shuhua; HU Yong; ZHAO Jijun; HE Xianfeng; LIU Yong; XU Weihua; DU Jingyuan; FU Dehao

    2007-01-01

    This study examined effect of a new intervertebral cervical disc prosthesis in relieving the neurological symptoms and signs, improving the patients' ability to perform daily activities, reducing pain, and maintaining the stability and segmental motion. From December 2003 to October 2004, 12 patients, who had received 14 replacements of cervical artificial discs, were followed-up for 2 to 8 months (with a mean of 5.2 months). Of them 5 had cervical spondylotic myelopathy and 7 had cervical disc herniation. The patients included 7 males and 5 females, with their age ranging from 35 to 62 y and a mean of 50.3 y. Single-level replacements were performed in 10 cases and 2 cases received two-level replacement. Operation time of the single-level surgery averaged 130±50 min and the time of two-level surgery was 165±53 min on average (from skin incision to skin suturing).Neurological or vascular complications during or after surgery was not observed. Japanese Orthopedic Association scores (JOA scores) increased from 8.6 to 15.8 on average. There was no prothesis subsidence or excursion. Replaced segments were stable and the range of motion was partially restored, being 4.68° (3.6°-6.1°) in flexion and extension position and 3.51° (2.5°-4.6°) 3.42° (2.6°-4.3°) in left and right bending position. No obvious loss of physiological curvature was noted. CT or MRI follow-up showed that excursion was less than 1.5 mm) in 2 of 14 levels and between 1.5 mm and 3 mm) in 1 of 14 levels. No ossification in the replaced levels was observed. It is concluded that satisfactory short-term results were achieved in the 12 cases of artificial disc replacements. Different from anterior cervical discectomy and fusion, the replacement could achieve quick functional recovery and did not lead to the movement limitation of cervical vertebrae. At least a 5-years follow-up was needed to assess the long-term effect of the prosthesis on its neighboring segments.

  2. Application of percutaneous endoscopic RF/holmium laser lumbar discectomy in the lumbar disc herniation (attach 160 cases reported)

    International Nuclear Information System (INIS)

    Objective: To evaluate the efficacy of endoscopic discectomy for the lumbar disc herniation and to determine the prognostic factors affecting surgical outcome. Methods: In the group of 160 cases, posterolateral and trans-interlaminar endoscopic Ho: YAG laser and radio frequency-assisted disc excisions were performed under local anesthesia. Results: In 160 patients with post-surgical follow-up period was 15 months on average (7 ∼ 24 months). Based on the MacNab criteria, there were 117 cases in which result was excellent, in 19 cases good, in 12 cases fair, and in 12 cases poor, and successful rate was 85%. Conclusion: Percutaneous endoscopy lumbar discectomy is effective for recurrent disc herniation in the selected. In applies in particular to the traditional open surgery of lumbar disc herniation in patients with recurrent. (authors)

  3. Artificial Cervical Disc Replacement Improves Mobility

    Medline Plus

    Full Text Available ... over, you know, fusion. People wonder, does it cause problems at the next level up, so if ... a concern. Will the fusion at this disc cause problems at the disc above or the disc ...

  4. A REVIEW OF 3200 CASES 0F HERNIATED LUMBAR DISC

    Directory of Open Access Journals (Sweden)

    A. ALIMOHAMMADI

    1987-05-01

    Full Text Available I t 1S a t t emted t o reV1ew 3200 c a s e s of herniat ed lumbar d isc t o point out the i ndic a tions for ope ra t i o n , the value o f myelog raphy . t he r esult o f ope rat ion and the caus e s o f comp l i cat i ons . We believe tha t myelography s houl d be performed i n a l most a ll patients. I n ne a rl y"n96 .8 pe rcent of cases my e l o grams co r r e s pond to clinical f i ndings. In general when there is clear s igns and s ympt oms of dis c disease , con fi rmed r adiolo gically, i n the hand of an e xpo r t surgeon. in 93 percent the result will be excel e nt .

  5. Diagnostics and therapy of spinal disc herniation; Diagnostik und Therapie des Bandscheibenvorfalls

    Energy Technology Data Exchange (ETDEWEB)

    Zimmer, A.; Reith, W. [Universitaetsklinikum des Saarlandes, Klinik fuer Diagnostische und Interventionelle Neuroradiologie, Homburg/Saar (Germany)

    2014-11-15

    Degenerative processes in a movement segment of the vertebral column, which can potentially give rise to herniation of elements of the nucleus pulposus, are complex and of variable clinical and radiological dimensions; however the mere assumption that degenerative changes precede disc herniation remains a matter of debate. By definition, spinal disc herniation (SDH) refers to components of the gelatinous nucleus pulposus protruding beyond the dorsal level of the vertebral body margin through tears in the annulus fibrosus. Clinical presentation may include pain, paresis and sensory disturbances. Magnetic resonance imaging (MRI) is considered the gold standard in the diagnosis of SDH. In the majority of patients a conservative approach with physical therapy exercises and adequate analgesic and antiphlogistic medical treatment results in a substantial improvement of symptoms. (orig.) [German] Degenerative Prozesse eines Bewegungssegments, die in einem Prolaps des Nucleus pulposus resultieren koennen, sind vielschichtig und von unterschiedlicher klinischer und radiologischer Auspraegung. Selbst die Annahme, dass Bandscheibenvorfaellen eine Degeneration vorangeht, ist keineswegs unumstritten. Definitionsgemaess spricht man von einem Bandscheibenvorfall (BSV), wenn das Gewebe des gelatinoesen Nucleus pulposus durch eine Dehiszenz im Anulus fibrosus ueber das Niveau der normalen dorsalen Begrenzung des Bandscheibenfachs hinaus prolabiert. Klinisch kann dies mit Schmerzen, Paresen und Sensibilitaetsstoerungen einhergehen. Die Magnetresonanztomographie gilt als Goldstandard in der Diagnostik eines BSV. In der Mehrzahl der Faelle fuehrt ein konservatives Vorgehen zu einer deutlichen Besserung der Symptomatik im Verlauf. (orig.)

  6. MR findings of the transligamentous type of the herniated lumbar disc

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Byung Chul; Kim, Dong Ik; Yoon, Choon Sik; Suh, Jung Ho [College of Medicine, Yonsei University, Seoul (Korea, Republic of)

    1994-03-15

    The purpose of this study is to describe the findings of the transligamnetous type of the herniated lumbar disc (HLD) with magnetic resonance MR imaging. We retrospectively analyzed the MR images of surgically proven 20 cases of transligamentous type of HLD from January 1, 1992 to August 20, 1992. The MR imaging was performed with 1.0T MR unit, using sagittal spin echo (SE) and axial gradient echo (GE) techniques. The results were as follows; 1) the interruption of black line of the posterior longitudinal ligament (PLL) was identified in 19 levels and 17 levels in sagittal SE and axial GE images, retrospectively; 2) the widening of adjacent epidural fat space was demonstrated in 16 cases of central or posterolateral HLD. The herniated disc material, as compared with the parent intervertebral disc, showed intermediate signal intensity (SI) in 19 and low SI in 1 level on T1WI, high SI in 10, intermediate SI in 7, low SI in levels on T2WI, and high SI in 10, intermediate SI in 9, low SI in 1 level on GE images. The most important sign of the transligamentous type HLD on MRI was the interruption of the black line with additional finding of the widening of adjacent epidural fat space. The MR signal intensity of the herniated disc was variable. Axial GE image was valuable for the evaluation of the direction of HLD and it relationship with neural structure, but had no addiational information for the degree and biochemical change of HLD over SE image.

  7. Adjacent Lumbar Disc Herniation after Lumbar Short Spinal Fusion

    OpenAIRE

    Koshi Ninomiya; Koichi Iwatsuki; Yu-ichiro Ohnishi; Toshika Ohkawa; Toshiki Yoshimine

    2014-01-01

    A 70-year-old outpatient presented with a chief complaint of sudden left leg motor weakness and sensory disturbance. He had undergone L4/5 posterior interbody fusion with L3–5 posterior fusions for spondylolisthesis 3 years prior, and the screws were removed 1 year later. He has been followed up for 3 years, and there had been no adjacent segment problems before this presentation. Lumbar magnetic resonance imaging (MRI) showed a large L2/3 disc hernia descending to the L3/4 level. Compared to...

  8. No differences in post-operative rehabilitation across municipalities in patients with lumbar disc herniation

    DEFF Research Database (Denmark)

    Paulsen, Rune Tendal; Bergholdt, Erik; Carreon, Leah;

    2015-01-01

    decompressive surgery for lumbar disc herniation were identified. Changes in Oswestry disability index (ODI), EuroQol-5D (EQ-5D) and duration of sick leave were compared among the municipalities. RESULTS: Patient-reported outcome measures showed no statistical difference in ODI, EQ-5D or sick leave at the one...... study examined rehabilitation in the 22 municipalities of the Region of Southern Denmark for patients with lumbar disk herniation. METHODS: A total of 22 physiotherapists answered a questionnaire regarding their rehabilitation programmes. The municipalities of 789 patients who had undergone...... cooperation between hospital and rehabilitation unit to ensure the best possible patient treatment. Further studies should focus on the effect of rehabilitation. FUNDING: not relevant. TRIAL REGISTRATION: not relevant....

  9. A case of an 18-year-old male rugby union forward with a C5/C6 central disc herniation.

    Science.gov (United States)

    Broughton, Henare Renata

    2009-01-01

    The patient was an 18-year-old front row forward rugby player who had a history of episodic neck pain for over 2 years following playing games of rugby. The initial event of April 2005 for which the symptoms manifested was a scrum collapse; he continued playing until a front-on tackle occurred when the symptoms dictated that he leave the field and be taken to the local hospital. A diagnosis of a cervical sprain was made and conservative management ensued. During the selections held on January 2008, a medical assessment was made and an MRI found that he had a central disc herniation at C5/C6. He was referred to a spinal orthopaedic surgeon for further treatment. The risks to cervical spinal injuries are illustrated in this case, in a scrum and in the tackle. The prevention of such an injury is discussed. PMID:21686741

  10. Demographic Characteristics of 796 Patients Operated for Lumbar Disc Herniation in Thrace Region, Turkey

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    Emre Delen

    2014-12-01

    Full Text Available Aim: This study was designed was to determine the demographic characteristics of patients operated for lumbar disc herniation in Thrace Region, Turkey. Material and Method: We retrospectively searched our data to find out patients who had one sided, one level and only one spinal surgical intervention for herniated lumbar disc. Results: Among 796 cases, 336 (42% were men and 460 (58% were women. The level of the pathology is determined as L1 - 2 for 4 cases (0.5%, L2 - 3 for 15 cases (1.9%, L3 - 4 for 51 cases (6.4%, L4 - 5 for 412 cases (51.8% and as L5 - S1 on 314 cases (39.4%. While a total of 70 cases (8.9% were identified on upper-levels ( L1 %u2013 2, L2 %u2013 3, L3 %u2013 4; 726 cases (91.1% were found to be on lower-levels ( L4 %u2013 5, L5 - S1. A mild positive correlation between the pathology level and physical activity intensity (P < 0.05, P = 0.103 has been demonstrated; as well as a strong negative correlation between pathology level and mean age (P < 0.05, P = -0.404. Discussion: The demographic characteristics are consistent with the literature. Physical activity intensity influence on lower-level herniations might have significance due to the large sample size. The strong negative correlation between pathology level and mean age suggests that the degeneration raises the frequency of upper-level herniations.

  11. Clinical efficacy of three different minimally invasive procedures for far lateral lumbar disc herniation

    Institute of Scientific and Technical Information of China (English)

    LIU Tao; ZHOU Yue; WANG Jian; CHU Tong-wei; LI Chang-qing; ZHANG Zheng-feng; ZHANG Chad; ZHENG Wen-jie

    2012-01-01

    Background Far lateral lumbar disc hemiation (FLLDH) accounts for 2.6% to 11.7% of all lumbar herniated discs.Numerous surgical approaches have been described for treating this condition.The purpose of this study was to evaluate minimally invasive surgical techniques for the treatment of FLLDH.Methoda From June 2000 to March 2006,52 patients with FLLDH were treated with minimally invasive procedures.All patients were assessed by anteroposterior and lateral roentgenography and computed tomography (CT).Some patients underwent myelography,discography,and magnetic resonance imaging.Procedures performed included Yeung Endoscopy Spine System (YESS) (n=25),METRx MicroDiscectomy System (n=13),and X-tube (n=14).Patients were followed up for a mean of 13.5 months.Clinical outcomes were assessed using a visual analog scale (VAS) and Nakai criteria.Results All 3 procedures significantly improved radiating leg symptoms (P <0.005).After surgery,84.0%,84.6%,and 92.8% of patients in the YESS,METRx,and X-tube groups had excellent or good outcomes.There were no statistically significant differences of VAS scores between the groups.The YESS procedure was associated with the shortest operation time,simplest anesthesia,and least trauma compared with the other 2 procedures,especially for type Ⅰherniations.The METRx procedure was the most suitable for type Ⅱ herniations and posterior endoscopic facetectomy.Posterior lumbar interbody fusion and unilateral pedicle screw instrumentation with X-tube was the most suitable for herniations combined with degenerative lumbar instability (type Ⅲ).Conclusion Minimally invasive strategies and options should be determined with reference to the type of FLLDH.

  12. A Novel Approach to the Surgical Treatment of Lumbar Disc Herniations: Indications of Simple Discectomy and Posterior Transpedicular Dynamic Stabilization Based on Carragee Classification

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    A. F. Ozer

    2013-01-01

    Full Text Available Surgery of lumbar disc herniation is still a problem since Mixter and Barr. Main trouble is dissatisfaction after the operation. Today there is a debate on surgical or conservative treatment despite spending great effort to provide patients with satisfaction. The main problem is segmental instability, and the minimally invasive approach via microscope or endoscope is not necessarily appropriate solution for all cases. Microsurgery or endoscopy would be appropriate for the treatment of Carragee type I and type III herniations. On the other hand in Carragee type II and type IV herniations that are prone to develop recurrent disc herniation and segmental instability, the minimal invasive techniques might be insufficient to achieve satisfactory results. The posterior transpedicular dynamic stabilization method might be a good solution to prevent or diminish the recurrent disc herniation and development of segmental instability. In this study we present our experience in the surgical treatment of disc herniations.

  13. Usefulness of dynamic contrast enhanced lumbar spine MR imaging postoperative herniated lumbar disc

    Energy Technology Data Exchange (ETDEWEB)

    Nam, Ji Eun; Chung, Tae Sub; Kim, Young Soo; Cho, Yong Eun; Park, Mi Suk [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    1999-02-01

    To compare the usefulness of dynamic contrast enhanced lumbar spine MR imaging with that of conventional delayed contrast enhanced MR imaging in the assessment of postoperative herniated lumbar disc. Forty-one postoperative herniated lumbar disc (HLD) lesions of 32 patients with back pain were examined with MR imaging (1.5T, Vision, Siemens, Germany). Five-phase dynamic 2D FLASH sagittal images (TR/TE = 118.1msec/4.1msec) were obtained every 19 seconds with a 4 minutes delayed image after contrast injection. As seen on delayed images, the discs were assessed as recurred, fibrosis, or no change. On dynamic images, the pattern of enhancement was evaluated as follows : Type 1 (no change in peripheral disc enhancement between the early and late phases) ; or Type 2 (minimal internal extension of marginal smooth enhancement during the late phase) ; or Type 3 (marked internal extension of peripheral irregular enhancement). Dynamic and delayed imaging were compared, and early epidural space enhancement with rapid wash-out was also evaluated. Of 41 postoperative HLDs, 39 lesions showed peripheral contrast enhancement. Evaluation depended on delayed imaging, and was as follows : recurred HLD (n=27) ; fibrosis (n=5) ; no change in postoperative disc (n=7). On dynamic contrast-enhanced imaging, enhancement patterns were Type 1 (n=29), Type 2 (n=7), and Type 3 (n=3). In 29 Type 1 lesions, there were no significant differences in image findings between dynamic and delayed images. However, in ten lesions (type 2 : n=7, type 3 : n=3), findings additional to those revealed by delayed images were demonstrated by dynamic contrast-enhanced MR imaging. Nine of the ten Type 2 and 3 lesions were diagnosed as recurred HLD. On dynamic images, five lesions showed early epidural space enhancement. Dynamic contrast-enhanced lumbar spine MR imaging provided additional findings such as increased peripheral disc enhancement, and epidural space enhancement, which cannot be detected on

  14. Biomechanical analysis of the camelid cervical intervertebral disc

    Directory of Open Access Journals (Sweden)

    Dean K. Stolworthy

    2015-01-01

    Full Text Available Chronic low back pain (LBP is a prevalent global problem, which is often correlated with degenerative disc disease. The development and use of good, relevant animal models of the spine may improve treatment options for this condition. While no animal model is capable of reproducing the exact biology, anatomy, and biomechanics of the human spine, the quality of a particular animal model increases with the number of shared characteristics that are relevant to the human condition. The purpose of this study was to investigate the camelid (specifically, alpaca and llama cervical spine as a model of the human lumbar spine. Cervical spines were obtained from four alpacas and four llamas and individual segments were used for segmental flexibility/biomechanics and/or morphology/anatomy studies. Qualitative and quantitative data were compared for the alpaca and llama cervical spines, and human lumbar specimens in addition to other published large animal data. Results indicate that a camelid cervical intervertebral disc (IVD closely approximates the human lumbar disc with regard to size, spinal posture, and biomechanical flexibility. Specifically, compared with the human lumbar disc, the alpaca and llama cervical disc size are approximately 62%, 83%, and 75% with regard to area, depth, and width, respectively, and the disc flexibility is approximately 133%, 173%, and 254%, with regard to range of motion (ROM in axial-rotation, flexion-extension, and lateral-bending, respectively. These results, combined with the clinical report of disc degeneration in the llama lower cervical spine, suggest that the camelid cervical spine is potentially well suited for use as an animal model in biomechanical studies of the human lumbar spine.

  15. Postoperative changes of herniated intervertebral disc: Normal and discitis MR findings

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Seung Jae; Ryu, Kyung Nam; Choi, Woo Suk; Yoon, Yup; Kim, Ki Tack [Kyung Hee University Hospital, Seoul (Korea, Republic of)

    1994-08-15

    To describe normal postoperative MR findings and MR findings of postoperative discitis in patients who underwent operation due to herniated intervertebral disc. We retrospectively reviewed normal postoperative MR findings and MR findings of discitis in 30 patients(21-61 yrs) (13 cases diagnosed as discitis and 17 cases as normal) who previously underwent laminectomy and discectomy, or bony fusion. We analyzed signal intensity of end plate and disc, end plate destruction,and enhancement of end plate and disc on T1- and T2-weighted images(WI) of 1.5 T MRI. Among 14 out 17 patients with no evidence of discitis, 7 patients showed high signal of the posterior portion of disc on T1- and T2-WI and 11 patients revealed enhancement at the same sites. In all 13 patients suspected of having discitis, end plate and disc showed low signal on T1-WI, high signal on T2-WI, heterogeneous enhancement,and irregular destruction of end plate. Meanwhile, 3 cases with no evidence of postoperative discitis clinically who underwent bony fusion showed similar findings to those of the above 13 patients, except for homogeneous enhancement of end plate and vertebral body. The MR findings of postoperative discitis were low signal on T1-WI, high signal on T2-WI, and heterogeneous enhancement of and plate and disc, and destruction of end plate.

  16. Análise de fatores associados à lesão do nervo laríngeo recorrente em cirurgias de discectomia cervical via anterior Análisis de factores asociados a la lesión del nervio laríngeo recurrente en cirugías de discectomía cervical por vía anterior Analysis of factors associated with laryngeal nerve injury in anterior disc herniation surgery

    Directory of Open Access Journals (Sweden)

    Erasmo Abreu Zardo

    2011-01-01

    (incisiones de halo craneano. CONCLUSIÓN: El abordaje por el lado derecho presentó mayor índice de complicaciones con el NLR. A pesar de que el número limitado de pacientes no permite conclusiones estadísticas significativas, factores anatómicos intrínsecos del paciente como cuello corto y diámetro aumentado, bien como tiempo quirúrgico y dificultades técnicas que puedan aumentarlo, pueden estar asociados a lesiones en el NLR. Nuevos estudios evaluando las variables arriba estudiadas deben ser considerados.OBJECTIVE: To study other possible factors associated with RLN injury after anterior approach for treatment of disc herniation. METHODS: Between June 2009 and July 2010, we evaluated 30 patients underwent anterior approach for treatment of disc herniation in Hospital Sao Lucas, PUC-RS. At preoperative period, we evaluated the measure of neck circumference (at the level of the cricoid cartilage and cervical height (angle of the jaw to the upper edge of the clavicle. At perioperative period, we evaluated the time and difficulty in endotracheal intubation, surgical time, the approach side , the number of levels operated, and the type of incision (transverse / longitudinal and the use of the cranial halo. An endoscopic evaluation of the larynx was performed preoperatively. In the first 10 days after surgery, it was performed a second evaluation. The patients who had a normal second examination were considered without RLN injury. Patients who showed injuries were followed monthly until a period of six months when injuries were considered as definitive. RESULTS: We found 3/30 (10% cases of temporary RLN injury which recovered to up to 120 days post operate. Related to patients with no RLN injury, these patients had a neck circumference greater than average, their surgical time was above average, as well the number of levels operated, and the neck length was shorter than average. Two injuries occurred in the approach through the right side and one in the left side. All

  17. Spontaneous and complete regression of a thoracic disc herniation; Regression spontanee et complete en IRM d`une hernie discale dorsale

    Energy Technology Data Exchange (ETDEWEB)

    Coevoet, V.; Benoudiba, F.; Doyon, D.; Lignieres, C.; Said, G. [Centre Hospitalier Universitaire de Bicetre, 94 - Le Kremlin-Bicetre (France)

    1997-09-01

    Spontaneous regression of disc herniation is well known but the mechanism is not clear. Some hypotheses have been made. We present here a large thoracic disc herniation diagnosed by MRI which completely regressed one year after a medical treatment with complete amendment of symptoms. (authors). 11 refs.

  18. Effectiveness of percutaneous laser disc decompression versus conventional open discectomy in the treatment of lumbar disc herniation; design of a prospective randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Koes Bart W

    2009-05-01

    Full Text Available Abstract Background The usual surgical treatment of refractory sciatica caused by lumbar disc herniation, is open discectomy. Minimally invasive procedures, including percutaneous therapies under local anesthesia, are increasingly gaining attention. One of these treatments is Percutaneous Laser Disc Decompression (PLDD. This treatment can be carried out in an outpatient setting and swift recovery and return to daily routine are suggested. Thus far, no randomized trial into cost-effectiveness of PLDD versus standard surgical procedure has been performed. We present the design of a randomized controlled trial, studying the cost-effectiveness of PLDD versus conventional open discectomy in patients with sciatica from lumbar disc herniation. Methods/design The study is a randomized prospective multi-center trial, in which two treatment strategies are compared in a parallel group design. Patients (age 18–70 years visiting the neurosurgery department of the participating hospitals, are considered for inclusion in the trial when sciatica due to lumbar disc herniation has lasted more than 8 weeks. Patients with disc herniation smaller than 1/3 of the spinal canal diameter, without concomitant lateral recess stenosis or sequestration, are eligible for participation, and are randomized into one of two treatment arms; either Percutaneous Laser Disc Decompression or conventional discectomy. The functional outcome of the patient, as assessed by the Roland Disability Questionnaire for Sciatica at 8 weeks and 1 year after treatment, is the primary outcome measure. The secondary outcome parameters are recovery as perceived by the patient, leg and back pain, incidence of re-intervention, complications, quality of life, medical consumption, absence of work and secondary costs. Discussion Open discectomy is still considered to be the golden standard in the surgical treatment of lumbar disc herniation. Whether Percutaneous Laser Disc Decompression has at least as

  19. Comparison of Lumbar Disc Herniation and Degeneration Relationship with the Sagittal Morphology of the Spine

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    Emre Delen

    2016-01-01

    Full Text Available In this study, the relationship between the lower intervertebral disc herniation and the degeneration of the spine with the sagittal morphological values were investigated. The data on this study is obtained retrospectively from patients who were operated in our center with the diagnosis of lower level lumbar disc herniation. A total of 117 patients, 75 female and 42 male are included. Patients are divided into two groups as with degeneration (Pfirmann stage III-IV-V and without degeneration (Pfirmann stage I-II. Among 117 patients, 13 were in the with degeneration group, while 104 were in the without degeneration group. The mean age of the first group was 43.0 (± 11.2 years, while the second group had a mean age of 45.3 (± 11.4 years and there were not a statistically significant differences between them (P > 0.05. Mean lumbar lordosis angle was 23.30 (± 8.92 degree in the first group and 28.81 (± 9.17 degree in the without dejeneration group, thus a lower degree was observed in the group with degeneration (P = 0.050. Segmental lordosis angle was 24.69 (± 8.91 and 28.17 (± 5.75 degree respectively, in the group with degeneration the angle value was lower (P = 0.088. The sacral surface angle in the group with degeneration was 99.51 (± 5.36 degree and in the second group it was 100.56 (± 6.03 degree. Nevertheless the difference was not statistically significant (P = 0.509. The sacral kyphosis angle is determined as 170.13 (± 5.41 degree and 155.59 (± 45.96 degree in the two groups respectively and there was statistically significant difference between them (P = 0.059. For cases with lower level lumbar disc herniation there exists a significant relationship between the disc herniation and degeneration, therefore the lumbar lordosis and the segmental lordosis angles are lower in patients with degeneration.

  20. Effects of six-week exercise training protocol on pain relief in patients with lumbar disc herniation

    Directory of Open Access Journals (Sweden)

    Amir Hossein Yazdani

    2016-02-01

    Full Text Available Introduction: Paraspinal, abdominal, and core muscles are playing the main role in lumbar disc herniation. The aim of the present study was to investigate the efficacy of a 6 weeks exercise training protocol on pain relief in males and females with lumbar disc herniation. Methods: In this before-after trial study, 64 patients with lumbar disc herniation were assigned to a 6 weeks exercise training program. Training protocol included leg press, trunk lateral flexion, trunk rotation, trunk flexion/extension, and stretching exercises in two sessions a week with 25-30 minutes each. Pain was measured with visual analog scale (VAS at 1st, 6th, and 12th sessions. Results: A total of 64 patients (13 males with mean age 47.53 ± 11.71 years and 51 females with mean age 46.50 ± 11.76 years completed the protocol. The pain was significantly reduced in both males and females during sessions 6 and 12 in comparison with the first session (P = 0.001. The amount of pain relief in males was higher than females (P = 0.047. Conclusion: About 6 weeks exercise training program could reduce more pain in males with lumbar disc herniation compared to females. This core stabilizing exercise protocol could be a good recommendation for patients with disk herniated low back pain (LBP.

  1. Artificial Cervical Disc Replacement Improves Mobility

    Medline Plus

    Full Text Available ... spine problems in up to date but this new technology with the use of an artificial disc ... of patients for many, many. Prior to this new technology, we would take out that disc and ...

  2. Artificial Cervical Disc Replacement Improves Mobility

    Medline Plus

    Full Text Available ... problems in up to date but this new technology with the use of an artificial disc has ... patients for many, many. Prior to this new technology, we would take out that disc and then ...

  3. Comparison of open surgical discectomy versus plasma-laser nucleoplasty in patients with single lumbar disc herniation

    Directory of Open Access Journals (Sweden)

    Saeid Abrishamkar

    2015-01-01

    Full Text Available Background: Intervertebral disc herniation is a major cause of low back pain. Several treatment methods are available for lumbar disc herniation including Chemonucleolysis, open surgery, nucleoplasty, laser disc decompression, and intradiscal electrothermal therapy. The high prevalence of lumbar disc herniation necessitates a minimally invasive yet effective treatment method. In this study, we compared the outcomes of open surgery and nucleoplasty method in patients with single lumbar disc herniation. Materials and Methods: This study was a noninferiority randomized clinical trial conducted in one of the University Hospitals of Isfahan Medical University; The Alzahra Hospital. About 200 patients with the diagnosis of lumbar disc herniation were recruited and were assigned to either the treatment or control groups using block randomization. One group received open surgery and the other group received nucleoplasty as the method of treatment. Patients were revisited at 14 days, 1, 2, 3 months, and 1-year after surgery and were assessed for the following variables: Lower back pain, lower limb pain, common complications of surgery (e.g., discitis, infection and hematoma and recurrence of herniation. Results: The mean (standard deviation severity of low back pain was reduced from 6.92 (2.5 to 3.43 (2.3 in the nucleoplasty group (P = 0.04 and from 7.5 (2.2 to 3.04 (1.61 in the discectomy group (P = 0.73. Between group difference was not statistically significant (P = 0.44, however, time and treatment interaction was significant (P = 0.001. The level of radicular pain evaluated 1 year after treatment was reduced from 8.1 (1.2 to 2.9 (1.2 (P = 0.004 and from 7.89 (2.1 to 3.6 (2.5 (P =0.04 in the discectomy and the nucleoplasty groups respectively, significant interaction between time and treatment options was observed (P < 0.001 while there was no significant difference between two treatment groups (P = 0.82. Conclusion: Our results show that while

  4. Intra- and inter-observer reliability of MRI examination of intervertebral disc abnormalities in patients with cervical myelopathy

    Energy Technology Data Exchange (ETDEWEB)

    Braga-Baiak, Andresa [Center for Excellence in Surgical Outcomes, Duke University Medical Center, Durham, NC (United States); Post-graduation Program, Department of Radiology, University of Sao Paulo (Brazil); Shah, Anand [Center for Excellence in Surgical Outcomes, Duke University Medical Center, Durham, NC (United States); Pietrobon, Ricardo [Center for Excellence in Surgical Outcomes, Duke University Medical Center, Durham, NC (United States); Department of Surgery, Duke University Medical Center, Durham, NC (United States); Braga, Larissa [Center for Excellence in Surgical Outcomes, Duke University Medical Center, Durham, NC (United States); University of Nebraska Medical Center, Lincoln NE (United States); Neto, Arnolfo Carvalho [Clinica DAPI, Curitiba (Brazil); Section of Diagnostic Radiology, Department of Internal Medicine, Universidade Federal do Parana (Brazil); Cook, Chad [Center for Excellence in Surgical Outcomes, Duke University Medical Center, Durham, NC (United States); Division of Physical Therapy, Duke University Medical Center, Durham, NC (United States)], E-mail: chad.cook@duke.edu

    2008-01-15

    Purpose: Intervertebral cervical disc herniation (CDH) is a relatively common disorder that can coexist with degenerative changes to worsen cervicogenic myelopathy. Despite the frequent disc abnormalities found in asymptomatic populations, magnetic resonance imaging (MRI) is considered excellent at detecting cervical spine myelopathy (CSM) associated with disc abnormality. The objective of this study was to investigate the intra- and inter-observer reliability of MRI detection of CSM in subjects who also had co-existing intervertebral disc abnormalities. Materials and methods: Seven experienced radiologists reviewed twice the MRI of 10 patients with clinically and/or imaging determined myelopathy. MRI assessment was performed individually, with and without operational guidelines. A Fleiss Kappa statistic was used to evaluate the intra- and inter-observer agreement. Results: The study found high intra-observer percent agreement but relatively low Kappa values on selected variables. Inter-observer reliability was also low and neither observation was improved with operational guidelines. We believe that those low values may be associated with the base rate problem of Kappa. Conclusion: In conclusion, this study demonstrated high intra-observer percent agreement in MR examination for intervertebral disc abnormalities in patients with underlying cervical myelopathy, but differing levels of intra- and inter-observer Kappa agreement among seven radiologists.

  5. Clinical Observation on the Treatment of Relapsed Lumbar Disc Herniation after Disc Surgery by Acupuncture plus Medication

    Institute of Scientific and Technical Information of China (English)

    吴耀持; 汪崇淼; 张峻峰; 李石胜; 洪珏

    2010-01-01

    Objective:This study was to observe the therapeutic effect of electro-acupuncture combined with Chinese herbal fumigation and application in the treatment of relapsed lumbar disc herniation after lumbar disc surgery.Methods:Eighty-four subjects were randomized into a treatment group and a control group.The treatment group(44subjects)received electroacupuncture plus herbal fumigation and application therapy.The control group(40 subjects)only received electroacupuncture therapy.The therapeutic results were observed and compared afterwards.Results:The total effective rate was 90.9% in the treatment group and 82.5% in the control group.and the difierence was statistically significant(P<0.05).Conclusion:The combined therapy of electroacupuncture with Chinese herbal fumigation and application has better therapeutic effect than mono-electroacupuncture in the treatment of post-surgery relapsed lumbar disc herniation.%目的:观察电针配合中药外熏外敷治疗腰椎间盘突出症术后复发的临床疗效.方法:将84例病人随机分成治疗组和对照组,治疗组44例运用电针结合中药熏敷治疗,对照组40例单用电针进行治疗,观察并比较两组临床疗效.结果:治疗组总有效率为90.9%,对照组总有效率为82.5%,两组有显著性差异(P<0.05).结论:电针结合中药熏敷用于腰椎间盘突出症术后复发患者的治疗,其临床疗效要优于单纯电针治疗.

  6. Artificial Cervical Disc Replacement Improves Mobility

    Medline Plus

    Full Text Available ... to delineate the exact trajectory into the disc space. So now he’s found the disc space, what he wants to do is confirm it ... has stuck a marker into this actual disc space, and the next thing he is goes to ...

  7. MR imaging of the lumbar disk herniation : relationship between the direction of herniated disc and pressure effect on nerve root and dural sac

    Energy Technology Data Exchange (ETDEWEB)

    Cha, B. H.; Shon, M. Y.; Kim, K. W.; Lim, M. A.; Kwon, K. R; Kim, S. S. [Sunlin Presbyterian Hospital, Pohang (Korea, Republic of)

    1996-04-01

    To evaluate the relationship between the direction of herniated disc and pressure effect on nerve root and dural sac, as seen on MRI. We retrospectively reviewed lumbar spine MR images of 122 cases of lumbar disk herniation 75 patients MRI findings were analyzed with regard to the relationship between the direction of the herniated disc and pressure effect on nerve root and dural sac. Pressure effect on nerve root and dural sac was arbitrarily divided into three types. Type I was defined as zero or minimal compression of nerve roots or thecal sac by the herniated disc ; type II was defined as mild to moderate compression, while III was defined as severe compression or displacement of nerve roots and/or thecal sac. Of the 122 cases seen in these 75 patients, 97(80%) were observed at L4-5 and L5-S1. The central type(71cases ; 58%) was more frequently observed than the posterolateral type(48cases ; 40%) or lateral type(3cases ; 2%). The totals of types I, II, and III were 44(36%), 43(35%) and 35 cases(29%), respectively. Seventy-seven %(34/44) of type I and 65%(28/43) of type II were of the central type but for type III, the corresponding figure was only 26%(9/35). On MR imaging, most of lumbar disk herniations were observed at L4-5 and L5-S1, with a predominance of the central type rather than the posterolateral one. Most of the central types were either type I or type II.

  8. Bilateral post-injection fibrosis of the gluteal region mimicking lumbar disc herniation: a case report

    Directory of Open Access Journals (Sweden)

    Kamil Cagri Kose

    2009-11-01

    Full Text Available Tissue fibrosis is a known complication of intramuscular injections, which is especially seen in children due to vaccinations and injections. Herein we report a case of post injection gluteal fibrosis that had undergone two unsuccessful lumbar discectomies to treat the symptoms of this disease. A 45 years old male patient was consulted to our clinic from the department of neurochirurgy with complaints of bilateral hip pain. The patient was operated on for lumbar disc herniation in L4-5 level twice but his complaints had not resolved. A third operation including L4-5 instrumentation and fusion was planned. His examination revealed nodules in his both hips. His x-rays, MRI and blood tests were normal. He underwent bilateral gluteal fascia excision and his complaints resolved totally. The clinical diagnosis of post-injection fibrosis is problematic, due to the difficulty of determining the etiology. In many patients the diagnosis comes from a history of injection. Pain in the gluteal region is not a frequently described clinical feature of this condition. Many reports in the literature emphasize a contracture rather than pain. Post-injection fibrosis in the gluteal region may mimic lumbar disc herniation and a detailed physical examination is the key for correct differential diagnosis. In refractory cases not responding to conservative treatment, surgical excision of the nodules may lead to a complete clinical recovery of the patient.

  9. Treatment of 89 Cases of Lumbar Intervertebral Disc Herniation with Acupuncture

    Institute of Scientific and Technical Information of China (English)

    吴广伟; 杨湘宇

    2006-01-01

    采用以针刺为主、辅以腰部牵引和按摩等方法对89例腰椎间盘突出症患者进行综合治疗.经4个疗程的治疗,治愈65例,显效12例,有效7例,无效3例.采用以针刺为主的综合治疗腰椎间盘脱出症,能明显提高治疗效果,值得临床推广应用.%Eighty-nine cases of lumbar intervertebral disc herniation were mainly dealt with acupuncture method, supplementing with traction and Tuina at lumbar region. After 4 courses of treatment, 65 cases were cured, 12 cases got marked effects, 7 some effects, and 3 no effect. This integrated treatment had good effects on lumbar intervertebral disc herniation, and are worthy of being applied widely in clinic.

  10. CLINICAL OBSERVATION ON LUMBAR INTERVERTEBRAL DISC HERNIATION TREATED BY TRACTION COMBINED WITH ACUPUNCTURE

    Institute of Scientific and Technical Information of China (English)

    何涛; 何岚

    2004-01-01

    Objective: To observe the therapeutic effect of traction combined with acupuncture on lumbar intervertebral disc herniation (LIDH).Methods:Eighty-three patients diagnosed as LIDH were randomly divided into treatment group (n=42)and control group (n=41).In the treatment group, besides lumbar traction, electroacupuncture at Jiaji (EX-B 2, L3~5), Shenshu (BL 23), Qihai (CV 6), Mingmen (GV 4), Huantiao (GB 30), Chengshan (BL 57) and Yanglingquan (GB 34) was added.In the control group, only lumbar traction was applied.Results: In treatment group, the cure plus markedly effective rate was 80.95% with a total effective rate of 92.86%, while in control group, it was 39.02% with a total effective rate of 80.48%.The therapeutic effect in the treatment group was obviously better than that in the control group (P<0.001).Conclusion: Lumbar traction plus EA can effectively alleviate or even eliminate clinical symptoms and signs of lumbar intervertebral disc herniation.

  11. Recurrent Lumbar Disc Herniation: Results of Revision Surgery and Assessment of Factors that May Affect the Outcome. A Non-Concurrent Prospective Study

    OpenAIRE

    Ibrahim, Mohammed; Arockiaraj, Justin; Amritanand, Rohit; Venkatesh, Krishnan; David, Kenny Samuel

    2015-01-01

    Study Design Non-concurrent prospective study. Purpose To determine the functional outcome after open 'fragment' discectomy for recurrent lumbar disc herniation, and to analyze the factors that may affect the outcome. Overview of Literature Literature search revealed only four studies where the factors affecting the outcome of a revision surgery for recurrent disc herniation have been evaluated. None of these studies analyzed for diabetes, disc degeneration and facet arthropathy. We have anal...

  12. Comparison of Percutaneous Endoscopic Lumbar Discectomy and Open Lumbar Surgery for Adjacent Segment Degeneration and Recurrent Disc Herniation

    OpenAIRE

    Huan-Chieh Chen; Chih-Hsun Lee; Li Wei; Tai-Ngar Lui; Tien-Jen Lin

    2015-01-01

    Objective. The goal of the present study was to examine the clinical results of percutaneous endoscopic lumbar discectomy (PELD) and open lumbar surgery for patients with adjacent segment degeneration (ASD) and recurrence of disc herniation. Methods. From December 2011 to November 2013, we collected forty-three patients who underwent repeated lumbar surgery. These patients, either received PELD (18 patients) or repeated open lumbar surgery (25 patients), due to ASD or recurrence of disc herni...

  13. Does nuclear tissue infected with bacteria following disc herniations lead to Modic changes in the adjacent vertebrae?

    DEFF Research Database (Denmark)

    Albert, H. B.; Lambert, Peter; Rollason, Jess;

    2013-01-01

    the presence of low virulent anaerobic microorganisms, predominantly Propionibacterium acnes, in 7-53 % of patients. At the time of a herniation these low virulent anaerobic bacteria may enter the disc and give rise to an insidious infection. Local inflammation in the adjacent bone may be a secondary...

  14. Artificial Cervical Disc Replacement Improves Mobility

    Medline Plus

    Full Text Available ... implant components work together with the surrounding spinal structures to provide stability and function. The ProDisc C implant is secured to the vertebral bodies above and below the disc space and held in place with two central keels. ...

  15. Preoperative retrolisthesis as a risk factor of postdecompression lumbar disc herniation.

    Science.gov (United States)

    Takenaka, Shota; Tateishi, Kosuke; Hosono, Noboru; Mukai, Yoshihiro; Fuji, Takeshi

    2016-04-01

    OBJECT In this study, the authors aimed to identify specific risk factors for postdecompression lumbar disc herniation (PDLDH) in patients who have not undergone discectomy and/or fusion. METHODS Between 2007 and 2012, 493 patients with lumbar spinal stenosis underwent bilateral partial laminectomy without discectomy and/or fusion in a single hospital. Eighteen patients (herniation group [H group]: 15 men, 3 women; mean age 65.1 years) developed acute sciatica as a result of PDLDH within 2 years after surgery. Ninety patients who did not develop postoperative acute sciatica were selected as a control group (C group: 75 men, 15 women; mean age 65.4 years). Patients in the C group were age and sex matched with those in the H group. The patients in the groups were also matched for decompression level, number of decompression levels, and surgery date. The radiographic variables measured included percentage of slippage, intervertebral angle, range of motion, lumbar lordosis, disc height, facet angle, extent of facet removal, facet degeneration, disc degeneration, and vertebral endplate degeneration. The threshold for PDLDH risk factors was evaluated using a continuous numerical variable and receiver operating characteristic curve analysis. The area under the curve was used to determine the diagnostic performance, and values greater than 0.75 were considered to represent good performance. RESULTS Multivariate analysis revealed that preoperative retrolisthesis during extension was the sole significant independent risk factor for PDLDH. The area under the curve for preoperative retrolisthesis during extension was 0.849; the cutoff value was estimated to be a retrolisthesis of 7.2% during extension. CONCLUSIONS The authors observed that bilateral partial laminectomy, performed along with the removal of the posterior support ligament, may not be suitable for lumbar spinal stenosis patients with preoperative retrolisthesis greater than 7.2% during extension. PMID:26654340

  16. Cervical disc arthroplasty with ProDisc-C artificial disc: 5-year radiographic follow-up results

    Institute of Scientific and Technical Information of China (English)

    ZHAO Yan-bin; SUN Yu; ZHOU Fei-fei; LIU ZHONG-jun

    2013-01-01

    Background Cervical disc arthroplasty is an alternative surgery to standard cervical decompression and fusion for disc degeneration.Different types of cervical disc prosthesis are used in China.The aim of this study was to evaluate the radiographic outcomes of cervical arthroplasty using the ProDisc-C prosthesis.Methods Radiographic evaluation,including static and dynamic flexion-extension lateral images,was performed at baseline and at final follow-up.Results Twenty six patients who had single-level ProDisc-C arthroplasty were followed up for a mean period of 63 months (56-76 months).The range of motion at the operated level was 9.3°±3.7° at baseline and 7.3°±3.5° at final follow-up,with a significant difference (P <0.05).Seventeen of 26 levels (65.4%) developed heterotopic ossification:three were classified as grade Ⅱ,13 were classified as grade Ⅲ,and 1 as grade Ⅳ,according to McAfee's classification.Forty nine adjacent segments were evaluated by lateral Ⅹ-ray and 18 (36.7%) segments developed adjacent segment degenerations.Conclusions ProDisc-C arthroplasty had acceptable radiographic results at 5-year follow-up.The range of motion was preserved.However,more than 60% of the patients developed heterotopic ossification.

  17. Giant posterior fossa arachnoid cyst causing tonsillar herniation and cervical syringomyelia

    Directory of Open Access Journals (Sweden)

    Vijay P Joshi

    2013-01-01

    Full Text Available Acquired cerebellar tonsillar herniation and syringomyelia associated with posterior fossa mass lesions is an exception rather than the rule. In the present article, we describe the neuroimaging findings in a case of 28-year-old female patient presented with a history of paraesthesia involving right upper limb of 8-month duration. Magnetic resonance imaging showed a giant retrocerebellar arachnoid causing tonsillar herniation with cervical syringomyelia. The findings in the present case supports that the one of the primary mechanism for the development of syringomyelia may be the obstruction to the flow of cerebrospinal fluid causing alterations in the passage of extracellular fluid in the spinal cord and leading to syringomyelia.

  18. Hernia discal traumática: Implicaciones médico-legales Traumatic disc herniation: Forensic implications

    Directory of Open Access Journals (Sweden)

    J. Aso

    2010-06-01

    Full Text Available El origen traumático de la hernia discal es una cuestión relevante en Medicina Legal. El presente trabajo realiza una revisión de las causas de las hernias y protrusiones discales, en especial del papel de los factores mecánicos en su origen. Se concluye que el origen de la hernia discal es multifactorial (genético, bioantropométrico, metabólicos, de entorno, así como que las hernias traumáticas puras son excepcionales, ocurriendo corrientemente sobre discos ya degenerados. Se revisan los signos radiológicos y clínicos de degeneración espinal, así como aquellos que pueden denotar un origen traumático de la hernia. Ante una hernia discal después de un accidente, el perito deberá valorar siempre la posibilidad de un estado anterior, así como el papel del accidente en una eventual descompensación o agravamiento del mismo. Se propone una clasificación de la causalidad tanto para la valoración del grado de la misma como para la modalidad del papel del estado anterior.Traumatic origin of disc herniation, remains as a relevant Medico-Legal problem. The present paper makes a disc protrusion/herniation revision, mainly about mechanic and traumatic factors involved in their origin. A multifactorial (genetic, bio-antropometric, environnement, metabolic, etc. causation is concluded to explain etiology of disc herniation. Pure disc herniation (occurring in a healthy non degenerated disc is considered an exceptional phenomenon. Clinical and radiological spine degeneration sings are revised, along with others that can point to a traumatic origin. Dealing with a disc herniation after an accident, Medical Expert has always to consider the possibility of a precedent disc damage status, assessing the role of a worsening of such antecedent condition in each case. A classification of degree of causation accident-herniation, and antecedent disc damage decompensation are proposed.

  19. Artificial Cervical Disc Replacement Improves Mobility

    Medline Plus

    Full Text Available ... been utilized to perform anterior cervical discectomies and fusions. The fusion procedure has been the most common way to ... significant benefits over the previous procedure of the fusion, and that is, able to maintain motion of ...

  20. Progression of lumbar disc herniations over an eight-year period in a group of adult Danes from the general population

    DEFF Research Database (Denmark)

    Kjaer, Per; Tunset, Andreas; Boyle, Eleanor;

    2016-01-01

    might give the clinician a better understanding of the natural history and consequences of lumbar disc herniations. However, few longitudinal studies have investigated this process using reliable measures from magnetic resonance imaging (MRI). The objectives of this study were to examine changes in and......BACKGROUND: A lumbar disc herniation (LDH) is a localised displacement of disc material, which may initiate changes in the disc and adjacent structures such as the nerve root and the spinal canal. Knowledge about how morphological changes in the disc relate to changes in other spinal structures...... MRI-confirmed disc herniations at 41 or 45 years were included. Cross-sectional areas (mm(2)) of the LDH, dural sac and disc height were calculated from measurements performed on sagittal T2-weighted images using a previously validated method. Changes over time for the three MRI findings were defined...

  1. Artificial Cervical Disc Replacement Improves Mobility

    Medline Plus

    Full Text Available ... put my handle back on, and meanwhile, the scrub nurse is preparing the actual disc itself because ... was doing that on the back table, the scrub nurse and the circulating nurse were putting together ...

  2. Artificial Cervical Disc Replacement Improves Mobility

    Medline Plus

    Full Text Available ... the location of the diseased disc, and the soft tissues are moved away from the front of the ... a zero-profile implant that does not contact soft tissue structures after it is implanted. The technical aspect ...

  3. Artificial Cervical Disc Replacement Improves Mobility

    Medline Plus

    Full Text Available ... wonder, does it cause problems at the next level up, so if I fuse this disc here, ... fusion, then the hope is that the next levels hopefully won’t feel the stress, and by ...

  4. Artificial Cervical Disc Replacement Improves Mobility

    Medline Plus

    Full Text Available ... to date but this new technology with the use of an artificial disc has some significant benefits ... facing straight up. The incision that Dr. Beutler uses is a little over an inch long, and ...

  5. Artificial Cervical Disc Replacement Improves Mobility

    Medline Plus

    Full Text Available ... stress, and by not feeling the stress, they should maintain good discs, hopefully over the lifetime of ... right where it wants to be, and that should be a natural position for the bones of ...

  6. Artificial Cervical Disc Replacement Improves Mobility

    Medline Plus

    Full Text Available ... implant that is composed of two cobalt chrome alloy end plates and a polyethylene insert. The polyethylene ... the ProDisc C implant have a plasma-sprayed titanium coding to provide bony coating to promote bony ...

  7. Artificial Cervical Disc Replacement Improves Mobility

    Medline Plus

    Full Text Available ... place with two central keels. All bone contacting surfaces of the ProDisc C implant have a plasma-sprayed titanium coding to provide bony coating to promote bony on growth, providing long-term ...

  8. Artificial Cervical Disc Replacement Improves Mobility

    Medline Plus

    Full Text Available ... fascia, which is kind of connective tissue that helps hold things together. It’s the very last layer ... placing a marker external to the skin to help to delineate the exact trajectory into the disc ...

  9. Artificial Cervical Disc Replacement Improves Mobility

    Medline Plus

    Full Text Available ... it out, the patient’s chin is to the right and the chest wall is towards the left, and he’s dissecting up and down. So the ... other nerve, the one that goes down his left arm, and if both are freed up, we’ll put in a piece of disc where we took out our disc right through here. Can I have a nerve fork, ...

  10. Signal intensity loss of the intervertebral discs in the cervical spine of young patients on fluid sensitive sequences

    Energy Technology Data Exchange (ETDEWEB)

    Bruin, F. de; Horst, S. ter; Bloem, J.L.; Reijnierse, M. [Leiden University Medical Center, Department of Radiology, C2-S, Albinusdreef 2, PO box 9600, Leiden (Netherlands); Berg, R. van den; Hooge, M. de; Gaalen, F. van; Heijde, D. van der [Leiden University Medical Center, Department of Rheumatology, Leiden (Netherlands); Fagerli, K.M. [Diakonhjemmet Hospital, Department of Rheumatology, Oslo (Norway); Landewe, R. [Amsterdam Medical Center, Department of Rheumatology, Amsterdam (Netherlands); Oosterhout, M. van [Groene Hartziekenhuis, Department of Rheumatology, Gouda (Netherlands)

    2016-03-15

    To evaluate the signal intensity (SI) of the intervertebral discs of the cervical spine on magnetic resonance (MR) fluid sensitive sequences, and correlate this to secondary signs of degeneration on MR and radiographs as well as to age. A total of 265 patients aged ≥16 with back pain (≥3-months, <2-year, onset <45-years) from the SPondyloArthritis Caught Early (SPACE) cohort were included. Sagittal 1.5 T MR images and lateral radiographs of the cervical spine were independently evaluated by two readers for: SI of the intervertebral discs using a grading system based of Pfirrmann (grade 1 normal/bright SI; 2 inhomogeneous/bright SI; 3 inhomogeneous/mildly decreased SI; 4 inhomogeneous/markedly decreased SI; 5 signal void), disc herniation and Modic changes (MRI) and disc space narrowing, osteophytes and sclerosis (radiograph). Readers were blinded for clinical information. Descriptive statistics were used for characteristics and prevalence of findings, and regression analysis was used for age and grades. Of 265 patients (36 % male, mean age 30), 221 (83 %) patients had 1 to 6 discs (median 4) with decreased SI. Of 1,590 discs, 737 (46 %) were grade 1; 711 (45 %) grade 2; 133 (8 %) grade 3; 8 (1 %) grade 4 and 1 (0 %) grade 5. Secondary signs of degeneration were rare and seen predominantly in C5-C7 and appear to be related to signal loss grade 3 and 4. Low signal intensity of intervertebral discs in absence of secondary degenerative signs in the cervical spine on fluid sensitive MR images might be pre-existing and part of the natural course. (orig.)

  11. Efficacy of Transforaminal Endoscopic Spine System (TESSYS) Technique in Treating Lumbar Disc Herniation.

    Science.gov (United States)

    Pan, Zhimin; Ha, Yoon; Yi, Seong; Cao, Kai

    2016-01-01

    BACKGROUND To compare efficacy and safety of percutaneous transforaminal endoscopic spine system (TESSYS) and traditional fenestration discectomy (FD) in treatment of lumbar disc herniation (LDH). MATERIAL AND METHODS A total of 106 LDH patients were divided into TESSYS group (n=48) and FD group (n=58). Visual analogue scale (VAS), Oswestry disability index (ODI), Japanese Orthopedic Association (JOA), and modified MacNab criteria were used for efficacy evaluation. Post-operative responses were compared by enzyme-linked immunosorbent assay (ELISA) based on detection of serum IL-6, CRP, and CPK levels. RESULTS In the TESSYS group, compared with the FD group, we observed, shorter incision length, less blood loss, shorter hospital stay, lower hospitalization cost, shorter recovery time, lower complication rate (all Ptreatment of LDH. PMID:26887645

  12. The role of surgical decompression of Cauda equina in lumbar disc herniation in recovery of bladder function

    Directory of Open Access Journals (Sweden)

    Radulović Danilo

    2004-01-01

    Full Text Available INTRODUCTION Cauda equina syndrome from lumbar disc herniation accounts for up to 2-3% of all disc herniations. The aim of this study was to investigate whether recovery of bladder function after surgery depends on preoperative duration of disease. Patients and methods This retrospective study included 47 patients who underwent surgery for cauda equina syndrome due to a herniated disc in the period between 1997 and 2002. Eleven patients were female and 36 male, with a mean age of 43 years (range 23-67. All presented with sciatica and saddle hypoesthesia, whereas 13 presented with motor weakness of legs. All patients had been catheterized at the time of admission to the Neurosurgical unit. Levels of herniation were L4-L5 in 27 (57%, L5-S1 in 14 (30%, and L3-L4 in 6 (13% patients. In 7 (15% patients, surgery was performed within 48 hours of the cauda equina syndrome onset. None underwent surgery within 24 hours. 13 (28% patients were operated between the 2nd and 7th day and 27 (57% after 7th day of the cauda equina onset. The role of preoperative duration of symptoms in recovery of bladder function was examined (chi 2 analysis. RESULTS The follow-up ranged from 15 to 74 months (mean 24.2 months. In 33 patients (70% excellent result were achieved, in 9 (19% patients good results and 5 (11% patients presented with poor results. There was no statistically significant difference concerning the time between the onset of symptoms and surgical decompression and subsequent recovery of bladder function (p>0.05. CONCLUSION After accurate diagnosis and adequate operative treatment, postoperative results of cauda equina syndrome due to lumbar disc herniation appear satisfactory regardless of the timing of surgery.

  13. MR imaging of lumbar herniated intervertebral disc and spinal stenosis: Correlation with CT

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Won Jae; Park, Kil Sun; Chang, Kee Hyun; Han, Moon Hee; Kim, Hyun Jip; Han, Man Chung; Kim, Chu Wan [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1989-12-15

    MR imagings obtained in 40 patients with surgically proven lumbar herniated intervertebral disc (HIVD) and/or spinal stenosis were retrospectively analysed and compared with CT scans, in order to evaluate the MR findings of HIVD and spinal stenosis, and to assess the diagnostic accuracy of MR. The MR imaging was performed on a 2.0 T superconducting unit, using multislice spin echo (SE) and gradient echo (GE) techniques. The results were as follows: 1. The texture of vertebral body with spinal stenosis had the tendency to be more heterogeneous than that with HIVD. 2. The signal intensity of the diseased disc was isointense relative to normal disc in 81 % (60/74) and the remainder (19%) was hypointense on both T1 weighted SE and GE images. There was no significant difference in signal intensity among HIVD, HIVD combined with spinal stenosis and spinal stenosis groups, but there was the tendency of lower signal intensity of the diseased disc in patients with severe degenerative change of spine in both T1 weighted SE imaged and GE image. 3. The diagnostic accuracy of MR was 92%, which was similar to that of CT. 4. T1 weighted SE image appears superior to GE image in evaluation of most of the structural differentiation, but as for differentiating between lumina and ligamentum flavum, and for the vacuum phenomenon, GE image seems to be better than T1 weighted SE image. In conclusion, MR appears to be better than CT as a initial imaging modality in evaluation of the patients with suspected lumbar spinal stenosis or HIVD because MR has the capability of demonstrating rupture of anulus fibrosus in sagittal plane.

  14. Artificial Cervical Disc Replacement Improves Mobility

    Medline Plus

    Full Text Available ... it gets inserted, it’s very rough. It’s titanium plasma sprayed, and this allows for the body to ... surfaces of the ProDisc C implant have a plasma-sprayed titanium coding to provide bony coating to ...

  15. Artificial Cervical Disc Replacement Improves Mobility

    Medline Plus

    Full Text Available ... diseased disc and releasing pressure on the surrounding nerves and spinal cord. We’re going to do an image ... with that motion is going to push against nerves or the spinal cord. So it’s sometimes a little bit more ...

  16. Artificial Cervical Disc Replacement Improves Mobility

    Medline Plus

    Full Text Available ... is exactly where I’m putting my instruments right now, and those are small pieces of disc that I’m taking out. I’m obviously going real slow through this area, and the reason is ...

  17. Artificial Cervical Disc Replacement Improves Mobility

    Medline Plus

    Full Text Available ... ultrahigh molecular weight polyethylene, and it’s a medical-grade plastic that’s really been made to sustain active ... the disc level above and below as well. Good point. It does, and so I’m kind ...

  18. Artificial Cervical Disc Replacement Improves Mobility

    Medline Plus

    Full Text Available ... the next levels hopefully won’t feel the stress, and by not feeling the stress, they should maintain good discs, hopefully over the ... was an appropriate procedure that would work. These studies turned out well, and the FDA has approved ...

  19. Artificial Cervical Disc Replacement Improves Mobility

    Medline Plus

    Full Text Available ... the next levels hopefully won’t feel the stress, and by not feeling the stress, they should maintain good discs, hopefully over the ... FDA studies, in our study, in all the literature that I’ve read has been extremely positive ...

  20. Artificial Cervical Disc Replacement Improves Mobility

    Medline Plus

    Full Text Available ... see it gets inserted, it’s very rough. It’s titanium plasma sprayed, and this allows for the body ... the ProDisc C implant have a plasma-sprayed titanium coding to provide bony coating to promote bony ...

  1. Artificial Cervical Disc Replacement Improves Mobility

    Medline Plus

    Full Text Available ... That’s the actual disc space right there. It’s beautiful. So I’m going to take a scalpel ... And that’s where I wan it. That looks beautiful, so I’m very pleased about that. I’ ...

  2. Artificial Cervical Disc Replacement Improves Mobility

    Medline Plus

    Full Text Available ... plate. Obviously that procedure has worked out very well, but there’s probably a lot of really significant ... fusing this area, putting in an artificial disc. Well it allows motion, you know, and there’s been ...

  3. Artificial Cervical Disc Replacement Improves Mobility

    Medline Plus

    Full Text Available ... the next levels hopefully won’t feel the stress, and by not feeling the stress, they should maintain good discs, hopefully over the ... cord. So it’s sometimes a little bit more work. Well, there’s the space for where that nerve ...

  4. Biomechanical analysis of press-extension technique on degenerative lumbar with disc herniation and staggered facet joint.

    Science.gov (United States)

    Du, Hong-Gen; Liao, Sheng-Hui; Jiang, Zhong; Huang, Huan-Ming; Ning, Xi-Tao; Jiang, Neng-Yi; Pei, Jian-Wei; Huang, Qin; Wei, Hui

    2016-05-01

    This study investigates the effect of a new Chinese massage technique named "press-extension" on degenerative lumbar with disc herniation and facet joint dislocation, and provides a biomechanical explanation of this massage technique. Self-developed biomechanical software was used to establish a normal L1-S1 lumbar 3D FE model, which integrated the spine CT and MRI data-based anatomical structure. Then graphic technique is utilized to build a degenerative lumbar FE model with disc herniation and facet joint dislocation. According to the actual press-extension experiments, mechanic parameters are collected to set boundary condition for FE analysis. The result demonstrated that press-extension techniques bring the annuli fibrosi obvious induction effect, making the central nucleus pulposus forward close, increasing the pressure in front part. Study concludes that finite element modelling for lumbar spine is suitable for the analysis of press-extension technique impact on lumbar intervertebral disc biomechanics, to provide the basis for the disease mechanism of intervertebral disc herniation using press-extension technique. PMID:27275119

  5. Return to Play After Cervical Disc Surgery.

    Science.gov (United States)

    Kang, Daniel G; Anderson, Justin C; Lehman, Ronald A

    2016-10-01

    Criteria for return to sports and athletic activities after cervical spine surgery are unclear. There is limited literature regarding the outcomes and optimal criteria. Determining return to play criteria remains a challenge and continues to depend on the experience and good judgment of the treating surgeon. There is strong consensus in the literature, despite lack of evidence-based data, that athletes after single-level anterior cervical discectomy and fusion (ACDF) may safely return to collision and high-velocity sports. The athlete should be counseled and managed on a case-by-case basis, taking into consideration the type of sport, player-specific variables, and type of surgery performed. PMID:27543397

  6. Does a herniated nucleus pulposus contribute significantly to a decrease in height of the intervertebral disc? Quantitative volumetrich MRI

    Energy Technology Data Exchange (ETDEWEB)

    Holodny, A.I.; Kisza, P.S.; Contractor, S.; Liu, W.C. [Department of Radiology, UMDNJ-New Jersey Medical School, University Hospital C-320, 150 Bergen Street, Newark, NJ 07103-2714 (United States)

    2000-06-01

    A lumbar intervertebral disc with a herniated nucleus pulposus (HNP) often exhibits a decrease in the height of the intervertebral space. Our purpose was to ascertain whether the loss of volume of an HNP is sufficient to cause a perceptible decrease in the height of the intervertebral space. MRI of 44 patients with 51 HNPs were reviewed. The volumes of the herniated material and of the intervertebral discs were calculated for every level from L 1-2 to L 5-S 1. The average volume of the HNP was 503{+-}301 mm{sup 3}. The average volumes of all 220 intervertebral discs and of the 127 normal-appearing discs were 14442{+-}4200 mm{sup 3} and 17476{+-}2885 mm{sup 3} respectively. The average volume of the HNP represented 3.5% of the parent disc. An average HNP caused a decrease in intervertebral space height of 0.35 mm (0.56 pixels). Therefore, the loss of the volume of the HNP does not cause a significant decrease in the intervertebral space height. The average calculated decrease in the disc height is less than that reported in normal diurnal variation. (orig.)

  7. Circumspinal decompression through a single posterior incision to treat thoracolumbar disc herniation

    Institute of Scientific and Technical Information of China (English)

    QI Qiang; SUN Chui-guo; CHEN Zhong-qiang; LIU Ning; GUO Zhao-qing; SHI Ze-feng; LIU Zhong-jun; LIU Xiao-guang; LI Wei-shi; ZENG Yan

    2011-01-01

    Background Various surgical approaches have been successfully used in the treatment of thoracolumbar disc herniation (TLDH).Although the anterior transthoracic approach has a reputation for better visualization than the posterolateral and lateral approaches,it involves the manipulation of the thoracic and pulmonary structures.Thus,this approach is technically demanding and prone to compromising the respiratory system.An ideal approach would involve adequate visualization and be accomplished through the posterior midline approach that is familiar to spine surgeons.The objective of this retrospective preliminary clinical study was to introduce a new surgical procedure,circumspinal decompression through a single posterior incision,for the treatment of TLDH (T10/11-L1/2) and to evaluate the surgical outcome of this procedure by comparing it to the conventional anterior transthoracic approach.Methods In this study,15 patients (10 males,5 females; mean age 51 years) with symptomatic TLDH underwent the circumspinal decompression through a single posterior incision procedure between January 2008 and December 2009.Altogether,17 herniated discs were excised,with 2 discs at T10/11,4 discs at T11/12,5 discs at T12/L1 and 6 discs at L1/2.Of these patients,13 were followed up with a mean follow-up period of 23.5 months.Clinical outcomes,including operative time,blood loss,perioperative complications,postoperative time of hospitalization,neurologic status improvement,back pain and correction of local kyphosis,were investigated by comparing these data with the results from patients who underwent the anterior transthoracic approach for TLDH during the same period.The patients' neurologic status was evaluated by a modified Japanese Orthopedic Association (JOA) scoring system of 11 points.Neurologic status improvement after the surgery was assessed by calculating the recovery rate,which was equal to the (postoperative JOA score-preoperative JOA score)/(11-preoperative JOA score)x100

  8. Magnetic resonance imaging of diseased cervical and lumbar intervertebral discs

    International Nuclear Information System (INIS)

    Magnetic resonance images (MRI) of diseased cervical and lumbar intervertebral discs involving both intrinsic and extrinsic cord lesions were examined using either a 0.15 T resistive or a 0.5 T superconductive magnetic imaging system. The vertebrae, intervertebral discs, and spinal cord were delineated on spin-echo (SE) images with a long repetition time (TR) and a short echo time (proton density-weighted image). Protrusion of degenerated intervertebral discs into the spinal canal was clearly demonstrated not only on sagittal but also on parasagittal and transverse views. The location of protruded discs and compression of the spinal cord, caudal sac, and nerve roots were well visualized three-dimensionally. Pathological features of intervertebral discs were well appreciated on T2-weighted images with long TR and SE pulse sequences. Degeneration of intervertebral discs resulted in decreased signal intensity in cases of lumbar disc involvement. For suspected myelomalacia, the intrinsic cord lesion resulting from traumatic disc protrusion appeared as focal low signal intensity on T1-weithed images and as somewhat high intensity on T2 weighted images. The inversion recovery sequence with median inversion time displayed an inferior image of low contrast and was judged uninformative in comparison to SE imags. The findings showed MRI to be an essential diagnostic technique for spinal cord disorders. It clearly pinpoints the anatomic structures of the spine and the features of disc degeneration. Both extrinsic and intrinsic cord abnormalities can be identified with MRI. The selection of proper pulse sequences is required for the differentiation of the object of interest. (Namekawa, K)

  9. Magnetic resonance imaging of diseased cervical and lumbar intervertebral discs

    Energy Technology Data Exchange (ETDEWEB)

    Kadoya, Satoru; Nakamura, Tsutomu; Takarada, Akira; Yamamoto, Itaru; Sato, Shuji.

    1989-02-01

    Magnetic resonance images (MRI) of diseased cervical and lumbar intervertebral discs involving both intrinsic and extrinsic cord lesions were examined using either a 0.15 T resistive or a 0.5 T superconductive magnetic imaging system. The vertebrae, intervertebral discs, and spinal cord were delineated on spin-echo (SE) images with a long repetition time (TR) and a short echo time (proton density-weighted image). Protrusion of degenerated intervertebral discs into the spinal canal was clearly demonstrated not only on sagittal but also on parasagittal and transverse views. The location of protruded discs and compression of the spinal cord, caudal sac, and nerve roots were well visualized three-dimensionally. Pathological features of intervertebral discs were well appreciated on T/sub 2/-weighted images with long TR and SE pulse sequences. Degeneration of intervertebral discs resulted in decreased signal intensity in cases of lumbar disc involvement. For suspected myelomalacia, the intrinsic cord lesion resulting from traumatic disc protrusion appeared as focal low signal intensity on T/sub 1/-weithed images and as somewhat high intensity on T/sub 2/ weighted images. The inversion recovery sequence with median inversion time displayed an inferior image of low contrast and was judged uninformative in comparison to SE imags. The findings showed MRI to be an essential diagnostic technique for spinal cord disorders. It clearly pinpoints the anatomic structures of the spine and the features of disc degeneration. Both extrinsic and intrinsic cord abnormalities can be identified with MRI. The selection of proper pulse sequences is required for the differentiation of the object of interest. (Namekawa, K).

  10. Structural brain alterations in patients with lumbar disc herniation: a preliminary study.

    Directory of Open Access Journals (Sweden)

    Michael Luchtmann

    Full Text Available Chronic pain is one of the most common health complaints in industrial nations. For example, chronic low back pain (cLBP disables millions of people across the world and generates a tremendous economic burden. While previous studies provided evidence of widespread functional as well as structural brain alterations in chronic pain, little is known about cortical changes in patients suffering from lumbar disc herniation. We investigated morphometric alterations of the gray and white matter of the brain in patients suffering from LDH. The volumes of the gray and white matter of 12 LDH patients were determined in a prospective study and compared to the volumes of healthy controls to distinguish local differences. High-resolution MRI brain images of all participants were performed using a 3 Tesla MRI scanner. Voxel-based morphometry was used to investigate local differences in gray and white matter volume between patients suffering from LDH and healthy controls. LDH patients showed significantly reduced gray matter volume in the right anterolateral prefrontal cortex, the right temporal lobe, the left premotor cortex, the right caudate nucleus, and the right cerebellum as compared to healthy controls. Increased gray matter volume, however, was found in the right dorsal anterior cingulate cortex, the left precuneal cortex, the left fusiform gyrus, and the right brainstem. Additionally, small subcortical decreases of the white matter were found adjacent to the left prefrontal cortex, the right premotor cortex and in the anterior limb of the left internal capsule. We conclude that the lumbar disk herniation can lead to specific local alterations of the gray and white matter in the human brain. The investigation of LDH-induced brain alterations could provide further insight into the underlying nature of the chronification processes and could possibly identify prognostic factors that may improve the conservative as well as the operative treatment of the

  11. Clinical study on microsurgical treatment of lumbar disc herniation assisted by METRx system

    Directory of Open Access Journals (Sweden)

    Xin-gang ZHAO

    2016-04-01

    Full Text Available Objective To explore the techniques and curative effect of microsurgical procedures assisted by minimal exposure tubular retractor system (METRx in the treatment of lumbar disc herniation (LDH.  Methods A total of 51 LDH patients, including 24 patients with L4-5 herniation and 27 patients with L5-S1 herniation, underwent discectomy assisted by METRx system. The operation time, intraoperative blood loss, postoperative complications and hospital stay were recorded. Visual Analogue Scale (VAS and Oswestry Disability Index (ODI were used to evaluate the degree of low back pain before operation, one week, 3 months after operation, and in the last follow-up. Lumbar MRI was used to evaluate the decompression of spinal canal.  Results The success rate of operations in 51 cases was 98.04% (50/51. The average operation time was 125 min, the average intraoperative blood loss was 50 ml, the mean hospital stay was 5 d, all patients were followed up for 6-48 months (average 24 months. Compared with preoperation, both VAS and ODI scores decreased significantly one week after operation (P = 0.036, 0.029, 3 months after operation (P = 0.018, 0.023 and in the last follow-up (P = 0.007, 0.013. The improvement rate of ODI was 35.37% in the last follow-up. No infection, postoperative cerebrospinal fluid (CSF fistula, neurological defects or incision infection was found. One patient presented acute abdominalgia on the 2nd day after operation, and was diagnosed as annexitis. One patient showed nerve root irritation symptoms after operation caused by thick nerve root during the surgery. They were cured after symptomatic treatment.  Conclusions Microsurgical procedures for treating LDH assisted by METRx system can effectively relieve nerve root compression, protect the dural sac and nerve roots, and reduce surgical complications. DOI: 10.3969/j.issn.1672-6731.2016.04.008

  12. Feasibility and Efficacy of Percutaneous Lateral Lumbar Discectomy in the Treatment of Patients with Lumbar Disc Herniation: A Preliminary Experience

    Directory of Open Access Journals (Sweden)

    Wenjin Jiang

    2015-01-01

    Full Text Available Objective. This study was aimed at evaluating the effectiveness and safety of percutaneous lateral lumbar discectomy (PLLD in treating patients with lumber disc herniation. Methods. A total of 183 patients with lumbar disc herniation were recruited to receive PLLD surgery from April 2006 to October 2011. All the adverse effects were recorded during the follow-up at 1, 3, 6, and 12 months after PLLD. The clinical outcomes were determined by visual analog scale and Japanese Orthopaedic Association score. Results. The surgery was performed successfully in all patients (102 males and 81 females aged from 21 to 66 years with a mean 16.6-month follow-up (range from 26 to 65 months. No postoperative complications, including intestinal and vascular complications, nerve injuries, and postoperative infections, were associated with PLLD. At one month after surgery, visual analog scale (3.12±1.44 versus 6.76±2.31, P<0.05 was significantly lower than the baseline and was sustained until 24 months after surgery (3.25±1.78 versus 6.76±2.31, P<0.05. Besides that, Japanese Orthopaedic Association score (25.25±3.21 versus 11.78±2.38, P<0.05 was increased when compared to the baseline. Conclusions. PLLD was a promising, mini-invasive, and effective treatment for lumber disc herniation.

  13. Posterior Decompression, Lumber Interbody Fusion and Internal Fixation in the Treatment of Upper Lumbar Intervertebral Disc Herniation

    Directory of Open Access Journals (Sweden)

    DONG Zhan

    2014-12-01

    Full Text Available Objective: To assess the clinical outcomes of posterior decompression, interbody fusion and internal fixationfor the treatment of the upper lumbar intervertebral disc herniation. Methods: Twelve patients with the upper lumbar intervertebral disc herniation were treated by posterior decompression, interbosy fusion and internal fixation. The time of the operation, the amount of bleeding and the clinical efficacy were evaluated. Results: The time of operation was (143±36 min and the amount of bleeding during operation was (331.5±47.9 mL. There was no spinal cord and injuries, nerve injury, epidural damage and leakage of cerebrospinal fluid. All patients were followed up for 10~19 months with the average being 12.6 months. The functional scoring of Japanese Orthopedic Association (JOA before the operation was (11.4±3.3 scores and final score after follow-up was (22.9±3.1 scores and there were statistical difference (P<0.01. Lumber interbody fusion of all patients completed successfully and the good rate after the operation was 91.7%. Conclusion: Posterior decompression, interbody fusion and internal fixation for the treatment of the upper lumbar intervertebral disc herniation was characterized by full exposure, safety and significant efficacy.

  14. Evaluation of canal stenosis of herniated lumbar disc and its correlation to anterior-posterior diameter with magnetic resonance imaging morphometry

    Directory of Open Access Journals (Sweden)

    Sitansu Kumar Panda

    2015-01-01

    Full Text Available Background: The term disc prolapse is defined as extrusion of nucleus pulposus through a rent in annulus fibrosus. This prolapse disc causes impairment of function by nerve root compression compelling the patient to seek medical advice for low backache. A lumbar herniated disc is a common cause of low back pain radiating to the leg. The problem of prolapsed intervertebral disc is of great importance in this part of the world, because of the fact that people are subjected to various physical stress due to their living habits, low socioeconomic status. Ninety percent of lumbar disc extrusions occur at L4- L5or L5-S1. Central lesion may cause no symptoms with the exiting nerve roots unaffected whereas paracentral lesions cause symptoms due to compression of the exiting nerve root. Radio imaging technique has a pivotal role in the diagnosis of vertebral disc herniation. Various radiological procedures are used for the diagnosis, but MRI which is a relatively newer technique is treated as the gold standard in the field. Aim of the Study: In the present study, an attempt is made to establish the anatomy of herniated lumbar disc by the help of MRI technique in the patients of Eastern India & to correlate the occurance of disc herniation with age, sex & vertebral level. Methods and Material: The present study included 120 patients who have lumbar disc herniation syndrome & their MRI findingd are compared with MRI findings of 80 normal persons who are used as control. Results and Conclusions: The different parameters are compared & observed that the maximum number of disc prolapse occurs between 31- 40 age group. Taking the vertebral level into consideration, it is seen maximum number of herniation occurs at the level of L4- L5.

  15. Magnetic resonance imaging of cervical myelopathy

    Energy Technology Data Exchange (ETDEWEB)

    Chosa, Hirofumi; Yamano, Kouichirou; Ihara, Fumitoshi; Ueda, Yoshiaki; Maekawa, Masayuki; Tokuhisa, Ginichirou; Kuwano, Tadashi; Kamo, Yoshi; Nomura, Shigeharu (Kyushu Rosai Hospital, Fukuoka (Japan))

    1990-03-01

    Forty-three patients operated for cervical myelopathy were examined with a 1.5 T magnetic resonance imaging. Cord compression was demonstrated directly on the sagittal image in cases of cervical disc herniation, cervical spondylosis and O.P. L.L. Herniated disc material was seen positive on axial image. But factors of cord compression in cases of cervical spondylosis and O.P. L.L. were not clearly confirmed, so additional examinations such as myelogram, tomogram and CT was needed. (author).

  16. Progression of lumbar disc herniations over an eight year period in a group of adult Danes from the general population

    DEFF Research Database (Denmark)

    Tunset, Andreas; Jensen, Tue Secher; Boyle, Eleanor;

    2013-01-01

    Background: The development in size and type of lumbar disc herniation (LDH) over time is not fully understood. Furthermore, the relationship between MRI defined LDH and clinical symptoms may not always confer with each other. This may be due to the lack of knowledge about the natural history of...... sizes of LDH and area of dural sac as well as disc height, and 3) LDH as a predictor of changes in dural sac areas and disc height after four and eight years. Methods: The study sample was assembled using a population-based cohort study of 41 year olds called “Backs on Funen Cohort”. All individuals who...... had MRI confirmed LDH during the first four years period were included in the study. The individuals were followed for 8 years with MRIs taken at baseline, four years and eight years. Cross-sectional areas (mm2) of LDH, disc heights and dural sacs were calculated from measurements using sagittal T2...

  17. MRI evaluation of spontaneous intervertebral disc degeneration in the alpaca cervical spine.

    Science.gov (United States)

    Stolworthy, Dean K; Bowden, Anton E; Roeder, Beverly L; Robinson, Todd F; Holland, Jacob G; Christensen, S Loyd; Beatty, Amanda M; Bridgewater, Laura C; Eggett, Dennis L; Wendel, John D; Stieger-Vanegas, Susanne M; Taylor, Meredith D

    2015-12-01

    Animal models have historically provided an appropriate benchmark for understanding human pathology, treatment, and healing, but few animals are known to naturally develop intervertebral disc degeneration. The study of degenerative disc disease and its treatment would greatly benefit from a more comprehensive, and comparable animal model. Alpacas have recently been presented as a potential large animal model of intervertebral disc degeneration due to similarities in spinal posture, disc size, biomechanical flexibility, and natural disc pathology. This research further investigated alpacas by determining the prevalence of intervertebral disc degeneration among an aging alpaca population. Twenty healthy female alpacas comprised two age subgroups (5 young: 2-6 years; and 15 older: 10+ years) and were rated according to the Pfirrmann-grade for degeneration of the cervical intervertebral discs. Incidence rates of degeneration showed strong correlations with age and spinal level: younger alpacas were nearly immune to developing disc degeneration, and in older animals, disc degeneration had an increased incidence rate and severity at lower cervical levels. Advanced disc degeneration was present in at least one of the cervical intervertebral discs of 47% of the older alpacas, and it was most common at the two lowest cervical intervertebral discs. The prevalence of intervertebral disc degeneration encourages further investigation and application of the lower cervical spine of alpacas and similar camelids as a large animal model of intervertebral disc degeneration. PMID:26135031

  18. Artificial cervical disc replacement: Principles, types and techniques

    Directory of Open Access Journals (Sweden)

    Sekhon L

    2005-01-01

    Full Text Available Cervical arthroplasty after anterior decompression with insertion of a prosthetic total disc replacement has been suggested as an alternate to anterior cervical fusion. Currently there are four cervical arthroplasty devices available on the market whose results in clinical use have been reported. Each device varies in terms of materials, range of motion, insertion technique and constraint. It is not known which device is ideal. Early studies suggest that in the short term, the complication rate and efficacy is no worse than fusion surgery. Long-term results have not yet been reported. This review examines the current prostheses available on the market as well as discussing issues regarding indications and technique. Pitfalls are discussed and early experiences reviewed. In time, it is hoped that a refinement of cervical arthroplasty occurs in terms of both materials and design as well as in terms of indications and clinical outcomes as spinal surgeons enter a new era of the management of cervical spine disease.

  19. Is intervertebral disc pressure linked to herniation?: An in-vitro study using a porcine model.

    Science.gov (United States)

    Noguchi, Mamiko; Gooyers, Chad E; Karakolis, Thomas; Noguchi, Kimihiro; Callaghan, Jack P

    2016-06-14

    Approximately 40% of low back pain cases have been attributed to internal disc disruption. This disruption mechanism may be linked to intradiscal pressure changes, since mechanical loading directly affects the pressure and the stresses that the inner annulus fibrosus experiences. The objective of this study was to characterize cycle-varying changes in four dependent measures (intradiscal pressure, flexion-extension moments, specimen height loss, and specimen rotation angle) using a cyclic flexion-extension (CFE) loading protocol known to induce internal disc disruption. A novel bore-screw pressure sensor system was used to instrument 14 porcine functional spinal units. The CFE loading protocol consisted of 3600 cycles of flexion-extension range of motion (average 18.30 (SD 3.76) degrees) at 1Hz with 1500N of compressive load. On average, intradiscal pressure and specimen height decreased by 47% and 62%, respectively, and peak moments increased by 102%. From 900 to 2100 cycles, all variables exhibited significant changes between successive time points, except for the specimen posture at maximum pressure, which demonstrated a significant shift towards flexion limit after 2700 cycles. There were no further changes in pressure range after 2100 cycles, whereas peak moments and height loss were significantly different from prior time points throughout the CFE protocol. Twelve of the 14 specimens showed partial herniation; however, injury type was not significantly correlated to any of the dependent measures. Although change in pressure was not predictive of damage type, the increase in pressure range seen during this protocol supports the premise that repetitive combined loading (i.e., radial compression, tension and shear) imposes damage to the inner annulus fibrosus, and its failure mechanism may be linked to fatigue. PMID:27157242

  20. The outcome of lumbar disc herniation surgery is worse in old adults than in young adults.

    Science.gov (United States)

    Strömqvist, Fredrik; Strömqvist, Björn; Jönsson, Bo; Karlsson, Magnus K

    2016-10-01

    Background and purpose - The outcome of surgical treatment of lumbar disc herniation (LDH) has been thoroughly evaluated in middle-aged patients, but less so in elderly patients. Patients and methods - With validated patient-reported outcome measures (PROMs) and using SweSpine (the national Swedish Spine Surgery Register), we analyzed the preoperative clinical status of LDH patients and the 1-year postoperative outcome of LDH surgery performed over the period 2000-2012. We included 1,250 elderly patients (≥ 65 years of age) and 12,840 young and middle-aged patients (aged 20-64). Results - Generally speaking, elderly patients were referred for LDH surgery with worse PROM scores than young and middle-aged patients, they improved less by surgery, they experienced more complications, they had inferior 1-year postoperative PROM scores, and they were less satisfied with the outcome (with all differences being statistically significant). Interpretation - Elderly patients appear to have a worse postoperative outcome after LDH surgery than young and middle-aged patients, they are referred to surgery with inferior clinical status, and they improve less after the surgery. PMID:27391663

  1. Comparison of diagnostic protocols and the equivalent effective dose in renal cancer and herniated lumbar disc

    International Nuclear Information System (INIS)

    Renal cancer (RC) and herniated lumbar disc (HLD) were the two pathologies selected for the study of the diagnostic protocols applied in different centers to determine how their variability is reflected in the effective equivalent dose (EED) and establish the optimal radiological protocol for diagnostic purposes, while using the lowest possible dose. On the basis of 222 case histories, it was observed that the EED resulting from the diagnosis of HLD can vary as much as a factor of 3(6.2-18.9 mSv). Likewise, the EED related to the diagnosis of RC can be modified by a factor of 1.5(32.6-48.3 mSv), depending on the diagnostic protocol employed. It can be considered that the optimal protocol to reach a diagnosis of HLD includes chest x-ray, lumbar spine x-ray and lumbar CT scan, while that required for the diagnosis of RC involves chest x-ray, IVU, abdominal CT scan and digital subtraction angiography. The optimization of the study protocols-especially the reduction of the number of exposures, modernization and quality control of the equipment, among other aspects, can reduce the EED by a factor of 2. (Author)

  2. Serial changes on MR imaging of herniated lumber discs treated by percutaneous laser nucleotomy. Correlation with early clinical results

    International Nuclear Information System (INIS)

    Percutaneous Laser Nucleotomy (PLN) is a new treatment for disc herniation applying neodymium: yttrium-aluminum-garnet (Nd : YAG) laser through inserted needle into the center of the disc, with less invasion and shorter hospitalization than conventional open surgery. Serial MR images were observed in 21 patients before and after PLN. Canal occupying ratio (COR) and signal intensity (S.I.) of herniated disc were measured. Recovery rate of symptoms was 57.2%, based on scoring system proposed by the Japanese Orthopaedic Association for low-back pain (JOA score). The successful group (≥30% improvement in JOA score) showed rapid decrease in signal intensity, though the ineffective group (2-weighted sequence. Increase of signal intensity was observed in some patients whose symptoms had become worse. This may correlate with increase of water content and inner pressure on the disc. There was no significant difference between pre- and post-COR; however, more than 10% COR decrease was observed in 7 patients and symptoms improved in these cases. Thus the prognosis of the patients treated with PLN can be assessed by MR findings. (author)

  3. Serial changes on MR imaging of herniated lumber discs treated by percutaneous laser nucleotomy. Correlation with early clinical results

    Energy Technology Data Exchange (ETDEWEB)

    Hiraishi, Kumiko; Ohmori, Naoki; Kosaka, Riya; Yonezawa, Takumi; Onomura, Toshinobu; Adachi, Itaru; Matsuoka, Takae; Honghan, Gong; Narabayashi, Isamu [Osaka Medical Coll., Takatsuki (Japan)

    1996-07-01

    Percutaneous Laser Nucleotomy (PLN) is a new treatment for disc herniation applying neodymium: yttrium-aluminum-garnet (Nd : YAG) laser through inserted needle into the center of the disc, with less invasion and shorter hospitalization than conventional open surgery. Serial MR images were observed in 21 patients before and after PLN. Canal occupying ratio (COR) and signal intensity (S.I.) of herniated disc were measured. Recovery rate of symptoms was 57.2%, based on scoring system proposed by the Japanese Orthopaedic Association for low-back pain (JOA score). The successful group ({>=}30% improvement in JOA score) showed rapid decrease in signal intensity, though the ineffective group (<30% improvement in JOA score) showed unchanged intensity on T{sub 2}-weighted sequence. Increase of signal intensity was observed in some patients whose symptoms had become worse. This may correlate with increase of water content and inner pressure on the disc. There was no significant difference between pre- and post-COR; however, more than 10% COR decrease was observed in 7 patients and symptoms improved in these cases. Thus the prognosis of the patients treated with PLN can be assessed by MR findings. (author)

  4. Brain herniation

    Science.gov (United States)

    ... herniation; Uncal herniation; Subfalcine herniation; Tonsillar herniation; Herniation - brain ... Brain herniation occurs when something inside the skull produces pressure that moves brain tissues. This is most ...

  5. Minimally invasive surgical procedures for the treatment of lumbar disc herniation

    Directory of Open Access Journals (Sweden)

    Raspe, Heiner

    2005-11-01

    Full Text Available Introduction: In up to 30% of patients undergoing lumbar disc surgery for herniated or protruded discs outcomes are judged unfavourable. Over the last decades this problem has stimulated the development of a number of minimally-invasive operative procedures. The aim is to relieve pressure from compromised nerve roots by mechanically removing, dissolving or evaporating disc material while leaving bony structures and surrounding tissues as intact as possible. In Germany, there is hardly any utilisation data for these new procedures – data files from the statutory health insurances demonstrate that about 5% of all lumbar disc surgeries are performed using minimally-invasive techniques. Their real proportion is thought to be much higher because many procedures are offered by private hospitals and surgeries and are paid by private health insurers or patients themselves. So far no comprehensive assessment comparing efficacy, safety, effectiveness and cost-effectiveness of minimally-invasive lumbar disc surgery to standard procedures (microdiscectomy, open discectomy which could serve as a basis for coverage decisions, has been published in Germany. Objective: Against this background the aim of the following assessment is: * Based on published scientific literature assess safety, efficacy and effectiveness of minimally-invasive lumbar disc surgery compared to standard procedures. * To identify and critically appraise studies comparing costs and cost-effectiveness of minimally-invasive procedures to that of standard procedures. * If necessary identify research and evaluation needs and point out regulative needs within the German health care system. The assessment focusses on procedures that are used in elective lumbar disc surgery as alternative treatment options to microdiscectomy or open discectomy. Chemonucleolysis, percutaneous manual discectomy, automated percutaneous lumbar discectomy, laserdiscectomy and endoscopic procedures accessing the disc

  6. Heterotopic ossification in cervical disc arthroplasty: Is it clinically relevant?

    OpenAIRE

    Barbagallo, Giuseppe M.; Corbino, Leonardo A.; Olindo, Giuseppe; Albanese, Vincenzo

    2010-01-01

    Study design:  Retrospective cohort study. Objective:  To analyze the presence and clinical relevance of heterotopic ossification (HO) at 3 years mean follow-up. Methods:  Thirty patients suffering from cervical radiculopathy and/or myelopathy treated with anterior disc replacement (ADR) were studied. HO was classified using the McAfee grading system. Range of motion was measured from flexion and extension x-rays. Short-form 36 and neck disability index (NDI) assessed functional outcome. Resu...

  7. Treatment of Protrusion of Cervical Intervertebral Disc by Tuina

    Institute of Scientific and Technical Information of China (English)

    YE Jian-guo

    2004-01-01

    Twenty-five cases of protrusion of cervical intervertebral disc were treated by the manipulations of rolling, pressing, pushing with one-finger, traction, obliquely pulling, grasping of five channels, sweeping, etc. The result showed that 10 cases were cured, 14 cases got marked effectiveness and 1 case was improved.%采用滚、按、一指禅、拔伸、斜扳、拿五经、扫散法等手法,治疗颈椎间盘突出症患者25例,结果治愈10例,显效14例,好转1例.

  8. Use of Temporary Implantable Biomaterials to Reduce Leg Pain and Back Pain in Patients with Sciatica and Lumbar Disc Herniation

    Directory of Open Access Journals (Sweden)

    Gere S. diZerega

    2010-05-01

    Full Text Available The principle etiology of leg pain (sciatica from lumbar disc herniation is mechanical compression of the nerve root. Sciatica is reduced by decompression of the herniated disc, i.e., removing mechanical compression of the nerve root. Decompression surgery typically reduces sciatica more than lumbar back pain (LBP. Decompression surgery reduces mechanical compression of the nerve root. However, decompression surgery does not directly reduce sensitization of the sensory nerves in the epidural space and disc. In addition, sensory nerves in the annulus fibrosus and epidural space are not protected from topical interaction with pain mediators induced by decompression surgery. The secondary etiology of sciatica from lumbar disc herniation is sensitization of the nerve root. Sensitization of the nerve root results from a mechanical compression, b exposure to cellular pain mediators, and/or c exposure to biochemical pain mediators. Although decompression surgery reduces nerve root compression, sensory nerve sensitization often persists. These observations are consistent with continued exposure of tissue in the epidural space, including the nerve root, to increased cellular and biochemical pain mediators following surgery. A potential contributor to lumbar back pain (LBP is stimulation of sensory nerves in the annulus fibrosus by a cellular pain mediators and/or b biochemical pain mediators that accompany annular tears or disruption. Sensory fibers located in the outer one-third of the annulus fibrosus increase in number and depth as a result of disc herniation. The nucleus pulposus is comprised of material that can produce an autoimmune stimulation of the sensory nerves located in the annulus and epidural space leading to LBP. The sensory nerves of the annulus fibrosus and epidural space may be sensitized by topical exposure to cellular and biochemical pain mediators induced by lumbar surgery. Annulotomy or annular rupture allows the nucleus pulposus

  9. Clinical and Magnetic Resonance Imaging Factors Which May Predict the Need for Surgery in Lumbar Disc Herniation

    Science.gov (United States)

    Motiei-Langroudi, Rouzbeh; Sadeghian, Homa

    2014-01-01

    Study Design Case-control. Purpose Evaluate clinical and imaging factors which may predict the risk of failure of medical therapy in patients with lumbar disc herniation (LDH). Overview of Literature LDH is a common cause of low back pain and radicular leg pain, with a generally favorable natural course. At present, however, it is not possible to identify patients who may be candidates for surgery in an early stage of their disease by means of clinical signs or diagnostic imaging criteria. Methods We designed a study investigating patients with untreated low back pain to assess the predictive value of demographic, clinical or imaging findings in identifying patients who finally would meet the classic current criteria for surgery. Results Among 134 patients, 80.6% were successfully treated with conservative therapy and 19.4% finally underwent surgery. Sex, occupation, involved root level, presence of Modic changes, osteophytes or annular tears were not significantly different between the 2 groups, while cerebrospinal fluid block, Pfirrmann's grade, location of herniation with regard to the midline, and type of herniation were significantly different. Anteroposterior fragment size was significantly higher and intervertebral foramen height and thecal sac diameters were significantly lower in the surgical group. Conclusions Although it is strongly recommended to practice conservative management at first for patients with LDH symptoms, the results of this study shows that higher Pfirrmann's grade, more laterally located discs, extrusion and protrusion herniation types, and larger fragments could predict the risk of conservative treatment failure. This way, unnecessarily prolonged conservative management (beyond 4-8 weeks) may be precluded. PMID:25187861

  10. Comparison of myelography, CT myelography and magnetic resonance imaging in cervical spondylosis and disk herniation

    International Nuclear Information System (INIS)

    Twenty-six patients with cervical radiculopathy and/or myelopathy caused by spondylosis or disk herniation were examined with myelography, CT myelography and MR. Fourteen of the patients were operated upon and 11 of them underwent postoperative MR and CT. The three radiologic methods provided comparable information about narrowing of the subarachnoid space and compression of the spinal cord. It was more difficult to distinguish bone from soft tissue with MR only, but the combination of MR and conventional radiography gave sufficient information for this differentiation. When radiologic nerve root sheath deformity was compared with clinical radiculopathy, myelography, CT myelography and MR had similar sensitivity and accuracy. Post-operative MR could reveal remaining indentation on the thecal sac and the cord but CT without contrast medium was useful as a complement to determine the aetiology of the indentation. Because MR has several practical advantages, it is well suited as the primary imaging modality, together with conventional radiography, for the preoperative radiologic evaluation of patients with cervical radiculopathy and/or myelopathy. Postoperative MR is useful in patients with persistent or new symptoms. (orig.)

  11. Clinical and radiologic comparison of dynamic cervical implant arthroplasty and cervical total disc replacement for single-level cervical degenerative disc disease.

    Science.gov (United States)

    Shichang, Liu; Yueming, Song; Limin, Liu; Lei, Wang; Zhongjie, Zhou; Chunguang, Zhou; Xi, Yang

    2016-05-01

    Anterior cervical discectomy and fusion, to date the most successful spine procedure for the surgical treatment of cervical radiculopathy, has limitations that have led to the development of non-fusion cervical procedures, such as cervical total disc replacement (TDR) and dynamic cervical implant (DCI) arthroplasty. We compared the clinical and radiological results of DCI and cervical TDR for the treatment of single-level cervical degenerative disc disease in Chinese patients. A retrospective review of 179 patients with cervical spondylotic myelopathy who underwent DCI or TDR between April 2010 and October 2012 was conducted, and 152 consecutive patients (67 patients single-level DCI and 85 single-level TDR) who completed at least 2years of follow-up were included. Clinical and radiological assessments were performed preoperatively and at 1week and 3, 6, 12, and 24months postoperatively. The most common operative level was C5/C6 (49.3%). The differences in blood loss, duration of surgery, and duration of hospitalization were not statistically significant. The Japanese Orthopaedic Association scale, Visual Analog Scale, Neck Disability Index, and Short Form-36 scores improved significantly after surgery in both the DCI and TDR groups (P<0.05), but the differences were not statistically significant at the final follow-up. The rate of occurrence of heterotopic ossification was 22.4% and 28.2% in the DCI and TDR groups, respectively. As an effective non-fusion technique, DCI is a more economical procedure. Further prospective, randomized studies with long-term follow-up periods are needed to determine the long-term effects. PMID:26928156

  12. Prognostic factors for non-success in patients with sciatica and disc herniation

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    Haugen Anne

    2012-09-01

    Full Text Available Abstract Background Few studies have investigated prognostic factors for patients with sciatica, especially for patients treated without surgery. The aim of this study was to identify factors associated with non-success after 1 and 2 years of follow-up and to test the prognostic value of surgical treatment for sciatica. Methods The study was a prospective multicentre observational study including 466 patients with sciatica and lumbar disc herniation. Potential prognostic factors were sociodemographic characteristics, back pain history, kinesiophobia, emotional distress, pain, comorbidity and clinical examination findings. Study participation did not alter treatment considerations for the patients in the clinics. Patients reported on the questionnaires if surgery of the disc herniation had been performed. Uni- and multivariate logistic regression analyses were used to evaluate factors associated with non-success, defined as Maine–Seattle Back Questionnaire score of ≥5 (0–12 (primary outcome and Sciatica Bothersomeness Index ≥7 (0–24 (secondary outcome. Results Rates of non-success were at 1 and 2 years 44% and 39% for the main outcome and 47% and 42% for the secondary outcome. Approximately 1/3 of the patients were treated surgically. For the main outcome variable, in the final multivariate model non-success at 1 year was significantly associated with being male (OR 1.70 [95% CI; 1.06 − 2.73], smoker (2.06 [1.31 − 3.25], more back pain (1.0 [1.01 − 1.02], more comorbid subjective health complaints (1.09 [1.03 − 1.15], reduced tendon reflex (1.62 [1.03 − 2.56], and not treated surgically (2.97 [1.75 − 5.04]. Further, factors significantly associated with non-success at 2 years were duration of back problems >; 1 year (1.92 [1.11 − 3.32], duration of sciatica >; 3 months (2.30 [1.40 − 3.80], more comorbid subjective health complaints (1.10 [1.03 − 1.17] and

  13. Lateral lumbar disc herniation: MR imaging findings and correlation with clinical symptoms

    International Nuclear Information System (INIS)

    To evaluate MRI findings of lateral lumbar disc herniations (LLDHs) and to determine whether those correlate with clinical symptoms. The study included 105 patients with LLDHs that were diagnosed by MRI. The distribution and location of the LLDHs (foraminal, extraforaminal, and foraminal and extraforaminal), the displacement of adjacent nerves, and the detection rate of LLDHs from axial and sagittal images were reviewed retrospectively by two radiologists. 36 patients were included in evaluating whether location of LLDHs and displacement of adjacent nerve correlate with radiculopathy. The distribution of the LLDHs were 3.4% at L1-2, 14.4% at L2-3, 33% at L3-4, 33% at L4-5, and 16.9% at L5-S1. The locations were foraminal in 38.6% of cases, extraforaminal in 45.4% of cases, and foraminal and extraforaminal in 16% of cases. In addition, 77.3% of the diagnosed LLDH cases displaced the adjacent nerve. The detection rates of LLDHs in the axial and sagittal images were 100% and 77.3%, respectively. In 36 patients, 47.4% had radiculopathy related to LLDHs. Location of LLDHs and displacement of adjacent nerve had no statistically significant difference between patients with or without radiculopathy. MRI is an effective method for evaluating the location of LLDHs and their influence on adjacent nerves. The axial image is more important than the sagittal image in diagnosing LLDHs. The location of LLDHs and the displacement of adjacent nerve were not found to be related to radiculopathy

  14. Prognostic Value of Impaired Preoperative Ankle Reflex in Surgical Outcome of Lumbar Disc Herniation

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    Farzad Omidi-Kashani

    2016-01-01

    Full Text Available Background: Several prognostic factors exist influencing the outcome of surgical discectomy in the patients with lumbar disc herniation (LDH. The aim of this study is to evaluate the relationship between severity of preoperative impaired ankle reflex and outcomes of lumbar discectomy in the patients with L5-S1 LDH. Methods: We retrospectively evaluated 181 patients (108 male and 73 female who underwent simple discectomy in our orthopedic department from April 2009 to April 2013 and followed them up for more than one year. The mean age of the patients was 35.3±8.9 years old. Severity of reflex impairment was graded from 0 to 4+ and radicular pain and disability were assessed by visual analogue scale (VAS and Oswestry disability index (ODI questionnaires, respectively. Subjective satisfaction was also evaluated at the last follow-up visit. Chi-square and Kruskal-Wallis tests were used to compare qualitative variables. Results: Reflex impairment existed in 44.8% preoperatively that improved to 10% at the last follow-up visit. Statistical analyses could not find a significant relationship between the severity of impaired ankle reflex and sex or age (P=0.538 and P=0.709, respectively. There was a remarkable relationship between severity of reflex impairment and preoperative radicular pain or disability (P=0.012 and P=0.002, respectively. Kruskal-Wallis test showed that a more severity in ankle reflex impairment was associated with not only less improvement in postoperative pain and disability but also less satisfaction rate (P Conclusions: In the patients with L5-S1 LDH, more severe ankle reflex impairment is associated with less improvement in postoperative pain, disability, and subjective satisfaction.

  15. Lateral lumbar disc herniation: MR imaging findings and correlation with clinical symptoms

    Energy Technology Data Exchange (ETDEWEB)

    Park, So Young; Park, Ji Seon; Jin, Wook; Ryu, Kyung Nam [KyungHee University Medical Center, Seoul (Korea, Republic of)

    2008-03-15

    To evaluate MRI findings of lateral lumbar disc herniations (LLDHs) and to determine whether those correlate with clinical symptoms. The study included 105 patients with LLDHs that were diagnosed by MRI. The distribution and location of the LLDHs (foraminal, extraforaminal, and foraminal and extraforaminal), the displacement of adjacent nerves, and the detection rate of LLDHs from axial and sagittal images were reviewed retrospectively by two radiologists. 36 patients were included in evaluating whether location of LLDHs and displacement of adjacent nerve correlate with radiculopathy. The distribution of the LLDHs were 3.4% at L1-2, 14.4% at L2-3, 33% at L3-4, 33% at L4-5, and 16.9% at L5-S1. The locations were foraminal in 38.6% of cases, extraforaminal in 45.4% of cases, and foraminal and extraforaminal in 16% of cases. In addition, 77.3% of the diagnosed LLDH cases displaced the adjacent nerve. The detection rates of LLDHs in the axial and sagittal images were 100% and 77.3%, respectively. In 36 patients, 47.4% had radiculopathy related to LLDHs. Location of LLDHs and displacement of adjacent nerve had no statistically significant difference between patients with or without radiculopathy. MRI is an effective method for evaluating the location of LLDHs and their influence on adjacent nerves. The axial image is more important than the sagittal image in diagnosing LLDHs. The location of LLDHs and the displacement of adjacent nerve were not found to be related to radiculopathy.

  16. Efficacy of transforaminal endoscopic discectomy using TESSYS technique in treatment of lumbar disc herniation

    Institute of Scientific and Technical Information of China (English)

    Liang Li|; Li-Ming Fang; Tao Niu; Xiao-Jun Yang

    2016-01-01

    Objective:To explore the clinical efficacy of transforaminal endoscopic discectomy using TESSYS technique in the treatment of lumbar disc herniation (LDH).Methods:A total of 60 patients with LDH who were admitted in our hospital from June, 2014 to February, 2016 were included in the study and randomized into the study group and the control group. The patients in the study group were performed with transforaminal endoscopic discectomy using TESSYS technique, while the patients in the control group were performed with the vertebral lamina fenestration. VAS was used to evaluate the pain relieving before operation, 1 d, 1 month, 3 months, and 6 months after operation. The fasting elbow venous blood before operation, 3, 6, 12, 24, and 48 h after operation was collected. The immune scatter turbidity was used to detect hs-CRP. ELISA was used to detect IL-6.Results:The difference of VAS scores before operation between the two groups was not statistically significant (P>0.05). With the time extending after operation, VAS score was significantly reduced (P0.05). The difference of hs-CRP and IL-6 before operation between the two groups was not statistically significant (P>0.05). The levels of hs-CRP and IL-6 after operation at each timing point in the study group were significantly superior to those in the control group (P<0.05). Conclusions:Transforaminal endoscopic discectomy using TESSYS technique in the treatment of LDH has advantages of small trauma, less stress reaction, and rapid postoperative recovery; therefore, it deserves to be widely recommended in the clinic.

  17. Frisbee - the first artificial cervical disc of 3RD generation

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    Karin Büttner-Janz

    2014-03-01

    Full Text Available OBJECTIVE: The current cervical disc arthroplasty is limited by postoperative facet joint arthritis, heterotopic ossification and segmental kyphosis. The total Frisbee disc, which has an upper convex/concave non-spherical surface and a lower flat sliding surface, is a new approach for improved outcomes. Prior to clinical application, safety and suitability tests are required. METHODS: The Frisbee is the first 3rd generation disc according to a new classification of total disc because it can precisely mimic the segmental ROM, including the soft limitation of axial rotation. The ISO 18192-1 test was carried out to determine the rate of wear debris. A FE model was used to assess the safety of prosthetic components. In the sagittal plane several variables to determine the most favorable lordotic angle were evaluated. RESULTS: Two angled prosthetic plates are safer than one sliding angled core to prevent the displacement. The lordosis of 7° of the Frisbee leads to kyphosis of no more than 2° without reduction of the ROM. The wear rate of the Frisbee is five times smaller compared to an FDA-approved disc with a spherical sliding surface. CONCLUSIONS: Based on the test results, the clinical application of Frisbee can now be studied. The postoperative kyphosis observed with other devices is not an issue with the Frisbee design. Physiological ROM is combined with the significant reduction of wear debris. For these reasons the Frisbee has the potential to provide a better balanced segmental loading reducing the degeneration of the joint surface and heterotopic ossification.

  18. Hérnia discal: procedimentos de tratamento Disc herniation: treatments process

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    Wilson Fábio Negrelli

    2001-12-01

    Full Text Available A hérnia de disco é um processo em que ocorre a ruptura do anel fibroso, com subsequente deslocamento da massa central do disco nos espaços intervertebrais. É considerada uma patologia extremamente comum, que causa séria inabilidade em seus portadores. Estima-se que 2 a 3 % da população sejam acometidos desse processo, cuja prevalência é de 4,8% em homens e 2,5% em mulheres, acima de 35 anos. São fatores de risco, causas ambientais, posturais, desequilíbrios musculares e possivelmente, a influência genética. A terapia conservadora tem sido a preferida como a primeira escolha de tratamento, cujos objetivos são o alívio da dor, o aumento da capacidade funcional e o retardamento da progressão da doença. Nesta revisão, são abordadas as principais metodologias, de acordo com a literatura, dando ênfase ao uso de fármacos analgésicos e anti-inflamatórios, o uso de órteses, a acupuntura, o repouso e a adoção de um programa de exercícios adequados.The disc herniation is a process where the fibrous ring disrupts, with subsequent central disc mass dislocation. It is considered a extremely common pathology, which causes disability. It is estimated that 2 to 3% of the population have taken with this process whose prevalence is 4.8% in males and 2.5% in female, over 35 years old. Environmental causes, posture, muscular imbalance and possibly genetic influence have been considered as risk factors. The conservative therapy has been preferred as the first choice treatment, aiming pain relief, increase of functional capacity and avoidment of disease progression. In this review, it is approached the main methodologies, according to the literature, focusing on drugs prescriptions, orthesis indication, acupunture, rest and a suitable exercise program.

  19. Are Modic changes related to outcomes in lumbar disc herniation patients treated with imaging-guided lumbar nerve root blocks?

    International Nuclear Information System (INIS)

    Objective: To compare outcomes after imaging-guided transforaminal lumbar nerve root blocks in MRI confirmed symptomatic disc herniation patients with and without Modic changes (MC). Methods: Consecutive adult patients with MRI confirmed symptomatic lumbar disc herniations and an imaging-guided lumbar nerve root block injection who returned an outcomes questionnaire are included. Numerical rating scale (NRS) pain data was collected prior to injection and 20–30 min after injection. NRS and overall improvement were assessed using the patient's global impression of change (PGIC) scale at 1 day, 1 week and 1 month post injection. The proportion of patients with and without MC on MRI as well as Modic I and Modic II was calculated. These groups were compared for clinically relevant ‘improvement’ using the Chi-squared test. Baseline and follow-up NRS scores were compared for the groups using the unpaired t-test. Results: 346 patients are included with MC present in 57%. A higher percentage of patients without MC reported ‘improvement’ and a higher percentage of patients with MC reported ‘worsening’ but this did not reach statistical significance. The numerical scores on the PGIC and NRS scales showed that patients with MC had significantly higher pain and worse overall improvement scores at 1 month (p = 0.048 and p = 0.03) and a significantly lower 1 month NRS change score (p = 0.04). Conclusions: Patients with MRI confirmed symptomatic lumbar disc herniations and MC report significantly lower levels of pain reduction after a lumbar nerve root block compared to patients without MC

  20. Effectiveness of heat-sensitive moxibustion in the treatment of lumbar disc herniation: study protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Yi Fan

    2011-10-01

    Full Text Available Abstract Background Lumbar disc herniation is a common and costly problem. Moxibustion is employed to relieve symptoms and might therefore act as a therapeutic alternative. Many studies have already reported encouraging results in heat-sensitive moxibustion for lumbar disc herniation. Hence, we designed a randomized controlled clinical trial to investigate the effectiveness of heat-sensitive moxibustion compared with conventional moxibustion. Methods This trial is a multicenter, prospective, randomized controlled clinical trial. The 316 eligible patients are randomly allocated to two different groups. The experimental group is treated with heat-sensitive moxibustion (n = 158; while the control group (n = 158 is treated with conventional moxibustion. The moxibustion locations are different for the groups. The experimental group selects heat-sensitization acupoints from the region which consists of bilateral Da Changshu (BL25 and Yao Shu (Du2. Meanwhile, fixed acupoints are used in control group; patients in both groups receive 18 sessions in 2 weeks. Discussion The study design guarantees a high internal validity for the results. It is one large-scale randomized controlled trial to evaluate the efficacy of heat-sensitive moxibustion compared to conventional moxibustion and may provide evidence for this therapy as a treatment for moderate and severe lumbar disc herniation. Moreover, the result may uncover the inherent laws to improve the therapeutic effect with suspended moxibustion. Trial Registration The trial is registered at Chinese Clinical Trials Registry: ChiCTR-TRC-09000604. The application date was 27 November 2009. The first patient was randomized on the 16 June 2011.

  1. Are Modic changes related to outcomes in lumbar disc herniation patients treated with imaging-guided lumbar nerve root blocks?

    Energy Technology Data Exchange (ETDEWEB)

    Peterson, Cynthia K., E-mail: cynthia.peterson@balgrist.ch [Department of Radiology, Orthopaedic University Hospital Balgrist, University of Zürich (Switzerland); Pfirrmann, Christian W.A. [Department of Radiology, Orthopaedic University Hospital Balgrist, University of Zürich (Switzerland); Hodler, Jürg [Department of Radiology, University Hospital, University of Zürich (Switzerland)

    2014-10-15

    Objective: To compare outcomes after imaging-guided transforaminal lumbar nerve root blocks in MRI confirmed symptomatic disc herniation patients with and without Modic changes (MC). Methods: Consecutive adult patients with MRI confirmed symptomatic lumbar disc herniations and an imaging-guided lumbar nerve root block injection who returned an outcomes questionnaire are included. Numerical rating scale (NRS) pain data was collected prior to injection and 20–30 min after injection. NRS and overall improvement were assessed using the patient's global impression of change (PGIC) scale at 1 day, 1 week and 1 month post injection. The proportion of patients with and without MC on MRI as well as Modic I and Modic II was calculated. These groups were compared for clinically relevant ‘improvement’ using the Chi-squared test. Baseline and follow-up NRS scores were compared for the groups using the unpaired t-test. Results: 346 patients are included with MC present in 57%. A higher percentage of patients without MC reported ‘improvement’ and a higher percentage of patients with MC reported ‘worsening’ but this did not reach statistical significance. The numerical scores on the PGIC and NRS scales showed that patients with MC had significantly higher pain and worse overall improvement scores at 1 month (p = 0.048 and p = 0.03) and a significantly lower 1 month NRS change score (p = 0.04). Conclusions: Patients with MRI confirmed symptomatic lumbar disc herniations and MC report significantly lower levels of pain reduction after a lumbar nerve root block compared to patients without MC.

  2. 按摩治疗腰椎间盘突出症疗效体会%Experience for treating lumbar disc herniation by massage

    Institute of Scientific and Technical Information of China (English)

    周光跃

    2014-01-01

    Lumbar disc herniation was common in clinical orthopedics. In this article, 271 patients with lumbar disc herniation were treated by massage, the total efficacy was 97%. Massage on lumbar disc herniation can relieve pain and restore limb function.%腰椎间盘突出症是临床骨伤科常见的疑难病之一。本文选取271例腰椎间盘突出患者行按摩治疗,总有效率97%,效果较好。按摩治疗腰椎间盘突出症可缓解疼痛,恢复肢体功能。

  3. Return to play after conservative treatment in athletes with symptomatic lumbar disc herniation: a practice-based observational study

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    Jun Iwamoto

    2011-03-01

    Full Text Available Jun Iwamoto1, Yoshihiro Sato2, Tsuyoshi Takeda1, Hideo Matsumoto11Institute for Integrated Sports Medicine, Keio University School of Medicine, Tokyo, Japan; 2Department of Neurology, Mitate Hospital, Fukuoka, JapanAbstract: The purpose of the study was to confirm the short-term outcome of conservative treatment in terms of the ability to return to play and factors influencing return to play in athletes with symptomatic lumbar disc herniation. A total of 100 consecutive athletes (72 male and 28 female who consulted our sports medicine clinic during the 16-year period between September 1993 and October 2009 because of severe low back pain and/or leg pain/numbness due to lumbar disc herniation were studied. The mean age of the subjects was 23 years. All of them were conservatively treated by being advised to discontinue their sporting activities with/without short-term medication. After the subjective symptoms had reduced by more than 80%, individual training was started in order to allow the athletes to return to play. Seventy-nine athletes (79.0% returned to play at an average of 4.8 months (range 1–12 months after the start of treatment and were able to sustain the activities for at least 6 months, the minimum duration of follow-up in the study. The outcome of the conservative treatment was not influenced by the intensity of the sporting activity. Multiple logistic regression analyses showed that the severity of the symptoms prior to the start of treatment was the factor influencing the ability of the athletes to return to play. The present study confirmed the satisfactory short-term outcome of conservative treatment in athletes with symptomatic lumbar disc herniation regarding return to play and revealed that subjective symptoms prior to the start of treatment appeared to be a key factor in return to play after conservative treatment.Keywords: lumbar disc herniation, athletes, return to play, conservative treatment, sciatica, low back pain

  4. MR imaging-guided minimally invasive surgery for treatment of posterolateral lumbar disc herniation via facet joint medial route

    International Nuclear Information System (INIS)

    Objective: To explore the value of MR imaging-guided percutaneous lumbar discectomy and discolysis with oxygen-ozone mixture for treatment of posterolateral lumbar disc herniation via a new puncture approach of facet joint medial route. Methods: All 114 lumbar intervertebral discs in 103 patients were diagnosed as posterolateral lumber disc herniation by CT or MRI, which were located at the levels of L3-4 in 5 cases, L4-5 in 87 cases and L5-S1 in 22 cases. The procedure was guided under 0.23 T open magnetic resonance with iPath 200 optical tracking system. A 14 G MR-compatible needle was punctured into the disc center via a new puncture approach of facet joint medial route. The therapy steps were as follows: firstly, cut nucleus pulposus and inject 6 ml oxygen-ozone mixture of 60 μg/ml in the disc center; secondly, retreat the needle to the local prominence, cut prominent part and inject 6 ml oxygen-ozone mixture of 60 μg/ml. Thirdly, retreat the needle to the periradicular nerve root, inject 15 ml oxygen-ozone mixture of 40 μg/ml and 4 ml pain-block liquid. All patients were followed up at 3 days, 1 month, 3 months and 6 months after operation, evaluated for the effect of treatment with the modified Macnab criteria, and the results were compared with the χ2 test. Results: All procedures were successfully performed. Intraoperative dural injury occurred in 5 cases. Postoperative infection of intervertebral space occurred in 2 cases. The clinical effective rate was 96.1% (99/103), 84.5% (87/103), 94.2% (97/103), 95.1% (98/103) respectively at 3 days, 1 month, 3 months and 6 months after operation, and the differences were significant (χ2=12.942, P=0.005). Conclusion: MR imaging-guided percutaneous lumbar discectomy and discolysis with oxygen-ozone mixture via facet joint medial route is a minimally invasive, safety and effective method for the treatment of posterolateraal lumbar disc herniation. (authors)

  5. Cost-effectiveness of microendoscopic discectomy versus conventional open discectomy in the treatment of lumbar disc herniation: a prospective randomised controlled trial [ISRCTN51857546

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    Brand Ronald

    2006-05-01

    Full Text Available Abstract Background Open discectomy is the standard surgical procedure in the treatment of patients with long-lasting sciatica caused by lumbar disc herniation. Minimally invasive approaches such as microendoscopic discectomy have gained attention in recent years. Reduced tissue trauma allows early ambulation, short hospital stay and quick resumption of daily activities. A comparative cost-effectiveness study has not been performed yet. We present the design of a randomised controlled trial on cost-effectiveness of microendoscopic discectomy versus conventional open discectomy in patients with lumbar disc herniation. Methods/Design Patients (age 18–70 years presenting with sciatica due to lumbar disc herniation lasting more than 6–8 weeks are included. Patients with disc herniation larger than 1/3 of the spinal canal diameter, or disc herniation less than 1/3 of the spinal canal diameter with concomitant lateral recess stenosis or sequestration, are eliglible for participation. Randomisation into microendoscopic discectomy or conventional unilateral transflaval discectomy will take place in the operating room after induction of anesthesia. The length of skin incision is equal in both groups. The primary outcome measure is the functional assessment of the patient, measured by the Roland Disability Questionnaire for Sciatica, at 8 weeks and 1 year after surgery. We will also evaluate several other outcome parameters, including perceived recovery, leg and back pain, incidence of re-operations, complications, serum creatine kinase, quality of life, medical consumption, absenteeism and costs. The study is a randomised prospective multi-institutional trial, in which two surgical techniques are compared in a parallel group design. Patients and research nurses are kept blinded of the allocated treatment during the follow-up period of 2 years. Discussion Currently, open discectomy is the golden standard in the surgical treatment of lumbar disc

  6. Síndrome de Brown-Séquard por hérnia discal cervical a duplo nível: caso clínico e revisão da literatura Síndrome de Brown-Séquard por hernia discal cervical en nivel doble: caso clínico y revisión de la literatura Brown-Séquard syndrome by double level cervical disc herniation: case report and review of the literature

    OpenAIRE

    Jorge Miguel Silva Ribeiro Olliveira Alves; Paulo Peixoto; Nuno Ferreira; Rui Martins; João Correia; Fernando Silva; Carlos de Sousa

    2012-01-01

    Descrição do caso clínico de um paciente com síndrome de Brown-Séquard por hérnia de disco cervical em duplo nível, 40 anos, do sexo masculino, sem história de patologia prévia da coluna cervical; teve início insidioso de paresia nos membros direitos, associada à diminuição da sensibilidade dolorosa e térmica do hemicorpo esquerdo, após mergulho que ocasionou trauma indireto da coluna cervical. A RM da coluna cervical mostrou hérnias discais paramedianas direitas nos níveis C4-C5 e C5-C6 com ...

  7. Postoperative care of lumbar disc herniation%腰间盘突出症的术后护理

    Institute of Scientific and Technical Information of China (English)

    付喜年; 孙慧芳

    2015-01-01

    This is due to lumbar disc herniation of intervertebral disc degeneration,rupture,kyphosis and spinal cord or nerve syndrome occurs,orthopedic common disease in the non-surgical treatment is conservative treatment fails,the surgery is a common,ef ective treatment.This paper studies on postoperative care.%腰间盘突出症是因椎间盘退变、破裂、后凸压迫脊髓或神经而出现的综合症,是骨科的常见病和多发病,在非手术治疗也就是保守治疗无效的情况下,手术是一种常用、有效的治疗方法。本文就其术后护理进行研究。

  8. Percutaneous treatment of non-contained lumbar disc herniation by injection of oxygen-ozone combined with collagenase

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    Wu Zhiqun [Therapy Center of Pain, Division of Interventional Radiology, Tang Du Hospital, Fourth Military Medical University, Xian 710038 (China)], E-mail: zhiqunwu@yahoo.com; Wei Longxiao [Therapy Center of Pain, Division of Interventional Radiology, Tang Du Hospital, Fourth Military Medical University, Xian 710038 (China); Li Jun [Therapy Center of Pain, Division of Orthopedic Surgery, Tang Du Hospital, Fourth Military Medical University, Xian 710038 (China); Wang Yiqing; Ni Daihui [Therapy Center of Pain, Division of Interventional Radiology, Tang Du Hospital, Fourth Military Medical University, Xian 710038 (China); Yang Peng; Zhang Yuhai [Department of Biostatistics, Fourth Military Medical University, Xian 710032 (China)

    2009-12-15

    Purpose: To evaluate the therapeutic results of oxygen-ozone combined collagenase injection for the treatment of lumbar disc herniation compared to the surgery. And to explore the role of this minimally invasive treatment as an alternative to disc surgery. Materials and methods: Two groups of patients (n = 108) were treated with different ways respectively. Minimally invasive group of patients was treated with the injection of oxygen-ozone combined with collagenase into the lumbar disc or the epidural space; the other group was treated with traditional surgery. After the treatment, the patients were followed-up and the therapeutic effect was assessed at 2 weeks, 3 and 12 months by the modified Macnab criteria. Results: The success rate was 86.11% and 88.89% in minimally invasive group at 3 and 12 months respectively, while 92.59% and 95.37% in surgical group. There was no statistically significant difference between two groups at 3 and 12 months (P = 0.123, P = 0.08). However, the surgical group produced a statistically significant greater improvement for back pain and disability in the first few weeks (P = 0.0001). The success rate was 51.86% and 85.18% at 2 weeks in minimally invasive group and surgical group respectively. No serious complication occurred in this group. Conclusions: The combination of the oxygen-ozone with collagenase shows significant reductions in pain and improvements in function at 3 and 12 months, it can be considered as an option for the treatment of non-contained lumbar disc herniation instead of surgery.

  9. Designing and Constructing Smart T-shirt for Prevention from Incidence and Recurrence of Lumbar Herniated Disc

    Directory of Open Access Journals (Sweden)

    Behnam Amini Daghalian

    2015-10-01

    Full Text Available Inappropriate positions of body in daily activities can lead to several problems in people health and impose great direct and indirect costs on different sectors of society.  The purpose of this research was to design and construct a smart T-shirt for prevention from incidence and recurrent of lumbar herniated disc (LHD. The plan of this T- shirt was provided using a number of tensile or stretch arms on T- shirt for identifying the inappropriate moves of the body and then associating them to a vibration system for alarming the individual. This cover has the ability to prevent from many problems of backbone, especially LHD. This innovation has several advantages including decline in many problems regarding backbone or spinal cord and chronic pain in such areas, decreasing in treatment costs, growing in productivity capacity of people and society, and high chance of product to mass production. Thanks to the cost-effectiveness of this T-shirt, its use is strongly recommended. Keywords: Smart T-shirt; Prevention; Lumbar Herniated Disc

  10. Impact of timing on surgical outcome in patients with cauda equina syndrome caused by lumbar disc herniation.

    Science.gov (United States)

    Bečulić, Hakija; Skomorac, Rasim; Jusić, Aldin; Alić, Fahrudin; Imamović, Melica; Mekić-Abazović, Alma; Efendić, Alma; Brkić, Harun; Denjalić, Amir

    2016-08-01

    Aim To analyze the relationship between timing of surgery and outcome in patients with cauda equina syndrome caused by lumbar disc herniation. Methods A retrospective, non-randomized clinical study included 25 consecutive patients with cauda equina syndrome (CES) caused by lumbar disc herniation. All patients were operated within 24 hours after hospitalization at the Department of Neurosurgery, Cantonal Hospital Zenica, Bosnia and Herzegovina, between January 2000 and December 2010. All patients were evaluated before surgery on the basis of complete history, neurological examination and neuroimaging evaluations using CT (computed tomography)and MRI (magnetic resonance imaging). Results Statistically significant difference between preoperative and postoperative bladder (p=0.05) and bowel (p=0.05) function was found. A significant number of patients had bladder and bowel recovery after surgery, nine (36%) and 11 (44%), respectively. Significant recovery of muscle strength was noted with complete recovery(5/5) in 12 (48%) and partial recovery in 13 (52%) patients. Complete sensory recovery was noted in 16 (64%), incomplete in four (16%), and in five (20%) patients there were no changes. Most commonly, patients with complete sensory recovery were operated within 48 hours of symptom onset. In most patients early surgery was associated with better outcome. Conclusion This research showed that early decompression correlated with better outcome. Patients with cauda equina syndrome must be cleared for surgery in optimal conditions and, if it possible within optimal timing for recovery (within 48 hours). PMID:27452326

  11. Randomized clinical trial comparing lumbar percutaneous hydrodiscectomy with lumbar open microdiscectomy for the treatment of lumbar disc protrusions and herniations

    Directory of Open Access Journals (Sweden)

    Alexandre Fogaça Cristante

    2016-05-01

    Full Text Available OBJECTIVES: Hydrodiscectomy is a new technique used for percutaneous spinal discectomy that employs a high-intensity stream of water for herniated disc ablation and tissue aspiration. No previous clinical study has examined the effects of percutaneous hydrodiscectomy. The aim of this study is to evaluate the outcomes of hydrodiscectomy compared to open microdiscectomy regarding pain, function, satisfaction, complications and recurrence rates. METHODS: In this randomized clinical trial, patients referred to our tertiary hospital for lumbar back pain were recruited and included in the study if they had disc protrusion or small herniation in only one level, without neurological deficits and with no resolution after six weeks of conservative treatment. One group underwent open microdiscectomy, and the other group underwent percutaneous microdiscectomy via hydrosurgery. Function was evaluated using the Oswestry Disability Index and pain was assessed using a visual analog scale. Evaluations were performed preoperatively, and then during the first week and at one, three, six and twelve months postoperatively. Personal satisfaction was verified. Clinicaltrials.gov: NCT01367860. RESULTS: During the study period, 20 patients were included in each arm and 39 completed one-year of follow-up (one patient died of unrelated causes. Both groups exhibited equal improvement on the visual analog scale and Oswestry evaluations after treatment, without any significant differences. The improvement in the lumbar visual analog scale score was not significant in the hydrodiscectomy group (p=0.138. The rates of infection, pain, recurrence and satisfaction were similar between the two groups. CONCLUSION: Percutaneous hydrodiscectomy was demonstrated to be as effective as open microdiscectomy for reducing pain. The rates of complications and recurrence of herniation were similar between groups. Patient satisfaction with the treatment was also similar between groups.

  12. Evaluation of Transforaminal Endoscopic Discectomy in Treatment of Obese Patients with Lumbar Disc Herniation.

    Science.gov (United States)

    Wang, Ya-Peng; Zhang, Wei; An, Ji-Long; Zhang, Jian; Bai, Jia-Yue; Sun, Ya-Peng

    2016-01-01

    BACKGROUND This study aimed to evaluate the efficacy of transforaminal endoscopic discectomy (TED) in the treatment of obese patients with lumbar disc herniation (LDH). MATERIAL AND METHODS A total of 69 obese patients with LDH (35 males and 34 females; age range, 24 to 43 years; median age, 34 years) were included in this study. These patients had undergone TED from March 2011 to December 2015 in the Third Hospital of Hebei Medical University. Their clinical and follow-up data were prospectively analyzed. The degree of pain and disability were measured on the basis of the Visual Analog Scale (VAS) at 1 day before surgery, immediately after surgery, and 3 months after surgery. Neurologic functions were measured on the basis of the Japanese Orthopaedic Association (JOA) system 1 day before surgery and 3 months after surgery. The MacNab score at last follow-up was recorded to evaluate the early clinical efficacy. Complications during and after the operation were recorded to evaluate the safety of surgery. RESULTS Two patients experienced abnormal sensations in the export nerve root zone postoperatively, which disappeared after 3 days of treatment with dehydration and administration of hormone (dexamethasone). Three cases of recurrence were observed at 6 months, 7 months, and 9 months postoperatively; they were scheduled to receive total laminectomy combined with bone grafting internal fixation. A total of 67 patients were followed up for 3-23 months and mean follow-up was 11.8 months. The VAS scores at postoperative 3 months and 1 year were significantly reduced compared to that before the operation, with significant differences between them (t=43.072, P<0.05; t=43.139, P<0.05). The JOA scores at last follow-up postoperatively was significantly higher than that before surgery (t=-60.312, P<0.05). At the last follow-up, 17 cases (25.3%) had excellent outcomes, 39 (58.2%) good, 7 (10.4%) fair, and 4 (5.9%) poor. Overall, 83.5% of patients had excellent or good rates

  13. Evaluation of Transforaminal Endoscopic Discectomy in Treatment of Obese Patients with Lumbar Disc Herniation

    Science.gov (United States)

    Wang, Ya-peng; Zhang, Wei; An, Ji-long; Zhang, Jian; Bai, Jia-yue; Sun, Ya-peng

    2016-01-01

    Background This study aimed to evaluate the efficacy of transforaminal endoscopic discectomy (TED) in the treatment of obese patients with lumbar disc herniation (LDH). Material/Methods A total of 69 obese patients with LDH (35 males and 34 females; age range, 24 to 43 years; median age, 34 years) were included in this study. These patients had undergone TED from March 2011 to December 2015 in the Third Hospital of Hebei Medical University. Their clinical and follow-up data were prospectively analyzed. The degree of pain and disability were measured on the basis of the Visual Analog Scale (VAS) at 1 day before surgery, immediately after surgery, and 3 months after surgery. Neurologic functions were measured on the basis of the Japanese Orthopaedic Association (JOA) system 1 day before surgery and 3 months after surgery. The MacNab score at last follow-up was recorded to evaluate the early clinical efficacy. Complications during and after the operation were recorded to evaluate the safety of surgery. Results Two patients experienced abnormal sensations in the export nerve root zone postoperatively, which disappeared after 3 days of treatment with dehydration and administration of hormone (dexamethasone). Three cases of recurrence were observed at 6 months, 7 months, and 9 months postoperatively; they were scheduled to receive total laminectomy combined with bone grafting internal fixation. A total of 67 patients were followed up for 3–23 months and mean follow-up was 11.8 months. The VAS scores at postoperative 3 months and 1 year were significantly reduced compared to that before the operation, with significant differences between them (t=43.072, P<0.05; t=43.139, P<0.05). The JOA scores at last follow-up postoperatively was significantly higher than that before surgery (t=−60.312, P<0.05). At the last follow-up, 17 cases (25.3%) had excellent outcomes, 39 (58.2%) good, 7 (10.4%) fair, and 4 (5.9%) poor. Overall, 83.5% of patients had excellent or good rates

  14. The Relationship Between The Level Of Knowledge The Mechanics Of The Body Of Patients With Lumbar Disc Herniation And Pain Intensity

    OpenAIRE

    AKCA, Nazan Kılıç; Editörden; AYDIN, Gökçen; GÜMÜŞ, Kenan

    2013-01-01

    This study of patients with lumbar disc herniation level of knowledge about the mechanics of the body was carried out to determine the effect on pain intensity. This cross-sectional descriptive study inpatient physical therapy and rehabilitation was conducted in nine monthly period among patients previously diagnosed with lumbar disc hernia (n=63). For collecting research data; socio-demographic data for and the form of information about body mechanics and Visual Analog Scale (VAS) were used....

  15. Cost-effectiveness of microendoscopic discectomy versus conventional open discectomy in the treatment of lumbar disc herniation : A prospective randomised controlled trial [ISRCTN51857546

    NARCIS (Netherlands)

    M.P. Arts (Mark); W.C. Peul (Wilco); R. Brand (René); B.W. Koes (Bart); R.T.W.M. Thomeer (Raph)

    2006-01-01

    textabstractBackground: Open discectomy is the standard surgical procedure in the treatment of patients with long-lasting sciatica caused by lumbar disc herniation. Minimally invasive approaches such as microendoscopic discectomy have gained attention in recent years. Reduced tissue trauma allows ea

  16. The treatment of disc herniation-induced sciatica with infliximab - One-year follow-up results of FIRST II, a randomized controlled trial

    NARCIS (Netherlands)

    Korhonen, Timo; Karppinen, Jaro; Paimela, Leena; Malmivaara, Antti; Lindgren, Karl-August; Bowman, Chris; Hammond, Anthony; Kirkham, Bruce; Jarvinen, Simo; Niinimaki, Jaakko; Veeger, Nic; Haapea, Marianne; Torkki, Markus; Tervonen, Osmo; Seitsalo, Seppo; Hurri, Heikki

    2006-01-01

    Study Design. A randomized controlled trial. Objectives. To evaluate the long-term efficacy of infliximab, a monoclonal antibody against tumor necrosis factor alpha (TNF-alpha), in patients with acute/subacute sciatica secondary to herniated disc. Summary of Background Data. The results of experimen

  17. Physical fitness as a predictor of herniated lumbar disc disease - a 33-year follow-up in the Copenhagen male study

    DEFF Research Database (Denmark)

    Jørgensen, Trine Ane Marie; Holtermann, Andreas; Gyntelberg, Finn;

    2013-01-01

    The role of physical fitness (VO2Max (mlO2*min-1*kg-1)) as a risk factor for herniated lumbar disc disease (HLDD) is unknown. The objective of this study was to examine the association between aerobic (physical) fitness and risk of hospitalisation due to HLDD in a long-term follow up....

  18. Epidural steroid following discectomy for herniated lumbar disc reduces neurological impairment and enhances recovery: a randomized study with two-year follow-up

    DEFF Research Database (Denmark)

    Rasmussen, S.; Krum-Moller, D.S.; Lauridsen, L.R.;

    2008-01-01

    : Convalescence after discectomy for herniated disc disease is dependent on pain and the inflammatory response. Previous studies in arthroscopic and abdominal surgery demonstrate steroids, which reduce the inflammatory response and enhance recovery. Here we report a 2-year follow-up of a randomized trial of...

  19. Prediction of the need for an MRI after surgical treatment of symptomatic lumbar herniated disc at discharge: evaluation of the necessity for regular visits at the outpatient clinic.

    NARCIS (Netherlands)

    Bartels, R.H.M.A.; Beems, T.; Verbeek, A.L.M.

    2010-01-01

    BACKGROUND: Surgical treatment of symptomatic lumbar disc herniations has been well established. The need for regular postoperative visits at the outpatient clinic has never been evaluated. In this study, factors predicting the need for magnetic resonance imaging, denoting an unfavorable outcome nee

  20. Long-Term Outcomes of Patients with Lumbar Disc Herniation Treated with Percutaneous Discectomy: Comparative Study with Microendoscopic Discectomy

    International Nuclear Information System (INIS)

    We assessed the long-term outcomes of patients with lumbar disc herniation treated with percutaneous lumbar discectomy (PLD) or microendoscopic discectomy (MED). A retrospective study was performed in consecutive patients with lumbar disc herniation treated with PLD (n = 129) or MED (n = 101) in a single hospital from January 2000 to March 2002. All patients were followed up with MacNab criteria and self-evaluation questionnaires comprising the Oswestry Disability Index and Medical Outcomes Study 36-Item Short-Form Health Survey. Several statistical methods were used for analyses of the data, and a p value of <0.05 was considered to be statistically significant. A total of 104 patients (80.62%) with PLD and 82 patients (81.19%) with MED were eligible for analyses, with a mean follow-up period of 6.64 ± 0.67 years and 6.42 ± 0.51 years, respectively. There were no significant differences between the two groups in age, number of lesions, major symptoms and physical signs, and radiological findings. According to the MacNab criteria, 75.96% in the PLD group and 84.15% in the MED group achieved excellent or good results, respectively, this was statistically significant (p = 0.0402). With the Oswestry Disability Index questionnaires, the average scores and minimal disability, respectively, were 6.97 and 71.15% in the PLD group and 4.89 and 79.27% in the MED group. Total average scores of Medical Outcomes Study 36-Item Short-Form Health Survey were 75.88 vs. 81.86 in PLD group vs. MED group (p = 0.0582). The cost and length of hospitalization were higher or longer in MED group, a statistically significant difference (both p < 0.0001). Long-term complications were observed in two patients (2.44%) in the MED group, no such complications were observed in the PLD group. Both PLD and MED show an acceptable long-term efficacy for treatment of lumbar disc herniation. Compared with MED patients, long-term satisfaction is slightly lower in the PLD patients; complications

  1. Safety of carboxymethylcellulose/polyethylene oxide for the prevention of adhesions in lumbar disc herniation – consecutive case series review

    Directory of Open Access Journals (Sweden)

    Fransen Patrick

    2008-05-01

    Full Text Available Abstract Background Epidural fibrosis is regarded as a cause of failed back surgery syndrome (FBSS when excessive adhesional/fibrotic scar tissue causes compression, pain or discomfort by tethering of nerve tissue to the surrounding muscle or bone. Fibrosis inhibitors could therefore increase the success rate of spinal surgery and decrease the need for reoperations. In recent years, bio-resorbable gels or films for the prevention of peridural fibrosis and post-operative adhesions have been developed that look clinically promising. This included a 100% synthetic, sterile, absorbable gel combinations of carboxymethylcellulose (CMC and polyethylene oxide (PEO used to coat the dura to reduce scarring after discectomy which became available in Europe in 2002. However, given the burden of the problem and unfavorable experience with other types of adhesion-reduction agents, our unit decided to evaluate the safety of CMC/PEO in a large population of patients undergoing spinal microdiscectomy for herniation. Methods To determine the safety and assess efficacy of carboxymethylcellulose/polyethylene oxide (CMC/PEO gel as an anti-adhesion gel, a consecutive series of 396 patients undergoing lumbar discectomy performed by one surgeon had CMC/PEO gel administered at the end of surgery. The patients were followed up in accordance with standard clinical practice and records reviewed for side effects, such as skin reactions, general reactions or local fluid collections. Reoperations for recurrent herniation included an evaluation of fibrosis reduction. Results No product related complications were observed. Five patients needed reoperations for recurrent herniation. Significant but subjective reduction in fibrosis was observed in these patients. Conclusion The findings provide confidence that CMC/PEO gel is well tolerated as an agent to achieve reduction of fibrosis in lumbar disc surgery. Further formal prospective study is recommended in this area of unmet

  2. Clinical protocol for lumbar disc herniation combined with herniated disc resorption%伴有"自溶"现象的腰椎椎间盘突出症的治疗探讨

    Institute of Scientific and Technical Information of China (English)

    顾庆国; 王新伟; 姜东杰; 王占超; 陈宇; 陈德玉; 袁文

    2013-01-01

    目的 探讨对伴有"自溶"现象的腰椎椎间盘突出症的治疗策略.方法 回顾2006年1月~2011年12月本院收治的腰椎椎间盘突出症患者34例,所有患者比较首次发病与入院前腰椎MRI检查发现均有突出椎间盘缩小的影像学表现.对其中15例行腰后路减压椎间植骨内固定术或髓核摘除术;19例采用卧床休息、腰围固定以及脱水、消炎镇痛等非手术治疗.采用Oswestry功能障碍指数(Oswestry disability index,ODI)、疼痛视觉模拟量表(visual analogue scale,VAS)评分及影像学检查评价治疗效果.结果 手术组15例,手术切口均一期愈合,随访2~16个月,平均12.3个月.术前ODI为42.8±4.25,末次随访时为12.5±1.26,与术前比较差异有统计学意义(P<0.01).VAS评分术前为7.13±1.24分,末次随访时为1.45±0.86分,与术前比较差异有统计学意义(P<0.01).非手术治疗组19例,治疗前ODI为27.9±3.61,末次随访时为10.5±6.4,治疗6个月后复查腰椎MRI平扫提示突出椎间盘完全消失者4例,部分消失者9例,无明显变化者6例.结论 对于伴有"自溶"现象的腰椎椎间盘突出症患者应根据影像学及临床表现采用相应的治疗方法,可获得较满意的临床疗效.%Objective To discuss the clinical protocol for lumbar disc herniation combined with herniated disc resorption. Methods From November 2006 to December 2011, 34 patients suffering from lumbar disc herniation ( LDH ) combined with spontaneous regression of herniated disc were reviewed. These patients were classified into surgical treatment group and conservative treatment group according to the progression of patient' s symptoms before treatment. The Oswestry disability index ( ODI ) and visual analogue scale ( VAS ) score were used to assess the outcome of treatment. Results The DOI of 15 patients in surgical treatment group improved from 42.8 ±4.25 to 12.5 ± 1.26 at the final follow-up( P <0.01 ), and the VAS scores decreased from 7

  3. Diagnostic imaging of the lumbar disc herniation for radiculopathy by 3D-MRI (MR-myelography)

    International Nuclear Information System (INIS)

    We have developed a new method of three-dimensional MRI (3D-MRI) which enables a stereoscopic view of the spinal cord and both sides of spinal nerve roots in one image. Anatomical study for normal subjects, the S1 angulations and length were significantly smaller than those of others. The S1 DRG was oval and was the largest. In a pathological study the use of 3D-MRI defects the signal changes following damage to the spinal nerve roots or ganglion in lumbar disc herniation. With regard to signal changes in damaged root ganglion, a good correlation between root compression and root inflammation was detected by experiments. We are currently examining the relationship between the damaged root ganglion, pain sensory disturbance. This study showed that the dorsal root ganglion plays an important role in sensory control of radiculopathy on 3D-MRI. (author)

  4. Diagnostic imaging of the lumbar disc herniation for radiculopathy by 3D-MRI (MR-myelography)

    Energy Technology Data Exchange (ETDEWEB)

    Taira, Gaku; Imakiire, Atsuhiro; Endo, Kenji [Tokyo Medical Coll. (Japan); Ichimaru, Katuji

    2002-02-01

    We have developed a new method of three-dimensional MRI (3D-MRI) which enables a stereoscopic view of the spinal cord and both sides of spinal nerve roots in one image. Anatomical study for normal subjects, the S1 angulations and length were significantly smaller than those of others. The S1 DRG was oval and was the largest. In a pathological study the use of 3D-MRI defects the signal changes following damage to the spinal nerve roots or ganglion in lumbar disc herniation. With regard to signal changes in damaged root ganglion, a good correlation between root compression and root inflammation was detected by experiments. We are currently examining the relationship between the damaged root ganglion, pain sensory disturbance. This study showed that the dorsal root ganglion plays an important role in sensory control of radiculopathy on 3D-MRI. (author)

  5. The Comparison of Effective between Acupuncture and Bee Venom Acupuncture on the Treatment of Acute Lumbar Herniation of Intervertebral Disc

    Directory of Open Access Journals (Sweden)

    Chang So-Young

    2006-06-01

    Full Text Available Objective : Herniation of Intervertebral Disc(HIVD is the most common disease causing low back pain. Acupuncture and Bee Venom Acupuncture has been used for treatment of HIVD. This study is to investigate the effective of Bee Venom Acupuncture for HIVD. Methods : We researched 18 patients who were diagnosed by CT and MRI as having HIVD, and treated them Acupuncture only or Acupuncture and Bee Venom Acupuncture. We compared the VAS and ROM angle of two groups. Results & Conclusions : 1. In admission date, no significant improvement between Acupuncture group and Bee Venom Acupuncture group 2. In variation of flexion and extension, Bee Venom Acupuncture group shows statistically significant improvement 3. In VAS, Bee Venom Acupuncture group shows statistically significant improvement for 1 week and discharge day

  6. Postoperative Care of Lumbar Disc Herniation%腰椎间盘突出症术后护理

    Institute of Scientific and Technical Information of China (English)

    胡耀芬

    2014-01-01

    目的:通过总结手术治疗腰间盘突出症术后护理体会,探讨腰椎后路术后临床护理的经验。方法回顾自2005年3月~2013年5月行腰椎后路椎间盘髓核摘除术术后护理的体会。结果采取健康护理的115例患者,均取得较满意的临床效果。%Objective To summarize the operation treatment of lumbar disc herniation postoperative nursing experience, explore the clinical nursing experience after lumbar spine surgery. Method From 2005 March to 2013:review of May for posterior lumbar discectomy in nursing care of postoperative. Results:115 cases of patients to health care, have achieved a satisfactory clinical ef ect.

  7. 椎间盘镜手术治疗腰椎间盘突出症124例临床观察%Intervertebral disc surgery treated on 124 cases with lumbar disc herniation

    Institute of Scientific and Technical Information of China (English)

    李再学; 谢文伟; 冉雪莲; 姚汉刚; 苏厂尧

    2016-01-01

    Objective:To investigate the clinical effect of intervertebral disc surgery in the treatment of lumbar intervertebral disc herniation.Methods:124 cases o lumbar intervertebral disc herniation were selected.They were treated with intervertebral disc surgery.Results:They were followed up from 6~12 months,with an average of 8.4 months.The excellent and good rate was 98.6%. Conclusion: effect of intervertebral disc surgery in the treatment of lumbar intervertebral disc herniation is significant.%目的:探讨椎间盘镜手术治疗腰椎间盘突出症的临床效果。方法:选取124例腰椎间盘突出症患者,均实施了椎间盘镜间盘髓核摘除术。结果:本组124例,随访6~12个月,平均8.4个月,优良率98.6%。结论:椎间盘镜手术治疗腰椎间盘突出症效果显著。

  8. Removal versus preservation of the posterior longitudinal ligament in Bryan cervical disc arthroplasty

    Institute of Scientific and Technical Information of China (English)

    YANG Da-long; DING Wen-yuan; ZHANG Ying-ze; ZHANG Wei; XU Jia-xin; SHEN Yong

    2013-01-01

    Background Bryan cervical disc arthroplasty can be used to restore and maintain the mobility and function of the involved cervical spinal segments.The efficiency of posterior longitudinal ligament (PLL) resection in anterior cervical decompression and fusion has been demonstrated.However,no clinical reports have compared PLL removal with preservation in Bryan cervical disc arthroplasty.This study aimed to assess the role of removal of PLL in Bryan cervical disc arthroplasty at an 18-month follow-up.Methods We performed a prospective investigation of clinical and radiological outcomes in patients after Bryan cervical disc arthroplasty.Sixty patients who underwent Bryan cervical disc arthroplasty were included.The PLL was removed in 35 patients (investigational group) and preserved in 25 patients (control group).All of the patients were followed up for more than 18 months.Clinical (Japanese Orthopedic Association score and Visual Analogue Scale pain score) and radiological (functional spinal unit (FSU) angle,range of movement (ROM),and diameter of the spinal cord) parameters were compared between the two groups before and after surgery (18 months).Results Clinical outcomes in the investigational group were significantly superior to those in the control group.There were no significant differences in the FSU angle and ROM (P=-0.41 and 0.16,respectively) between the two groups.However,the increase in diameter of the spinal cord in the investigational group was significantly greater than that in the control group (P <0.01).Conclusions Removal of the PLL can improve the clinical outcomes of Bryan cervical disc arthroplasty.This procedure does not have a large effect on imbalance and motion of the cervical spine.

  9. Evaluation of the kinesthetic sense and function of the hand in early period in operated cervical disc hernia

    OpenAIRE

    Kara, Býlge; Yildirim, Yücel; Karadýbak, Dýdem; Acar, Ümýt

    2005-01-01

    A prospective study made into cervical disc hernias. To determine the kinesthetic sense and hand functions, which are important for the patients with cervical disc hernia to return to work life and daily activities that need skill. Neurosurgical department. Data Symptoms in cervical disc hernias and hand functions are affected depending on long-term pain. The evaluation of the hand is essential in assessing the patients’ overall recovery and ability to return to daily activities and work life...

  10. Percutaneous Lumbar Disc Clamp Technique in the Treatment of Lumbar Disc Herniation%经皮后路椎间盘钳夹术治疗腰椎间盘突出症

    Institute of Scientific and Technical Information of China (English)

    刘晓光; 杨建; 燕春山

    2015-01-01

    目的:探讨经皮后路椎间盘钳夹术治疗腰椎间盘突出症的疗效。方法对30例腰椎间盘突出症患者行经皮后路钳夹术治疗腰椎间盘突出症针对靶点治疗。结果30例患者均成功施行经皮后路椎间盘钳夹术。优24例,占80%;良2例,占6.67%;可2例,占6.67%;差2例,优良率93.33%。术后均未出现严重并发症。结论经皮后路椎间盘钳夹术能有效治疗腰椎间盘突出症。%Objective To investigate the therapeutic effect of percutaneous lumbar disc clamp technique in the treatment of lumbar disc herniation. Methods30 cases of lumbar disc herniation underwent percutaneous posterior forceps in treatment of lumbar disc herniation. Results30 patients had successful percutaneous lumbar disc clamp. Excellent in 24 cases, accounting for 80%;good in 2 cases, accounting for 6.67%; 2 cases, accounting for 6.67%; 2 cases of poor, good rate of 93.33%. There were no severe complications after operation.Conclusion Percutaneous lumbar disc clamp can be effective in the treatment of lumbar disc herniation.

  11. Guillain-Barré Syndrome Combined with Acute Cervical Myelopathy

    OpenAIRE

    Abai, Siez; Kim, Sung Bum; Kim, Joo-Pyung; Lim, Young Jin

    2010-01-01

    Authors describe a patient who developed a myelopathy associated with Guillain-Barré syndrome and cervical myelopathy. We provide radiological evidence of non-compressive herniated cervical intervertebral disc with cord signal changes and show the clinical and electrophysiological result of coexisting Guillain-Barré syndrome and cervical myelopathy. We tried to introduce and review the case of Guillain-Barré syndrome which was combined with cervical myelopathy to let us recollect the presumpt...

  12. 胸腰段椎间盘突出症与休门病%Thoracolumbar disc herniation and Scheuermann's disease

    Institute of Scientific and Technical Information of China (English)

    石泽锋; 陈仲强; 刘宁; 齐强

    2011-01-01

    目的 探讨胸腰段椎间盘突出症(thoracolumbardisc herniation,TLDH)和休门病的内在联系以及休门病在TLDH发病中的作用.方法 2006年6月至2010年6月,以45例因TLDH(T10-11~L2-3)手术的患者作为研究组(TLDH组),及同期手术的低位(L3-4~L5S1)腰椎间盘突出症(1umbardisc herniation,LDH)患者中随机抽取45例作为对照组(LDH组).通过复习其CT、MRI和X线片,对比两组合并休门病和各种影像学休门样改变的比例,并比较两组的胸腰段后凸角度.进一步在TLDH组内部分别对比存在各种休门样改变的节段和无休门样改变节段合并椎间盘突出的比例.结果 TLDH组97.8%(44/45)的患者均合并休门病,LDH组仅为26.7%(12/45;x2=48.403,P=0.000).TLDH组出现各种休门样改变的比例均高于LDH组,分别为许莫结节66.7%(30/45)和15.6%(7/45;x2=24.278,P=0.000),终板不规则88.9%(40/45)和15.6%(7/45;x2=48.496,P=0.000),椎体后缘离断75.6%(34/45)和13.3%(6/45;x2=35.280,P=0.000),相邻椎体楔形变93.3%(42/45)和0%(x2=78.750,P=0.000).TLDH组患者平均胸腰段后凸角15.8°±6.9°,LDH组为4.8°±4.0°(t=7.703,P<0.001).TLDH组内,存在许莫结节(32.8%,39/119;x2=9.276,P=0.002),终板不规则(50.0%,55/110;x2=22.255,P=0.000),椎体后缘离断(100%,40/40;x2=69.421,P=0.000)和椎体楔形变(39.5%,58/147;x2=14.631,P=0.000)的节段发生椎间盘突出的比例均高于无休门样改变的节段(9.1%,4/44).结论 胸腰段椎间盘突出症与休门病关系密切,前者可能是后者的一种表现.许莫结节、终板不规则、椎体楔形变,尤其是椎体后缘离断,与椎间盘突出的发生有关.%Objective To explore the relationship between thoracolumbar disc herniation (TLDH) and Scheuermann1's disease (SD),as well as the role of SD in the etiology of TLDH.Methods From June 2006 to June 2010,45 patients with TLDH (T10-11-L2-3) underwent surgery in our department.Forty-five patients with lower lumbar disc herniation (LDH,L3-4-L5S1

  13. MRI DWI/ADC signal predicts shrinkage of lumbar disc herniation after O2–O3 discolysis

    Science.gov (United States)

    Perri, Marco; Grattacaso, Giuseppe; Di Tunno, Valeria; Marsecano, Claudia; Di Cesare, Ernesto; Gallucci, Massimo

    2015-01-01

    Purpose Evaluate the discal morpho-structural changes as a predictive sign in the clinical outcome after ozone therapy in lumbar disc herniation using the T2–shine through effect in diffusion-weighted imaging (DWI). Method One hundred and fifty-four patients suffering from lumbosciatica (89 men and 65 women; age range, 23–62 years) were included, previous MR study performed with FSE-T2 and T2-fat, SE-T1 and DWI sequences, and were randomly assigned to two groups. Seventy-seven patients (control group) underwent conservative treatment with intraforaminal injection of steroid and anaesthetic. The remaining 77 patients (study group) underwent the same treatment with the addition of oxygen–ozone (O2–O3). During the following six months, a MRI follow-up with the same sequences was performed. An intervertebral disc volumetric analysis (IDVA), DWI signal score and post treatment clinical outcome evaluation were performed for an assessment of hernia reduction. χ2 test, Student's t test and analysis of covariance were used for comparison of variables. Results In the study group, 58 of 77 patients had a successful outcome (responders). In the responders group, DWI T2–shine through effect was present during MRI follow-up and in particular in 53 of 77 patients in six months of follow-up (p < 0.05). Moreover, in the same group a statistically significant disc shrinkage was shown by IDVA in sixth months of follow-up (p < 0.05). Conclusions T2–shine through effect in DWI is present before morphological disc reduction and moreover could be considered as a predictive sign of response to oxygen–ozone treatment. PMID:25923680

  14. Inpatient or outpatient rehabilitation after herniated disc surgery? - Setting-specific preferences, participation and outcome of rehabilitation.

    Directory of Open Access Journals (Sweden)

    Margrit Löbner

    Full Text Available OBJECTIVE: To examine rehabilitation preferences, participation and determinants for the choice of a certain rehabilitation setting (inpatient vs. outpatient and setting-specific rehabilitation outcomes. METHODS: The longitudinal observational study referred to 534 consecutive disc surgery patients (18-55 years. Face-to-face baseline interviews took place about 3.6 days after disc surgery during acute hospital stay. 486 patients also participated in a follow-up interview via telephone three months later (dropout-rate: 9%. The following instruments were used: depression and anxiety (Hospital Anxiety and Depression Scale, pain intensity (numeric analog scale, health-related quality of life (Short Form 36 Health Survey, subjective prognosis of gainful employment (SPE-scale as well as questions on rehabilitation attendance, return to work, and amount of sick leave days. RESULTS: The vast majority of patients undergoing surgery for a herniated disc attended a post-hospital rehabilitation treatment program (93%. Thereby two-thirds of these patients took part in an inpatient rehabilitation program (67.9%. Physical, psychological, vocational and health-related quality of life characteristics differed widely before as well as after rehabilitation depending on the setting. Inpatient rehabilitees were significantly older, reported more pain, worse physical quality of life, more anxiety and depression and a worse subjective prognosis of gainful employment before rehabilitation. Pre-rehabilitation differences remained significant after rehabilitation. More than half of the outpatient rehabilitees (56% compared to only one third of the inpatient rehabilitees (33% returned to work three months after disc surgery (p<.001. CONCLUSION: The results suggest a "pre-selection" of patients with better health status in outpatient rehabilitation. Gaining better knowledge about setting-specific selection processes may help optimizing rehabilitation allocation procedures

  15. 电针腰神经根为主治疗腰椎间盘突出症63例%SIXTY-THREE CASES OF LUMBR DISC HERNIATION TREATED WITH ELECTROACUPUNCTURE AT LUMBAR NERVE ROOT

    Institute of Scientific and Technical Information of China (English)

    王志兴; 梁云武; 廖曼娜

    2008-01-01

    @@ The authors had treated 63 cases of lumbar disc herniation with electro acupuncture at lumbar nerve root from January to July, 2007, and had achieved quite good therapeutic effect. The report is as follows.

  16. Advances of imaging-guided interventional minimally invasive techniques for the treatment of lumbar disc herniation%影像导引腰椎间盘突出症微创治疗技术进展

    Institute of Scientific and Technical Information of China (English)

    李福元; 许文哲

    2012-01-01

    Lumbar disc herniation (LDH) is a common disease, which leads to the most common cause of low back pain. Imaging-guided interventional minimally invasive treatment of lumbar disc herniation. which was performed with minimal invasion, less pain, quicker recovery and less complications, has been widely used in clinic, and become the preferred method for the treatment of mild to moderate lumbar disc herniation.%腰椎间盘突出症(lumbar disc herniation,LDH)是一种常见病、多发病,是导致腰腿痛最常见的原因.影像导引微创治疗腰椎间盘突出症创伤小、痛苦少、恢复快、并发症少现已广泛应用于临床,成为治疗轻、中度腰椎间盘突出症的首选方法.

  17. A report of complications of lumbar disc herniation after lumbar disc herniation by microendoscopic discectomy%经椎间盘镜治疗腰椎间盘突出症术后并发症的报告

    Institute of Scientific and Technical Information of China (English)

    李文强; 刘晓峰; 海拉提·瓦提别克

    2016-01-01

    To investigate the complications of lumbar disc herniation after lumbar disc herniation by microendoscopic dis -cectomy, search for relevant causes and preventive measures .Methods:Retrospective analysis of June 2012 to June 2014, a single seg-ment of LDH MED was treated in our hospital for 93 patients, information such as age, gender, intraoperative and postoperative complica-tions were acquired .Results:Open posterior operation in 7 cases, dural tear in 4 cases, nerve root injury in 2 case, MED sliding instabil-ity in 2 cases, spinal bleeding in 3 cases.Follow up 1-3 years, 14(15.05%) cases were lost visit , 1 cases of surgical site infection , 6 cases of symptoms relieved after surgery , 17 cases were followed up for 87 cases.Conclusion:MED had the risk of complications associ-ated with LDH, strict operation indication and skilled operation technology , to reduce the incidence of MED related complications .%目的:探讨经椎间盘镜(Microendoscopic Discectomy, MED)治疗椎间盘突出症(Lumbar Disc Herniation, LDH)术后并发症,寻找相关原因及预防措施。方法:回顾性分析2012年6月~2014年6月,我院收治的单节段LDH行MED手术治疗93例患者,获得如年龄、性别、术中及术后并发症等信息。结果:中转开放后路手术7例,硬脊膜撕裂4例,神经根拉伤2例,MED滑移不稳2例,椎管内出血3例。随访1~3年,14(15.05%)例失访,1例手术部位感染,术后6周症状缓解87例,随访终末期复发17例。结论:MED治疗LDH存在相关并发症风险,严格的手术适应证,熟练的操作技术,以降低MED相关并发症发生率。

  18. In-vivo T2-relaxation times of asymptomatic cervical intervertebral discs

    International Nuclear Information System (INIS)

    Limited research exists on T2-mapping techniques for cervical intervertebral discs and its potential clinical utility. The objective of this research was to investigate the in-vivo T2-relaxation times of cervical discs, including C2-C3 through C7-T1. Ten asymptomatic subjects were imaged using a 3.0 T MR scanner and a sagittal multi-slice multi-echo sequence. Using the mid-sagittal image, intervertebral discs were divided into five regions-of-interest (ROIs), centered along the mid-line of the disc. Average T2 relaxation time values were calculated for each ROI using a mono-exponential fit. Differences in T2 values between disc levels and across ROIs of the same disc were examined. For a given ROI, the results showed a trend of increasing relaxation times moving down the spinal column, particularly in the middle regions (ROIs 2, 3 and 4). The C6-C7 and C7-T1 discs had significantly greater T2 values compared to superior discs (discs between C2 and C6). The results also showed spatial homogeneity of T2 values in the C3-C4, C4-C5, and C5-C6 discs, while C2-C3, C6-C7, and C7-T1 showed significant differences between ROIs. The findings indicate there may be inherent differences in T2-relaxation time properties between different cervical discs. Clinical evaluations utilizing T2-mapping techniques in the cervical spine may need to be level-dependent. (orig.)

  19. In-vivo T2-relaxation times of asymptomatic cervical intervertebral discs

    Energy Technology Data Exchange (ETDEWEB)

    Driscoll, Sean J.; Mao, Haiqing; Li, Guoan [Massachusetts General Hospital/Harvard Medical School, Bioengineering Laboratory, Department of Orthopaedic Surgery, Boston, MA (United States); Zhong, Weiye [Massachusetts General Hospital/Harvard Medical School, Bioengineering Laboratory, Department of Orthopaedic Surgery, Boston, MA (United States); Second Xiangya Hospital and Central South University, Department of Spinal Surgery, Changsha, Hunan (China); Torriani, Martin [Massachusetts General Hospital/Harvard Medical School, Musculoskeletal Imaging and Intervention, Department of Radiology, Boston, MA (United States); Wood, Kirkham B.; Cha, Thomas D. [Massachusetts General Hospital/Harvard Medical School, Spine Service, Department of Orthopaedic Surgery, Boston, MA (United States)

    2016-03-15

    Limited research exists on T2-mapping techniques for cervical intervertebral discs and its potential clinical utility. The objective of this research was to investigate the in-vivo T2-relaxation times of cervical discs, including C2-C3 through C7-T1. Ten asymptomatic subjects were imaged using a 3.0 T MR scanner and a sagittal multi-slice multi-echo sequence. Using the mid-sagittal image, intervertebral discs were divided into five regions-of-interest (ROIs), centered along the mid-line of the disc. Average T2 relaxation time values were calculated for each ROI using a mono-exponential fit. Differences in T2 values between disc levels and across ROIs of the same disc were examined. For a given ROI, the results showed a trend of increasing relaxation times moving down the spinal column, particularly in the middle regions (ROIs 2, 3 and 4). The C6-C7 and C7-T1 discs had significantly greater T2 values compared to superior discs (discs between C2 and C6). The results also showed spatial homogeneity of T2 values in the C3-C4, C4-C5, and C5-C6 discs, while C2-C3, C6-C7, and C7-T1 showed significant differences between ROIs. The findings indicate there may be inherent differences in T2-relaxation time properties between different cervical discs. Clinical evaluations utilizing T2-mapping techniques in the cervical spine may need to be level-dependent. (orig.)

  20. 105例腰椎问盘突出症的康复护理体会%Rehabilitation Nursing Experience of 105 Cases of Lumbar Disc Herniation

    Institute of Scientific and Technical Information of China (English)

    贾芳

    2015-01-01

    目的寻找腰椎问盘突出症的康复护理方法。方法将105例腰椎间盘突出症患者,在常规康复治疗(针灸、动力灸、物理因子治疗等)的基础上,采用综合康复护理,观察效果。结果综合康复护理在腰椎问盘突出症的康复中取得了较好的效果。结论综合康复护理是腰椎问盘突出症康复的有效方法。%Objective To search for the lumbar intervertebral disc protrusion rehabilitation nursing method.Methods 105 cases of patients with lumbar disc herniation, in routine rehabilitation treatment (acupuncture, moxibustion, dynamic physical factor treatment etc.) basis, by comprehensive rehabilitation nursing, observe the ef ect.Results The comprehensive rehabilitation nursing disc herniation rehabilitation achieved good results in the lumbar spine.Conclusion The comprehensive rehabilitation nursing is lumbar intervertebral disc herniation of the ef ective method of rehabilitation.

  1. Lumbar disc herniation: Is there an association between histological and magnetic resonance imaging findings?

    Directory of Open Access Journals (Sweden)

    Shiju A Majeed

    2016-01-01

    Conclusion: The study shows that the Pfirmann grading system, MCs and HDS can reliably be used as scoring systems for assessing lumbar disc degeneration. The radiological assessment can be used as a noninvasive tool to assess the probable change in content rather than the microstructure of a disc undergoing degeneration.

  2. The Mobi-C cervical disc for one-level and two-level cervical disc replacement: a review of the literature

    Directory of Open Access Journals (Sweden)

    Alvin MD

    2014-11-01

    Full Text Available Matthew D Alvin,1,2 Thomas E Mroz1,3,41Cleveland Clinic Center for Spine Health, Cleveland Clinic, Cleveland, OH, USA; 2Case Western Reserve University School of Medicine, Cleveland, OH, USA; 3Cleveland Clinic Lerner College of Medicine, Cleveland, OH, USA; 4Department of Neurological Surgery, Cleveland Clinic, Cleveland, OH, USABackground: Cervical disc arthroplasty (CDA is a novel motion-preserving procedure that is an alternative to fusion. The Mobi-C disc prosthesis, one of many Food and Drug Administration (FDA-approved devices for CDA, is the only FDA-approved prosthesis for two-level CDA. Hence, it may allow for improved outcomes compared with multilevel fusion procedures.Purpose: To critically assess the available literature on CDA with the Mobi-C prosthesis, with a focus on two-level CDA.Methods: All clinical articles involving the Mobi-C disc prosthesis for CDA through September 1, 2014 were identified on Medline. Any paper that presented Mobi-C CDA clinical results was included. Study design, sample size, length of follow-up, use of statistical analysis, quality of life outcome scores, conflict of interest, and complications were recorded.Results: Fifteen studies were included that investigated Mobi-C CDA, only one of which was a level Ib randomized control trial. All studies included showed non-inferiority of one-level Mobi-C CDA to one-level anterior cervical discectomy and fusion (ACDF. Only one study analyzed outcomes of one-level versus two-level Mobi-C CDA, and only one study analyzed two-level Mobi-C CDA versus two-level ACDF. In comparison with other cervical disc prostheses, the Mobi-C prosthesis is associated with higher rates of heterotopic ossification (HO. Studies with conflicts of interest reported lower rates of HO. Adjacent segment degeneration or disease, along with other complications, were not assessed in most studies.Conclusion: One-level Mobi-C CDA is non-inferior, but not superior, to one-level ACDF for patients

  3. A long-term follow-up study of the remote result of lumbar discectomy versus conservative treatment for single-level lumbar disc herniation

    Directory of Open Access Journals (Sweden)

    Ke-dong HOU

    2012-09-01

    Full Text Available Objective To analyze and compare the long-term therapeutic effect and image changes of conservative therapy versus lumbar discectomy for lumbar disc herniation to provide valid reference for its clinical treatment. Methods The clinical data from 182 patients with single-level lumbar disc herniation, who were treated from January 1983 to June 2008 and followed-up for more than 10 years, were analyzed retrospectively. These patients were divided into conservative treatment (CT group (n=73 with a mean follow-up time of 17.61±3.87 years, and surgery group (n=109 with a mean follow up time of 17.17±3.47 years. In the CT group, 49 patients were male, 24 female; there were 44 patients with L4-L5 disc herniation, and 29 L5-S1 disc herniation. In 109 patients in the surgery group, 71 were male, 38 female; 68 had L4-L5 disc herniation, 41 had L5-S1 disc herniation, and all of them received lumbar discectomy. The long-term therapeutic effects were reviewed and compared retrospectively in the two groups, including clinical manifestations, image changes, neurofunctional evaluation, height of morbid intervertebral space, adjacent segment intervertebral space and the incidence of cephalad adjacent segment degeneration. Results Eight of 73 patients received lumbar spinal canal decompression because of intermittent claudication in the CT group, and 13 in surgery group underwent resurgery for recurrent lumbar disc herniation. At final follow up, the height of morbid intervertebral space (0.62±0.15cmin surgery group was significantly lower than that in CT group (0.69±0.13cm, P < 0.05, the Oswestry score (23.9%±6.3% in surgery group, 23.3%±6.5% in CT group and height of adjacent segment intervertebral space (0.83±0.11cm in surgery group, and 0.82±0.11cm in CT group were statistically compared, and no significant difference was found between the two groups. Five patients in CT group and 9 in surgery group were found to have degenerative instability by

  4. A potential role for cell-based therapeutics in the treatment of intervertebral disc herniation

    OpenAIRE

    Ganey, Timothy M.; Meisel, Hans

    2002-01-01

    Lower back pain and disc degeneration negatively affect quality of life and impose an enormous financial burden. An extensive body of scientific work has evolved that characterizes the disc, demonstrating spinal anatomy and morphology that contribute to risk and likely promote failure. Ultimately, matrix failure is responsible for mechanical failure, which in turn results in spinal compromise anatomically and subsequent pain. One intervening approach to breaking this sequence has been to repo...

  5. A Minimally Invasive Treatment for Lumbar Disc Herniation: DiscoGel® Chemonucleolysis in Patients Unresponsive to Chemonucleolysis with Oxygen-Ozone

    OpenAIRE

    S. Stagni; De Santis, F.; Cirillo, L.; Dall’Olio, M.; Princiotta, C.; Simonetti, L.; Stafa, A.; Leonardi, M.

    2012-01-01

    A multitude of therapies is available to treat disc herniation, ranging from conservative methods (medication and physical therapy) to minimally invasive (percutaneous) treatments and surgery. O2-O3 chemonucleolysis (O2-O3 therapy) is one of the minimally invasive treatments with the best cost/benefit ratio and lowest complication rate. Another substance recently made available exploiting the chemical properties of pure ethanol is DiscoGel®, a radiopaque gelified ethanol more viscous than abs...

  6. 胸椎及高位腰椎间盘突出的手术治疗%Operative treatment of thoracic and upper lumbar disc herniation

    Institute of Scientific and Technical Information of China (English)

    杨明杰; 李立钧; 祝建光; 谭军

    2012-01-01

    Objective To study the; operative treatment of thoracic and upper lumbar disc hernia-tion. Methods The clinical data of 23 cases with thoracic and upper lumbar disc herniation undergoing laminectomy and transversoarthropedicidectomy from July 2006 to July 201 1 in our hospital were retrospectively reviewed, including 9 cases of posterolateral approach,8 cases of anterolateral approach and 6 cases of thoracoscopic approach. Results The follow-up period was from 1 to 5 years. According to the Otani scoring system, 12 cases were excellent,9 cases were good,2 case were average and the excellent-good rate was 91.3%. Conclusion The surgical procedure of thoracic and upper lumbar disc herniation is both complicated and difficult. Individual situation and the level of the disc herniation will influence the choice of surgical procedure.%目的 探讨胸椎及高位腰椎间盘突出的手术治疗方法及效果.方法 回顾分析2006年7月至2011年7月间我院23例患者临床资料.手术采用全椎板切除侧后方入路9例,侧前方入路8例,胸腔镜下手术6例.结果 所有患者均随访1~5年.根据Otani′s等分级方法评价:优12例,良9例,一般2例,手术优良率为91.3%.结论 胸椎及高位腰椎间盘突出手术方式多且手术难度大,应根据患者的个体情况及发病节段,选择合适的手术方式.

  7. Variation in eligibility criteria from studies of radiculopathy due to a herniated disc and of neurogenic claudication due to lumbar spinal stenosis: a structured literature review

    OpenAIRE

    Genevay, Stéphane; Atlas, Steve J.; Katz, Jeffrey N.

    2010-01-01

    STUDY DESIGN: A structured literature review. SUMMARY OF THE BACKGROUND DATA: Widely recognized classification criteria for rheumatologic disorders have resulted in well-defined patient populations for clinical investigation. OBJECTIVE: We sought to determine whether similar criteria were needed for back pain disorders by examining variability in eligibility criteria in published studies. METHODS: Studies involving radiculopathy due to lumbar herniated disc (HD) and for neurogenic claudicatio...

  8. Chemonucleolysis in lumbar disc herniation: a meta-analysis Quimonucleólise em hernia de disco lombar: metanálise

    OpenAIRE

    José Mauro Cardoso Couto; Euclides Ayres de Castilho; Paulo Rossi Menezes

    2007-01-01

    PURPOSE: To carry out a systematic review and meta-analysis of the efficacy of chemonucleolysis in the treatment of lumbar disc herniation. METHODS: Clinical trials were selected from 3 electronic databases (The Cochrane Controlled Trials Register, MEDLINE, and EMBASE). Data were analyzed with the software STATA, using the meta command. RESULTS: Twenty-two clinical trials were eligible. For chemonucleolysis versus placebo, the summary risk ratio estimate for pain relief as outcome was 1.51 (9...

  9. 小切口开窗治疗腰椎间盘突出症%Treatment of Lumbar Disc Herniation with Small Incisior Fenestration

    Institute of Scientific and Technical Information of China (English)

    曹华敏; 黄洪善

    2003-01-01

    @@ 自1995年6月始,笔者应用小切口开窗髓核摘除术治疗腰椎间盘突出症(lumbar disc herniation,LDH),创伤较小、术后疤痕粘连小、恢复快,现将资料完整的465例报道如下.

  10. Clinical Research of Minimally Invasive in Treatment of Lumbar Disc Herniation%腰椎间盘突出症微创治疗临床研究

    Institute of Scientific and Technical Information of China (English)

    高晓明

    2016-01-01

    目的:对比分析腰椎间盘突出症采用传统手术和微创手术治疗的临床效果。方法选取2014年12月~2015年6月在我院接受治疗的106例腰椎间盘突出症患者,59例进行微创手术治疗,47例进行传统手术治疗,观察和对比治疗效果。结果微创手术组比传统手术组患者的VAS评分下降,传统手术治疗腰椎间盘突出症的优良率为76.4%,而微创手术法优良率为93.5%,两种方法临床效果对比,差异具有统计学意义(P<0.05)。结论腰椎间盘突出症微创治疗的临床疗效明显,几乎无并发症,对于患者身体损伤小。%Objective Compared with traditional lumbar disc herniation surgery and the clinical effect of minimally invasive surgery treatment. Methods Selected 106 cases of patients with lumbar disc herniation from December 2014 to June 2015 in our hospital, including 59 cases of patients with minimally invasive surgery treatment, 47 cases of patients with traditional surgery treatment, to observe and compare the treatment effect of two groups.ResultsMinimally invasive surgery group VAS score lower than patients with traditional surgery group, the traditional surgical treatment of lumbar disc herniation was 76.4%, and method of minimally invasive surgery was 93.5%, lumbar intervertebral disc herniation statistical signiifcance (P<0.05).Conclusion The clinical curative effect of minimally invasive treatment of lumbar disc herniation is very obvious, and almost no complications, for small body injury, the clinical treatment in lumbar intervertebral disc protrusion.

  11. 针灸治疗腰椎间盘突出症的研究进展%The Research Progress of Treating Lumbar Disc Herniation by Acupuncture

    Institute of Scientific and Technical Information of China (English)

    曾红文

    2014-01-01

    我院针灸治疗腰椎间盘突出症LDH的方法主要包括火针、电针、温针、穴位注射、针刀疗法、刺络拔罐、腹针等。针灸具有疏通经络、活血化瘀、消炎镇痛、解除痉挛等作用,其治疗腰椎间盘突出症具有见效快、安全性高等优点。本文将总结针灸治疗腰椎间盘突出症的研究进展,以供临床参考。%The acupuncture methods in our hospital for lumbar disc herniation (LDH) include fire needle, electro-acupuncture, warm needing, acu-point injection, the needle-knife therapy, pricking and cupping,abdominal acupuncture and so on. Acupuncture has some effects like dredging chan-nels, promoting blood circulation for removing blood stasis, anti-inflammatory and analgesic, relieving spasm, and there are advantages such as quickly effective and high safety in treating lumbar disc herniation. This article would summarize the research progress of treating lumbar disc hernia-tion by acupuncture, in order to provide some references to clinical treatment.

  12. Treatment of 116 Cases of Cervical Intervertebral Disc Protrusion by Tuina

    Institute of Scientific and Technical Information of China (English)

    WANG Guang-zong; XIAO Yuan-chun

    2007-01-01

    Objective: To observe the clinical efficacy of uplifting massage therapy in the treatment of cervical intervertebral disc protrusion and study the effectiveness of this massage therapy for cervical intervertebral disc protrusion. Methods: 116 subjects were randomized into two groups: treatment group in which 60 cases were treated by uplifting massage therapy and conventional massage, and control group in which 56 cases were treated by simple conventional massage. Results: After 1-2 courses of treatment, the total effective rate was 95.0% in treatment group and 80.4% in control group; the former rate was higher than the latter one(P<0.05).Conclusion: The uplifting massage therapy combined with conventional massage has better effects than simple conventional massage in the treatment of cervical intervertebral disc protrusion.

  13. Cervical Disc Deformation During Flexion–Extension in Asymptomatic Controls and Single-Level Arthrodesis Patients

    OpenAIRE

    Anderst, William; Donaldson, William; Lee, Joon; Kang, James

    2013-01-01

    The aim of this study was to characterize cervical disc deformation in asymptomatic subjects and single-level arthrodesis patients during in vivo functional motion. A validated model-based tracking technique determined vertebral motion from biplane radiographs collected during dynamic flexion–extension. Level-dependent differences in disc compression–distraction and shear deformation were identified within the anterior and posterior annulus (PA) and the nucleus of 20 asymptomatic subjects and...

  14. Autologous nucleus pulposus transplantation to lumbar 5 dorsal root ganglion after epineurium discission in rats: a modified model of non-compressive lumbar herniated intervertebral disc

    Institute of Scientific and Technical Information of China (English)

    ZHANG Jin-jun; SONG Wu; LUO Wen-ying; WEI Ming; SUN Lai-bao; ZOU Xue-nong; LIAO Wei-ming

    2011-01-01

    Background Nucleus pulposus of intervertebral discs has proinflammatory characteristics that play a key role in neuropathic pain in lumbar herniated intervertebral disc. One of the most commonly used animal models (the traditional model) of non-compressive lumbar hemiated intervertebral disc is created by L4-L5 hemilaminectomy and the application of autologous nucleus pulposus to cover the left L4 and L5 nerve roots in rats. However, such procedures have the disadvantages of excessive trauma and low success rate. We proposed a modified model of non-compressive lumbar herniated intervertebral disc in which only the left L5 dorsal root ganglion is exposed and transplanted with autologous nucleus pulposus following incision of epineurium. We aimed to compare the modified model with the traditional one with regard to trauma and success rate.Methods Thirty Sprague-Dawley male rats were randomized into three groups: sham operation group (n=6). traditional group (n=12), and modified group (n=12). The amount of blood loss and operative time for each group were analyzed. The paw withdrawal threshold of the left hind limb to mechanical stimuli and paw withdrawal latency to heat stimuli were examined from the day before surgery to day 35 after surgery.Results Compared with the traditional group, the modified group had shorter operative time, smaller amount of blood loss, and higher success rate (91.7% versus 58.3%, P <0.05). There was no decrease in paw withdrawal latency in any group. The sham operation group had no decrease in postoperative paw withdrawal threshold, whereas the modified and traditional groups had significant reduction in paw withdrawal threshold after surgery (mechanical hyperalgesia).Conclusions Transplantation of nucleus pulposus onto the L5 dorsal root ganglion following incision of epineurium in rats established an improved animal model of non-compressive lumbar herniated intervertebral disc with less trauma and more stable pain ethology.

  15. Scoliotic posture as the initial symptom in adolescents with lumbar disc herniation: its curve pattern and natural history after lumbar discectomy

    Directory of Open Access Journals (Sweden)

    Ding Yitao

    2011-09-01

    Full Text Available Abstract Background There have been few studies focusing on the curve pattern of scoliosis caused by lumbar disc herniation (LDH in adolescents and the natural history of scoliosis after discectomy. The current study was carried out to identify the curve pattern of scoliosis and investigate the effect of posterior discectomy on the curve improvement in adolescents with LDH. Methods This review focused on a group of 26 adolescents with LDH who initially presented to our clinic for evaluation of scoliosis, followed by posterior discectomy between 2000 and 2009. Radiographic measurements included curve pattern, specific curve features, trunk shift, and sagittal profile. The correlation between the side of disc herniation and the direction of lumbosacral curve and the trunk shift was evaluated. Results A typical curve pattern was initially identified in all of the patients as a short lumbosacral curve accompanied with a long thoracic or thoracolumbar curve toward the opposite side. 23 of 26 patients (88.5% had a trunk shift more than 2.0 cm away from the midline, showing a poor coronal balance. A relatively straight sagittal profile was noted in all the patients. 84.6% (22/26 patients had a disc herniation at the convex side of lumbosacral curve. Similarly, 73.1% (19/26 patients showed a trunk shift toward the opposite side of disc herniation. All of the patients had an marked curve improvement immediately after discectomy. In the 17 patients with a more than 2-year follow-up, only two had a residual lumbosacral curve greater than or equal to 20 degrees. The mean ODI improved from 21.4% before surgery to 7.3% at the final follow-up. Conclusions A short lumbosacral curve accompanied with a long thoracic or thoracolumbar curve toward the opposite side, and a relatively straight sagittal profile have been noted in all the patients. The direction of lumbosacral curve and trunk shift was related to the side of disc herniation. A majority of patients have

  16. Cervical total disc replacement is superior to anterior cervical decompression and fusion: a meta-analysis of prospective randomized controlled trials.

    Directory of Open Access Journals (Sweden)

    Yujie Zhang

    Full Text Available Despite being considered the standard surgical procedure for symptomatic cervical disc disease, anterior cervical decompression and fusion invariably accelerates adjacent segment degeneration. Cervical total disc replacement is a motion-preserving procedure developed as a substitute to fusion. Whether cervical total disc replacement is superior to fusion remains unclear.We comprehensively searched PubMed, EMBASE, Medline, and the Cochrane Library in accordance with the inclusion criteria to identify possible studies. The retrieved results were last updated on December 12, 2014. We classified the studies as short-term and midterm follow-up.Nineteen randomized controlled trials involving 4516 cases were identified. Compared with anterior cervical decompression and fusion, cervical total disc replacement had better functional outcomes (neck disability index [NDI], NDI success, neurological success, neck pain scores reported on a numerical rating scale [NRS], visual analog scales scores and overall success, greater segmental motion at the index level, fewer adverse events and fewer secondary surgical procedures at the index and adjacent levels in short-term follow-up (P 0.05.Cervical total disc replacement presented favorable functional outcomes, fewer adverse events, and fewer secondary surgical procedures. The efficacy and safety of cervical total disc replacement are superior to those of fusion. Longer-term, multicenter studies are required for a better evaluation of the long-term efficacy and safety of the two procedures.

  17. Integrative TCM Conservative Therapy for Low Back Pain due to Lumbar Disc Herniation: A Randomized Controlled Clinical Trial

    Directory of Open Access Journals (Sweden)

    Wei An Yuan

    2013-01-01

    Full Text Available Low back pain due to lumbar disc herniation (LDH is very common in clinic. This randomized controlled trial was designed to investigate the effects of integrative TCM conservative therapy for low back pain due to LDH. A total of 408 patients with low back pain due to LDH were randomly assigned to an experimental group with integrative TCM therapy and a control group with normal conservative treatment by the ratio of 3 : 1. The primary outcome was the pain by the visual analogue scale (VAS. The secondary outcome was the low back functional activities by Chinese Short Form Oswestry Disability Index (C-SFODI. Immediately after treatment, patients in the experimental group experienced significant improvements in VAS and C-SFODI compared with the control group (between-group difference in mean change from baseline, −16.62 points, P<0.001 in VAS; −15.55 points, P<0.001 in C-SFODI. The difference remained at one-month followup, but it is only significant in C-SFODI at six-month followup (−7.68 points, P<0.001. No serious adverse events were observed. These findings suggest that integrative TCM therapy may be a beneficial complementary and alternative therapy for patients with low back pain due to LDH.

  18. Root compression on MRI compared with clinical findings in patients with recent onset cervical radiculopathy

    NARCIS (Netherlands)

    B. Kuijper; J.T.J. Tans; B.F. van der Kallen; F. Nollet; G.J. Lycklama a Nijeholt; M. Visser

    2011-01-01

    Objectives To evaluate the occurrence of symptomatic and asymptomatic root compression caused by herniated discs and spondylotic foraminal stenosis by MRI in patients with recent onset cervical radiculopathy. Participants 78 patients with symptoms and signs of cervical radiculopathy of less than one

  19. A Prospective Study of the Functional Outcome of Anterior Cervical Discectomy With Fusion in Single Level Degenerative Cervical Disc Prolapse

    Science.gov (United States)

    Kamani, Mayur M; Shetty, Vikram; Rai, H. Ravindranath; Hegde, Deepak

    2016-01-01

    Introduction Cervical spondylotic myelo-radiculopathy is a form of spinal cord dysfunction syndrome and usually accompanies age related degeneration of the spine. Aim To determine the functional outcome of anterior cervical discectomy with fusion and plating in single level degenerative cervical disc prolapse. Materials and Methods A total of 20 patients diagnosed with degenerative single level cervical disc prolapse who presented to the Department of Orthopaedic Surgery, Justice KS Hegde Charitable Hospital, Mangalore from the period of November 2012 to May 2014 were enrolled in the study. Complete clinical and radiological evaluation of the patients was done. A trial of conservative management was tried in all these patients for a period of two months. They were taken up for surgery only when conservative management had failed. Scoring of neck function before the surgery was done as per the Modified Japanese Orthopaedic Association (MJOA) score. All patients underwent anterior cervical discectomy and fusion (ACDF) with tricortical iliac crest bone grafting. Fixation was performed with titanium locking cervical plates. All patients were reviewed at 6 weeks and 6 months postoperatively. Assessment of neck function was done as per the MJOA scoring during all the reviews. Radiographic assessment was also done during all the reviews. The complications noted were documented. The statistical analysis was done using percentages; the arithmetic mean was calculated using SPSS software (version 16.0). Results Amongst the 20 patients included in the study, 1 patient died postoperatively due to oesophageal rupture. of the remaining 19 patients reviewed and followed up, all of them had improvement of symptoms and were reported to be in the ‘mild category’ as per the MJOA score. One patient developed dysphonia, in the immediate postoperative period due to recurrent laryngeal nerve palsy which recovered in a period of three months postoperative. Conclusion Single level

  20. 腰椎间盘突出症术后复发的研究进展%Research Progresses on Postoperative Recurrence of Lumbar Disc Herniation

    Institute of Scientific and Technical Information of China (English)

    张振海; 周建生

    2012-01-01

    Objective:To probe research progresses on postoperative recurrence of lumbar disc hernia -tion. Methods:To look up the relevant reference concerning recurrent lumbar disc herniation from PubMed and CNKI database , and to generalize the etiology of RLDH . Results: Determined etiology, correct diagnosis , choosing a suitable treatment method and early prevention are important to reduce the lumbar disc herniation recur - rence rate. Conclusions;To preferentially select conservative treatment or surgery for the lumbar disc herniation recurrence and if operation is performed , which mode of operation should be chosen , these problems still need to be solved. Further researches will help the diagnosis and treatment of the patients with RLDH .%目的:总结与腰椎间盘突出症术后复发相关研究的进展.方法:查阅PubMed、CNKI数据库中近年来关于腰椎间盘突出症术后复发方面的研究文献,进行归纳分析.结果:在腰椎间盘突出症术后复发的研究中,明确病因、正确诊断、选择合适的治疗方法及早期预防是降低腰椎间盘突出症术后复发率的关键.结论:随着这方面的研究深入,在腰椎间盘突出症术后复发的治疗中,保守治疗还是手术治疗,治疗应选择何种手术方式,仍需解决.

  1. Follow-up radiographs of the cervical spine after anterior fusion with titanium intervertebral disc

    International Nuclear Information System (INIS)

    Purpose: We examined the postoperative changes of the cervical spine after treatment of cervical nerve root compression with anterior cervical discectomy and fusion with a new titanium intervertebral disc. Patients and Methods: 37 patients were examined prior to, as well as 4 days, 6 weeks, and 7 months after surgery. Lateral view X-rays and functional imaging were used to evaluate posture and mobility of the cervical spine, the position of the implants, and the reactions of adjacent bone structures. Results: Implantation of the titanium disc led to post-operative distraction of the intervertebral space and slight lordosis. Within the first 6 months a slight loss of distraction and re-kyphosis due to impression of the implants into the vertebral end-plates were found in all patients. We noted partial infractions into the vertebral end-plates in 10/42 segments and slight mobility of the implants in 14/42 segments. Both groups of patients showed reactive spondylosis and local symptoms due to loosening of the implants. The pain subsided after onset of bone bridging and stable fixation of the loosened discs. Conclusions: The titanium intervertebral disc provides initial distraction of the fusioned segments with partial recurrence of kyphosis during the subsequent course. Loosening of the implants with local symptoms can be evaluated with follow-up X-rays and functional imaging. (orig.)

  2. Clinical and radiologic comparison of dynamic cervical implant arthroplasty versus anterior cervical discectomy and fusion for the treatment of cervical degenerative disc disease.

    Science.gov (United States)

    Li, Zhonghai; Yu, Shunzhi; Zhao, Yantao; Hou, Shuxun; Fu, Qiang; Li, Fengning; Hou, Tiesheng; Zhong, Hongbin

    2014-06-01

    This study compared the clinical and radiological outcomes of dynamic cervical implant (DCI; Scient'x, Villers-Bretonneux, France) arthroplasty versus anterior cervical discectomy and fusion (ACDF) for the treatment of cervical degenerative disc disease. This prospective cohort study enrolled patients with single-level cervical degenerative disc disease who underwent DCI arthroplasty or ACDF between September 2009 and June 2011. Patients were followed up for more than 2years. Clinical evaluation included the Medical Outcomes Study 36-Item Short Form Health Survey (SF-36), Neck Disability Index (NDI), Japan Orthopedic Association (JOA) score, and visual analog scale (VAS) scores for neck and arm pain. Radiological assessments included segmental range of motion (ROM), overall ROM (C2-C7), disc height (DHI), and changes in adjacent disc spaces. The VAS, SF-36, JOA, and NDI scores improved significantly after surgery in both the DCI and ACDF groups. The VAS, JOA, and SF-36 scores were not significantly different between the DCI and ACDF groups at the final follow-up. The segmental ROM at the treated level and overall ROM increased significantly after surgery in the DCI group, but the ROM in the adjacent cephalad and caudal segments did not change significantly. The mean DHI at the treated level was significantly restored after surgery in both groups. Five patients (12.8%) in the DCI group showed new signs of adjacent segment degeneration. These results indicate that DCI is an effective, reliable, and safe procedure for the treatment of cervical degenerative disc disease. However, there is no definitive evidence that DCI arthroplasty has better intermediate-term results than ACDF. PMID:24411326

  3. Total Disc Arthroplasty and Anterior Cervical Discectomy and Fusion in Cervical Spine: Competitive or Complimentary? Review of the Literature

    OpenAIRE

    Jawahar, Ajay; Nunley, Pierce

    2012-01-01

    Anterior cervical discectomy and arthrodesis has come to represent standard of care for patients with persistent radicular and/or myelopathic symptoms that have failed to improve with conservative treatments. One potential complication of the procedure is the accelerated degeneration of the vertebrae and the intervertebral discs adjacent to the level fused and the effects of fusion on those levels. The concern that fusion may be a contributing factor to accelerated adjacent segment degenerati...

  4. MULTIMODAL PHYSIOTHERAPEUTIC APPROACH IN TREATING A PATIENT WITH ACUTE CERVICAL DISC PROLAPSE: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Rathish Manickam

    2015-12-01

    Full Text Available Background and Purpose: Cervical disc prolapse is one of the leading cause of morbidity and affecting the patients routine work of their ADL. Due to severity of symptoms and patients feeling of insecurity, physiotherapeutic conservative approach is questionable and has become challengeable against surgery. The purpose of this case report is to explore the efficacy of multimodal physiotherapeutic approach in treating a patient with acute cervical disc prolapse. Case Description: 33 year old male patient was diagnosed with acute cervical disc prolapse and the pain was radiating to the right upper limb associated with numbness. The patient was given initially physiotherapeutic modalities like cryotherapy, ultrasound and mechanical traction to reduce pain. Muscle Energy Technique was also implemented for initial days along with cryotherapy based on cryokinetics concept to enhance movements of cervical spine. Mckenzie exercises with appropriate techniques was administered for 10 days along with retraction exercise, basic ROM and neck isometrics as a home program. The patient received treatment for a period of 12 days. Outcome Measures: The outcome measures used were Numeric Pain Rating Scale, Neck Disability Index, Tampa Scale for Kinesiophobia, and Cervical ROM. Conclusion: Multimodal physiotherapeutic approach along with Mckenzie technique played a significant role in alleviating pain, numbness and improvement of the patient functionally for return to his normal work.

  5. Preoperative motor deficit in lumbar disc herniation and its influence on quality of life

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    Asdrubal Falavigna

    2014-12-01

    Full Text Available Objective: Evaluate the impact of motor deficit (MD on pain, disability, depression and quality of life measures of patients with LDH prior to a specific treatment. Methods: A total of 254 consecutively enrolled patients with LDH associated to neurological impairment and sciatica who have not responded to conservative treatment were evaluated. After reviewing the exclusion criteria, 168 were included. Validated instruments were used in the preoperative period to evaluate: pain, disability, quality of life, anxiety and depression. Results: Normal motor strength was observed in 57 (33.9% patients and MD was observed in 111 (66.1% cases. No statistically significant differences were observed between patients with and without MD regarding gender, age, level of herniation, lateralization and workers' compensation. Regarding quality of life, no difference was detected in the eight domains of SF36 and between the PCS and MCS groups. The only difference observed was a higher disability rate in the MD group, with the mean ODI difference being 7.84 (CI 95%: 1.82â€"13.87; p=0.011. Motor weakness was observed in 35.1% (n=39/111 of patients who had abnormal results at the motor evaluation, being related to severity (X²: 46.058; p<0.0001. Conclusion: In patients with LDH without prior specific treatment, the presence of MD did not modify the pain, disability, depression measures and self-reported quality of life. The MD has no discriminative power for measures of quality of life in patients with LDH.

  6. The Role of Posterior Longitudinal Ligament in Cervical Disc Replacement: An Ovine Cadaveric Biomechanical Analysis.

    Science.gov (United States)

    Yu, Cheng-Cheng; Hao, Ding-Jun; Ma, Yu-Li; Huang, Da-Geng; Li, Hou-Kun; Feng, Hang; Hou, Qian

    2016-01-01

    BACKGROUND Cervical disc replacement (CDR) has been widely used to restore and maintain mobility and function of the treated and adjacent motion segments. Posterior longitudinal ligament (PLL) resection has been shown to be efficient in anterior cervical decompression and fusion. However, less is known about the biomechanical effect of PLL removal versus preservation in cervical disc arthroplasty. MATERIAL AND METHODS Three motion segments of 24 ovine cervical spines (C2-C5) were evaluated in a robotic spine system with axial compressive loads of 50 N. These cervical spines were divided in three groups according to the following conditions: (1) intact spine, (2) C3/C4 CDR with the Prestige LP prosthesis and PLL preservation, and (3) C3/C4 CDR with the Prestige LP prosthesis and PLL removal. The ranges of motion (ROMs) were recorded and analyzed in each group. RESULTS The C3/C4 ROM in group 3 (CDR with PLL removed) increased significantly in flexion-extension and axial rotation compared with group 1 (intact spine). Moreover, in flexion-extension, the mean total ROM was significantly larger in group 3 than in group 1. All the ROM observed in group 2 (CDR with PLL preserved) did not significantly differ from the ROM observed in group 1. CONCLUSIONS Compared with intact spines, CDR with PLL removal partly increased ROM. Moreover, the ROM in CDR with PLL preservation did not significantly differ from the ROM observed in intact spines. The PLL appears to contribute to the balance and stability of the cervical spine and should thus be preserved in cervical disc replacement provided that the posterior longitudinal ligament is not degenerative and the compression can be removed without PLL takedown. PMID:27243444

  7. Efficacy evaluation for the treatment of unstable lumbar disc herniation by traditional and modified lamina osteotomy replantation

    Institute of Scientific and Technical Information of China (English)

    XU Hong-hai; WANG Xiao-qing; ZHANG Yue-lin; GUO Xiong; LIU Zong-zhi; LUO Zhen-qun; MA Qiang

    2013-01-01

    Background The traditional lamina osteotomy replantation method is prone to nerve root injury and low back pain recurrence.Our team has proposed a modified approach that improves the osteotomy site and its fixation procedure.The aim of this study was to evaluate the clinical efficacy of traditional and modified lamina replantation methods in treating unstable lumbar disc herniation.Methods From March 2008 to August 2011,124 patients with unstable lumbar disc herniation were enrolled and randomly divided into the following two groups according to random digital table:group A (traditional group) consisting of 61 patients who underwent traditional laminectomy replantation,and group B (modified group) consisting of 63 patients who underwent modified lamina replantation.Both surgeries were performed by the same surgeons.The two groups had no significant difference in gender,age,symptoms,time of onset and the prominent segment.Visual analogue scale (VAS),Oswertry disability index (ODI),and Japanese Orthopaedic Association (JOA) scores,operative time,blood loss,complication rate,radiographic healing rates,and low back pain recurrence rates were compared between the two groups.Results There were 121 patients followed up for more than one year,and the follow-up rate was 97.6%.Nerve injury occurred in two patients (3.3%) in the modified group and 12 patients (20.0%) in the traditional group.Dural injury occurred in one patient (1.6%) in the modified group and seven patients (11.7%) in the traditional group.Pseudarthrosis occurred in two patients in the modified group and in 18 patients in the traditional group with 1-year fusion rates of 96.7% and 70.0%,respectively.Recurrence of lower back pain after one year was noted in three patients (4.9%) in the modified group,and in 15 (25.0%) in the traditional group.Leg pain recurrence was noted in one patient (1.6%) in the modified group and in three cases (5.0%) in the traditional group.The one-year healing

  8. Outcome Measure of Pain in Patients with Lumbar Disc Herniation: Validation Study of the Iranian version of Pain Sensitivity Questionnaire

    Science.gov (United States)

    Azhari, Shirzad; Shahzadi, Sohrab; Nayeb Aghaei, Hossain; Mohammadi, Hassan Reza; Montazeri, Ali

    2016-01-01

    Study Design Cross-sectional. Purpose To translate and culturally adapt an Iranian version of the Pain Sensitivity Questionnaire (PSQ) in Iran. Overview of Literature Instruments measuring patient reported outcomes should satisfy certain psychometric properties. Methods The PSQ was translated following cross-cultural adaptation guidelines. A total of 101 patients with lumbar disc herniation (LDH), and 39 healthy cases were included in the study. All participants completed the PSQ and the Pain Catastrophizing Scale (PCS). The internal consistency, test-retest reliability, known group comparison, criterion validity and item-scale correlations were assessed. Results The mean age of participants was 51.7 years. Reliability, validity and correlation of PSQ and PCS showed satisfactory results. Cronbach's alpha coefficients were 0.81 for PSQ-total, 0.82 for PSQ-minor, and 0.82 for PSQ-moderate. The intraclass correlation coefficients value was 0.84 (0.616–0.932) indicating an excellent test-retest reliability. The instrument discriminated well between sub-groups of patients who differed in a standard predictive measure of LDH surgery (the Finneson–Cooper score). Total PSQ were also significantly correlated with the total scores of the PCS, lending support to its good convergent validity. Additionally, the correlation of each item with its hypothesized domain on the PSQ indicated acceptable results, suggesting that the items had a substantial relationship with their own domains. Conclusions The adapted Iranian PSQ is a valid and reliable questionnaire for the assessment of pain in patients with LDH. PMID:27340527

  9. Factors Predicting Patient Dissatisfaction 2 Years After Discectomy for Lumbar Disc Herniation in a Chinese Older Cohort

    Science.gov (United States)

    Wang, Hui; Zhang, Di; Ma, Lei; Shen, Yong; Ding, Wenyuan

    2015-01-01

    Abstract We aim to identify factors predicting patient dissatisfaction 2 years after discectomy for lumbar disc herniation (LDH) in a Chinese older cohort. Preoperative and 2-year follow-up data for 843 patients were analyzed. After 2 years of discectomy, the patients rated their satisfaction by Patient Satisfaction Index (PSI), with response of 1 or 2 defining satisfaction and a PSI response of 3 or 4 defining dissatisfaction. Associations between perioperative variables and satisfaction with the results of surgery were examined in univariate and multivariate analysis. Six hundred fifty-seven patients had a PSI of 1 or 2 and were enrolled as satisfied group, 186 patients had a PSI of 3 or 4 and were enrolled as dissatisfied group. At baseline, no significant differences were found between the 2 groups in age, occupation, Oswestry Disability Index (ODI), Visual Analog Scale (VAS)-leg, and VAS-back. Compared to satisfied group, dissatisfied group had a significantly higher BMI and a higher incidence of depression. Two years after discectomy, no significant differences were found between the 2 groups in decrease of ODI, decrease of VAS-back, decrease of VAS-leg, surgery complications. Compared to satisfied group, dissatisfied group experienced higher incidence of symptom recurrence and depression. Logistic regression analysis showed that obesity, pre- and postoperative depression, symptom recurrence were independently associated with patient dissatisfaction 2 years after discectomy. In conclusion, more than 70% patients expressed satisfaction with discectomy for LDH. Two factors could predict patient dissatisfaction and be assessed before surgery: obesity and preoperative depression. Symptom recurrence and postoperative depression are also associated with diminished patient satisfaction. PMID:26448005

  10. Cut-Off Value for Pain Sensitivity Questionnaire in Predicting Surgical Success in Patients with Lumbar Disc Herniation

    Science.gov (United States)

    Azimi, Parisa; Benzel, Edward C.

    2016-01-01

    Various factors related to predict surgical success were studied; however, a standard cut-off point for the Pain Sensitivity Questionnaire (PSQ) measure has not yet been established for a favorable surgical outcome for lumbar disc herniation (LDH). This study was to find the optimal cut-off point on the PSQ to distinguish surgical success in patients with LDH. A total of 154 patients with LDH consecutively referred to our clinic were enrolled into this prospective study between February 2011 and January 2014. All participants completed the PSQ. Patients completed the Oswestry Disability Index (ODI) score before surgery, and at 2 years after surgery. Surgical success was defined as a 13-point improvement from the baseline ODI scores. The cut-off value for PSQ was determined by the receiver-operating characteristic curve (ROC). The mean age of patients was 49.3±9.6 years, and there were 80 women. The mean time for follow-up assessment was 31±5 months (range 24–35). Post-surgical success was 79.9% (n = 123) at 2 years follow up. The mean score for the total PSQ, PSQ-minor, and PSQ-moderate were 6.0 (SD = 1.6), 5.4 (SD = 1.9) and 6.5 (SD = 1.7), respectively. Total PSQ score was also significantly correlated with the total scores of the ODI. The optimal total PSQ cut-off point was determined as > 5.2 to predict surgical success in LDH patients, with 80.0% sensitivity and 75.6% specificity (AUC-0.814, 95% CI 0.703–0.926). This study showed that the PSQ could be considered a parameter for predicting surgical success in patients with LDH, and can be useful in clinical practice. PMID:27494617

  11. Use of pain drawing as an assessment tool of sciatica for patients with single level lumbar disc herniation.

    Science.gov (United States)

    Tachibana, Toshiya; Maruo, Keishi; Inoue, Shinichi; Arizumi, Fumihiro; Kusuyama, Kazuki; Yoshiya, Shinichi

    2016-01-01

    The objectives of this study were to examine the diagnostic accuracy of pain drawing (PD) in determining the level of involvement and to investigate how the quantitative evaluation results of PD using a grid score (GS) correlates with the results of other clinical evaluation measures in diagnosis and assessment of patients with lumber disc herniation (LDH) involving a single nerve root. Thirty-one patients with single level LDH who were diagnosed and conservatively treated by the first author constituted the study population. In order to assess the diagnostic accuracy of PD, the level of involvement as determined by PD was compared to the final diagnosis. In 26 of the 31 patients who could be followed for more than 6 months of conservative treatment, the GS in PD evaluation was compared to the score assessed by the Japanese Orthopaedic Association scoring system for low back pain (JOA score) and the visual analog scale (VAS) both before and after the treatment. The overall diagnostic accuracy of PD for the determination of the affected level averaged 68.8 %, and the accuracy was higher at the L4/5 and L5/S levels than the L2/3 and L3/4 levels. The average values of VAS and GS significantly decreased and the JOA score significantly improved after the treatment. Moreover, a significant correlation was demonstrated between the scores derived from these three evaluation measures. The present study indicated the potential usefulness of PD in clinical assessment during the treatment course. PMID:27547686

  12. 枢经推拿治疗腰椎间盘突出症疗效观察%Efficacy Observation on Shujing Massage Treating Lumbar Disc Herniation

    Institute of Scientific and Technical Information of China (English)

    唐宏亮; 庞军; 甘炜; 莫巧明; 王开龙; 李建敏; 甘振宝; 黄俊杰

    2014-01-01

    目的:观察枢经推拿治疗腰椎间盘突出症的疗效。方法:将120例腰椎间盘突出症患者随机分为枢经推拿组(60例)和常规推拿组(60例),分别施以枢经推拿和常规推拿,隔日1次,每次30min,共治疗21天,比较两组患者治疗前后的JOA评分变化情况。结果:治疗后,两组患者的JOA评分均显著提高(P<0.05),枢经推拿组高于常规推拿组(P<0.05)。结论:枢经推拿治疗腰椎间盘突出症疗效优于常规推拿治疗。%Objective:To observe the curative effects of Shujing massage treating lumbar disc herniation. Methods:120 cases of lumbar disc hernia-tion were randomly divided into Shujing massage group (60 cases) and routine massage group (60 cases), respectively with Shujing massage and rou-tine massage, a time every other day and each time of 30min with treating 21 days totally, changes of JOA score before and after treatment were com-pared between the two groups. Results:JOA scores of two groups after treatment both significantly increased (P<0.05), and that of Shujing massage group was higher than routine massage group (P<0.05). Conclusion:Efficacy of Shujing massage treating lumbar disc herniation is superior to con-ventional massage therapy.

  13. Histological, magnetic resonance imaging, and discographic findings on cervical disc degeneration in cadaver spines. A comparative study

    International Nuclear Information System (INIS)

    A total of 210 cervical intervertebral discs were taken at autopsy from 36 cadavers, and underwent both magnetic resonance imaging (MRI) and discography to compare their diagnostic efficacies for investigating degenerative changes in the cervical spine. The age of the subjects had ranged from 43 to 92 years with an average of 68.1 years. Following the autopsy, MRI and discography were performed on the excised cervical spinal column, and the specimen was then prepared for histological examination. The findings were compared with those of the lumbar spine that had previously been reported by Yasuma et al. on 1238 lumbar discs from 197 cadavers ranging in age from 11 to 92 years. The results were as follows: Low intensity in the T2-weighted MRI was well correlated with histological degeneration in the cervical disc. The rate of appearance of the posterior protrusion of the cervical disc on the MRI was in accordance with the degree of histological disc degeneration, but it did not always correspond with histological posterior protrusion. There was a remarkably high incidence for false-positive posterior protrusion on the MRI, which should be kept in mind on reading the MRI. In the comparison of the MRI with the discography, a certain positive correlation was found as for disc degeneration, but not in complete accordance. There was a considerable difference in the patterns of degeneration and in posterior protrusion of the discs between the cervical spine and the lumbar spine. The posterior protrusion in the cervical disc was more likely related to horizontal fissure and hyalinization of the posterior annulus, while posterior protrusion in the lumbar disc was often related to reversed orientation of the bundles and myxomatous degeneration of the posterior annulus. This difference was attributed to the difference in the mechanical properties of the cervical and lumbar spines. (author)

  14. The long-term therapeutic effect of central lumbar intervertebral disc herniation: a comparison between microendoscopy discectomy and percutaneous lumbar discectomy

    International Nuclear Information System (INIS)

    Objective: To discuss the indications, long-term outcomes and complications of microendoscopy discectomy (MED) and percutaneous lumbar discectomy (PLD) in treating central lumbar intervertebral disc herniation, and to compare the advantages of the two procedures. Methods: During the period from Jan. 2001 to March 2002 surgical procedure was carried out in sixty-three patients with single central lumbar disc herniation. The surgeries included MED (n=23) and PLD (n=40). The clinical data were retrospectively analyzed. The lesion site, the operation time, the blood loss in operation, the time staying in bed, the hospitalization cost and the postoperative hospitalization days were recorded. Oswestry disability index (ODI) and MacNab score were determined. Statistical analysis was performed by using pair sample t-test, κ-test and Fisher exact test. All patients were followed up. Results: A mean follow-up time was (5.1±0.6) years for patients receiving MED and (6.6±0.7) years for patients receiving PLD. The ODI and MacNab scores of patients receiving MED were better than these of patients receiving PLD. The hospitalization cost and the postoperative hospitalization days of MED group was higher and longer than these of PLD group, the differences between the two groups were statistically significant. The occurrence of long-term complication in MED group was 3.49%, while no complication was seen in PLD group. Conclusion: For the treatment of central lumbar intervertebral disc herniation, both MED and PLD are safe and minimally-invasive procedures with satisfactory long-term effectiveness, and the patients recover from clinical symptoms quickly. The PLD has used more common than MED. The performance of MED needs more skill and experience. Therefore, an interventional radiologist has to follow a relatively long learning curve in order to get the sufficient training and practice before he or she can master the technique of MED with full confidence. However, the long

  15. Anterior surgery for the treatment of acute single segment 30 cases of cervical disc%前路手术治疗急性单节段颈椎间盘突出30例

    Institute of Scientific and Technical Information of China (English)

    吴成如; 张诗虎

    2013-01-01

    目的 研究探讨前路颈椎间盘切除+椎间融合器+钛板内固定治疗急性颈椎间盘突出症的效果.方法 采用前路手术对我科2008-03-2011-03收治的30例急性颈椎间盘突出症患者进行治疗,所有患者均获得平均15个月的随访,根据术后摄片及JOA评分判断疗效.结果 在随访过程中,所有患者均未出现临床并发症,术后摄片显示均获得骨性融合,依据JOA评分标准:优(改善率大于75%)20例,良(改善率50~75%)8例,好转(改善率25~50%)2例.结论 该方法治疗急性颈椎间盘突出症可达到充分减压、重建颈椎生理曲度、恢复椎间隙高度、椎体间高融合率、颈椎牢固固定的作用.而且该术式操作简单,手术时间短、出血少、并发症少,是治疗急性颈椎间盘突出一种可靠方法.%Objective research and discuss the effect of the treatment of acute cervical disc herniation by using anterior cervical discectomy, Intervertebral fusion and Internal fixation with titanium plate. Methods 30 cases of patients with acute cervical disc herniation in our department in March 2008-March 2011 were treated by using anterior surgery,all patients received an average of 15 months of follow-up visit,then judge the curative effect according to postoperative radiography and JOA scores. Results In the process of follow-up, all patients did not show clinical complications, postoperative radiography showed bony fusion,according to JOA scoring criteria, optimal (improvement rate more than 75%) 20 cases, fine (improvement rate 50%~75%) 8 cases,improved (improvement rate 25%-50%) 2 cases. Conclusion the treatment of acute cervical disc herniation can achieve full decompression, reconstruction of cervical physiological curvature, restore interverte-bral disc height,high fusion rate between the vertebral bodies, cervical vertebra firmly fixed. And the operation is simple,short operation time,less bleeding,fewer complications,so the treatment of acute

  16. Lumbar disc herniation associated with scoliosis in a 15-year-old girl: case report Hérnia de disco lombar associada a escoliose em uma jovem de 15 anos: relato de caso

    OpenAIRE

    Fernando Campos Gomes Pinto; Arthur W. Poetscher; Fausto Ricardo Erba Quinhones; Mário Pena; Mário Augusto Taricco

    2002-01-01

    Intervertebral disc herniation is a rare condition in childhood and adolescence, although some cases have already been reported in the literature. We present the case of a 15 year-old-girl with low back pain and scoliosis. She had no previous history of trauma or collagen diseases. MRI showed L4-L5 and L5-S1 disc herniations and no further bone and structural changes. After two level discectomy, pain ceased and scoliosis improved, without further treatment. Based on her evolution and on what ...

  17. The Clinical Characteristics and Treatment of Far Lateral Lumbar Disc Herniation%极外侧型腰椎间盘突出症的临床特征及治疗

    Institute of Scientific and Technical Information of China (English)

    孟增东; 胡彪; 雷云坤; 李俊昌; 刘思波; 陈一沧

    2011-01-01

    Objective To study the clinical characteristics of far lateral lumbar disc herniation (FLLDH) and the appropriate operation way. Methods Thirteen patients with far lateral disc herniation were divided into two types by the place of herniated disc, that was foraminal disc herniation and extraforaminal disc herniation. The patients with foraminal disc herniation were treated with posterior lumbar interbody fusion (PLIF) while the patients with extraforaminal disc herniation were treated with intertransverse approach discectomy (IAD). Results All cases were observed for 6 to 24 months (average 18 months). Clinical outcomes were assessed by Macanab and Visual Analogue Score ( VAS). The postoperative overall excellent and good rate wre 92.31%. The average preoperative leg pain VAS score was 8 points, 1.4 points after surgery, low back pain VAS score was 1.6 points before surgery, 1 points after surgery. Conclusions The patients with far lateral lumbar disc herniation should be treated with different operations according to its types, choosing a appropriate operative way is a key to get satisfactory result.%目的 探讨极外侧型腰椎间盘突出症的临床特征和术式选择.方法 13例极外侧型腰椎间盘突出症患者中,椎间孔内型8例,椎间孔外型5例.分别采用单侧后路椎板减压、切除关节突关节、摘除椎间盘,并进行后路椎间植骨融合内固定手术和横突间入路单纯摘除椎间盘手术.结果 13例患者均获得随访,平均随访18个月.疗效按照Macanab分级和VAS评定:本组优8例,良4例,可1例,差0例,总优良率92.31%.术前腿痛平均VAS评分为8分,术后为1.4分,术前腰痛VAS评分为1.6分,术后为1分.结论 对椎间孔内型采用单侧后路椎板减压、髓核摘除间植骨融合内固定术;对椎间孔外型,采用横突间入路单纯摘除椎间盘术疗效满意.

  18. Herniación discal intravertebral cervical (Nódulo de Schmorl en un perro Cervical intravertebral disk herniation (Schmorl's node in a dog

    Directory of Open Access Journals (Sweden)

    M. Gómez

    2000-01-01

    Full Text Available Un perro de 2 años de edad, mestizo, ingresó a la Clínica del Hospital Veterinario de la Universidad Austral de Chile para evaluación por signología de parálisis. El examen general y especial del sistema nervioso reveló una tetraplejia aguda y atonía digestiva y vesical. Se observó además arreflexia y pérdida de la sensibilidad superficial y profunda desde la región cervical craneal. Un día después de su evaluación el perro murió por parálisis respiratoria, por tanto se procedió a realizar su necropsia. Este examen reveló una herniación patólogica del núcleo pulposo dentro de la vertebra C3. Este tipo de lesiones se conoce como nódulos de Schmorl, cuya presentación en caninos es rara. Se discute el posible mecanismo de formación de este tipo de lesiones en caninos así como en seres humanosA two year old male mixed dog was refered for evaluation of acute paralysis. On the initial examination, the dog had tetraplegia and vesical and anal atony. No spinal reflex and superficial or deep sensation were detected behind the craneal neck. Result of CBC and serum biochemical analysis were within references ranges. Two days after the onset of sign, due to severe respiratory distress the dog died of respiratory paralysis. The anatomopathologic study revealed a cervical medular compression due to pathologic herniation of the nucleus pulposus into the trabecular bone of the caudal endplate of the body vertebra of C3. The herniation of the disk material into the vertebral body are known as Schmorl`s node. The ocurrence of these disease in dogs is uncommon. This report also discussed the mechanism of Schmorl`s node in dogs as well as in human beings

  19. Biomechanical analysis of the camelid cervical intervertebral disc

    OpenAIRE

    Dean K. Stolworthy; R. Amy Fullwood; Tyler M. Merrell; Bridgewater, Laura C.; Anton E. Bowden

    2015-01-01

    Chronic low back pain (LBP) is a prevalent global problem, which is often correlated with degenerative disc disease. The development and use of good, relevant animal models of the spine may improve treatment options for this condition. While no animal model is capable of reproducing the exact biology, anatomy, and biomechanics of the human spine, the quality of a particular animal model increases with the number of shared characteristics that are relevant to the human condition. The purpose o...

  20. Transforaminal Percutaneous Endoscopic Discectomy for Lumbar Disc Herniation in Parkinson's Disease: A Case-Control Study

    Science.gov (United States)

    Giovannopoulou, Eirini; Charitoudis, George; Kazakos, Konstantinos

    2016-01-01

    Study Design A case-control study. Purpose To investigate the effectiveness of transforaminal percutaneous endoscopic discectomy (TPED) in Parkinson's disease (PD). Overview of Literature Patients with PD frequently suffer from radiculopathy and low back pain. Additionally, they demonstrate higher complication rates after open spine surgery. However, the clinical outcome of minimally invasive techniques for lumbar discectomy, such as TPED, have not been established for this population. Methods Patients diagnosed with lumbar disc hernia were divided into Group A (11 patients diagnosed with PD), and Group B (10 patients as the control, non-PD group). All patients underwent TPED. Indexes of visual analogue scale (VAS) for leg pain and Oswestry disability index (ODI) were assessed right before surgery and at six weeks, three months, six months and one year post-surgery. Results At the baseline visit, groups did not differ significantly with age (p=0.724), gender (p=0.835), level of operation (p=0.407), ODI (p=0.497) and VAS (p=0.772). Parkinson's patients had higher scores in ODI at every visit, but the outcome was statistically significant only at 3 months (p=0.004) and one year (p=0.007). Similarly, VAS measurements were higher at each time point, with the difference being significant at 3 (psurgery. At the end of a year of follow up, ODI was reduced by 49.6% (±16.7) in Group A and 59.2% (±8.0) in Group B (p=0.111), translating to a 79.5% (±13.0) and 91.5% (±4.1) average improvement in daily functionality (p=0.024). VAS was reduced by 59.1 mm (±11.8) in Group A and 62.2 mm (±7.4) in Group B (p=0.485), leading to an 85.3 % (±4.0) and 91.9% (±2.6) general improvement in leg pain (psurgery.

  1. Analysis and evaluation of MRI in diagnosis of the patients with lumbar disc herniation%椎间盘突出患者的 MRI 诊断评价分析

    Institute of Scientific and Technical Information of China (English)

    汪学松

    2015-01-01

    目的::探讨椎间盘突出患者的 MRI 诊断效果。方法:选择椎间盘突出症患者100例,对 MRI 诊断椎间盘突出患者的临床效果进行评估。结果:椎间盘突出患者在 MRI 影像表现上主要为椎间隙狭窄、椎间盘向后延伸及硬膜外脂肪线受压移位;MRI 诊断准确率为99.0%。结论:椎间盘突出的 MRI 影像学确诊率高,值得在临床上推广。%Objective: To study effect of MRI in diagnosis of intervertebral disc herniation patients. Methods: 100 cases of intervertebral disc herniation patients were selected, and the effects of MRI diagnosis were evaluated. Results: The MRI images of the intervertebral disc herniation patients showed mainly intervertebral space narrowing, backward extension of intervertebral disc, and compression shift of epidural fat line. The MRI diagnostic accuracy was 99. 0% . Conclusions: The MRI imaging in the diagnosis of intervertebral disc herniation has a high diagnosis rate, and is worth popularizing in clinic.

  2. Incidence and risk factors analysis of heterotopic ossification after cervical disc replacement

    Institute of Scientific and Technical Information of China (English)

    Qi Min; Chen Huajiang; Cao Peng; Tian Ye; Yuan Wen

    2014-01-01

    Background Cervical disc replacement (CDR) as a substitute for traditional fusion surgery has been widely used in treating degenerative cervical disc diseases.The objectives of this study were to assess the clinical and radiological findings for patients with heterotopic ossification (HO) following CDR and to detect the risk factors of HO after CDR.Methods A total of 125 patients with symptomatic cervical single-or double-level disc diseases,who underwent CDR procedure with Discover prosthesis in Department of Spine Surgery,Changzheng Orthopedics Hospital from March 2009 to March 2011,were enrolled in this retrospective study.Occurrence of HO was defined by the McAfee classification on cervical lateral X-rays in this study.Prosthesis vertebral ratio (PVR) was used to determine the matching degree between the cervical disc prosthesis and cervical vertebra.Logistic regression analyses were performed to determine the risk factors of HO.Variables evaluated for their association with HO occurrence included age,gender,high-intensity signal in spinal cord,preoperative range of motion (ROM),postoperative ROM,operation level number,and PVR.Results Mean follow-up time was (26.4±5.8) months.All the patients had significant symptoms and neurological function improvements during the follow-up period.The ROM of the operated segment from the preoperative period to the last follow-up was relatively well maintained.The rate of HO in this cohort of patients,who underwent Discover disc,was 27.92% per surgical level and 24.8% per patient by the last follow-up.There were 19 patients (19.79%) with HO in the single-level group while 12 patients (41.38%) in the double-level group.Conclusions We identified preoperative high-intensity signal in spinal cord,postoperative ROM of surgical level,number of operation level,and PVR as significant risk factors for postoperative HO occurrence.

  3. 微创术治疗腰椎间盘突出症研究现状%Update of research on minimally invasive treatment of lumbar disc herniation

    Institute of Scientific and Technical Information of China (English)

    李盛华; 周明旺; 李亚军; 梁雄勇

    2012-01-01

    以内窥镜技术和影像技术为基础的微创术治疗腰椎间盘突出症(lumbar disc herniation,LDH)进展迅速,它的开展减少了手术创伤和患者痛苦,比传统手术有很多优点,但适应证相对狭窄.尚不能取代传统手术,如何操作规范扩大适应证并解决腰椎重建等诸多方面是其今后突破的方向.现从微创治疗LDH的经皮穿刺技术和内镜、内窥镜技术两大方面综述其研究现状.%There has been rapid progress in endoscopy-and imaging technology-based minimally invasive surgery for the treatment of lumbar disc herniation (LDH). It is advategeous over conventional surgery in that it not only reduces surgical trauma but relieves sufferings of patients. However, endoscopy-and imaging technology-based minimally invasive surgery cannot completely replace traditional surgery at present because of its limited indications. How to expand the indications and solve the practical problem of lumbar reconstruction remains to be the direction of future breakthrough. This article is a summary of the progress and current situation of minimally invasive percutaneous and endoscopic techniques for the treatment of LDH.

  4. Systematic review of anterior interbody fusion techniques for single- and double-level cervical degenerative disc disease

    NARCIS (Netherlands)

    Jacobs, W.; Willems, P.C.P.H.; Kruyt, M.; Limbeek, J. van; Anderson, P.G.; Pavlov, P.; Bartels, R.H.M.A.; Oner, C.

    2011-01-01

    STUDY DESIGN: A systematic review of randomized controlled trials. OBJECTIVE: To determine which technique of anterior cervical interbody fusion (ACIF) gives the best outcome in patients with cervical degenerative disc disease. SUMMARY OF BACKGROUND DATA: The number of surgical techniques for decomp

  5. Comparison Of Percutaneous Laser Discectomy With Other Modalities For The Treatment Of Herniated Lumbar Discs And Cadaveric Studies Of Percutaneous Laser Discectomy

    Science.gov (United States)

    Johansen, W. E.; Smith, Chadwick F.; Vangsness, Thomas; McEleney, Emmett T.; Yamaguchi, Ken; Bales, Peter

    1987-03-01

    Current modalities for treating a herniated lumbar disc include standard open discectomy, microsurgical discectomy, chemonucleoysis and percutaneous discectomy. The Food and Drug Administration has not yet approved percutaneous laser discectomy for clinical investigation. The investigators believe that percutaneous laser discectomy combines the efficacy of both chemonucleoysis and percutaneous discectomy with the safety of both open standard discectomy and microsurgical discectomy. The investigators removed two lumbar discs from a cadaveric spine and weighed each of them. The two lumbar discs weighed in the range of 13.654 grams and 15.713 grams, respectively. The investigators initiated several series of 10 firing cycles from a surgical carbon dioxide laser system. In each firing cycle the surgical carbon dioxide laser system delivered a beam of light energy having an output power of 18.0 watts at pulse duration of 0.045 second at the rate of 15 pulses per second for a period of 6 seconds and vaporized approximately 325 milligrams of disc material. Based on the findings of other investigators reported in the literature relating to percutaneous discectomy the investigators postulated that 10 to 20 firing cycles are required to vaporize 30 to 40% (2.4 to 6.4 grams) of the disc material. The investigators initiated two series of 10 firing cycles in order to perform laser discectomy in a third lumbar disc of the cadaveric spine in situ. The investigators harvested and then bisected the laser-treated third lumbar disc for gross review. Their gross findings indicated a high probability of success For percutaneous laser discectomy.

  6. The effect of age on result of straight leg raising test in patients suffering lumbar disc herniation and sciatica

    Directory of Open Access Journals (Sweden)

    Homayoun Tabesh

    2015-01-01

    Full Text Available Background: Ninety percent of all people sometimes during their lives experience low back pain, and 30-40% develops radicular leg pain with the sciatica characteristics. Although for clinical diagnosis of lumbar disc herniation (LDH straight leg raising (SLR test in 85-90% of cases indicates LDH, but in our practice with LDH patients this test is frequently negative despite radicular leg pain due to LDH. Hence, we decided to evaluate this test in LDH in different age groups. Materials and Methods: All patients with leg pain referring to neurosurgery clinic were enrolled. Those with a history of pain other than sciatica excluded and SLR test and magnetic resonance imaging (MRI of the lumbosacral spine performed. The patients with negative MRI findings excluded and finally 269 patients with true sciatica and positive MRI were included. SLR tests were performed for different age groups. Results: Of 269 patients, 167 were male. The age range was 16-80 years. The most involved levels were L5-S1 (47% and L4-L5 (42%, respectively. The rate of positive SLR result, which was 100%, 87% and 82% for 10-19, 20-29 and 30-39 years age group respectively. With an increment of age, the rate of positive test regularly declined . The chance of positive SLR in men is 1.3 times the women (odds ratio [OR] 2.4; 95% confidence interval [CI] = 1.265-4.557; P = 0.007. Increasing the age has suppression effect in positivity of SLR so that for each 1-year the chance of SLR become 0.27 times less to become positive and this is also statically meaningful (OR = 0.271;95% CI = 0.188-0.391; P,0.001. The chance of positive SLR for patients under 60 is 5.4 folds more than patients above 60 years old (OR = 5.4; 95% CI = 4-8.3; P, 0.001. Conclusion: Age, sex (male, and disk level had statistically the effect on SLR positive test.

  7. Mid- to Long-Term Outcomes of Cervical Disc Arthroplasty versus Anterior Cervical Discectomy and Fusion for Treatment of Symptomatic Cervical Disc Disease: A Systematic Review and Meta-Analysis of Eight Prospective Randomized Controlled Trials.

    Directory of Open Access Journals (Sweden)

    Yan Hu

    Full Text Available This study aimed to investigate the mid- to long-term outcomes of cervical disc arthroplasty (CDA versus anterior cervical discectomy and fusion (ACDF for the treatment of 1-level or 2-level symptomatic cervical disc disease.Medline, Embase, and the Cochrane Central Register of Controlled Trials databases were searched to identify relevant randomized controlled trials that reported mid- to long-term outcomes (at least 48 months of CDA versus ACDF. All data were analyzed by Review Manager 5.3 software. The relative risk (RR and 95% confidence intervals (CIs were calculated for dichotomous variables. The weighted mean difference (WMD and 95%CIs were calculated for continuous variables. A random effect model was used for heterogeneous data; otherwise, a fixed effect model was used.Eight prospective randomized controlled trials (RCTs were retrieved in this meta-analysis, including 1317 and 1051 patients in CDA and ACDF groups, respectively. Patients after an ACDF had a significantly lower rate of follow-up than that after CDA. Pooled analysis showed patients in CDA group achieved significantly higher rates of overall success, Neck Disability Index (NDI success, neurological success and significantly lower rates of implant/surgery-related serious adverse events and secondary procedure compared with that in ACDF group. The long-term functional outcomes (NDI, Visual Analog Scale (VAS neck and arm pain scores, the Short Form 36 Health Survey physical component score (SF-36 PCS, patient satisfaction and recommendation, and the incidence of superior adjacent segment degeneration also favored patients in CDA group with statistical difference. Regarding inferior adjacent segment degeneration, patients in CDA group had a lower rate without statistical significance.This meta-analysis showed that cervical disc arthroplasty was superior over anterior discectomy and fusion for the treatment of symptomatic cervical disc disease in terms of overall success, NDI

  8. Clinical and Radiological Comparison of Femur and Fibular Allografts for the Treatment of Cervical Degenerative Disc Diseases

    OpenAIRE

    Oh, Hyeong-Seok; Shim, Chan Shik; Kim, Jin-Sung; Lee, Sang-Ho

    2013-01-01

    Objective This consecutive retrospective study was designed to analyze and to compare the efficacy and outcomes of anterior cervical discectomy and fusion (ACDF) using a fibular and femur allograft with anterior cervical plating. Methods A total of 88 consecutive patients suffering from cervical degenerative disc disease (DDD) who were treated with ACDF from September 2007 to August 2010 were enrolled in this study. Thirty-seven patients (58 segments) underwent anterior interbody fusion with ...

  9. Experience of Treatment for Lumbar Disc Herniation by Caudal Injection%骶管注射治疗腰椎间盘突出症的体会

    Institute of Scientific and Technical Information of China (English)

    梁涛

    2014-01-01

    目的:探讨骶管注射治疗腰椎间盘突出症的临床效果和体会。方法:回顾性分析我院收治的160例椎间盘突出的病人的临床资料,采用骶管注射治疗腰4~5及腰5~骶1椎间盘突出。结果:160例患者中有效130例,好转16例,总有效率为91.25%;无效者14例;复发10例,占6.85%,其中有6例经再次骶管注射而痊愈,另外4例则改为手术治疗。结论:骶管注射治疗腰椎间盘突出症易于操作,且疗效显著,安全可靠,费用低,无明显的并发症,故很值得临床使用和推广。%Objective:To investigate the caudal injection for lumbar disc herniation clinical results and experience .Methods:A retro-spective analysis of 160 cases in our hospital clinical data disc herniation , lumbar caudal injection using 4 to 5 lumbar 5 sacral 1 disc.Re-sults:160 patients, 130 cases effective, 16 cases improved, the total effective rate was 91.25%;ineffective in 14 cases;recurrence in 10 cases, accounting for 6.85%, of which 6 cases were cured again caudal injection while the other four cases the to surgery .Conclusion:caudal injection for lumbar disc herniation is easy to operate , and the effect is significant , safe, reliable, low cost, without significant complications, so it is worthy of clinical use and promotion .

  10. EFFECTIVENESS OF SPINAL MOBILIZATION WITH LEG MOVEMENT (SMWLM IN PATIENTS WITH LUMBAR RADICULOPATHY (L5 / S1 NERVE ROOT IN LUMBAR DISC HERNIATION

    Directory of Open Access Journals (Sweden)

    Sahiba Yadav

    2014-10-01

    Full Text Available Background: Various manual therapy techniques are known to treat discogenic pain. Research is limited and controversial in the effectiveness of manual therapy for treatment of lumbar radiculopathy due to lumbar disc disease. In manual therapy, Mulligan has described spinal mobilisation with leg movement technique, for improvement in lumbar lesion resulting in pain and other signs below knee. Purpose of the study: To find out if Mulligan’s Spinal Mobilisation with Leg Movement technique (SMWLM in conjunction with conventional treatment is better than conventional treatment alone in improving leg pain intensity (VAS, localization of leg pain (body diagram by Donelson, back specific disability (RMQ in patients with lumbar radiculopathy (L5/ S1 nerve root in lumbar disc herniation. Methods: The study is a randomized controlled trial performed on 30 patients with lumbar radiculopathy. Both the groups received back extension exercises, hot pack, precautions and ergonomic advice. The experimental group received SMWLM technique in addition to the conventional treatment. Outcomes included leg pain intensity, Roland Morris Questionnaire and body diagram by Donelson. Results: There was significant improvement in VAS (p=0.000, body diagram (p=0.000 for experimental group and p=0.003 for conventional group and Roland Morris Questionnaire score (p=0.000 within the groups. Between group analysis showed significant improvement in VAS (p=0.000, body diagram score (p=0.000. Although there was significant improvement in Roland Morris Questionnaire score within the groups but there no significant difference between the group (p=0.070. Conclusion: Spinal Mobilization with Leg Movement technique in addition to conventional physical therapy produced significant improvement in leg pain intensity, location of pain and back specific disability in patients with lumbar radiculopathy in lumbar disc herniation.

  11. Advantage of transforaminal endoscopic surgery for lumbar disc herniation%椎间孔镜手术治疗腰椎间盘突出症的优势

    Institute of Scientific and Technical Information of China (English)

    鹿洪辉; 唐佩福

    2014-01-01

    目前,腰椎间盘突出症的治疗逐渐呈现微创化趋势,尤其是自从德国医生Hoogland发明TESSYS技术以来,腰椎间盘突出症的微创治疗更是有了革命性的进步。我们引进该技术后,总结经验,逐渐取得了与Hoogland医生相似的疗效。同时,我们在镜下发现腰椎间盘突出症的病理表现分为多种,根据这种镜下分型指导治疗能取得更好的效果。此外,我们还拓展了TESSYS技术的适应证。%At present,there is a minimally invasive trend in the treatment of lumbar disc herniation gradually, especially since the German doctor Hoogland invent the TESSYS technology, it brings a revolutionary progress in the minimally invasive treatment of lumbar disc herniation.We gradually sum up experience and achieve similar effect as Dr.Hoogland after introducing the technology.At the same time,we find that there are multiple pathological manifestation of lumbar protrusion of the intervertebral disc,it can achieve better results according to the endoscopic classification. In addition,we also expand the indications of TESSYS technology.

  12. Percutaneous endoscopic cervical discectomy using working channel endoscopes.

    Science.gov (United States)

    Ahn, Yong

    2016-06-01

    Percutaneous endoscopic cervical discectomy has evolved as an efficient, minimally invasive spine surgery for cervical disc herniation or radiculopathy. The development of the working channel endoscope makes definitive decompression surgery through a percutaneous approach feasible. There are two methods of approach to target the pathology: anterior and posterior approach. The approach can be determined according to the zone of pathology or the surgeon's preference. The most significant benefits of this endoscopic surgical technique are minimal access tissue trauma and early recovery from the intervention. However, this technique is still evolving and have a steep learning curve. Extensive development of surgical technique and working channel endoscopes will enable us to treat cervical disc herniation more practically. The objective of this review is to describe the cutting-edge techniques of endoscopic surgery in the cervical spine and to discuss the pros and cons of these minimally invasive surgical techniques. PMID:27086505

  13. Experiences and lessons of surgery for lumbar disc herniation%腰椎间盘突出症手术治疗的经验与教训

    Institute of Scientific and Technical Information of China (English)

    闫剑平; 孔亚军; 张永; 刘海东

    2012-01-01

    目的 探讨手术治疗腰椎间盘突出症的临床疗效,总结经验与教训.方法 回顾性分析2007年3月-2011年3月在保定市第三中心医院采用外科手术治疗的33例腰椎间盘突出患者的临床资料,并以同期采用保守治疗的33例患者为对照组,比较2组患者的治疗效果.结果 根据T.Nankna疗效评定标准判定,观察组33例,疗效优良者30例,占90.91%;可2例,差1例,二者占9.09%;其中术中髓核切除不彻底1例,椎管狭窄未完全解除2例.观察组有效率明显高于对照组,组间比较差异具有统计学意义(P<0.05).结论 手术治疗腰椎间盘突出症疗效确切,并发症发生率低,值得临床推广应用.%[Objective]To explore the clinical efficacy of surgical treatment for lumbar disc herniation, summarize experiences and lessons. [Methods] The clinical data of 33 lumbar disc herniation patients who were treated by surgery in the Third Central Hospital of Baoding City from March 2007 to March 2011 were studied with a retrospective analysis, the control group included 33 patients who were treated by conservative treatment, and the efficacy of two groups were compared. [Results]The efficacy was valuated according to the T. Nankna evaluation standard. Among 33 cases of the observation group, 30 cases had good efficacy, which accounted for 90.91%. In the remaining 3 cases (9.1% ) 2 cases had moderate efficacy, and 1 case had poor efficacy, removal of the nucleus pulposus is not complete during surgery in 1 case, spinal stenosis is not completely removed in 2 cases. The effective rate of the observation group was significantly higher than that of the control group (P < 0.05). [Conclusion] The surgical treatment for lumbar disc herniation has obvious curative effect, low incidence of complications, which is worth popularizing.

  14. 手术治疗腰椎间盘突出症的临床研究%Clinical Study on Surgical Treatment of Lumbar Intervertebral Disc Herniation

    Institute of Scientific and Technical Information of China (English)

    杨国玉

    2015-01-01

    Objective Scalpel surgery treatment approach and its effect to patients of lumbar intervertebral disc herniation are to be observed. Methods Choose 38 patients of lumbar intervertebral disc herniation who are treated in hospital from April 2013 to July 2014 and separate them into two groups at random;21 patients in study group are given scalpel surgery treatment,while 17 patients in control group are given conventional acupuncture treatment; and then compare treatment effects between two groups. Results Treatment efficacy in study group is up to 90.48%,while treatment efficacy in control group is 76.47%;there is a treatment differential between two groups,and such a differential has statistic value(P<0.05). Conclusion Scalpel surgery treatment is of efficiency in treatment of lumbar intervertebral disc herniation;it is conducive to promoting patients’lumbar function,relieving surgery pain and improving patients’quality of life;thus,such an effective approach is quite worthwhile to be promoted widespread.%目的:探究腰椎间盘突出症患者采用小针刀手手术治疗的方法和效果。方法选取2013年4月~2014年7月收治的38例腰椎间盘突出症患者进行治疗,随机分组,实验组21例患者选择小针刀的手术治疗,对照组17例患者采用传统的针刺治疗,对比患者的治疗效果。结果实验组患者治疗有效率为90.48%,对照组患者治疗有效率为76.47%。两组患者的治疗效果差异较为显著,有统计学意义(P<0.05)。结论腰椎间盘突出症患者采用小针刀的手术治疗,可明显改善腰椎功能,缓解疼痛,提高生活质量,效果显著,值得推荐。

  15. Decompression alone versus decompression with instrumented fusion for young patients with single-level lumbar disc herniation:a short-term prospective comparative study

    Institute of Scientific and Technical Information of China (English)

    Sun Zhuoran; Li Weishi; Chen Zhongqiang; Guo Zhaoqing; Qi Qiang; Zeng Yan; Sun Chuiguo

    2014-01-01

    Background For young patients,the surgical method for lumbar disc herniation remains controversial.The aim of this study was to prospectively determine the short-term clinical outcome after surgery for young patients with lumbar disc herniation.Methods In this prospective comparative study between April 2010 and August 2011,a total of 80 patients underwent primary surgery at a single level for lumbar disc herniation.The patients were divided into two groups:decompression alone and decompression with instrumented fusion.An independent examiner clinically evaluated the patients at preoperation and at 1,3,6,and 12 months after surgery.The patients filled out the instruments for back and leg pain using a Visual Analog Scale (VAS),Oswestry Low Back Pain Disability Questionnaire (ODI),and Japanese Orthopaedic Association (JOA) scores.The differences between the two groups were analyzed.Results The mean age of all the patients at the time of surgery was 33.7 years.Of the 80 patients,38 patients underwent decompression alone and 42 patients underwent posterior lumbar interbody fusion.Increasing complexity of surgery was associated with a longer surgery time,greater blood loss,and a longer hospital stay after surgery.Both methods of surgery independently improved outcomes compared with baseline status based on VAS,ODI,and JOA scores (P <0.05),and no significant differences were found between the two groups at most of the measuring points in time,although patients with decompression alone had a higher JOA score (P=0.016) and higher JOA recovery rate (P=0.010) at the 3-month follow-up.Conclusions The short-term results of our study showed that both methods of surgery obtained effective clinical outcomes,but decompression alone had some advantages (shorter surgery time,less blood loss,shorter hospital stay,and lower cost) compared with decompression with instrumented fusion.Young patients with decompression alone could achieve great physical function earlier.

  16. Cervical Spine Disc Deformation During In Vivo Three-Dimensional Head Movements.

    Science.gov (United States)

    Anderst, William; Donaldson, William; Lee, Joon; Kang, James

    2016-05-01

    Although substantial research demonstrates that intervertebral disc cells respond to mechanical signals, little research has been done to characterize the in vivo mechanical environment in the disc tissue. The objective of this study was to estimate cervical disc strain during three-dimensional head movements. Twenty-nine young healthy adults performed full range of motion flexion/extension, lateral bending, and axial rotation of the head within a biplane radiography system. Three-dimensional vertebral kinematics were determined using a validated model-based tracking technique. A computational model used these kinematics to estimate subject-specific intervertebral disc deformation (C3-4 to C6-7). Peak compression, distraction and shear strains were calculated for each movement, disc level, and disc region. Peak compression strain and peak shear strain were highest during flexion/extension (mean ± 95% confidence interval) (32 ± 3 and 86 ± 8%, respectively), while peak distraction strain was highest during lateral bending (57 ± 5%). Peak compression strain occurred at C4-5 (33 ± 4%), while peak distraction and shear strain occurred at C3-4 (54 ± 8 and 83 ± 11%, respectively). Peak compression, distraction, and shear strains all occurred in the posterior-lateral annulus (48 ± 4, 80 ± 8, and 109 ± 12%, respectively). These peak strain values may serve as boundary conditions for in vitro loading paradigms that aim to assess the biologic response to physiologic disc deformations. PMID:26271522

  17. Imaging techniques for diagnosis after surgery for degenerative disc disease

    International Nuclear Information System (INIS)

    The magnetic resonance imaging findings recorded in patients after surgery for degenerative disc disease in the lumbar and cervical spine are discussed in comparison with conventional radiographs and computed tomography findings. In the lumbar spine normal postoperative findings in the immediate postoperative period can be demonstrated by MR imaging. Contrast-enhanced MR imaging can differentiate disc herniation from postoperative scar formation with a greater degree of confidence than other imaging modalities. MR imaging improves differentiation between other causes of failed back syndrome such as postoperative hematoma and infection, lateral spinal stenosis and arachnoiditis. In the cervical spine types of operative approaches, the appearance of bony stenosis and disc herniations by MR imaging are discussed. Computer tomography still has a role in the assessment of osseous complications such as central or foraminal stenosis. (orig.)

  18. The effect of infliximab, a monoclonal antibody against TNF-alpha, on disc herniation resorption - A randomized controlled study

    NARCIS (Netherlands)

    Autio, Reijo A.; Karppinen, Jaro; Niinimaki, Jaakko; Ojala, Risto; Veeger, Nic; Korhonen, Timo; Hurri, Heikki; Tervonen, Osmo

    2006-01-01

    Study Design. Randomized, controlled study. Objective. To evaluate the effect of infliximab on herniated nucleus pulposus (HNP) resorption. Summary of Background Data. Although the effects of tumor necrosis factor alpha (TNF-alpha) on HNP resorption are not fully understood, TNF-alpha appears to be

  19. Cervical spine degenerative changes (narrowed intervertebral disc spaces and osteophytes) in coal miners

    International Nuclear Information System (INIS)

    A series of 685 x-rays films of the cervical spine obtained in coal miners was analyzed to explore the occurrence of narrowed disc spaces and osteophytes in this occupational group, and to examine the association of x-rays changes with age, duration of employment, and duration of occupational exposure to hand-arm vibration. All data were extracted from individual medical files of coal miners examined for suspected hand-arm vibration-related disorders in 1989-1999 at the Occupational Medicine Center in Katowice. The narrowed intervertebral disc spaces were found in 188 coal miners (26.9%) and osteophytes in 332 coal miners (47.5%). The occurrence of degenerative changes in coal miners was similar to that observed in a small group of 68 blue-collar workers (no exposure to hand-arm vibration) employed in the coal industry. Univariate comparisons showed that intervertebral disc spaces and osteophytes were more frequent among older subjects and among subjects with longer duration of employment. The results of logistic regression analysis confirmed statistically significant effect of age, but not of other factors included in the model. When both x-ray changes were grouped together (a combined dependent variable) age remained the only statistically significant explanatory variable. The findings do not support the view that the examined degenerative changes in cervical spine are more prevalent in coal miners and depend on duration of physical work or local exposure to hand-arm vibration in this occupational group. (author)

  20. Application of CT guided ozone therapy in the treatment of lumbar disc herniation complicated with acute muscle fiber%CT引导臭氧治疗椎间盘突出合并急性肌纤维炎的临床应用

    Institute of Scientific and Technical Information of China (English)

    彭浩; 彭丽静; 胡效坤; 李子祥

    2016-01-01

    目的:探讨CT引导臭氧( O3)消融术治疗椎间盘突出症合并急性肌纤维炎的适应症、消融方法,并判断其疗效。方法112例椎间盘突出症合并急性肌纤维炎行CT引导下O3消融治疗,其中颈椎间盘11例,腰椎间盘101例。结果本组病例随访1~12月。近期疗效急性疼痛消失65例,疼痛级别降低1~2级47例,有效率100%。远期疗效明显82例,有效26例,无效4例,总有效率达96.4%。无出现明显的并发症。结论 CT引导O3消融术治疗椎间盘突出症合并急性肌纤维炎效果明显,操作简便,定位准确,严格掌握适应症及消融方法对提高短期疗效及长期疗效有着重要的意义。%Objective To investigate the indications and ablation methods of CT guided ozone therapy in the treatment of lum -bar disc herniation with acute muscle fiber , and to judge the curative effect .Methods CT guided ozone therapy was performed in 112 patients with lumbar disc herniation complicated with acute muscle fiber .Among them , 11 cases of cervical intervertebral disc and 101 cases of lumbar intervertebral disc were treated .Results The patients were followed up for 1~12 months.The recent efficacy of acute pain disappeared in 65 cases, the pain level of 47 cases lower to 1~2, the effective rate was 100%.Long term curative effect was obvious in 82 cases, effective in 26 cases, ineffective in 4 cases, the total effective rate was 96.4%.There were no obvious complications .Conclusion CT guided ozone treatment of intervertebral disc herniation with acute muscle inflam -mation effect obviously has the advantages of simple operation , accurate positioning .Strictly grasping the indications and ablation method has important significance has important significanle in impruving the short -term and lorg-oerm curative effect .

  1. p38 mitogen-activated protein kinase inhibition modulates nucleus pulposus cell apoptosis in spontaneous resorption of herniated intervertebral discs: An experimental study in rats.

    Science.gov (United States)

    Zhu, Yu; Liu, Jin-Tao; Yang, Li-Yan; Du, Wen-Pei; Li, Xiao-Chun; Qian, Xiang; Yu, Peng-Fei; Liu, Jian-Wen; Jiang, Hong

    2016-05-01

    The present study was performed to investigate the role of p38 mitogen‑activated protein kinase (MAPK) in the resorption of herniated intervertebral discs in 30 rats. In the non‑contained and p38 MAPK inhibition (p38i) groups, two coccygeal intervertebral discs (IVDs) were removed and wounded prior to relocation into the subcutaneous space of the skin of the back. In the contained group, the cartilage endplates maintained their integrity. Furthermore, SB203580 was injected intraperitoneally into the p38i group, whereas saline was injected into the other two groups. In the non‑contained group, the weight of the relocated IVDs decreased to a greater extent over time when compared with the contained and p38i groups. Phosphorylated p38, tumor necrosis factor‑α, and interleukin‑1β were observed to exhibit higher expression levels in the non‑contained group compared with the contained and p38i groups, at weeks 1 and 4 post‑surgery. The expression level of caspase‑3 and the densities of apoptotic disc cells were significantly higher in the non‑contained group compared with the contained and p38i groups at 4 weeks post‑surgery. In conclusion, p38 MAPK induces apoptosis in IVDs, while also accelerating the resorption of the relocated IVDs. Thus, p38 MAPK may be important in spontaneous resorption of IVDs. PMID:27035219

  2. Clinical application of dermatomal somatosensory evoked potential in pre- and post-percutaneous lumbar discectomy in patients with lumbosacral disc herniation

    International Nuclear Information System (INIS)

    Objective: To study the changes of dermatomal somatosensory evoked potential (DSEP) in patients with lumbosacral disc herniation (LDH) before and after percutaneous lumbar discectomy(PLD). Methods: L5 and S1 DSEP was recorded from 31 patients with radiculopathy caused by LDH before and after PLD. Results: The DSEP from L5 and/or S1 dermatomes was abnormal in 28 cases (90.3%) before PLD and in only 5 cases (16.1%) after PLD. The abnormality of DSEP from L5 dermatome was detected mainly in patients with L4-5 LDH, and the abnormality of DSEP from S1 dermatome was demonstrated mainly in patients with L5-S1 LDH. Conclusion: The DSEP from L5 and S1 dermatomes was a sensitive method to diagnose the radiculopathy caused by LDH, and it was helpful in evaluating the effect of the PLD

  3. 前路减压植骨融合内固定术治疗颈椎间盘突出症的疗效分析%Analysis of anterior cervical decompression and autograft fusion combined with internal fixation in the treatment of cervical disc protrusion

    Institute of Scientific and Technical Information of China (English)

    杨朝晖; 吴险峰; 邹磊

    2013-01-01

    Objective To explore the clinical outcome of treatment of the anterior cervical discertomy and fusion with rigid plate fixation for cervical disc herniation. Methods Twenty five patients with cervical disc herniation had been treated by multilevel anterior cervical discectomy and fusion with rigid plate fixation from Oct 2008 to Oct 2011. Results All patients had been followed - up for 8 to 24 months ( I I months in average ). Bone union was achieved in all patients. All cases were scored after operation to assess the curative effect. There were 15 cases that belonged to the excellent, 8 to the good, 2 to the fair and 0 to the poor based on the Jndet criteria. The good and excellence rate was 92% in patients. Conclusion The treatment of traumatic cervical disc protrusion with anterior cervical decompression and bone autograft fusion combined with internal fixation has satisfactory clinical effect with fewer complications.%目的 探讨前路减压植骨融合钢板内固定治疗颈椎间盘突出症的疗效.方法 对收治的25例颈椎椎间盘突出症患者行颈椎前路减压,取自体髂骨植骨融合内固定治疗.结果 本组患者均获得随访,随访时间8~24个月,平均11个月.植骨均达到骨性愈合,无骨不连发生.25例患者神经功能获得改善,根据JOA神经功能评定标准,优15例,良8例,可2例,差0例,优良率92%.结论 颈椎前路减压、椎间盘切除、植骨融合钢板内固定是治疗颈椎间盘突出症的一种有效方法.

  4. Interobserver agreement on MRI evaluation of patients with cervical radiculopathy

    International Nuclear Information System (INIS)

    Aim: To evaluate the interobserver agreement on magnetic resonance imaging (MRI) evaluation of herniated discs, spondylotic neuroforaminal stenosis, and root compression in patients with recent onset cervical radiculopathy and in addition, to assess the added value of disclosure of clinical information to interobserver agreement. Materials and methods: The MRI images of 82 patients with less than 1 month of symptoms and signs of cervical radiculopathy were evaluated independently by two neuroradiologists who were unaware of clinical findings. MRI analysis was repeated after disclosure of clinical information. Interobserver agreement was calculated using kappa statistics. Results: The kappa score for evaluation of herniated discs and of spondylotic foramen stenosis was 0.59 and 0.63, respectively. A kappa score of 0.67 was found for the presence of root compression. After disclosure of clinical information kappa scores increased slightly: from 0.59 to 0.62 for the detection of herniated discs, from 0.63 to 0.66 for spondylotic foramen stenosis, and from 0.67 to 0.76 for root compression. Conclusion: Interobserver reliability of MRI evaluation in patients with cervical radiculopathy was substantial for root compression, with or without clinical information. Agreement on the cause of the compression, i.e., herniated disc or spondylotic foraminal stenosis, was lower.

  5. Interobserver agreement on MRI evaluation of patients with cervical radiculopathy

    Energy Technology Data Exchange (ETDEWEB)

    Kuijper, B., E-mail: kuijperb@maasstadziekenhuis.n [Department of Neurology, Medical Centre Haaglanden, The Hague (Netherlands); Department of Neurology, Maasstad Hospital, Rotterdam (Netherlands); Beelen, A. [Department of Rehabilitation, Academic Medical Centre, Amsterdam (Netherlands); Kallen, B.F. van der [Department of Neurology, Medical Centre Haaglanden, The Hague (Netherlands); Department of Radiology, Medical Centre Haaglanden, The Hague (Netherlands); Nollet, F. [Department of Rehabilitation, Academic Medical Centre, Amsterdam (Netherlands); Lycklama a Nijeholt, G.J. [Department of Neurology, Medical Centre Haaglanden, The Hague (Netherlands); Department of Radiology, Medical Centre Haaglanden, The Hague (Netherlands); Visser, M. de [Department of Neurology, Academic Medical Centre, Amsterdam (Netherlands); Tans, J. Th.J. [Department of Neurology, Medical Centre Haaglanden, The Hague (Netherlands)

    2011-01-15

    Aim: To evaluate the interobserver agreement on magnetic resonance imaging (MRI) evaluation of herniated discs, spondylotic neuroforaminal stenosis, and root compression in patients with recent onset cervical radiculopathy and in addition, to assess the added value of disclosure of clinical information to interobserver agreement. Materials and methods: The MRI images of 82 patients with less than 1 month of symptoms and signs of cervical radiculopathy were evaluated independently by two neuroradiologists who were unaware of clinical findings. MRI analysis was repeated after disclosure of clinical information. Interobserver agreement was calculated using kappa statistics. Results: The kappa score for evaluation of herniated discs and of spondylotic foramen stenosis was 0.59 and 0.63, respectively. A kappa score of 0.67 was found for the presence of root compression. After disclosure of clinical information kappa scores increased slightly: from 0.59 to 0.62 for the detection of herniated discs, from 0.63 to 0.66 for spondylotic foramen stenosis, and from 0.67 to 0.76 for root compression. Conclusion: Interobserver reliability of MRI evaluation in patients with cervical radiculopathy was substantial for root compression, with or without clinical information. Agreement on the cause of the compression, i.e., herniated disc or spondylotic foraminal stenosis, was lower.

  6. Diffusion-weighted imaging for pretreatment evaluation and prediction of treatment effect in patients undergoing CT-guided injection for lumbar disc herniation

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    Niu, Xiang Ke [Dept. of Radiology, Affiliated Hospital of Chengdu University, Chengdu (China); Bhetuwal, Anup; Yang, Han Feng [Schuan Key Laboratory of Medical Imaging and Dept. of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong (China)

    2015-08-15

    To determine whether a change in apparent diffusion coefficient (ADC) value could predict early response to CT-guided Oxygen-Ozone (O{sub 2}-O{sub 3}) injection therapy in patients with unilateral mono-radiculopathy due to lumbar disc herniation. A total of 52 patients with unilateral mono-radiculopathy received a single intradiscal (3 mL) and periganglionic (5 mL) injection of an O{sub 2}-O{sub 3} mixture. An ADC index of the involved side to the intact side was calculated using the following formula: pre-treatment ADC index = ([ADC involved side - ADC intact side] / ADC intact side) x 100. We analyzed the relationship between the pre-treatment Oswestry Disability Index (ODI) and the ADC index. In addition, the correlation between ODI recovery ratio and ADC index was investigated. The sensitivity and specificity of the ADC index for predicting response in O{sub 2}-O{sub 3} therapy was determined. Oswestry Disability Index and the ADC index was not significantly correlated (r = -0.125, p = 0.093). The ADC index and ODI recovery ratio was significantly correlated (r = 0.819, p < 0.001). When using 7.10 as the cut-off value, the ADC index obtained a sensitivity of 86.3% and a specificity of 82.9% for predicting successful response to therapy around the first month of follow-up. This preliminary study demonstrates that the patients with decreased ADC index tend to show poor improvement of clinical symptoms. The ADC index may be a useful indicator to predict early response to CT-guided O{sub 2}-O{sub 3} injection therapy in patients with unilateral mono-radiculopathy due to lumbar disc herniation.

  7. Analysis and treatment of surgical complications after percutaneous transforaminal endoscopic discectomy for treating lumbar disc herniation and lumbar intervertebral foraminal stenosis

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    Guang HAN

    2016-04-01

    Full Text Available Objective To analyze the causes of surgical complications after treatment of lumbar disc herniation (LDH and lumbar intervertebral foraminal stenosis by percutaneous transforaminal endoscopic discectomy (PTED.  Methods From December 2009 to December 2014, 286 patients with LDH (N = 201 and lumbar intervertebral foraminal stenosis (N = 85 were confirmed by X-ray, CT or MRI and treated by PTED in our hospital. Visual Analogue Scale (VAS was used to evaluate the degree of pain in each paitent before and after operation. The curative effect was evaluated by Macnab score. Surgical complications were recorded to find out the causes and methods to prevent them.  Results All cases were followed up for 3 months, and the VAS score decreased significantly compared with preoperation [1.00 (0.00, 1.05 vs 8.50 (7.75, 9.25; Z = 2.825, P = 0.050]. According to Macnab score, the rate of excellent and good functional recovery was 95.45% (273/286. Procedure-related complications included nerve injury in 8 cases (2.80%, hemorrhage at the operation site and hematoma formation around nerve root in 6 cases (2.10%, rupture of dural sac in one case (0.35%, muscle cramps in 3 cases (1.05%, surgical infection in one case (0.35%, postoperative recurrence in 4 cases (1.40%. All patients with complications were cured after symptomatic treatment. Conclusions The overall effect of percutaneous transforaminal endoscopic discectomy for treating lumbar disc herniation and lumbar intervertebral foraminal stenosis is satisfactory, which has a low incidence rate of postoperative complications. Some tips can effectively reduce the rate of surgical complications such as preoperative evaluation, precise performance, careful hemostasis, shortening the operation time and postoperatively symptomatic treatment, etc. DOI: 10.3969/j.issn.1672-6731.2016.04.007

  8. Diffusion-weighted imaging for pretreatment evaluation and prediction of treatment effect in patients undergoing CT-guided injection for lumbar disc herniation

    International Nuclear Information System (INIS)

    To determine whether a change in apparent diffusion coefficient (ADC) value could predict early response to CT-guided Oxygen-Ozone (O2-O3) injection therapy in patients with unilateral mono-radiculopathy due to lumbar disc herniation. A total of 52 patients with unilateral mono-radiculopathy received a single intradiscal (3 mL) and periganglionic (5 mL) injection of an O2-O3 mixture. An ADC index of the involved side to the intact side was calculated using the following formula: pre-treatment ADC index = ([ADC involved side - ADC intact side] / ADC intact side) x 100. We analyzed the relationship between the pre-treatment Oswestry Disability Index (ODI) and the ADC index. In addition, the correlation between ODI recovery ratio and ADC index was investigated. The sensitivity and specificity of the ADC index for predicting response in O2-O3 therapy was determined. Oswestry Disability Index and the ADC index was not significantly correlated (r = -0.125, p = 0.093). The ADC index and ODI recovery ratio was significantly correlated (r = 0.819, p < 0.001). When using 7.10 as the cut-off value, the ADC index obtained a sensitivity of 86.3% and a specificity of 82.9% for predicting successful response to therapy around the first month of follow-up. This preliminary study demonstrates that the patients with decreased ADC index tend to show poor improvement of clinical symptoms. The ADC index may be a useful indicator to predict early response to CT-guided O2-O3 injection therapy in patients with unilateral mono-radiculopathy due to lumbar disc herniation

  9. The treatment of lumbar disc herniation: a comparison between percutaneous lumbar diskectomy combined with ozone and percutaneous lumbar diskectomy combined with collagenase

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    Objective: To evaluate the short-term curative effect and the incidence of postoperative adverse events of percutaneous lumbar diskectomy (PLD) combined with ozone or PLD combined with collagenase in treating lumbar disk herniation. Methods: A total of 223 patients with lumbar disk herniation were enrolled in this study. Patients in the study group (n=108) were treated with PLD combined with ozone, while patients in the control group (n=115) were treated with PLD combined with collagenase. The short-term effectiveness and the incidence of postoperative adverse events were documented. The results were analyzed and compared between the two groups. Results: In the study group, the excellent and good therapeutic results were achieved in 85.18% of the patients (n=92) and the occurrence of adverse events was 5.56%, while in the control group, the excellent and good therapeutic results were achieved in 80.00% of the patients (n=92) and the occurrence of adverse events was 13.04%. No significant difference in the short-term effectiveness existed between the two groups (Pearson Chi-Square =1.038, P=0.308). And the difference in the occurrence of postoperative adverse events was not significant between the two groups (Pearson Chi-Square =3.661, P=0.056). No disc infection occurred in the study group. Conclusion: The short-term curative effect of PLD combined with ozone is not significantly different from that of PLD combined with collagenase. In order to maintain decompression within the disc for a long period and to reduce the incidence of postoperative adverse events PLD combined with ozone ablation is an effective complementary treatment. (authors)

  10. Comparison of simple discectomy and instrumented posterior lumbar interbody fusion for treatment of lumbar disc herniation combined with Modic endplate changes

    Institute of Scientific and Technical Information of China (English)

    Cao Peng; Chen Zhe; Zheng Yuehuan; Wang Yuren; Jiang Leisheng; Yang Yaoqi; Zhuang Chengyu

    2014-01-01

    Background The purpose of this retrospective study was to compare the surgical outcomes of simple discectomy and instrumented posterior lumbar interbody fusion (iPLIF) in patients with lumbar disc herniation and Modic endplate changes.Our hypothesis was that iPLIF could provide better outcome for patients with refractory lumbar disc herniation and Modic changes (LDH-MC).Methods Ninety-one patients with single-segment LDH-MC were recruited.All patients experienced low back pain as well as radicular leg pain,and low back pain was more severe than leg pain.Forty-seven patients were treated with discectomy and 44 were treated with iPLIE The outcomes of both low back pain and radicular leg pain using visual analogue scale (VAS) as well as the clinical outcome related to low back pain using Japanese Orthopaedic Association (JOA) score were assessed before and 18 months after surgery,respectively.Results Both low back and leg pain were significantly improved 18 months after simple discectomy and iPLIE Compared to patients undergoing simple discectomy,low back pain was significantly reduced in patients undergoing iPLIE but there was no significant difference in leg pain between two groups.Solid fusion was achieved in all patients who underwent iPLIF.Conclusions In patients with LDH-MC,iPLIF can yield significantly superior outcome on the relief of low back pain compared to simple discectomy.Simple discectomy can relieve radicular leg pain as efficient as iPLIE Accordingly,iPLIF seems to be a reliable treatment for patients with LDH-MC and predominant low back pain.

  11. Autotraction in lumbar disc herniation with CT examination before and after treatment, showing no change in appearance of the herniated tissue

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    Ljunggren, A.E.; Eldvik, O.P.

    1986-09-01

    Fifteen hospitalized patients who were candidates for lumbar disc surgery, were examined by CT before and after one week with autotraction therapy. Seven patients had to be operated upon, wheras complete or considerable reduction of clinical signs and symptoms was registered in eight patients. CT did not show change in size, shape or position of the prolapse in any patient shortly after the traction or after 3 months in 4 of the unoperated cases The reason for clinical improvement after traction in some patiens is still a matter of conjecture.

  12. Application of cervical arthroplasty with Bryan cervical disc:long-term X-ray and magnetic resonance imaging follow-up results

    Institute of Scientific and Technical Information of China (English)

    ZHAO Yan-bin; SUN Yu; CHEN Zhong-qiang; LIU Zhong-jun

    2010-01-01

    Background Cervical disc arthroplasty is a new technique for treating degenerative cervical disease. Its goal is to avoid the degeneration of adjacent levels by preserving motion at the treated level. The aims of this study were to evaluate the radiologic outcomes of Bryan cervical disc replacement and the degenerative status of adjacent segments.Methods Twenty-two patients at a single center underwent discectomy and implantation of Bryan cervical disc. The mean follow-up period was 60 months (57-69 months). Twenty patients underwent single-level arthroplasty and two underwent arthroplasty at two levels. The levels of surgery included C3/4 (3 levels), C4/5 (2 levels), C5/6 (18 levels) and C6/7 (1 level). Radiographic evaluation included dynamic X-ray examination and magnetic resonance imaging (MRI) at baseline and at final follow-up.Results On X-ray examination, the range of motion (ROM) at the operated level was 7.2° (2.5°-13.0°) at baseline and 7.8° (1.0°-15.0°) at final follow-up (P >0.05). Heterotopic ossification around the prosthesis was observed in eight levels,and two levels showed loss of motion (ROM <2°). MRI showed worsening by a grade at the upper level in 2/22 patients,and worsening by a grade at the lower level in 3/22, according to Miyazaki's classification. No further impingement of the ligamentum flavum into the spinal canal was observed at adjacent levels, though the disc bulge was slightly increased at both the adjacent upper and lower levels at final follow-up.Conclusions Arthroplasty using Bryan cervical disc prosthesis resulted in favorable radiologic outcomes in this study.Disc degeneration at adjacent levels may be postponed by this technique.

  13. Artroplastia total de disco cervical com prótese de Bryan: resultados clínicos e funcionais Artroplastía cervical total con prótesis de Bryan: resultados clínicos y funcionales Cervical total disc arthroplasty with Bryan disc: clinical and functional outcomes

    Directory of Open Access Journals (Sweden)

    Eduardo Machado de Menezes

    2012-09-01

    resultados buenos y excelentes, 10% satisfactorios y el 7% malos. Hubo sólo una complicación (3%, que se revirtió con artrodesis anterior. CONCLUSIONES: La artroplastia discal cervical ha demostrado ser un método seguro y eficaz para el tratamiento de casos seleccionados de hernia de disco cervical asociada a la radiculopatía y/o a compresión de la médula espinal en el corto y mediano plazo.OBJECTIVE: To evaluate results of cervical disc arthroplasty with the Bryan prosthesis for treatment of cervicobrachial pain (radiculopathy and spinal cord compression (myelopathy. METHODS: From 2002 to 2007, the CECOL surgical staff has operated 65 patients. Only 28 patients were found in 2010 to a new data collection. The pre- and post-operative evaluation was conducted using the CSOQ questionnaire (Cervical Spine Outcomes Questionnaire. Odom criteria were used only in the postoperative evaluation. Both were translated and adapted to local culture. RESULTS: There was a significant symptomatic and functional improvement in most patients. The reduction of neck pain (axial and brachial pain (radicular was similar. Odom criteria showed 82.1% good and excellent results, 10% satisfactory and 7% poor. There was only one complication (3% which was reversed with anterior arthrodesis. CONCLUSIONS: The total cervical disc arthroplasty has proved to be a safe and effective method to treat selected cases of cervical disc herniation with radiculopathy and/or myelopathy in the short and medium term.

  14. Analysis of mid-long term clinical efficacy and complications of Bryan artificial cervical disc replacement%Bryan人工颈椎椎间盘置换术后中长期临床疗效及相关问题分析

    Institute of Scientific and Technical Information of China (English)

    蒋涛; 任先军; 王卫东; 初同伟; 李长青

    2011-01-01

    目的 探讨Bryan人工颈椎椎间盘置换术(artificial cervical disc replacement,ACDR)治疗颈椎椎间盘突出症的中长期临床疗效及并发症发生情况.方法 回顾分析13例颈椎椎间盘突出症患者,采用Bryan ACDR治疗,单节段11例,双节段2例,共置换了15个节段.术后定期随访,依照Odom评级和日本骨科学会(Japanese Orthopaedic Association,JOA)评分评定临床疗效和神经功能改善情况,通过影像学资料观察假体位移、假体周围骨吸收、异位骨化、假体活动度及颈椎生理曲度变化.结果 经过5年以上的随访,患者神经症状有明显缓解,Odom评级临床优良率达到92.3%,JOA评分由术前的11.6分增加到的15.6分.术后X线片示假体稳定,没有出现假体前后位移>2mm.术后1例出现自发性融合;1例在置换节段上位椎体前下缘有明显骨吸收,接近2.5mm,并伴椎体后缘的异位骨化.末次随访时置换假体活动度平均为9.2°,邻近节段活动度与术前相当.结论 通过5~7年的中长期随访,Bryan ACDR术治疗颈椎椎间盘突出症具有较好的临床疗效,并发症少,安全可靠.%Objective To evaluate the mid-long term clinical efficacy and complications of Bryan artificial cervical arthro-plasty replacement (ACDR) for treatment of cervical disc herniation. Methods Thirteen cases of cervical disc herniation were retrospectively analyzed. A total of 15 sets of Bryan cervical disc prosthesis were implanted into 13 cases, including single level disc replacement in 11 cases and bi-level in 2 cases. During follow-up, the clinical efficacy and neurological function were evaluated by Odom's criteria and Japanese Orthopaedic Association (JOA)score; the mobility, resorption, heteropic ossification, physiological lordosis and range of motion of the implanted and adjacent segment were observed on dynamic radiograph. Results After more than 5 years of follow-up, all cases showed significant improvement in neurological

  15. 游离型腰椎间盘突出症的手术治疗%The Surgical Treatment of the Sequested Lumbar Disc Herniation

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    胡豇; 刘仲前; 王跃; 万仑; 唐六一; 张耀明

    2012-01-01

    Objective To evaluate the clinical efficacy of neucleus extraction for the sequested lumbar disc herniation. Methods 58 patients with sequested lumber disc herniation were treated surgically between Jan. 2003-Dec. 2009. There were 31 males and 27 females with average age of 38. 5 years(range froml9 to 54 years). L3-4were involved in 3 cases,L4-5 in 29 cases,L5S1in 26 cases. The patients were treated by window-open,semi-laminectomy,complete laminectomy respectively based on site of herniation. The duration,symptoms and signs,the radiology performance and the operation treatment result were discussed. Results All the patients were followed-up for an average of 3. 5 years (range 1 to 6 years). The surgery time was(1. 0±0. 2) hours and the bleeding was(280±25) mL. Complications included cerebrospinal fluid leakage in 6 cases .unilateral transient lower extremity paresthesia in 2 cases. According to Nakai Criterion,the result for the operative treatment was excellent in 24cases,good in 27 cases,fair in 5 cases,poor in 2 cases. The rate of excellent and good results was 87. 9%. Conclusion The sequested neucleus extracted completely is a good method for the sequested lumbar disc herniation.%目的 评价游离髓核摘除术治疗游离型腰椎间盘突出症的疗效.方法 2003年1月至2009年12月采用游离髓核摘除术治疗游离型腰椎间盘突出症69例,获得完整随访资料者58例,其中男31例,女27例,年龄19~54岁,平均38.5岁.L3~4椎间盘突出3例,L4~5椎间盘突出29例,L5S1椎间盘突出26例.根据游离髓核的位置,分别采用扩大开窗、半椎板切除和全椎板切除,摘除游离髓核,研究其发病情况、临床症状、体征、影像学表现、手术方法、术中发现及治疗效果.结果 随访时间1~6年,平均3.5年,平均手术时间(1.0±0.2)h,平均出血量(280±25)mL.硬脊膜撕破8例,一过性单侧神经根麻痹2例.末次随访复发2例,58例患者按Nakai标准评定疗效,优24例,良27

  16. Motion analysis of total cervical disc replacements using computed tomography: Preliminary experience with nine patients and a model

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    Svedmark, Per (Div. of Orthopedics, Dept. of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm (Sweden); Stockholm Spine Center, Lowenstromska Hospital, Stockholm (Sweden)), email: per.svedmark@spinecenter.se; Lundh, Fredrik; Olivecrona, Henrik (Div. of Orthopedics, Dept. of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm (Sweden)); Nemeth, Gunnar (Capio group, Stockholm (Sweden)); Noz, Marilyn E. (Dept. of Radiology, New York Univ. School of Medicine, New York (United States)); Maguire Jr, Gerald Q. (School of Information and Communication Technology, Royal Inst. of Technology, Kista (Sweden)); Zeleznik, Michael P. (Saya Systems Inc., Salt Lake City (United States))

    2011-12-15

    Background. Cervical total disc replacement (CTDR) is an alternative to anterior fusion. Therefore, it is desirable to have an accurate in vivo measurement of prosthetic kinematics and assessment of implant stability relative to the adjacent vertebrae. Purpose. To devise an in vivo CT-based method to analyze the kinematics of cervical total disc replacements (CTDR), specifically of two prosthetic components between two CT scans obtained under different conditions. Material and Methods. Nine patients with CTDR were scanned in flexion and extension of the cervical spine using a clinical CT scanner with a routine low-dose protocol. The flexion and extension CT volume data were spatially registered, and the prosthetic kinematics of two prosthetic components, an upper and a lower, was calculated and expressed in Euler angles and orthogonal linear translations relative to the upper component. For accuracy analysis, a cervical spine model incorporating the same disc replacement as used in the patients was also scanned and processed in the same manner. Results. Analysis of both the model and patients showed good repeatability, i.e. within 2 standard d